Office Quarters Logo Manufacturer RebatesShipping InformationShopping Cart
Keyword Part No.
Office Quarters HomeSpecialsShop Our CatalogCustomer ServiceAccount InformationHelp
Office Quarters® is a virtual office supply store featuring over 24,000 office supply items.
From attache cases to zebra pens, we're your one stop source for all your office supplies.		Login
View more Claim Forms

Tops UB-04 Continuous Forms
Tops Business Forms



Description:
UB-04 continuous forms are designed for hospitals to file a claim with the patient's insurance company. The Health Care Finance Administration format ensures accuracy in reporting all necessary information. Forms meet the requirements of the Centers for Medicare and Medicaid Services (CMS). Forms are printed on 20 lb. bond paper.
Pfx, Number Description Shipping Qty Price Business** ORDER
TOP 59770R Billing Forms, Continuos, 1-Part, 20 lb., 9-1/2"x11", 2500/CT 2500 EA/CT 126.12/CT OUT OF STOCK
TOP 59772R Billing Forms, Continuos, 2-Part, 20 lb., 9-1/2"x11", 1000/CT 1000 EA/CT 107.28/CT OUT OF STOCK

Business pricing is available with a verifiable FEIN.
Email cust_serv@officequarters.com or call (518) 453-6563 for more information.
Cross Reference
OQ part number Equivalent
TOP 59770R 025932597701 2593259770 TOP59770 TOP-59770 TOP59770R TOP-59770R
TOP 59772R 025932597725 2593259772 TOP59772R TOP-59772R





Credit Cards
We accept Visa, Mastercard, Discover Card and American Express
Office Quarters is the registered Trademark of Office Quarters, Inc. Reg. No. 2859971.
  Website Design and Development by Albany NY's WSG
 ShopWiki Certified Store
Brands · Categories · Products · Top Searches