Office Quarters: From $144.12 - Tops 1-part UB-04 Laser-cut Forms TOP 59870R TOP59870R


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View more Claim Forms Tops 1-part UB-04 Laser-cut Forms Tops Business Forms
	Description: UB-04 laser-cut forms are designed for medical offices 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 59870R	Billing Forms, 20 lb., 8-1/2"x11", 2500/CT		2500 EA/CT	144.12/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.

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