Scannable Barcode for UPC 025932598708
Sellers
| Marketplace | Price | Updated |
|---|---|---|
| $67.99 | 08/14/2018 05:56:05 GMT - Details | |
| $94.65 | 08/14/2018 05:56:07 GMT | |
| $108.49 | 09/11/2017 21:11:24 GMT | |
| $112.50 | 09/11/2017 21:11:24 GMT | |
| $115.92 | 09/11/2017 21:11:24 GMT | |
| $125.17 | 08/14/2018 05:56:10 GMT | |
| $135.99 | 08/14/2018 05:56:10 GMT | |
| $205.99 | 08/14/2018 05:56:10 GMT |
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Attributes
| Attribute | Value |
|---|---|
| MPN | SPRICHAVE47978PAS |
| Brand | Tops |
| Color | White |
| Model | 59870R |
| Manufacturer | TOP |
Product Features
- Tops
- Tops 1-part UB-04 Laser-cut Forms
- SPRICHAVE47978PAS
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.
Product Name Variations
- TOPS 1-part UB-04 Laser-cut Forms, White, 2500 / Carton (Quantity)
- Adams UB-04 Continuous Hospital Insurance Claim Form, 1 Part, Laser, 8.5 x 11 Inches, 2500 Sets per Carton, White (59870R)
- UB04 Hospital Insurance Claim Form 8 1/2 x 11 Laser Printer 2500 Forms
- TOPS UB04 Hospital Insurance Claim Form (Case of 2,500)
- TOPS UB04 Hospital Insurance Claim Form, 8 1/2 x 11, Laser Printer, 2500 Forms
- TOPS 59870R UB-04 Hospital Claim Form - 1 Part - 11"" x 8.50"" Form Size - 2500 / Carton
- TOPS(R) UB-04 Forms, 1 Part, White, 8 1/2in. x 11in., Box Of 2,500
Price Disclaimer
Product prices are accurate as of the date/time indicated and are subject to change. Any price and availability information displayed on amazon.com, amazonsupply.com, or myhabit.com at the time of purchase will apply to the purchase of this product.