TOPS 1-part UB-04 Laser-cut Forms

Description

1 Part – 11″ x 8.50″ Form Size – White – Red Print Color – 2500 / Carton

• Continuous forms are designed for hospitals to file a claim with the patient’s insurance company
• Forms are printed to GPO standards in OCR ink on 20 lb. bond
• Health Care Finance Administration format ensures accuracy in reporting all necessary information
• 11″ Length x 8.50″ Width; 2500 / Carton
• Replaces the UB-92