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Form, Ub-04, 1Part Laser Pk
Mfr # TOP59870R
Zoro # G601824477
product price: $173.99
/pk 2500, $0.07/ea
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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.
Restrictions
- WARNING: Cancer and Reproductive Harm For more information go to www.P65Warnings.ca.gov
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