Tops UB-04 Hospital Claim Form
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 repor...
Top Retailers
Details | Retailer | Base Price | Promo / Tax & Shipping | Price | ||
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TOPS UB-04 Continuous Forms 1 ... UB-04 continuous forms are desig... | $105.57 | FREE shipping | $105.57 go to store | |||
TOPS UB04 Hospital Insurance ... Printed to Government Printing O... | ReStockIt | $198.42 | $198.42 go to store | |||
UB-04 laser-cut forms are design... | Office Products Mall | 42% off $198.36 $115.21 | $115.21 go to store | |||
5% off $167.99 $159.99 | FREE shipping | $159.99 go to store | ||||
TOPS™ Ub04 Hospital Insura... | 123Office.com | $174.33 | $174.33 go to store | |||
Used by hospitals and institutio... | Office Depot | $261.49 | $261.49 go to store | |||
Tops Laser UB-04 Claim Forms, ... UB-04 laser-cut forms are design... | Global Equipment Company | $279.95 | $279.95 go to store | |||
Product Specifications
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...
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