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| Best Seller  | TOPS UB-04 Continuous Forms 1 Part - 11 x 9.50 Form Size - White - Red Print Color - 2500 / Carton UB-04 continuous forms are designed for hospitals 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... more | $115.30 $98.01 FREE shipping go to store |
 | TOPS UB04 Health Care Form Revised HCFA Compliant 59770R Revised Format. AMA approved format. The UB-04 is the form hospitals and institutions e to file a medical claim with the patient s insurance company. e TOPS UB-04 forms with confidence. They meet the requirements of the Centers for Medicare and... more | FREE shipping go to store |
| Best Seller  | Tops Billing Forms - White - 8.5 in. x 11 in. Designed for medical offices to file a claim with the patient s insurance company these UB-04 laser-cut forms meet the requirements of the Centers for Medicare and Medicaid Services (CMS) and ensure accuracy in reporting all necessary information.... more | FREE shipping go to store |
 | 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 reporting all necessary information. Forms meet the requirements of the... more | compare prices |
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