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TOPS 1-part UB-04 Laser-cut Forms
1 Part - 11" x 8.50" Form Size - 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
$207.93 CT
TOP59870R
Qty
TOPS UB-04 Continuous Forms
1 Part - 11" x 9.50" Form Size - Red Print Color - 2500 / Carton
  • UB-04 1-part continuous is a form that hospitals use to file a claim with the patient's insurance company
  • Forms are printed to GPO standards in OCR ink on 20 lb. bond
$183.24 CT
TOP59770R
Qty

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