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TOP59870R

TOPS 1-part UB-04 Laser-cut Forms

1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton

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TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton TOP59870R TOPS 1-part UB-04 Laser-cut Forms 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton

General Information
Catalog Page Number	O109
General Information
Manufacturer	TOPS Products
Manufacturer Part Number	59870R
Manufacturer Website Address	http://www.tops-products.com
Brand Name	TOPS
Product Model	UB-04
Product Name	1-part UB-04 Laser-cut Forms
Marketing Information	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.
Packaged Quantity	2500 / Carton
Product Type	Claim Form
Product Information
Number of Forms per Sheet	1
Form Length	11"
Form Width	8.50"
Number of Parts	1
Printed Side	Front
Print Color	Red
Print Technology	Laser
Physical Characteristics
Color Family	White
Product Color	White
Miscellaneous
Certifications & Standards	American Medical Association
Recycled	No
Assembly Required	No
Country of Origin	United States
Environmental Certification	Sustainable Forestry Initiative (SFI)