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Insurance Claim Forms

TOPS 59870R UB04 Hospital Insurance Claim Form, 8 1/2 x 11, Laser Printer, 2500 Forms

R 6,812

or 4 x payments of R1,703.00 with Payflex

Payflex

Availability: Currently in Stock

Delivery: 10-20 working days

TOPS 59870R UB04 Hospital Insurance Claim Form, 8 1/2 x 11, Laser Printer, 2500 Forms
- Sold as 2500/Carton.
- Printed to Government Printing Office standards. OCR ink for scanning.
- AMA approved format.
- Contains 2500 forms per package. Replaces the UB-92.
- Printed with OCR red ink on laser-cut white paper. SFI certified sourcing.
Country USA
Brand Tops
Manufacturer TOPS
Binding Office Product
ItemPartNumber TOP59870R
Color White
UPCs 641438084127
EANs 0641438084127
ReleaseDate 0000-00-00