Claim/Medical Forms

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TOPS 1-part UB-04 Laser-cut Forms
SKU: TOP59870R
Categories: Claim/Medical Forms, Forms & Recordkeeping
1 Part – 11″ x 8.50″ Form Size – White – 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
- Health Care Finance Administration format ensures accuracy in reporting all necessary information
- 11″ Length x 8.50″ Width; 2500 / Carton
- Replaces the UB-92
$343.14

TOPS 1-part UB-04 Laser-cut Forms quantity
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TOPS CMS-1500 Laser Printer Forms
SKU: TOP50126RV
Categories: Claim/Medical Forms, Forms & Recordkeeping
20 lb – 1 Part – 8.50″ x 11″ Form Size – White – Red Print Color – Paper – 500 / Pack
- Approved by the AMA and the National Uniform Claim Committee (NUCC)
- Printed in red OCR ink without a sensor bar
- Compatible with laser printers
- Detached size: 8-1/2″ x 11″
$73.62

TOPS CMS-1500 Laser Printer Forms quantity
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TOPS CMS-15000 Health Insurance Claim Forms
SKU: TOP50135RV
Categories: Claim/Medical Forms, Forms & Recordkeeping
20 lb – 11″ x 8.50″ Sheet Size – White Sheet(s) – Red Print Color – 250 / Pack
- CMS, NUCC and OMB approved format
- Printed front and back
- Convenient scanning
- Compatible with laser printers
$40.59

TOPS CMS-15000 Health Insurance Claim Forms quantity

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