Claim Forms

Claim Forms

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Manufacturer
Color
SPRTOP50135RV
Tops
Tops Laser 1-part CMS-1500 Health Insur. Clm Forms
White, CMS 1500 Claim Form,Laser,20 lb,8-1/2"x11",250/PK,8PK
Health insurance claim forms are printed front and back in red OCR ink on white, letter-size, 20 lb. bond for convenient scanning. Forms are compatible with laser printers.
SPRTOP59770R
Tops
Tops UB-04 Continuous Forms
White/Red, Billing Forms,Continuos,1-Part,20 lb.,9-1/2"x11",2500/CT
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 for Medicare and Medicaid Services (CMS). Continuous forms are printed on 20 lb. bond paper.
SPRTOP59870R
Tops
Tops 1-part UB-04 Laser-cut Forms
White/Red, Billing Forms, 20 lb., 8-1/2"x11", 2500/CT
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.

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