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TOPS UB-04 Continuous Forms - 1 Part - 11" x 9.50" Form Size - Red Print Color - 2500 / Carton

TOP59770R

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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.

General Information
Manufacturer: TOPS Products
Manufacturer Part Number: 59770R
Manufacturer Website Address: http://www.tops-products.com
Product Model: UB-04
Product Name: UB-04 Continuous Forms
Packaged Quantity: 2500 / Carton

Product Information
Number of Forms per Sheet: 1
Form Length: 11"
Form Width: 9.50"
Number of Parts: 1
Printed Side: Front
Print Color: Red
Print Technology: Dot Matrix

Physical Characteristics
Color: White

Miscellaneous
Environmentally Friendly: Yes
Environmental Certification: SFI

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(1/1) ErrorException

file_put_contents(): Only 0 of 194 bytes written, possibly out of free disk space
in Filesystem.php line 122
at HandleExceptions->handleError(2, 'file_put_contents(): Only 0 of 194 bytes written, possibly out of free disk space', '/var/www/html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php', 122, array('path' => '/var/www/html/storage/framework/sessions/va9YZMtYw61whek4jcIRdU2nNGsB6VUgXOZyAe5g', 'contents' => 'a:3:{s:6:"_token";s:40:"NSeGccljwi6tuGskFXdo71wgDz2Nf7Vnro0kijG9";s:9:"_previous";a:1:{s:3:"url";s:36:"https://usbpi.com/product/1014265165";}s:6:"_flash";a:2:{s:3:"old";a:0:{}s:3:"new";a:0:{}}}', 'lock' => true))
at file_put_contents('/var/www/html/storage/framework/sessions/va9YZMtYw61whek4jcIRdU2nNGsB6VUgXOZyAe5g', 'a:3:{s:6:"_token";s:40:"NSeGccljwi6tuGskFXdo71wgDz2Nf7Vnro0kijG9";s:9:"_previous";a:1:{s:3:"url";s:36:"https://usbpi.com/product/1014265165";}s:6:"_flash";a:2:{s:3:"old";a:0:{}s:3:"new";a:0:{}}}', 2)in Filesystem.php line 122
at Filesystem->put('/var/www/html/storage/framework/sessions/va9YZMtYw61whek4jcIRdU2nNGsB6VUgXOZyAe5g', 'a:3:{s:6:"_token";s:40:"NSeGccljwi6tuGskFXdo71wgDz2Nf7Vnro0kijG9";s:9:"_previous";a:1:{s:3:"url";s:36:"https://usbpi.com/product/1014265165";}s:6:"_flash";a:2:{s:3:"old";a:0:{}s:3:"new";a:0:{}}}', true)in FileSessionHandler.php line 83
at FileSessionHandler->write('va9YZMtYw61whek4jcIRdU2nNGsB6VUgXOZyAe5g', 'a:3:{s:6:"_token";s:40:"NSeGccljwi6tuGskFXdo71wgDz2Nf7Vnro0kijG9";s:9:"_previous";a:1:{s:3:"url";s:36:"https://usbpi.com/product/1014265165";}s:6:"_flash";a:2:{s:3:"old";a:0:{}s:3:"new";a:0:{}}}')in Store.php line 128
at Store->save()in StartSession.php line 88
at StartSession->terminate(object(Request), object(Response))in Kernel.php line 218
at Kernel->terminateMiddleware(object(Request), object(Response))in Kernel.php line 189
at Kernel->terminate(object(Request), object(Response))in index.php line 58