Tops UB04 Hospital Insurance Claim Form, 8 1/2 x 11, 2,500 Forms (TOP59870R)

 
$111.91 /Carton
 
 
Tops Business Forms UB04 Hospital Insurance Claim Form, 8 1/2 x 11, 2,500 Forms
  • Product SKU: TOP59870R
  • Includes 500 forms.
  • Printed to Government Printing Office standards.
  • OCR ink for scanning.
  • American Medical Association (AMA) approved format.

Product Details

UB04 Hospital Insurance Claim Form

Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. Form Size: 8 1/2 x 11; Forms Per Page: 1; Form Quantity: 2500; Layout: One Form per Sheet.

Tops UB04 Hospital Insurance Claim Form, 8 1/2 x 11, 2,500 Forms

Product Specifications

  • Global Product Type: Forms-Insurance Claim
  • Form Size: 8 1/2 x 11
  • Forms Per Page: 1
  • Form Quantity: 2500
  • Layout: One Form per Sheet
  • Printer Compatibility: Laser
  • Paper Stock: 20-lb.
  • Paper Color(s): Red;White
  • Print and Ruling Color(s): Red
  • Pre-Consumer Recycled Content Percent: 0%
  • Post-Consumer Recycled Content Percent: 0%
  • Total Recycled Content Percent: 0%
  • Special Features: For Laser Printers

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Tops UB04 Hospital Insurance Claim Form, 8 1/2 x 11, 2,500 Forms (TOP59870R)
Tops UB04 Hospital Insurance Claim Form, 8 1/2 x 11, 2,500 Forms (TOP59870R)
Sku: TOP59870R
Weight: 26 lbs.
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