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

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

Brand: TOPS™
Item Number: TOP59870R

TOPS™ UB04 Hospital Insurance Claim Form

UB04 hospital insurance claim form.
  • Printed to Government Printing Office standards.
  • OCR ink for scanning.
  • American Medical Association (AMA) approved format.
MSRP: $211.25
Qty:
$211.14 per CT
Conventional

Recycled Content

No Matching Criteria

Biodegradable/Compostable

No Matching Criteria

Reduced Chemical Content

No Matching Criteria

Third Party Certifications

No Matching Criteria

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.

Global Product Type Forms-Insurance
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
No greener items (0)
No product line items