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:
$204.99 per CT
Conventional

Recycled Content

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Biodegradable/Compostable

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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
Unit of Measure: CARTON
Item Weight With Packaging 26.0 lbs.
Item Depth With Packaging 12.0"
Item Height With Packaging 10.25"
Item Width With Packaging 9.25"
Carton Weight With Packaging 9.25 lbs.
Carton Package Width 9.25"
Carton Package Depth 12.0"
Carton Package Height 10.25"
Carton Package Quantity 2500
Packaging Unit Contained In The Carton EA
Returnable? YES
UNSPSC (United Nations Standard Products and Services Code) 14111806
UPC 025932598708
200441

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Qty:
Green
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