Ub04 Hospital Insurance Claim Form For Laser Printers, One-part (no Copies), 8.5 X 11, 2,500 Forms Total
TOPS™
SKU: TOP59870R
Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format.
- Printed to Government Printing Office standards.
- OCR ink for scanning.
- American Medical Association (AMA) approved format.
| Dated/Undated | Undated |
| Forms Per Page | 1 |
| Form Quantity (Total) | 2,500 |
| Paper Color(s) | White |
| Color Family | White |
| Paper Stock | 20 lb Bond |
| Print and Ruling Color(s) | Red |
| Format Indicator | Unbound |
| Post-Consumer Recycled Content Percent | 0% |
| Pre-Consumer Recycled Content Percent | 0% |
| Total Recycled Content Percent | 0% |
| Ship Class Code | M |
| Form Type Details | UB04 |
| Global Product Type | Insurance Forms |
| Copy Types | One-Part (No Copies) |
| Form Size | 8.5 x 11 |
| Printer Compatibility | Laser |
| Special Features | Laser Printer Compatible |
| Manufacturer | TOPS™ |
| Processing Time | 1-2 Business Days |
| Brand | TOPS™ |
| Mpn | 59870R |
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