Ub04 Hospital Insurance Claim Form For Laser Printers, One-part (no Copies), 8.5 X 11, 2,500 Forms Total

TOPS™ SKU: TOP59870R

Ub04 Hospital Insurance Claim Form For Laser Printers, One-part (no Copies), 8.5 X 11, 2,500 Forms Total

TOPS™ SKU: TOP59870R
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$206.34 Regular price
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  • In stock
  • Inventory on the way
  • Brand: TOPS™
  • MPN: #59870R made by TOPS™
  • Order Processing: 1-2 Business Days + Delivery Time
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.
Global Product Type Insurance Forms
Ship Class Code M
Special Features Laser Printer Compatible
Total Recycled Content Percent 0%
Post-Consumer Recycled Content Percent 0%
Pre-Consumer Recycled Content Percent 0%
Print and Ruling Color(s) Red
Paper Color(s) White
Paper Stock 20 lb Bond
Printer Compatibility Laser
Forms Per Page 1
Form Size 8.5 x 11
Form Type Details UB04
Dated/Undated Undated
Format Indicator Unbound
Form Quantity (Total) 2,500
Copy Types One-Part (No Copies)
Color Family White
Processing Time 1-2 Business Days
Mpn 59870R
Brand TOPS™
Manufacturer TOPS™
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