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UB04 Hospital Insurance Claim Form for Laser Printers, One-Part (No Copies), 8.5 x 11, 2,500 Forms Total

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.


Global Product Type
 
Insurance Forms
Form Type Details
 
UB04
Dated/Undated
 
Undated
Forms Per Page
 
1
Format Indicator
 
Unbound
Copy Types
 
One-Part (No Copies)
Color Family
 
White
Form Size
 
8.5 x 11
Form Quantity (Total)
 
2,500
Paper Color(s)
 
White
Printer Compatibility
 
Laser
Paper Stock
 
20 lb Bond
Print and Ruling Color(s)
 
Red
Product Biodegradability in Days
 
0
Pre-Consumer Recycled Content Percent
 
0%
Post-Consumer Recycled Content Percent
 
0%
Total Recycled Content Percent
 
0%
Special Features
 
Laser Printer Compatible
Length: 0.00 Haz Mat Class: None
Width: 0.00 UN NA Key:
Height: 0.00 Haz Mat Packing Group: None
Cube: 0.00 Haz Mat Active Ingredients:
Weight: 0.00 Manufacturer: TOPS BUSINESS FORMS
Inner Pack Description:
Product References: