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Tops UB04 Hospital Insurance Claim Form One-Part 8.5 x 11 2500 Forms 59870R

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Your Price: $184.27

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TOPS™ UB04 Hospital Insurance Claim Form

Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. Laser Printer Compatible. Form Type Details: UB04; Dated/Undated: Undated; Forms Per Page: 1; Form Size: 8.5 x 11.

Form Type Details: UB04
Global Product Type: Insurance Forms
Dated/Undated: Undated
Forms Per Page: 1
Form Size: 8.5 x 11
Format Indicator: Unbound
Form Quantity (Total): 2,500
Copy Types: One-Part (No Copies)
Paper Color(s): White
Color Family: 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

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Shipping Restrictions

This item cannot be shipped to PO Boxes.
This item can be shipped only within the U.S.

UPC: 025932598708
Mfr's Part #: 59870R