TOPS UB04 Hospital Insurance Claim Form, 8.5 x 11, 1/Page, 2,500 Forms
TOPS UB04 Hospital Insurance Claim Form, 8.5 x 11, 1/Page, 2,500 Forms
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TOPS UB04 Hospital Insurance Claim Form, 8.5 x 11, 1/Page, 2,500 Forms
TOPS UB04 Hospital Insurance Claim Form, 8.5 x 11, 1/Page, 2,500 Forms

UB04 Hospital Insurance Claim Form, 8.5 x 11, 1/Page, 2,500 Forms

Item #: TOP59870R

$333.15/1 Carton
$219.99/1 Carton

Estimated Delivery: Thu 4/18 to Fri 4/19
Qty:Add to cart
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Product Details

Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format.


COLOR: Red, White
ALTERNATE ITEM #: 526935, 811021, B001E662W4

UPC: 025932598708

ITEM #: TOP59870R

Product Type: General Forms

Red, White General Forms
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Product Specifications

Case Pack
1 Carton
Color
Red, White
Dimensions
8 1/2" x 11"
Form Quantity
2,500
Form Size
8.5 x 11
Format
Loose Form
Forms Per Page
1
Global Product Type
Forms-Insurance
Layout
One Form per Sheet
Manufacturer Name
TOPS
Paper Color(s)
White
Paper Stock
20 lb
Post-Consumer Recycled Content Percent
0%
Pre-Consumer Recycled Content Percent
0%
Print and Ruling Color(s)
Red
Printer Compatibility
Laser
Product Type
Insurance Claim
Special Features
For Laser Printers
Total Recycled Content Percent
0%
Weight
26 lb(s)
TOPS UB04 Hospital Insurance Claim Form, 8.5 x 11, 1/Page, 2,500 Forms (TOP59870R)