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

Manufacturer: TOPS BUSINESS FORMS
SKU: TOP59870R
Manufacturer part number: 59870R
UPC: 0025932598708
MSRP: $343.14
$258.39
Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. For Laser Printers. Form Size: 8.5 x 11; Forms Per Page: 1; Form Quantity: 2,500; Layout: One Form per Sheet.
Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. For Laser Printers. Form Size: 8.5 x 11; Forms Per Page: 1; Form Quantity: 2,500; Layout: One Form per Sheet.

Products specifications

Attribute name Attribute value
Paper Stock 20 lb
Global Product Type Forms-Insurance
Special Features For Laser Printers
Paper Color(s) White
Form Size 8.5 x 11
Forms Per Page 1
Form Quantity 2,500
Layout One Form per Sheet
Print and Ruling Color(s) Red
Printer Compatibility Laser
Pre-Consumer Recycled Content Percent 0%
Post-Consumer Recycled Content Percent 0%
Total Recycled Content Percent 0%
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Products specifications

Attribute name Attribute value
Paper Stock 20 lb
Global Product Type Forms-Insurance
Special Features For Laser Printers
Paper Color(s) White
Form Size 8.5 x 11
Forms Per Page 1
Form Quantity 2,500
Layout One Form per Sheet
Print and Ruling Color(s) Red
Printer Compatibility Laser
Pre-Consumer Recycled Content Percent 0%
Post-Consumer Recycled Content Percent 0%
Total Recycled Content Percent 0%
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