Description
Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format.
Note: This is a non-returnable item.
Ub04 Hospital Insurance Claim Form For Laser Printers, One-part (no Copies), 8.5 X 11, 2,500 Forms Total
$343.15
In Stock
Additional information
| Weight | 26.00 lbs |
|---|---|
| Dimensions | 12.00 × 9.25 × 10.25 in |
| Brand | TOPS™ |
| Color Family | White |
| Copy Types | (No, Copies), One-Part |
| Dated | No |
| Form Quantity (Total) | 2, 500 |
| Form Size | 11, 8.5, x |
| Form Type Details | UB04 |
| Format Indicator | Unbound |
| Forms Per Page | 1 |
| Global Product Type | Forms, Insurance |
| MPN | 59870R |
| Paper Color(s) | White |
| Paper Stock | 20, Bond, lb |
| Print and Ruling Color(s) | Red |
| Printer Compatibility | Laser |
| Ship Class Code | M |
| Special Features | compatible, Laser, Printer |
| UPC | 025932598708 |
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