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

Item #: TOP59870R-ES 
TOPS™ UB04 Hospital Insurance Claim Form
  • Printed to Government Printing Office standards.
  • OCR ink for scanning.
  • American Medical Association (AMA) approved format.
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TOP59870R-ES
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.

Forms

Form Quantity
2,500
Form Size
8.5 x 11
Forms Per Page
1
Global Product Type
Forms-Insurance
Layout
One Form per Sheet
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
Special Features
For Laser Printers
Total Recycled Content Percent
0%
UPC
025932598708

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