UB04 Hospital Insurance Claim Form, 8 1/2 x 11, Laser Printer, 2500 Forms

SKU: 7300007941

Mfg: TOPS™

Mfg part #: TOP59870R

$197.86

Savings: $135.29 (40.61 %)

Pack 2500 EA/CT

Availability: Out of stock

Reward Points: 19

Temporarily Unavailable

Delivery date: Typically 3-5 days, but due to COVID related issues, there may be a delay

Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. Form Size: 11 x 8 1/2; Forms Per Page: 1; Form Quantity: 2500; Layout: One Form per Sheet.

Products specifications

UOM	CT
Pack	2500 EA/CT
Form Quantity	2500
Form Size	11 x 8 1/2
Forms Per Page	1
Global Product Type	Forms-Insurance Claim
Layout	One Form per Sheet
Paper Color(s)	Red; 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%
UBN	COST
Category	Forms
Manufacturer	TOPS™