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UB04 Hospital Insurance Claim Form, 8.5 x 11, 1/Page, 2,500 Forms1

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

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Manufacturer: TOPS BUSINESS FORMS
Availability: In stock
SKU: TOP59870R
Manufacturer part number: 59870R
MSRP: $333.15
$282.63
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 nameAttribute value
Global Product TypeForms-Insurance
Form Quantity2,500
Print and Ruling Color(s)Red
Printer CompatibilityLaser
Paper Stock20 lb
Special FeaturesFor Laser Printers
Form Size8.5 x 11
Forms Per Page1
LayoutOne Form per Sheet
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