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

TOPS™ UB04 Hospital Insurance Claim Form, 8 1/2 x 11, Laser Printer, 2500 Forms - M-628058-3919 - CT/1

$339.99
Packaging *

TOPS™

Forms

In Stock

M-628058-3919

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Delivery - 7-10 Days, Ship Directly from Manufacturer

  • Printed to Government Printing Office standards.
  • OCR ink for scanning.
  • American Medical Association (AMA) approved format.

    • Item Id 628058
    MF ID TOP-59870R
    Manufacturer TOPS™
    Form Quantity 2500
    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%
    UNSPSC 14111806

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