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Ub04 Hospital Insurance Claim Form, 8.5 X 11, 1/Page, 2,500 Forms

Original Original
SKU: TOP59870R • Catalog SKU: TOP-59870R

DETAILS

Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format.
$249.89 /CT
60 In stock
You pay:
$249.89
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DESCRIPTION

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

SPECIFICATIONS

Environmental Certification SFI
Environmentally Friendly Yes
Brand Name TOPS
Number of Parts 1
Product Model UB-04
Manufacturer Website Address http://www.tops-products.com
Packaged Quantity 2500 / Carton
Manufacturer Part Number 59870R
Assembly Required No
Product Name 1-part UB-04 Laser-cut Forms
Recycled No
Form Length 11"
Certifications & Standards

American Medical Association
Form Width 8.50"
Country of Origin United States of America
Number of Forms per Sheet 1
Color(s) White
Manufacturer TOPS Products
Print Technology Laser
Product Type Claim Form
Printed Side Front
Print Color Red
Post-Consumer Recycled Content Percent 0%
Form Quantity 2500
Forms Per Page 1
Paper Stock 20-lb.
Pre-Consumer Recycled Content Percent 0%
Layout One Form per Sheet
Form Size 8 1/2 x 11
Total Recycled Content Percent 0%
Print and Ruling Color(s) Red
Paper Color(s) White