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TOPS™

UB04 Hospital Insurance Claim Form for Laser Printers, One-Part (No Copies), 8.5 x 11, 2,500 Forms Total

Category Forms
TOP59870R
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TOPS™

UB04 Hospital Insurance Claim Form for Laser Printers, One-Part (No Copies), 8.5 x 11, 2,500 Forms Total

Item Code: TOP59870R
Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. Laser Printer Compatible. Form Type Details: UB04; Dated/Undated: Undated; Forms Per Page: 1; Form Size: 8.5 x 11.
Category Forms
Manufacturer TOPS BUSINESS FORMS
Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. Laser Printer Compatible. Form Type Details: UB04; Dated/Undated: Undated; Forms Per Page: 1; Form Size: 8.5 x 11.

Specifications

Made In

US

UNSPSC Code

14111806

Weight

26lb

Height

10.25in

Width

9.25in

Length

12in

Brand

TOPS™

Category

Forms

Color Family

White

Copy Types

One-Part (No Copies)

Dated/undated

Undated

Form Quantity (Total)

2,500

Form Size

8.5 X 11

Form Type Details

UB04

Format Indicator

Unbound

Forms Per Page

1

Global Product Type

Insurance Forms

Paper Color(s)

White

Paper Stock

20 Lb Bond

Post-Consumer Recycled Content Percent

0%

Pre-Consumer Recycled Content Percent

0%

Print and Ruling Color(s)

Red

Printer Compatibility

Laser

Special Features

Laser Printer Compatible

Total Recycled Content Percent

0%

Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. Laser Printer Compatible. Form Type Details: UB04; Dated/Undated: Undated; Forms Per Page: 1; Form Size: 8.5 x 11.

Specifications

Made In

US

UNSPSC Code

14111806

Weight

26lb

Height

10.25in

Width

9.25in

Length

12in

Brand

TOPS™

Category

Forms

Color Family

White

Copy Types

One-Part (No Copies)

Dated/undated

Undated

Form Quantity (Total)

2,500

Form Size

8.5 X 11

Form Type Details

UB04

Format Indicator

Unbound

Forms Per Page

1

Global Product Type

Insurance Forms

Paper Color(s)

White

Paper Stock

20 Lb Bond

Post-Consumer Recycled Content Percent

0%

Pre-Consumer Recycled Content Percent

0%

Print and Ruling Color(s)

Red

Printer Compatibility

Laser

Special Features

Laser Printer Compatible

Total Recycled Content Percent

0%

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