Office Supplies → Forms, Recordkeeping & Reference Materials → TOPS 59870R UB04 Hospital Insurance Claim Form, 8 1/2 x 11, Laser Printer, 2500 Forms (TOP59870R)

TOPS 59870R UB04 Hospital Insurance Claim Form, 8 1/2 x 11, Laser Printer, 2500 Forms (TOP59870R)

Price: $432.35
Summary
  • Printed to Government Printing Office standards.
  • OCR ink for scanning.
  • American Medical Association (AMA) approved format.

Product Description

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

Product Specs

Global Product TypeForms-Insurance
Form Size8 1/2 x 11
Forms Per Page1
Form Quantity2500
LayoutOne Form per Sheet
Printer CompatibilityLaser
Paper Stock20-lb.
Paper Color(s)Red; White
Print and Ruling Color(s)Red
Pre-Consumer Recycled Content Percent0%
Post-Consumer Recycled Content Percent0%
Total Recycled Content Percent0%
Special FeaturesFor Laser Printers
Country of OriginUS
Carton Weight26 lbs.
Carton Pack Quantity2500 EA
UNSPSC14111806

Shipping Weight & Item Dimensions

Weight26
Width9.25
Height10.25
Depth12

National Chemical Laboratories
Victory Innovations