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![Ub04 Hospital Insurance Claim Form, 8 1/2 X 11, Laser Printer, 2500 Forms Ub04 Hospital Insurance Claim Form, 8 1/2 X 11, Laser Printer, 2500 Forms](https://cdn11.bigcommerce.com/s-urqaay1iv3/images/stencil/500x659/products/1657/5361/9441002__41009__94716.1606102625.jpg?c=1)
Ub04 Hospital Insurance Claim Form, 8 1/2 X 11, Laser Printer, 2500 Forms
- SKU:
- TOP59870R |
- UPC:
- 25932598708 |
-
Brand:
TOPS™
In Stock
$113.88
Saving
$123.75
MSRP:
$237.63
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Description
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: 2500; Layout: One Form per Sheet.
- Form Quantity : 2500
- Forms Per Page : 1
- Total Recycled Content Percent : 0%
- Form Size : 8.5 x 11
- Layout : One Form per Sheet
- Global Product Type : Forms-Insurance
- Paper Color(s) : Red,White
- Printer Compatibility : Laser
- Print and Ruling Color(s) : Red
- Post-Consumer Recycled Content Percent : 0%
- Special Features : For Laser Printers
- Paper Stock : 20-lb.
- Pre-Consumer Recycled Content Percent : 0%
Dimensions & Weight
- Width:
- 9.25 Inches
- Height:
- 10.25 Inches
- Depth:
- 12.00 Inches
Detailed Specs
- MPN:
- 59870R
- Form Quantity:
- 2500
- Paper Stock:
- 20-lb.
- Form Size:
- 8.5 x 11
- Total Recycled Content Percent:
- 0%
- Special Features:
- For Laser Printers
- Pre-Consumer Recycled Content Percent:
- 0%
- Paper Color(s):
- Red,White
- Post-Consumer Recycled Content Percent:
- 0%
- Layout:
- One Form per Sheet
- Print and Ruling Color(s):
- Red
- Global Product Type:
- Forms-Insurance
- Printer Compatibility:
- Laser
- Forms Per Page:
- 1