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UB04 Hospital Insurance Claim Form, 8.5 x 11, 1/Page, 2,500 Forms

by TOPS™
SKU TOP59870R
  • Printed to Government Printing Office standards.
  • OCR ink for scanning.
  • American Medical Association (AMA) approved format.

More Info

$166.70/CT
In Stock 2-day ship Your order will ship out within 2 business days
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TOPS™
Made in USA

Product Description

UB04 Hospital Insurance Claim Form, 8.5 x 11, 1/Page, 2,500 Forms. 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.
  • Printed to Government Printing Office standards.
  • OCR ink for scanning.
  • American Medical Association (AMA) approved format.

Technical Specifications

  • 2500
  • 8.5 x 11
  • 1
  • Forms-Insurance
  • One Form per Sheet
  • Red; White
  • 20-lb.
  • Red
  • Laser
  • For Laser Printers
  • 0%
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