UB04 Hospital Insurance Claim Form for Laser Printers, One-Part (No Copies), 8.5 x 11, 2,500 Forms Total
$343.15
Tax excluded
Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format.
TOP59870R
18 Items
Data sheet
- Special Features
- Laser Printer Compatible
- Special Features
- For Laser Printers
- Paper Color(s)
- Red
- Paper Color(s)
- White
- Global Product Type
- Forms-Insurance
- Global Product Type
- Insurance Forms
- Dated/Undated
- Undated
- Pre-Consumer Recycled Content Percent
- 0%
- Post-Consumer Recycled Content Percent
- 0%
- Total Recycled Content Percent
- 0%
- Form Size
- 8.5 x 11
- Form Size
- 8 1/2 x 11
- Forms Per Page
- 1
- Form Quantity
- 2500
- Form Quantity
- 2,500
- Layout
- One Form per Sheet
- Paper Stock
- 20-lb.
- Paper Stock
- 20 lb Bond
- Paper Stock
- 20 lb
- Print and Ruling Color(s)
- Red
- Copy Types
- One-Part (No Copies)
- Printer Compatibility
- Laser
- Unit Of Measure
- CT
- Color Family
- White
- Form Type Details
- UB04
- Format Indicator
- Unbound
- Form Quantity (Total)
- 2,500
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Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format.