Tops Ub04 Hospital Insurance Claim Form For Laser Printers, One-Part (No Copies), 8.5 X 11, 2,500 Forms Total

SKU: OFC-59870R
  • Printed to Government Printing Office standards.
  • OCR ink for scanning.
  • American Medical Association (AMA) approved format.
  • Learn more about TOPS Products
Unit Price
Quantity
Subtotal
US$ 189.56
US$ 189.56
US$ 188.421%
2
US$ 187.761%
3
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Brand
Tops
Manufacturer
TOPS
Model#
59870R
Assembly Required
No assembly is required
Contains Recycled Materials
N
Unit of Measure
CT
This item is sold by the
CT which contains 2500 EA
Country of Origin
US
Global Product Type
Insurance Forms
Post-Consumer Recycled Content Percent
0%
Pre-Consumer Recycled Content Percent
0%
Special Features
Laser Printer Compatible
Total Recycled Content Percent
0%
Green Product
N
Carton Pack Quantity
2500 EA
Color Family
White
Paper Color(s)
White
Copy Types
One-Part (No Copies)
Form Size
8.5 x 11
Forms Per Page
1
Print and Ruling Color(s)
Red
Printer Compatibility
Laser
Paper Stock
20 lb Bond
Dated/Undated
Undated
Upc carton
50025932598703
Form type details
UB04
Format indicator
Unbound
Form quantity (total)
2,500
Barcode
025932598708
Description

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

Shipping specs
Weight
26 lbs
Shipping from
This product is shipped from our supplier's warehouse in FL, United States
Our guarantee
This product is brand new and includes the manufacturer's warranty, so you can buy with confidence.
A 25% handling charge is levied against all authorized returns except those due to our error. Unauthorized returns are subject to a 40% handling charge. Damages & defects must be reported to us within 14 days.
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