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Office Supplies > Forms, Recordkeeping & Reference Materials > Forms

TOPS™ UB04 Hospital Insurance Claim Form, 8 1/2 x 11, Laser Printer, 2500 Forms

Manufacturer Number: 59870R
Number: TOP-59870R



A Picture of product TOP-59870R TOPS™ UB04 Hospital Insurance Claim Form, 8 1/2 x 11, Laser Printer, 2500 Forms
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Product Details

Case* Information
Product Details:
Number: TOP-59870R
Description: TOPS™ UB04 Hospital Insurance Claim Form, 8 1/2 x 11, Laser Printer, 2500 Forms
Additional Information:

UB04 hospital insurance claim form.

Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format.
Status: Current
Manufacturer Number: 59870R
Manufacturer Name: TOPS Products
Case count 2500 Each
Supplier categories Office Supplies, Forms, Recordkeeping & Reference Materials, Forms
Unspsc 14111806
Keywords Claim Form, Claim Forms, Continuous Form, Documents, HCFA Claim Form, Health Care Claim Forms, Human Resources, Insurance Forms, Paperwork, Personnel, Personnel Forms, Pre-Printed, Record-Keeping, Records, TOPS, UB04
Layout One Form per Sheet
Printer Compatibility Laser
Post-Consumer Recycled Content Percent 0%
Case Count 2500 Each
Pre-Consumer Recycled Content Percent 0%
Paper Stock 20-lb.
Forms Per Page 1
Paper Color(s) White
Form Size 11 x 8 1/2
Form Quantity 2500
Total Recycled Content Percent 0%
Print and Ruling Color(s) Red
Global Product Type Forms-Insurance Claim
Special Features For Laser Printers