TOPS™ UB04 Hospital Insurance Claim Form for Laser Printers, One-Part (No Copies), 8.5 x 11, 2,500 Forms Total (TOP59870R)

TOPS™ UB04 Hospital Insurance Claim Form
Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format.

Global Product Type: Insurance Forms
Form Type Details: UB04
Dated/Undated: Undated
Forms Per Page: 1
Form Size: 8.5 x 11
Format Indicator: Unbound
Form Quantity (Total): 2,500
Copy Types: One-Part (No Copies)
Paper Color(s): White
Color Family: White
Printer Compatibility: Laser
Paper Stock: 20 lb Bond
Print and Ruling Color(s): Red
Pre-Consumer Recycled Content Percent: 0%
Post-Consumer Recycled Content Percent: 0%
Total Recycled Content Percent: 0%
Special Features: Laser Printer Compatible