Sale! TOPS UB04 Hospital Insurance Claim FormPrinted to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format.Global Product Type: Insurance FormsForm Type Details: UB04Dated/Undated: UndatedForms Per Page
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
Product Biodegradability in Days: 0
Pre-Consumer Recycled Content Percent: 0%
Post-Consumer Recycled Content Percent: 0%
Total Recycled Content Percent: 0%
Special Features: Laser Printer Compatible
$25
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