Office EssentialsOffice SuppliesBusiness Forms & Record KeepingGeneral Forms
UB04 Hospital Insurance Claim Form
TOPS
Item #TOP59870R
Paper Red White
Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format.

  • Features
  • Printed to Government Printing Office standards.
  • OCR ink for scanning.
  • American Medical Association (AMA) approved format.

  • Specifications
  • Form Quantity 2500
  • Form Size 8.5 x 11
  • Forms Per Page 1
  • Global Product Type Forms-Insurance
  • Layout One Form per Sheet
  • Paper Color Red White
  • Paper Stock 20-lb.
  • Post-Consumer Recycled Content Percent 0%
  • Pre-Consumer Recycled Content Percent 0%
  • Print and Ruling Color Red
  • Printer Compatibility Laser
  • Special Features For Laser Printers
  • Total Recycled Content Percent 0%

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