FORM,UB-04,1-PT,LASER,WE

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

SKU TOP59870R Categories General Forms, Office Supplies

Description

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

Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. Laser Printer Compatible. Form Type Details: UB04; Dated/Undated: Undated; Forms Per Page: 1; Form Size: 8.5 x 11.

Product Specs

Manufacturer
UOM
Assembly Indicator
Box Pack Qty
Box Pack Unit
Carton Pack Qty
Carton Pack Unit
COO
Hazardous Material Code
Package Includes
Recycled Ctnt %-Total
UPS Indicator
UNSPSC Number
UPS Retail

TOPS BUSINESS FORMS
CT
N
0
2500
EA
UNITED STATES
N
0%
Y
0014111806
025932598708

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