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

TOPS™ UB04 Hospital Insurance Claim Form is printed to government printing office standards. OCR ink for scanning. American Medical Association (AMA) approved format.

Product Specifications:

• Form Type Details : UB04
• Global Product Type : Insurance Forms
• 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
• Special Features : Laser Printer Compatible