Product Media

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

Product Number: ESS-TOP59870R
$333.15
Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format.
Quantity

Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format.
TOPS™
ESS-TOP59870R

Data sheet

Special Features
Laser Printer Compatible
Special Features
For Laser Printers
Paper Color(s)
White
Paper Color(s)
Red
Global Product Type
Forms-Insurance
Global Product Type
Insurance Forms
Dated/Undated
Undated
Color Family
White
Pre-Consumer Recycled Content Percent
0%
Post-Consumer Recycled Content Percent
0%
Total Recycled Content Percent
0%
Unit Of Measure
CT
Form Size
8 1/2 x 11
Form Size
8.5 x 11
Forms Per Page
1
Form Quantity
2,500
Form Quantity
2500
Layout
One Form per Sheet
Paper Stock
20 lb
Paper Stock
20-lb.
Paper Stock
20 lb Bond
Print and Ruling Color(s)
Red
Copy Types
One-Part (No Copies)
Printer Compatibility
Laser
Form Type Details
UB04
Format Indicator
Unbound
Form Quantity (Total)
2,500