TOP59870R - UB04 Hospital Insurance Claim Form, 8-1/2 x 11, 2500 Forms - Discount
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→ UB04 Hospital Insurance Claim Form, 8-1/2 x 11, 2500 Forms
UB04 Hospital Insurance Claim Form, 8-1/2 x 11, 2500 Forms
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Unit Of Measure:
CT
Manufacturer:
TOPS BUSINESS FORMS
Model Number:
TOP59870R
Usually deliveres in 1-2 business days.
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List Price: $186.97
On Sale For: $149.99
Description
Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. Form Size (W x H): 8 1/2 in x 11 in; Number of Columns: N/A; Forms Per Page: 1; Number of Entry Lines: N/A.
Product Details
Global Product Type: Forms-Insurance Claim
Form Size (W x H): 8 1/2 in x 11 in
Forms Per Page [Nom]: 1
Form Quantity [Nom]: 2500
Layout: One Form per Sheet
Printer Compatibility: Laser
Paper Stock: 20-lb.
Paper Color(s): Red, White
Print and Ruling Color(s): Red
Form Special Features: For Laser Printers
Pre-Consumer Recycled Content Percent [Nom]: 0 %
Post-Consumer Recycled Content Percent [Nom]: 0 %
Total Recycled Content Percent [Nom]: 0 %
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