UB04 Hospital Insurance Claim Form, 8.5 x 11, 1/Page, 2,500 Forms

SKU: TOP59870R

Manufacturer part number: 59870R

GTIN: 0025932598708

Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. For Laser Printers. Form Size: 8.5 x 11; Forms Per Page: 1; Form Quantity: 2,500; Layout: One Form per Sheet.

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Products specifications

Attribute name	Attribute value
Special Features	For Laser Printers
Form Quantity	2,500
Global Product Type	Forms-Insurance
Pre-Consumer Recycled Content Percent	0%
Post-Consumer Recycled Content Percent	0%
Total Recycled Content Percent	0%
Paper Color(s)	White
Form Size	8.5 x 11
Forms Per Page	1
Layout	One Form per Sheet
Print and Ruling Color(s)	Red
Printer Compatibility	Laser
Paper Stock	20 lb

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Products specifications

Attribute name	Attribute value
Special Features	For Laser Printers
Form Quantity	2,500
Global Product Type	Forms-Insurance
Pre-Consumer Recycled Content Percent	0%
Post-Consumer Recycled Content Percent	0%
Total Recycled Content Percent	0%
Paper Color(s)	White
Form Size	8.5 x 11
Forms Per Page	1
Layout	One Form per Sheet
Print and Ruling Color(s)	Red
Printer Compatibility	Laser
Paper Stock	20 lb