TOPS UB04 Hospital Insurance Claim Form for Laser Printers, One-Part (No Copies), 8.5 x 11, 2,500 Forms Total
Part # TOP59870R
UPC 025932598708
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Product Details
Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format.
Additional Information
- Part #: TOP59870R
- MPN: 59870R
- UPC: 025932598708
- UNSPC: 14111806
- Printed to Government Printing Office standards.
- OCR ink for scanning.
- American Medical Association (AMA) approved format.
| Brand | TOPS |
|---|---|
| Form Size | 8.5 x 11 |
| Forms Per Page | 1 |
| Form Quantity | 2500 |
| Layout | One Form per Sheet |
| Printer Compatibility | Laser |
| Paper Stock | 20-lb. |
| Paper Color(s) | Red; White |
| Print and Ruling Color(s) | Red |
| Pre-Consumer Recycled Content Percent | 0% |
| Post-Consumer Recycled Content Percent | 0% |
| Total Recycled Content Percent | 0% |
| Special Features | For Laser Printers |
| Country of Origin | US |
| Prop65 | No |
| Unit of Measure | CT |
| Last Updated | 11/8/2020 |
Additional Information
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