#628058
TOPS™ #TOP-59870R

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

FORM,UB-04,1-PT,LASER,WE

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

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Product Specifications

McKesson #

628058

Manufacturer #

TOP-59870R

Manufacturer

TOPS™

Country of Origin

United States

Color Family

White

Copy Types

One-Part (No Copies)

Dated/Undated

Undated

Form Quantity (Total)

2,500

Form Size

8.5 x 11

Form Type Details

UB04

Format Indicator

Unbound

Forms Per Page

Global Product Type

Insurance Forms

Paper Color(s)

White

Paper Stock

20 lb Bond

Post-Consumer Recycled Content Percent

Pre-Consumer Recycled Content Percent

Print and Ruling Color(s)

Red

Printer Compatibility

Laser

Product Biodegradability in Days

Special Features

Laser Printer Compatible

Total Recycled Content Percent

UNSPSC

14111806

Features

Printed to Government Printing Office standards.
OCR ink for scanning.
American Medical Association (AMA) approved format.

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