Picture of UB04 Hospital Insurance Claim Form, 8 1/2 x 11, Laser Printer, 2500 Forms

UB04 Hospital Insurance Claim Form, 8 1/2 x 11, Laser Printer, 2500 Forms

$162.09
Reward Points: 16
Mfg: TOPS™
Availability: Out of stock
Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. Form Size: 11 x 8 1/2; Forms Per Page: 1; Form Quantity: 2500; Layout: One Form per Sheet.
Products specifications
Attribute nameAttribute value
UOMCT
Pack2500 EA/CT
Form Quantity2500
Form Size11 x 8 1/2
Forms Per Page1
Global Product TypeForms-Insurance Claim
LayoutOne Form per Sheet
Paper Color(s)Red; White
Paper Stock20-lb.
Post-Consumer Recycled Content Percent0%
Pre-Consumer Recycled Content Percent0%
Print and Ruling Color(s)Red
Printer CompatibilityLaser
Special FeaturesFor Laser Printers
Total Recycled Content Percent0%
UBNCOST
CategoryForms
ManufacturerTOPS™
ELEVATE Marketplace
BBB Accredited Business
GODaddy Verified & Secured
Information
Customer service

    Copyright © 2025 ELEVATE Marketplace.

    All Rights Reserved.

    ELEVATE Marketplace