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Due to challenges caused by the COVID-19 pandemic, We Are working diligently to minimize Items having to be Backordered, however Stockage level cannot be guaranteed at this time, Please Bare With us During this trying time, We are sorry for any inconvenience that this is causing. Your Base Supply Center is working hard to stay on top of this issue. Please contact the store to confirm availability of items. Thank you for your understanding.

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TOPS

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

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

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

51 In Stock
Item Code: TOP59870R
Category Forms
Manufacturer TOPS BUSINESS FORMS

Description

Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. Laser Printer Compatible. Form Type Details: UB04; Dated/Undated: Undated; Forms Per Page: 1; Form Size: 8.5 x 11.

Specifications

Made In

US

UNSPSC Code

14111806

Weight

26lb

Height

10.25in

Width

9.25in

Length

12in

Brand

TOPS

Category

Forms

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

1

Global Product Type

Insurance Forms

Paper Color(s)

White

Paper Stock

20 Lb Bond

Post-Consumer Recycled Content Percent

0%

Pre-Consumer Recycled Content Percent

0%

Print and Ruling Color(s)

Red

Printer Compatibility

Laser

Special Features

Laser Printer Compatible

Total Recycled Content Percent

0%

Starting from
$248.69 / CT
/
LIST PRICE $333.15
25%
- +
Add to quicklist
Compare
TOPS

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

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

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

51 In Stock
Item Code: TOP59870R
Category Forms
Manufacturer TOPS BUSINESS FORMS

Description

Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. Laser Printer Compatible. Form Type Details: UB04; Dated/Undated: Undated; Forms Per Page: 1; Form Size: 8.5 x 11.

Specifications

Made In

US

UNSPSC Code

14111806

Weight

26lb

Height

10.25in

Width

9.25in

Length

12in

Brand

TOPS

Category

Forms

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

1

Global Product Type

Insurance Forms

Paper Color(s)

White

Paper Stock

20 Lb Bond

Post-Consumer Recycled Content Percent

0%

Pre-Consumer Recycled Content Percent

0%

Print and Ruling Color(s)

Red

Printer Compatibility

Laser

Special Features

Laser Printer Compatible

Total Recycled Content Percent

0%

Starting from
$248.69 / CT
/
LIST PRICE $333.15
25%
- +
Add to quicklist
Compare
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