Insurance/UB04 Hospital Claim, 8-1/2 x 11, 2500 Continuous Forms/Carton

Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. Form Type: Insurance Claim; Format: Continuous Form; Form Size: 8 1/2 x 11; Sheet Size: N/A.

Product Attributes Form Size 8 1/2 x 11 Form Type Insurance Claim Format Continuous Form Layout One Form per Sheet Paper Color(s) Red, White Paper Stock 20-lb. Post-Consumer Recycled Content Percent [Nom] 0 % Pre-Consumer Recycled Content Percent [Nom] 0 % Print and Ruling Color(s) Red Printer Compatibility Dot Matrix Punching Dot Matrix Holes Total Recycled Content Percent [Nom] 0 %

Item Weight	28.000 lbs
Unit of Measure	CT
Carton Quantity	2500 EA
Ships via UPS	Y

Brand	TOPS
Manufacturer Stock No.	59770R
UPC Class Code	00025932597701
Country of Origin	US
Tariff Code
UNSPSC Number	14111806
Meets ANSI/BIFMA
Manufacturer Website	www.tops-products.com
Manufacturer Phone	800-621-1291

Legacy Description	FORM,UB-04,1-PT,CONT,WE
Keywords	Claim Form;Claim Forms;Continuous Form;HCFA Claim Form;Health Care Claim Forms;Human Resources;Insurance Forms;Personnel;Personnel Forms;TOPS;UB04
Catalog Page	918
Office Depot SKU:	TOP59770

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