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

Item #: TOP59870R
by TOPS™
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Nationwide Stock: 115 CT
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Product Details

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

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

Product Specifications

Item Specifications
Brand TOPS™
Global Product Type Forms-Insurance
Form Size 8 1/2 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

Dimensions / Specifications
Unit of Measure CT
Item Weight 26.000 lbs
Ships via UPS? Yes
Carton Pack Quantity 2500 EA
This item is sold by the CT which contains 2500 EA
Warranty Offered? No
Manufacturer Info
Brand TOPS™  (website)
Brand Contact 800-282-7261
Warranty Offered? n
Manufacturer Stock No. 59870R
Staples Equivalent SKU TOP59870R
Office Max Equivalent SKU 21954208
Office Depot Equivalent SKU 526935
Retail UPC 025932598708
Country of Origin US
UNSPSC Number 14111806
Meets ANSI/BIFMA? 025932598708
OTS Product ID 9461823

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Document printed / saved on 06/19/2018. Prices subject to change.