TOPS UB04 Hospital Insurance Claim Form, 8.5 x 11, 1/Page, 2,500 Forms (59870R)
- Printed to Government Printing Office standards.
- OCR ink for scanning.
- American Medical Association (AMA) approved format.
$168.90 $333.15
IN STOCK
Product#: 59870R
EXPIDITED SHIPPING - Estimated Delivery Fri 4/26
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Product Description
Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. For Laser Printers. Form Size: 8.5 x 11; Forms Per Page: 1; Form Quantity: 2,500; Layout: One Form per Sheet.
Printed to Government Printing Office standards.
OCR ink for scanning.
American Medical Association (AMA) approved format.
Product Specification
| Manufacturer | TOPS |
|---|---|
| Categories | TOPS Office SuppliesTOPS Forms, Recordkeeping & Reference MaterialsTOPS Forms |
| Manufacturer Stock No. | 59870R |
| MPN | TOP59870R |
| Model# | 59870R |
| UPC Code | 025932598708 |
| UNSPSC Code | 0 |
| Form Quantity | 2,500 |
| Form Size | 8.5 x 11 |
| Forms Per Page | 1 |
| Global Product Type | Forms-Insurance |
| Layout | One Form per Sheet |
| Paper Color(s) | White |
| Paper Stock | 20 lb |
| Post-Consumer Recycled Content Percent | 0% |
| Pre-Consumer Recycled Content Percent | 0% |
| Print and Ruling Color(s) | Red |
| Printer Compatibility | Laser |
| Special Features | For Laser Printers |
| Total Recycled Content Percent | 0% |
| Assembly Required | No assembly is required |
| Contains Recycled Materials | N |
| Green Product | N |
| Unit of Measure | CT |
| Item Weight | 26 |
| Ships via UPS | Y |
| Carton Pack Quantity | 2500 EA |
| This item is sold by the | CT which contains 2500 EA |
| Brand | TOPS |
| Country of Origin | US |
| UNSPSC Number | 14111806 |
