Health Insurance Claim Form: UB04, 2, 500, One-Part, 8 1/2 in, 11 in, No Copies, 20 lb Paper Wt
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TOPS Health Insurance Claim Form: UB04, 2, 500, On...
Item 860K97
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Product Details
| Brand | TOPS |
| Product Powered by Fossil Fuel | N |
| Safety Data Sheet (SDS) Applicable? | N |
| California Biodegradable Labeling Compliance | N |
| EnvironmentallyPreferable_Indicator | N |
| Overall Length | 11 in |
| Storage Protection Code | A |
| Should Sales be Restricted by Region? | N |
| Copy Type | No Copies |
| Compatible Product Type | Laser Printer, Inkjet Printer |
| RoHS - Restricted Use of Hazardous Substances Directive (RoHS) | N |
| Number of Parts | One-Part |
| Overall Width | 8-1/2 in |
| Features | Printed in Scannable OCR, Red Ink |
| Ozone Depleting Substance | N |
| Paper Color | White |
| Standards | GPO, AMA |
| Number of Forms | 2,500 |
| Recycled Content | 0 % |
| California Prop 65 Reproductive Harm | N |
| Product Type | Health Insurance Claim Form |
| Paper Color Family | White |
| Paper Weight | 20 lb |
| California Prop 65 Cancer | N |
| Form Code | UB04 |
| Freight Class Code | 18 |
| Is this a Hazardous Material Product? | N |
| Mfr. Model # | 59870R |
Description
Health Insurance Claim Form, 11" L, PK2500