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 KD-1355434
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Product Details
| Brand | TOPS |
| Paper Color Family | White |
| Recycled Content | 0 % |
| Number of Parts | One-Part |
| Paper Color | White |
| Copy Type | No Copies |
| Contains California Prop 65 Reproductive Toxicant | N |
| Paper Weight | 20 lb |
| Overall Length | 11 in |
| Product Type | Health Insurance Claim Form |
| Number of Forms | 2,500 |
| Contains California Prop 65 Carcinogen | N |
| Features | Printed in Scannable OCR, Red Ink |
| Compatible Product Type | Inkjet Printer, Laser Printer |
| Form Code | UB04 |
| Overall Width | 8-1/2 in |
| Standards | GPO, AMA |
| Mfr. Model # | 59870R |
Description
Health Insurance Claim Form, 11" L, PK2500