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

UB04 Hospital Insurance Claim Form for Laser Printers, One-Part (No Copies), 8.5 x 11, 2,500 Forms Total

$343.15

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

  • Printed to Government Printing Office standards.
  • OCR ink for scanning.
  • American Medical Association (AMA) approved format.
Manufacturer # 59870R
Global Product Type Insurance Forms
Form Type Details UB04
Dated/Undated Undated
Forms Per Page 1
Form Size 8.5 x 11
Format Indicator Unbound
Form Quantity (Total) 2,500
Copy Types One-Part (No Copies)
Paper Color(s) White
Color Family White
Printer Compatibility Laser
Paper Stock 20 lb Bond
Print and Ruling Color(s) Red
Product Biodegradability in Days 0
Pre-Consumer Recycled Content Percent 0%
Post-Consumer Recycled Content Percent 0%
Total Recycled Content Percent 0%
Special Features Laser Printer Compatible
Details

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

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

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