Description
Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. Laser Printer Compatible. Form Type Details: UB04; Dated/Undated: Undated; Forms Per Page: 1; Form Size: 8.5 x 11.
Features
- Printed to Government Printing Office standards.
- OCR ink for scanning.
- American Medical Association (AMA) approved format.
Specifications
| Color Family | White |
|---|---|
| Copy Types | One-Part (No Copies) |
| Dated/Undated | Undated |
| Form Quantity (Total) | 2,500 |
| Form Size | 8.5 x 11 |
| Form Type Details | UB04 |
| Format Indicator | Unbound |
| Forms Per Page | 1 |
| Global Product Type | Insurance Forms |
| Paper Color(s) | White |
| Paper Stock | 20 lb Bond |
| Post-Consumer Recycled Content Percent | 0% |
| Pre-Consumer Recycled Content Percent | 0% |
| Print and Ruling Color(s) | Red |
| Printer Compatibility | Laser |
| Product Biodegradability in Days | 0 |
| Special Features | Laser Printer Compatible |
| Total Recycled Content Percent | 0% |
UB04 Hospital Insurance Claim Form for Laser Printers, One-Part (No Copies), 8.5 x 11, 2,500 Forms Total
43 in stockSKU: TOP59870R-SPF
$261.11
- Ships in 24hFast & reliable delivery
- 30-day returnsHassle-free returns
- Secure checkoutYour data is protected
- Bulk ordersGreat for businesses
Payment.
Pay online with Apple Pay, Google Pay, Visa, Mastercard, PayPal and more.
Warranty.
12 months manufacturer warranty. Free returns within 30 days.
Delivery timeline
Order by 1:00 PM EST on a business day for same-day processing. Avg. delivery: 3 business days.
- Order Confirmed Today
- Preparing Shipment Same day
- In Transit Next business day
- Delivered 2–5 business days
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