UB04 Hospital Insurance Claim Form for Laser Printers, One-Part (No Copies), 8.5 x 11, 2,500 Forms Total
Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format.
| Manufacturer: | TOPS BUSINESS FORMS |
| Brand: | TOPS™ |
| Item Number: | TOP59870R |
| Manufacturer Part Number: | 59870R |
| Unit of Measure: | CT |
| Recycled: | No |
| Pre-Consumer Recycled Content: | 0% |
| Post-Consumer Recycled Content: | 0% |
| Total Recycled Content: | 0% |
