Adams UB-04 Continuous Hospital Insurance Claim Form, 1 Part, Laser, 8.5 x 11 Inches, 2500 Sets per Carton, White (59870R)

Adams UB-04 Continuous Hospital Insurance Claim Form, 1 Part, Laser, 8.5 x 11 Inches, 2500 Sets per Carton, White (59870R)

Product ID: B001E662W4 Condition: New

$ 1,104
includes Duties & VAT
Delivery: 10-20 working days
Ships from USA warehouse.
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Product Description

Adams UB-04 Continuous Hospital Insurance Claim Form, 1 Part, Laser, 8.5 x 11 Inches, 2500 Sets per Carton, White (59870R)

  • Continuous forms are designed for hospitals to file a claim with the patient's insurance company
  • Forms are printed to GPO standards in OCR ink on 20 pound stock bond
  • Health Care Finance Administration format ensures accuracy in reporting all necessary information
  • 2,500 sets per carton
  • 8.5 x 11 inch sheet size
  • Replaces the UB-92

Adams Business Forms provide the tools to help keep track of messages, finances, transactions, employees, taxes, and customers to businesses throughout the world. The Adams UB-04 Hospital Insurance Claim forms are used by hospitals to file claims with the patient's insurance company. Each form is printed to GPO standards in OCR ink on a 8.5 x 11 inch laser cut sheet size, with 2,500 form sets per carton. These UB-04 forms are made to replace the UB-92 forms. These business forms are the perfect way to create and maintain a professional image for small businesses and service providers. Whether it's a multi-part form, notebooks, writing pads, record books, or any of the hundreds of items we offer, you can count on Adams products to help!

Technical Specifications

Country
USA
Brand
Adams
Manufacturer
TOPS Business Forms, Inc.
PartNumber
59870R
Model
59870R
Color
White
Height
4.4
Length
11
Weight
26
Width
8.5
Size
8 1/2 In X 11 In
NumberOfItems
1