Office Products > Forms, Recordkeeping & Money Handling > Human Resources Forms > Insurance Claim Forms
UB04 Hospital Insurance Claim Form 8 1/2 x 11 2,500 Forms
Product ID: B005D9I4R4
Condition: New
$ 875
includes Duties & VAT
Delivery: 10-20 working days
Ships from USA warehouse.
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Product Description
UB04 Hospital Insurance Claim Form 8 1/2 x 11 2,500 Forms
Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association AMA approved format. Form Size: 8 1/2 x 11 Forms Per Page: 1 Form Quantity: 2500 Layout: One Form per Sheet.
Technical Specifications
Country
USA
Brand
Tops
Manufacturer
Tops Business Forms
PartNumber
59870R
Model
TOP59870R
Height
10.25
Length
12
Weight
26
Width
9.25
