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

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Product Information

  • UB-04 claim forms used by hospitals file a claim with the patient's insurance company, replaces the UB-92 form
  • Forms are printed to GPO standards in OCR ink on 20 pound stock bond
  • Laser cut sheets
  • 2,500 sets per carton
  • 8.5 x 11 inch sheet size

Attributes

Part Number
59870R
Label
TOPS Business Forms, Inc.
Number Of Items
1
Platforms
Windows
Publication Date
2010-06-29
Publisher
TOPS Business Forms, Inc.
Studio
TOPS Business Forms, Inc.
Lang
en-US

Product Identifiers

AIDAlgopix unique identifier
AIDRQ9ZO5001
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Shipping Dimensions

Width
11.2 in.
Length
11.4 in.
Height
8.8 in.
Weight
427.2 oz.

Product Dimensions

Width
8.5 in.
Length
11 in.
Height
4.4 in.
Weight
416 oz.

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