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Tops 59870R UB04 Hospital Insurance Claim Form, 8-1/2 x 11, 2,500 Forms
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UB-04 laser-cut forms are designed for medical offices to file a claim with the patient's insurance company. The Health Care Finance Administration format ensures accuracy in reporting all necessary information. Forms meet the requirements of the Centers for Medicare and Medicaid Services (CMS). Forms are printed on 20 lb. bond paper.
Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. Global Product Type - Forms-Insurance Form Size - 8 1/2 x 11 Forms Per Page - 1 Form Quantity - 2500 Layout - One Form per Sheet Printer Compatibility - Laser Paper Stock - 20-lb. Paper Color(s) - Red Paper Color(s) - White Print and Ruling Color(s) - Red Pre-Consumer Recycled Content Percent - 0% Post-Consumer Recycled Content Percent - 0% Total Recycled Content Percent - 0% Special Features - For Laser Printers
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Warranty, Returns, And Additional Information
Warranty
- Please contact the Seller directly for warranty information. Warranty information may also be found on the Manufacturer's website.
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Return Policies
- Return for refund within: 30 days
- Return for replacement within: 30 days
- This item is covered by IPC Store Return Policy
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