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| SLI Medical# | 628058 |
| Manufacturer # | TOP-59870R |
| Manufacturer | TOPS™ |
| Country of Origin | United States |
| Color Family | White |
| Copy Types | One-Part (No Copies) |
| Dated/Undated | Undated |
| Form Quantity (Total) | 2 |
| Form Size | 500 |
| Form Type Details | 8.5 x 11 |
| Format Indicator | UB04 |
| Forms Per Page | Unbound |
| Global Product Type | 1 |
| Paper Color(s) | Insurance Forms |
| Paper Stock | White |
| Post-Consumer Recycled Content Percent | 20 lb Bond |
| Pre-Consumer Recycled Content Percent | 0% |
| Print and Ruling Color(s) | 0% |
| Printer Compatibility | Red |
| Special Features | Laser |
| Total Recycled Content Percent | Laser Printer Compatible |
| UNSPSC | 0% |
| 14111806 |
| Product Name | UB04 Hospital Insurance Claim Form for Laser Printers, One-Part (No Copies), 8.5 x 11, 2,500 Forms Total |
|---|---|
| SKU | 100628058 |
| Price | $365.24 |
| Weight | 5.25 |
| Featured Product | No |
| Manufacturer Sku | TOP-59870R |
| UOM | CT |
| Manufacturer | TOPS™ |
| Short Description | FORM,UB-04,1-PT,LASER,WE |
