TOPS™ UB04 Hospital Insurance Claim Form for Laser Printers, One-Part (No Copies), 8.5 x 11, 2,500 Forms Total (TOP59870R) 1 Carton

SKU: 57443

Brand: TOPS™

Category: Forms

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TOPS™ UB04 Hospital Insurance Claim Form for Laser Printers, One-Part (No Copies), 8.5 x 11, 2,500 Forms Total (TOP59870R) 1 Carton

TOPS™ UB04 Hospital Insurance Claim Form for Laser Printers, One-Part (No Copies), 8.5 x 11, 2,500 Forms Total (TOP59870R) 1 Carton

SKU: 57443

Brand: TOPS™

Category: Forms

Bulk Quote
Print
$333.15 $241.32 Save 28%
In Stock
Estimated Delivery: Thu 9/25 - Mon 9/29

Description

TOPS™ UB04 Hospital Insurance Claim Form
Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format.

Global Product Type: Insurance Forms
Form Type Details: UB04
Dated/Undated: Undated
Forms Per Page: 1
Form Size: 8.5 x 11
Format Indicator: Unbound
Form Quantity (Total): 2,500
Copy Types: One-Part (No Copies)
Paper Color(s): White
Color Family: White
Printer Compatibility: Laser
Paper Stock: 20 lb Bond
Print and Ruling Color(s): Red
Product Biodegradability in Days: 0
Pre-Consumer Recycled Content Percent: 0%
Post-Consumer Recycled Content Percent: 0%
Total Recycled Content Percent: 0%
Special Features: Laser Printer Compatible
Printer Compatibility Laser
Layout One Form per Sheet
Format Loose Form
Paper Stock 20 lb
Color Red, White
Product Type Insurance Claim
Dimensions 8 1/2" x 11"
Print and Ruling Color(s) Red
Case Pack 1 Carton
Paper Color(s) White
Post-Consumer Recycled Content Percent 0%
Pre-Consumer Recycled Content Percent 0%
Total Recycled Content Percent 0%
Global Product Type Forms-Insurance
Form Quantity 2,500
Special Features For Laser Printers
Forms Per Page 1
Form Size 8.5 x 11

Returns are available due to customer error (such as ordering the wrong product), only if the product is in new, unopened, and unused condition within 30 days of the invoice date.  There will be a 20% restocking fee and the customer will be responsible for the shipping costs to return the product.  

Damaged goods or incorrect product shipments must be reported within 5 business days of receipt. Please save any shipping cartons, boxes and the damaged product, and use the returns process within the return window time frame. All products must be returned in the original packaging, and we may require pictures of the damaged items in order to initiate the return. GoodEarth will ship a replacement for no additional charge.

If the guidelines for returns are not met, GoodEarth will not process the refund.

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