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Insurance Claim Forms
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TOPS 59870R UB04 Hospital Insurance Claim Form, 8 1/2 x 11, Laser Printer, 2500 Forms
R 7,033
or 4 x payments of R1,758.25 with
Add to cart
Availability: Currently in Stock
Delivery: 10-20 working days
Please be aware orders placed now will not arrive in time for Christmas, please check delivery times.
TOPS 59870R UB04 Hospital Insurance Claim Form, 8 1/2 x 11, Laser Printer, 2500 Forms
Sold as 2500/Carton.
Printed to Government Printing Office standards. OCR ink for scanning.
AMA approved format.
Contains 2500 forms per package. Replaces the UB-92.
Printed with OCR red ink on laser-cut white paper. SFI certified sourcing.
Country
USA
Brand
Tops
Manufacturer
TOPS
Binding
Office Product
ItemPartNumber
TOP59870R
Color
White
UPCs
641438084127
EANs
0641438084127
ReleaseDate
0000-00-00