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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Brand: Tops

Color: White


  • 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

Details: Adams Business Forms provide the tools to help keep track of messages, finances, transactions, employees, taxes, and customers to businesses throughout the world. The Adams UB-04 Hospital Insurance Claim forms are used by hospitals to file claims with the patient's insurance company. Each form is printed to GPO standards in OCR ink on a 8.5 x 11 inch laser cut sheet size, with 2,500 form sets per carton. These UB-04 forms are made to replace the UB-92 forms. These business forms are the perfect way to create and maintain a professional image for small businesses and service providers. Whether it's a multi-part form, notebooks, writing pads, record books, or any of the hundreds of items we offer, you can count on Adams products to help!

EAN: 0025932598708