UB04 Hospital Insurance Claim Form for Laser Printers, One-Part (No Copies), 8.5 x 11, 2,500 Forms Total [SKU: TOP59870R]

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MSRP: $837.48
$209.37
(You save $628.11 )
SKU:
TOP59870R
UPC:
025932598708
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Product Overview

Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. Laser Printer Compatible. Form Type Details: UB04; Dated/Undated: Undated; Forms Per Page: 1; Form Size: 8.5 x 11. [QTY/UOM: 2500 / 1CT]

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