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UB04 Hospital Insurance Claim Form, 8.5 x 11, 1/Page, 2,500 Forms - White

$247.92

Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. For Laser Printers. Form Size: 8.5 x 11; Forms Per Page: 1; Form Quantity: 2,500; Layout: One Form per Sheet.

Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. For Laser Printers. Form Size: 8.5 x 11; Forms Per Page: 1; Form Quantity: 2,500; Layout: One Form per Sheet.

In stock
  • Color
  • White
  • Gtin
  • 00025932598708
  • Mpn
  • 59870R
  • Condition
  • new