Adams UB-04 Continuous Hospital Insurance Claim Form, 1 Part, Laser, 8.5 x 11 Inches, 2500 Sets per Carton, White (59870R)
$98.01$198.36
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Description
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
