Picture of UB04 Hospital Insurance Claim Form for Laser Printers, One-Part (No Copies), 8.5 x 11, 2,500 Forms Total

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

Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format.
Manufacturer: TOPS BUSINESS FORMS
SKU: TOP59870R
Manufacturer part number: 59870R
$333.15
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Availability: 26 in stock