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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
Quick Find
: 9461823
Casepack
: 2500
UOM
: CT
Model #
: 59870R
SKU
: TOP59870R
$387.65
/ CT
This product qualifies for quantity discount pricing.
Quantity
Per Item Price
1-5
$387.65
6-10
$376.57
11+
$365.49
Quantity:
Add to Cart
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Product Description
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.