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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

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