Description
Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. Form Size: 2 x 8 1/2; Forms Per Page: 1; Form Quantity: 2500; Layout: One Form per Sheet.
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UB04 Hospital Insurance Claim Form, 8 1/2 x 11, Laser Printer, 2500 Forms
Original price was: $123.78.$22.25Current price is: $22.25.
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