- Receive within 1-5 Business Days!
- Insurance/UB04 Hospital Claim Form, 8-1/2 x 11, 2500 Loose Forms/Carton
- FORMS – GENERAL
Product Standards Government Printing Office DescriptionPrinted. OCR ink for scanning. American Medical Association (AMA) approved format. Printed Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. overall shape Product Type: Form of insurance claim forms, dimensions (W x H): 8 1 / 2 inches x 11 inches; Format: free form; forms per page: N / A.
TOPS ® UB04 Hospital Insurance Claim Form Form, UB-04 ,1-PT, laser, we




