• Receive within 1-5 Business Days!
• Insurance/UB04 Hospital Claim Form, 8-1/2 x 11, 2500 Loose Forms/Carton
• FORMS – GENERAL

Product Description
Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. Global Product Type: Forms-Insurance Claim; Form Size (W x H): 8 1/2 in x 11 in; Format: Loose Form; Forms Per Page: N/A.

TOPS® UB04 Hospital Insurance Claim Form FORM,UB-04,1-PT,LASER,WE