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Mississippi Industries for the Blind

Mississippi Industries for the Blind

UB04 Hospital Insurance Claim Form for Laser Printers, One-Part (No Copies), 8.5 x 11, 2,500 Forms Total

  • SKU: TOP59870R
  • Category: Forms
  • Brand: TOPS®
  • Qty per pack: 2500
  • Ships UPS: Yes
  • Returnable: Yes
  • 264.73 USD$264.73

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.