Tops Business Forms UB04 Hospital Insurance Claim Form - UB04 Hospital Insurance Claim Form, 8.5" x 11", Laser Printer, 2, 500 Forms - 59870R
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Product Information: UB04 Hospital Insurance Claim Form, 8.5" x 11", Laser Printer, 2, 500 Forms
Manufacturer Part # 59870R
- Printed to Government Printing Office standards
- ORC ink ideal for scanning
- American Medical Association (AMA) approved
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