ComplyRight UB-04 Hospital Claim Form, 500 Forms/Pack (UB04LC5)
$27.59Market price
Highlights
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- Designed for hospitals to file a medical claim with the patient's insurance carrier
- One-part health insurance forms
- Printed with OCR dropout red ink on white paper
MADE IN AMERICA
ComplyRight UB-04 Hospital Claim Form, 500 Forms/Pack (UB04LC5)
Item #: 24614845Model #: UB04LC5
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$27.59Market price