TOPS UB04 Hospital Insurance Claim Form

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UB04 Hospital Insurance Claim Form, 8 1/2 x 11, Laser Printer, 2500 Forms

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Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. Form Size: 8 1/2 x 11
Forms Per Page: 1
Form Quantity: 2500
Layout: One Form per Sheet.
Unit of Measure : Carton of 2500

Brand TOPS

Reference ESTOP59870R

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