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

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

Price: 123.78 from Zuma Office Supply US