TFP UB-04 CMS-1450 1-Part Health Insurance Claims, 2500/Carton (UB04LC);
TFP UB-04 CMS-1450 1-Part Health Insurance Claims, 2500/Carton (UB04LC)

UB-04 Hospital Claim Form Laser-Cut Sheet (2,500/case) Printed in OCR red "dropout" ink 20# Environmental Paper Alliance (EPA) Recycled Paper (White) 2,500/case

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UB-04 Hospital Claim Form Laser-Cut Sheet (2,500/case) Printed in OCR red "dropout" ink 20# Environmental Paper Alliance (EPA) Recycled Paper (White) 2,500/case

  • UB-04 Hospital Claim Form for Laser Printers
  • Approved OMB NO: 0938-0997
  • 2,500 Sheets
  • Accommodate the reporting of the National Provider Identifier (NPI) Number
  • UB-04 Hospital Claim Form for Laser Printers
  • Approved OMB NO: 0938-0997
  • 2,500 Sheets
  • Accommodate the reporting of the National Provider Identifier (NPI) Number

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