UB-04 laser-cut forms are designed for medical offices to file a claim with the patient's insurance company. The Health Care Finance Administration format
UB-04 laser-cut forms are designed for medical offices to file a claim with the patient's insurance company. The Health Care Finance Administration format ensures accuracy in reporting all necessary information.
Color | White |
Size | 11.5 In. L X 8.5 In. W X 11.0 In. H |
Gtin | 00025932598708 |
Mpn | 59870R |
Condition | new |