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Home > Medical Billing Filing Solutions > Medical Claim Forms > UB-04 Hospital Claim Form Laser Format
Alternative Views:	Product Code: UB04LC Qty and Price: 500 Qty [Add $48.00] 1,000 Qty [Add $90.00] 2,500 Qty [Add $220.00] 5,000 Qty [Add $375.00] 10,000 Qty [Add $680.00]

Description   UB-04 Hospital Claim Form Laser Single Sheet Format. Guaranteed compliant UB-04 Billing Forms. Contact us today at 877-212-1220 for a free sample. Compatible Accessories UB-04 Hospital Claim Form Large Left Window Envelope

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