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Claim Forms CMS/UB04/ADA
> UB-04 Forms, Laser, 8.5 x 11
Laser UB-04 Form
UB-04 Forms, Laser, 8.5 x 11
1 Review(s)
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Price
Your Price:
$39.95
Availability:
In Stock.
Part Number:
WEB-NLCF-UB04-1
Quantity
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Quantity Pricing
Quantity
Price
5 - 9
$37.95
10 - 19
$36.95
20+
$35.95
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Description
Customer Reviews
Laser- 8 1/2" x 11" for laser or inkjet printers
Box quantity: 2500
Printed in red, OCR scannable ink in compliance with government standards
Medicare approved for billing Medicare Part A claims
accounting assistant
good
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Reviewed by:
(Verified Buyer)
Judy Tang
from oakland.
on 11/17/2015
5
/
5
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