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UB04 Hospital Insurance Claim Form 8 1/2 x 11 2,500 Forms avery 8395 000 sheets)TOPS UB04 Hospital Insurance Claim Form, 8 1 2 x 11, 2,500 FormsPrinted to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. Form Size: 8 1 2 x 11; Forms Per Page: 1. 2500 Forms Carton UB04 Claim Forms For Laser Printers This is the NEW UB04 (HCFA 1450) adding the split provider identifier fields for NPI numbers 100% compatible with UCCI requirements Expedited shipping available
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