Adams UB-04 Continuous Hospital Insurance Claim Form, 1 Part, Laser, 8.5 x 11 Inches, 2500 Sets per Carton, White (59870R)

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image:imageAdams UB04 Continuous Hospital Insurance Claim Form 1 Part Laser 85 x 11 Inches 2500 Sets per Carton White 59870R
image:imageAdams UB04 Continuous Hospital Insurance Claim Form 1 Part Laser 85 x 11 Inches 2500 Sets per Carton White 59870R

Adams UB-04 Continuous Hospital Insurance Claim Form, 1 Part, Laser, 8.5 x 11 Inches, 2500 Sets per Carton, White (59870R)

Original price was: $194.78.Current price is: $82.47.

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SKU: 2306-1777935580386-301fe0f3 Category:

Description

Continuous forms are designed for hospitals to file a claim with the patient's insurance company
Forms are printed to GPO standards in OCR ink on 20 pound stock bond
Health Care Finance Administration format ensures accuracy in reporting all necessary information
2,500 sets per carton
8.5 x 11 inch sheet size
Replaces the UB-92

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