UB04 Claim Forms, 2 Part Continuous White/Canary, 9 1/2 x 11, 1000 Forms

UB04 Claim Forms, 2 Part Continuous White/Canary, 9 1/2 x 11, 1000 Forms

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UB04 Claim Forms, 2 Part Continuous White/Canary, 9 1/2 x 11, 1000 Forms
PRB 05110

Expedite Medicare, Medicaid or private insurance claims processing. Forms meet all Federal regulations. Formerly known as HCFA-1500 forms. Two-part continuous feed, white/canary. Form Size: 9 1/2 x 11; Forms Per Page: 1.

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