FORM, CMS, 8.5X11, LSR CT, WH
UB04 Claim Forms, 8 1/2 x 11, 2500 Forms
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Ships within 1–2 business days
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Genuine Product
100% manufacturer supplied
Expedite Medicare, Medicaid or private insurance claims processing. Forms meet all Federal regulations. Formerly known as HCFA-1500 forms. Form Size: 8 1/2 x 11; Forms Per Page: 1.
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