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UB-04 Hospital Claim Form 3-Part Continuous:

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UB-04 Hospital Claim Form 3-Part Continuous
Item #: UB043

UB-04 form is designed for hospitals, skilled nursing, home health care facilities and other institutional health care providers to file medical claims with the patient's insurance carrier.

Product Details

UB-04 Hospital Claim Form
3-Part
Continuous
(All White)
1000/Carton

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