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UB04 / Insurance Forms. 8-1/2 x 11 Inches, 2500 Forms
Printed to Government Printing Office standards. OCR ink for scanning. Approved format. Form Size 8 1/2 x 11; Forms Per Page 1; Form Quantity 2500; Layout One Form per Sheet. Printed to Government Printing Office standards. OCR ink for scanning. Approved format. Manufacturer LSC Communications US, LLC, Brand Tops, Weight 26 pounds, Dimensions 12 x 9.25 x 10.25 inches, model number Is Discontinued No, Color Red; White, s 1, Size 8 1/2 x 11, Manufacturer Part Rank Office Products Health Insurance Claim Forms 135, Available April 18, 200

Price is $186.00
Price: $186.24