TOPS UB04 Hospital Insurance Claim Form, 8.5 x 11, 1/Page, 2,500 Forms (TOP59870R)($343.15Value)

$343.15

TOPS UB04 Hospital Insurance Claim Form, 8.5 x 11, 1/Page, 2,500 Forms (TOP59870R)($343.15Value)

Category: Paper

DESCRIPTION
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Description

Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format.

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RevType	2
Manufacturer	TOPS™
Sku	TOP59870R
Identity	34809891550