TFP UB-04 CMS-1450 1-Part Health Insurance Claims, 2500/Carton (UB04LC)
R 5,914
or 4 x payments of R1,478.50 with
Availability: Currently in Stock
Delivery: 10-20 working days
This item may be available in a different size, colour, scent, version or platform:
TFP UB-04 CMS-1450 1-Part Health Insurance Claims, 2500/Carton (UB04LC)
UB-04 Hospital Claim Form for Laser Printers
Approved OMB NO: 0938-0997
2,500 Sheets
Accommodate the reporting of the National Provider Identifier (NPI) Number
UB-04 Hospital Claim Form Laser-Cut Sheet (2,500/case) Printed in OCR red "dropout" ink 20# Environmental Paper Alliance (EPA) Recycled Paper (White) 2,500/case