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HomeHCFA FormsHospital Claim CONTINUOUS (SINGLE) FORM UB92  


Hospital Claim CONTINUOUS (SINGLE) FORM UB92

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Description

 

Hospital Claim Form UB-92 - Continuous (One Part)
 
Description: Price Per Sheet:
  • Item: Hospital Claim Form
  • Format: Continuous (Single) Form UB92
  • Type: One Part for pin feed printer
  • Size: 8-1/2" X 11"
  • Weight: 24#
2500:  $47.90
5000:  $79.90

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