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Shipped by Newegg
UB-04 laser-cut forms are designed for medical offices to file a claim with the patient's insurance company. The Health Care Finance Administration format ensures accuracy in reporting all necessary information. Forms meet the requirements of the Centers for Medicare and Medicaid Services (CMS). Forms are printed on 20 lb. bond paper.
Warranty Notice:
This product does not include manufacturer warranty when purchased or used outside of its designated sales region. By purchasing internationally, you acknowledge that warranty support from the manufacturer will not be available.