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The UB-04 Insurance Claim Form is a standard form used for billing healthcare services. This 2-part form is printed in white and canary color, measuring 9.5 x 11 inches. It is designed for efficient processing of insurance claims and comes in a bulk package of 1000 forms for convenience.
Paris Corporation 05110 UB-04 Insurance Claim Form, 2-Part, 9.5 x 11, White
