UB04 Hospital Insurance Claim Form 8 1/2 x 11 2,500 Forms avery 8395 Label Size: 4" x 2"

Label Size: 4" x 2" 10 Labels on an 8-1/2 x 11"

- Pack of 50 - Pack of 200 - Case of 1000

Compulabel 910258 1" x 1" Translucent Wafer Seals with Perforation and Timing Marks - Translucent - 5

opacity and brightness ^3

5# cfb sheet and a 15# cf sheet

UB04 Hospital Insurance Claim Form 8 1/2 x 11 2,500 Forms avery 8395 Label Size: 4" x 2"TOPS UB04 Hospital Insurance Claim Form, 8 1 2 x 11, 2,500 FormsPrinted to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. Form Size: 8 1 2 x 11; Forms Per Page: 1. 2500 Forms Carton UB04 Claim Forms For Laser Printers This is the NEW UB04 (HCFA 1450) adding the split provider identifier fields for NPI numbers 100% compatible with UCCI requirements Expedited shipping available