UB92 Hospital Claim Form

UB92 Hospital Claim Form

Buy Now!
Sale Price: $112.19*
Retail: $118.63 (5% off!)

Buy Now!
Sale Price: $112.19*
Retail: $118.63 (5% off!)

UB92 Hospital Claim Form • American Medical Association (AMA) approved format For filing claims with patient’s insurance carrier. Printed to Government Printing Office standards with OCR red ink for scanning. 20-lb. paper. For Laser Printers 8-1/2 x 11. 2, 500 Forms per Carton One-Part Form

Merchant: Betty Mills Janitorial Products