1 PLY- Laser Cut Sheet UB-04 Hospital Claim Form
Item # 310987- 8 1/2 X 11, 20# , Quantity Per Box: 2500 Sheets
310987- THIS IS THE NEW VERSION OF OLD UB-92 FORM
Manufacturer: Metro Forms
Quantity:
SKU: 310987
LIST PRICE: $0.00
OUR PRICE: $54.50
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| 5-9 | $51.78 (per item) | all customers |
| 10-19 | $49.05 (per item) | all customers |
| 20-49 | $46.33 (per item) | all customers |
| 50-99 | $43.60 (per item) | all customers |
| 100+ | $38.15 (per item) | all customers |
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