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UB04 Hospital Insurance Claim Form 8 1/2 x 11 2,500 Forms
$99.99
SKU:JL-5OTH-EY7E
SKU: 8379
$99.99
In Stock
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
2 Part Carbonless Patients Sign in Forms (50)
2 Part confidentially sign in forms is approved and required by the HIPAA, Every single patient who comes in to the dr. office will sign on the next line removable...
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2 Part Carbonless Patients Sign in Forms (250)
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NCR Carbonless 3 Part Patient Sign in Forms, HIPAA Approved and Compliant for Confidentiality in All Medical Offices. (Green)
Green color carbon-less 3 part sign in forms is required by the HIPAA, Every single patient who comes in to the doctor (medical) office will sign on the next line...
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NCR Carbonless 3 Part Patient Sign in Forms, HIPAA Approved and Compliant for Confidentiality in All Medical Offices. (Blue)
Blue color carbon-less 2 part sign in forms is required by the HIPAA, Every single patient who comes in to the doctor (medical) office will sign on the next line...
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NCR Carbonless 3 Part Patient Sign in Forms, HIPAA Approved and Compliant for Confidentiality in All Medical Offices. (Purple)
Pack of 25 Sets Patients Sign in Sheets (Purple) Confidentiality and privacy are of key importance in professional medical offices, and our Next Day Labels Patient sign-in sheets are the...
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NCR Carbonless 3 Part Patient Sign in Forms, HIPAA Approved and Compliant for Confidentiality in All Medical Offices. (Burgundy)
Burgundy color carbon-less 3 part sign in forms is required by the HIPAA, Every single patient who comes in to the doctor (medical) office will sign on the next line...
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3" x 11" Infant Band (2 Each) (Carton of 600)
3" x 11" Infant Band (2 Each) (Carton of 600)
$262.12
in stock(500)
30 Days free return
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Free & fast shipping
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Made in USA
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