Ub04 Hospital Insurance Claim Form, 8 1/2 X 11, Laser Printer, 2500 Forms
Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format.
Call: 1-360-345-1290
771 S. Market Blvd.
Chehalis, WA 98532
Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format.