UB-04 2-part NCR Billing Form

SKU

MPSBRG-2203/2-R07

In stock

$80.17

Note : Image shown for reference purposes only. Actual product appearance may vary. Please read product description for full and accurate details

Use for filing patient claims.

8 " x 11", 2-Part NCR paper,white paper both pages,red ink, wrapped in 250s.

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