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310987 5108 - 1 PLY- Laser Cut Sheet UB-04 Hospital Claim Form
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310987
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Item # 310987- 8 1/2 X 11, 20# , Quantity Per Box: 2500 Sheets
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List Price: $130.41
Your Price: $61.60
You Save: $68.81 (53 %)
99,999 In Stock
Quantity Discounts - Order a quantity in the range below to receive the discount
| Quantity | Amount |
| 3 to 9 | $59.75 |
| 10 to 19 | $56.98 |
| 20 to 49 | $50.82 |
| 50 to 499 | $49.28 |
Detailed Description
310987- THIS IS THE NEW VERSION OF OLD UB-92 FORM
Product Reviews
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