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SR Direct (home) > Forms > Healthcare Forms >

Hospital Billing Envelope UB92 / UB04 Hospital Billing Claim Form Left Window 9 X 12 1/2", 500/Carton - 1492LL

Item #: 1492LL
Retail: $158.57 Price: $105.71

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Envelope for UB04 and UB92 healthcare forms with jumbo left window. Dimensions are 9" X 12 1/2", perfect for UB04 and UB92 forms. Security lined.
  • Official UB04 / UB92 hospital billing claims forms
  • Large 9 X 12 1/2" envelopes
  • Security lined for safe mailing
  • Features large left window
  • Sold by the carton, 500 envelopes per carton.

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