UB-04
The Uniform Billing Form – known either as the UB-04 – is the standard for billing all major insurance providers as well as Medicare.
3926/2-R07: 8 ½" x 11", 2-part NCR, Both parts white paper, red ink, boxed in 1000s.
3926L-R07: 8 ½"x 11", white laser stock, red ink, boxed in 1000s.
3926-S-R07: 8 ½" x 11", one-part continuous form, white paper, red ink, 1000 per case.