UB-04 (UB92) 4 part continuous GROUND FREIGHT PAID WITHIN THE 48 CONTIGUOUS UNITED STATES (If you are outside the 48 contiguous United States please call 800-841-0200 or 912-437-3192 to place your order- shipping costs for you must be calculated separately.) FOR QUANTITY PRICING OR EXPEDITED OR SPECIALTY SHIPPING COSTS MUST BE CALCULATED SEPARATELY - CALL 800-841-0200 BE SURE TO BOOKMARK THIS PAGE FOR YOUR RETURN VISIT :) 4 PART UB-04500 SETS PER CASE 4 PART UB04 (31-0974)$47.80, 3/$138.00, 8/$360.00, 10/$420.00 MEDICAL CLAIM FORM ENVELOPES RETURN