Home >

UB-04 Hospital Claim Form (UB04CF)
UB-04 Hospital Claim Form (UB04CF)
 



Product Code: UB04CF

SELECT A QTY

QTY & PRICE (Scroll Down)*:


Description
 
The UB04 Hospital Claim Form contains a number of improvements and enhancements that include better alignment with the electronic HIPAA ASC X12N 837-Institutional Transaction Standard.
Specifications
  • UB-04 Hospital Claim Form (UB04CF)

Share your knowledge of this product with other customers... Be the first to write a review


W-2 Continuous Employee 3-pt (TSCW2EE053)
1099-INT Electronic Reporting Form 2pt - 3up Self-Mailer (MMPAINT052)
Preprinted 1095-C Full Page Form w/Instructions (B95CFPREC05)
MI State Tax Envelope for Refund - #10 (MIR410)
Past Due' Label (Orange) (ST09) $6.50
1099-NEC Prepr 4pt Kit SS Env-NECS4E
ME State Estimate Tax Envelope - 3-7/8" x 8-7/8" (MEEST10)
GA Federal Tax Filing Envelope for All Returns - 9" x 12" (FGA910)
1099-OID Form - Copy A (Federal) (BOIDFED05)