To take full advantage of this site, please enable your browser's JavaScript feature.
Learn how
Search
Categories
Tax Products
ACA Forms - 1094 & 1095
Tax Presentation Materials
Tax Folders
Tax Envelopes
Tax Preparation Supplies
Greeting Cards & Postcards
1099 & W-2 TAX REPORTING
NEW 1099-NEC FORMS & KITS
1099 Tax Forms & Envelopes
W2 Tax Forms & Envelopes
941 & Other Wage Reporting Forms
Real Estate Supplies/Mortgage
Stock Mortgage Supplies
Mortgage File Folder Organizers
REAL ESTATE SUPPLIES
REAL ESTATE FOLDERS-LETTER SIZE
REAL ESTATE FOLDERS-LEGAL SIZE
CHECKS SUPPLIES
CHECK ENVELOPES
PROMOTIONAL PRODUCTS
SEARCH PROMOTIONAL PRODUCTS
Toggle navigation
Join Our Email List for Monthly Specials
Home
My Account
Contact Us
About Us
Cart
0
Search
Categories
Tax Products
ACA Forms - 1094 & 1095
Tax Presentation Materials
Tax Folders
Tax Envelopes
Tax Preparation Supplies
Greeting Cards & Postcards
1099 & W-2 TAX REPORTING
NEW 1099-NEC FORMS & KITS
1099 Tax Forms & Envelopes
W2 Tax Forms & Envelopes
941 & Other Wage Reporting Forms
Real Estate Supplies/Mortgage
Stock Mortgage Supplies
Mortgage File Folder Organizers
REAL ESTATE SUPPLIES
REAL ESTATE FOLDERS-LETTER SIZE
REAL ESTATE FOLDERS-LEGAL SIZE
CHECKS SUPPLIES
CHECK ENVELOPES
PROMOTIONAL PRODUCTS
SEARCH PROMOTIONAL PRODUCTS
Home
>
UB-04 Hospital Claim Form (UB04CF)
Alternative Views:
Product Code:
UB04CF
SELECT A QTY
QTY & PRICE (Scroll Down)
*
:
Qty 1000 [Add $17.70]
Qty 2500 [Add $44.25]
Qty 5000 [Add $88.50]
Qty 10,000 [Add $177.00]
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
2up 1099-MISC Miscellaneous Income 4-part - Carbonless (CMIS054)
W-2 Double Window Envelope - 4up Ver. 1 (DWR4)
First Class Mail Single Window Envelope - Peel & Close (80925)
OR State Tax E-file Envelope - #10 (OREF410)
W-2 - Copy C - Employee Record - 2up (BW2EEC05)
Redi-Tags - Mail to Local/City (Blue) (CTLCENV14)
$12.00
DENTAL FORM, PATIENT DOCUMENTATION OF ALL TREATMENTS,DF9124
TX Federal 1040 Envelope for Returns without Payment - #10 (FTXRF10)
IL State Tax Envelope for Balance Due - 6" x 9" (ILB610)