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


1040V Tax Envelope Atlanta, GA - 9" x 12" (VGA9210)
UT State Tax Envelope for Refunds - #10 (UTR410)
w-2 condensed Laser set 8 part 4up (horizontal) condensed laser set (w24down805)
GA 1040EZ Tax Envelope - #10 (FGAEZ10)
CA State Tax Filing Envelope for Refund - 9" x 12" Scannable (CAR910)
1099-DIV Kit 4pt with Moisture-Seal Envelopes (DIVS4EG)
W-2 - Copy A - 2up (BW2FED05)
1098-T Pressure Seal Form - 11" Z-Fold (80736)
Prompt Payment is Appreciated' Label (Yellow) (ST10) $5.04