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 Form - Copies 2/2/B/C (Employee) - Condensed 4up Ver. 1 (Quadrants) (80071)
1099-INT 4pt - 3up Self-Mailer (QMINT054)
Self-Adhesive Business Card Holders (1002)
MA State Tax Envelope for Balance Due - 6" x 9" (MAB610)
CA State Estimate Tax Filing Envelope - 3-7/8" x 8-7/8" (CAEST10)
Large Single Window Envelope with Patriotic Design (CLNT9P10)
1099-DIV Kit 4pt - Preprinted with Self-Seal Envelope (DIVS4E)
1065 Tax Filing Envelope, Cincinnati OH - 9" x 12" (FOHP910)
Preprinted 1095-B Full Page Form w/Instructions (B95BFPREC05)