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


1099-B 2up Proceeds from Broker and Barter Transactions - 4 part Carbonless (CB054)
IA State Tax Estimate Envelope - #10 (IAEST10)
REVISED GOOD FAITH ESTIMATE
MO StateTax Envelope for Refunds - #10 (MOR410)
1040 Tax Return Envelope "Stars" - Peel & Close Flap (CLNT9FPS10)
GA State Tax Filing Envelope for Refunds - 6" x 9" 2-D barcode (GARS610)
W-2 Employer 3-pt (TSCW2ER053)
1099-OID Form - Copy B (Recipient) (BOIDREC05)
CA State Estimate Tax Filing Envelope - 3-7/8" x 8-7/8" (CAEST10)