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


Form 1099-INT Interest Income - State Copy 1 Payer (BINT105)
Self-Adhesive Business Card Holders (1002)
1120 Tax Filing Envelope, Ogden UT - 6" x 9" (FUTC610)
Double Window Tax Return Envelope 11-1/2" x 9-1/2" (landscape) - Peel-and-Close (ENV400PS)
ME State Estimate Tax Envelope - 3-7/8" x 8-7/8" (MEEST10)
1099-MISC Miscellaneous Income Preprinted 3pt Kit with Tamper Evident Envelopes (MISCS3TE) 25 filings $45.00
NE State Estimate Tax Envelope - 3-7/8" x 87/8" (NEEST10)
1120-S Tax Filing Envelope, Cincinnati OH - 9" x 12" (FOHSC910)
Past Due' Label (Orange) (ST09) $6.50