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


1120 Tax Filing Envelope, Ogden UT - 6" x 9" (FUTC610)
OK State Estimate Tax Envelope - 3-7/8" x 8-7/8" (OKEST10)
Double Window Tax Return Envelope 10" x 13" (landscape) Peel & Close (ENV201PS)
CA State Tax Filing Envelope for Balance Due - 9" x 12" (CAB910)
Blank Envelope #9 (BLNKES10)
SC State Tax Envelope for Balance Due - #10 (SCB410)
W-2 Envelope - 3up Double Window with Self Seal (1973S)
First Class Envelope with Single Window for 1040 Forms - Moisture Seal Flap (CLNT910)
NJ State Estimate Tax Envelope - 3-7/8" x 87/8" (NJEST10)