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


1065 Tax Filing Envelope, Cincinnati OH - 9" x 12" (FOHP910)
MI State Estimate Tax Envelope - 3-7/8" x 8-7/8" (MIEST10)
1099-LTC 4-part - 3up Carbonless (CLTC054)
Form W-2 - Emp Copies 1/D - 4up Ver 1 Quadrants (80026)
IN State Estimate Tax Envelope - 3-7/8" x 8-7/8" (INEST10)
TX Federal Tax Filing Envelope for All Returns - 9" x 12" (FTX910)
W-2 Double Window Envelope - 4up Ver. 1 (DWR4)
DENTAL FORM, PATIENT DOCUMENTATION OF ALL TREATMENTS,DF9124
Prompt Payment is Appreciated' Label (Yellow) (ST10) $5.04