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-R Set 8-part - 4up Blank (R4UPSET805)
GA State Estimate Tax Envelope - 3-7/8" x 8-7/8" (GAEST10)
1099-MISC Kit 5pt - Preprinted Forms with Self-Seal Envelopes (MISCS5E)
Prompt Payment is Appreciated' Label (Yellow) (ST10) $5.04
1040ES Tax Filing Envelope to Hartford, CT (ESCT210)
1099-INT Electronic Reporting Form 2pt - 3up Self-Mailer (MMPAINT052)
W-2 Blank 4up Form Ver. 2 (Horizontal) with Instructions (4DWNPERF05)
IN State Estimate Tax Envelope - 3-7/8" x 8-7/8" (INEST10)
MA State Estimate Tax Envelope - 3-7/8" x 8-7/8" (MAEST10)