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


HCFA ENVELOPE, HC10RG
SC State Tax Envelope for Refunds - #10 (SCR410)
1099-MISC Set 4pt - Preprinted (MISCS405)
1094-C Employer Health Transmittal Kit (B1094CS05)
1099-PATR Form - Copy B (Recipient) (BPATRRC05)
1099-MISC Miscellaneous Income Preprinted 3pt Kit with Tamper Evident Envelopes (MISCS3TE) 25 filings $45.00
1099-INT Interest Income - Copy B Recipient (BINTREC05) (BINTREC05)
Expandable Conformer Folder - Blue Linen (CONFLDRXX)
Blank Envelope #10 (4 1/8 x 9 1/2) (4697)