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


CA Federal 1040 Tax Filing Envelope - All Tax Returns - #10 (4352)
1099-MISC Kit 5pt - Preprinted Forms with Self-Seal Envelopes (MISCS5E)
1099-OID Form - Copy A (Federal) (BOIDFED05)
1098 Forms - 3-part Carbonless Mortgage Interest Statement (C1098053)
AL State Tax Estimate Envelope - 3-7/8" x 8-7/8" (ALEST10)
1099-PATR Form - Copy B (Recipient) (BPATRRC05)
1099-CAP Form - Copy A (Federal) (BCAPFED05)
DENTAL FORM, PATIENT DOCUMENTATION OF ALL TREATMENTS,DF9124
Double Window Envelope - Self Seal - 9 1/2 " x 12" (C80596)