To take full advantage of this site, please enable your browser's JavaScript feature.
Learn how
Search
Categories
Tax Products
ACA Forms - 1094 & 1095
Tax Presentation Materials
Tax Folders
Tax Envelopes
Tax Preparation Supplies
Greeting Cards & Postcards
1099 & W-2 TAX REPORTING
NEW 1099-NEC FORMS & KITS
1099 Tax Forms & Envelopes
W2 Tax Forms & Envelopes
941 & Other Wage Reporting Forms
Real Estate Supplies/Mortgage
Stock Mortgage Supplies
Mortgage File Folder Organizers
REAL ESTATE SUPPLIES
REAL ESTATE FOLDERS-LETTER SIZE
REAL ESTATE FOLDERS-LEGAL SIZE
CHECKS SUPPLIES
CHECK ENVELOPES
PROMOTIONAL PRODUCTS
SEARCH PROMOTIONAL PRODUCTS
Toggle navigation
Join Our Email List for Monthly Specials
Home
My Account
Contact Us
About Us
Cart
0
Search
Categories
Tax Products
ACA Forms - 1094 & 1095
Tax Presentation Materials
Tax Folders
Tax Envelopes
Tax Preparation Supplies
Greeting Cards & Postcards
1099 & W-2 TAX REPORTING
NEW 1099-NEC FORMS & KITS
1099 Tax Forms & Envelopes
W2 Tax Forms & Envelopes
941 & Other Wage Reporting Forms
Real Estate Supplies/Mortgage
Stock Mortgage Supplies
Mortgage File Folder Organizers
REAL ESTATE SUPPLIES
REAL ESTATE FOLDERS-LETTER SIZE
REAL ESTATE FOLDERS-LEGAL SIZE
CHECKS SUPPLIES
CHECK ENVELOPES
PROMOTIONAL PRODUCTS
SEARCH PROMOTIONAL PRODUCTS
Home
>
UB-04 Hospital Claim Form (UB04CF)
Alternative Views:
Product Code:
UB04CF
SELECT A QTY
QTY & PRICE (Scroll Down)
*
:
Qty 1000 [Add $17.70]
Qty 2500 [Add $44.25]
Qty 5000 [Add $88.50]
Qty 10,000 [Add $177.00]
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
E-File Authorization Envelope (E024)
1099-MISC Kit 5pt - Preprinted Forms with Self-Seal Envelopes (MISCS5E)
1120 Tax Filing Envelope, Ogden UT - 6" x 9" (FUTC610)
REVISED GOOD FAITH ESTIMATE
1099 Double Window Envelope 3-up - Tamper Evident (99DWENVSTE)
W-2 Set - 2up Preprinted for up to 50 filings with envelopes - 6 part (W2TRD6E50)
$59.70
2015 W-4 Emp'ee W/H Cert pg1&2
4up Preprinted W-2 Forms - Ver. 2 - Horizontal (80483)
2up 1099-OID Original Issue Discount 4-part - Carbonless (COID054)