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


Embossed Income Tax Return Folder with Pockets - Oversized (FOLDER5LGX)
SC State Tax Envelope for Refunds - #10 (SCR410)
W-2 Blank 4up Form Ver. 1 (Quadrants) with Instructions - 24# paper (4UP24
UT Federal Tax Filing Envelope for All Returns - 6" x 9" (FUT610)
WI State Homestead Tax Envelope - #10 (WIH410)
ME State Estimate Tax Envelope - 3-7/8" x 8-7/8" (MEEST10)
1040ES Tax Filing Envelope to Hartford, CT (ESCT210)
HCFA ENVELOPE, HC10RG
DENTAL FORM, DF9152