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


Post It Notes - Filing Instructions (Yellow) (2237) $12.70
W-2c Form - Copy 2 - Employee State/City/Local (80077)
SC State Tax Envelope for Balance Due - #10 (SCB410)
Offset Window Tax Envelope 9-5/8" x 11-5/8" - Peel & Close (80385)
W-2 Form - Copies B/2/C/2 (Employee) - 4up Ver. 2 for High-Speed Processing Equipment (B4DWNEMP)
RI State Tax Envelope for Refunds - 6" x 9" (RIR610)
1040V Tax Envelope Hartford, CT - #10 (VCT210)
First Class Mail Envelope with Single Window (LA700)
W-2 & 1099 Complete Kit for Up to 150 Filings (9975) $137.93