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


Form 1099-R Distributions From Pensions, etc. - Recipient Copy 4up Quadrant (LR4UP)
1099-DIV Dividends and Distributions - Copy B Recipient (BDIVREC05)
1099-MISC Set 4pt - Preprinted (MISCS405)
We Love Referrals!' Heart-Shaped Label (Red) (ST15) $5.04
1099-MISC Kit 5pt - Preprinted Forms with Self-Seal Envelopes (MISCS5E)
LA State Estimate Tax Envelope - 3-7/8" x 8-7/8" (LAEST10)
1099-MISC Kit 3pt - Preprinted Forms with Self-Seal Envelopes (MISCS3E)
1099-OID Form - Copy A (Federal) (BOIDFED05)
WI State Estimate Tax Envelope - 3-7/8" x 8-7/8" (WIEST10)