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


Double Window Envelope - Self Seal - 9 1/2 " x 12" (C80596)
W-2 Set 8-part - Preprinted Condensed 2up (W2COMBS805)
1099-OID Form - Copy A (Federal) (BOIDFED05)
Prompt Payment is Appreciated' Label (Yellow) (ST10) $5.04
Tax Folder with Top-Staple Tabs and Offset Windows (50D)