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


GA State Estimate Tax Envelope - 3-7/8" x 8-7/8" (GAEST10)
IN State Estimate Tax Envelope - 3-7/8" x 8-7/8" (INEST10)
1099-MISC Set 4pt - Preprinted (MISCS405)
1099-NEC 2up Federal Copy A-BNECFED05
w-2 condensed Laser set 8 part 4up (horizontal) condensed laser set (w24down805)
Form W-2 - Emp Copies 1/D - 4up Ver 1 Quadrants (80026)
W-2 & 1099 Blank Universal Form (B4PERF05)
SC State Tax Envelope for Refunds - #10 (SCR410)
MA State Tax Envelope for Refund - 6" x 9" (MARS610)