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


1099-INT 4pt - 3up Self-Mailer (QMINT054)
UT State Tax Envelope for Balance Due - #10 (UTB410)
1099-DIV Kit 3pt with Moisture-Seal Envelopes (DIVS3EG)
SC State Tax E-file Envcelope - #10 (SCEF410)
CA State Tax Filing Envelope for Balance Due - 6" x 9" (CAB610)
1099-C Cancellation of Debt - 3up - 4 Part - Carbonless (CC054)
OR State Tax Envelope for Balance Due - #10 (ORB610)
Double Window "First Class Mail" Envelope 9-1/2" x 12" - Peel & Close (80922)
AZ State Tax Estimate Envelope - 3-7/8" x 8-7/8" (AZEST10)