To take full advantage of this site, please enable your browser's JavaScript feature.
Learn how
Search
Categories
Tax Products
ACA Forms - 1094 & 1095
Tax Presentation Materials
Tax Folders
Tax Envelopes
Tax Preparation Supplies
Greeting Cards & Postcards
1099 & W-2 TAX REPORTING
NEW 1099-NEC FORMS & KITS
1099 Tax Forms & Envelopes
W2 Tax Forms & Envelopes
941 & Other Wage Reporting Forms
Real Estate Supplies/Mortgage
Stock Mortgage Supplies
Mortgage File Folder Organizers
REAL ESTATE SUPPLIES
REAL ESTATE FOLDERS-LETTER SIZE
REAL ESTATE FOLDERS-LEGAL SIZE
CHECKS SUPPLIES
CHECK ENVELOPES
PROMOTIONAL PRODUCTS
SEARCH PROMOTIONAL PRODUCTS
Toggle navigation
Join Our Email List for Monthly Specials
Home
My Account
Contact Us
About Us
Cart
0
Search
Categories
Tax Products
ACA Forms - 1094 & 1095
Tax Presentation Materials
Tax Folders
Tax Envelopes
Tax Preparation Supplies
Greeting Cards & Postcards
1099 & W-2 TAX REPORTING
NEW 1099-NEC FORMS & KITS
1099 Tax Forms & Envelopes
W2 Tax Forms & Envelopes
941 & Other Wage Reporting Forms
Real Estate Supplies/Mortgage
Stock Mortgage Supplies
Mortgage File Folder Organizers
REAL ESTATE SUPPLIES
REAL ESTATE FOLDERS-LETTER SIZE
REAL ESTATE FOLDERS-LEGAL SIZE
CHECKS SUPPLIES
CHECK ENVELOPES
PROMOTIONAL PRODUCTS
SEARCH PROMOTIONAL PRODUCTS
Home
>
UB-04 Hospital Claim Form (UB04CF)
Alternative Views:
Product Code:
UB04CF
SELECT A QTY
QTY & PRICE (Scroll Down)
*
:
Qty 1000 [Add $17.70]
Qty 2500 [Add $44.25]
Qty 5000 [Add $88.50]
Qty 10,000 [Add $177.00]
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
W-2 Blank 4up Form Ver. 2 (Horizontal) with Instructions (4DWNPERF05)
4up Preprinted W-2 Forms - Ver. 1 - Quadrants (80481)
Estimate Envelope - Maryland #9 (MDEST10)
DENTAL FORM, DF9152
OR State Tax Envelope for Refunds - 6" x 9" (ORR610)
1094-C Employer Health Transmittal Kit (B1094CS05)
1098 Forms - 3-part Carbonless Mortgage Interest Statement (C1098053)
Redi-Tags - Pls Sign & Date (Yellow) (3192)
$74.00
1099-MISC Kit 4pt - Preprinted Forms with Self-Seal Envelopes (MISCS4E)
