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


Blank Envelope #9 (BLNKES10)
4up Blank W-2 & 1099 Form - Quadrants (4UPPERF05)
Client Copy Tax Return Cover (TAXCVRX)
NJ State Estimate Tax Envelope - 3-7/8" x 87/8" (NJEST10)
1065 Tax Filing Envelope, Cincinnati OH - 9" x 12" (FOHP910)
Double Window Tax Organizer Envelope 11-1/2" x 9" (landscape) (LA100)
1099-S Form 4-part - 3up Self Mailer (QMS053)
Client Copy Tax Return Folder with Pockets (8784)
1099-NEC Preprinted 5-part Kit with Moisture Seal Envelopes-NECS5EG