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-S Form 4-part - 3up Self Mailer (QMS053)
Blank Envelope #9 (BLNKES10)
Tax Folder with Top-Staple Tabs and Offset Windows (50D)
1099-LTC 4-part - 3up Carbonless (CLTC054)
IA State Tax Estimate Envelope - #10 (IAEST10)
GA State Estimate Tax Envelope - 3-7/8" x 8-7/8" (GAEST10)
SC State Tax Envelope for Balance Due - #10 (SCB410)
1120 Tax Filing Envelope, Ogden UT - 6" x 9" (FUTC610)
REVISED GOOD FAITH ESTIMATE