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


1098-T Form - Copy C (Filer) (B98TPAY05)
Blank Envelope #9 (BLNKES10)
We Love Referrals!' Heart-Shaped Label (Red) (ST15) $5.04
NJ State Estimate Tax Envelope - 3-7/8" x 87/8" (NJEST10)
E-File Authorization Envelope (E024)
WV State Tax Envelope for Balance Due - #10 (WVB410)
TX Federal 1040A Envelope - #10 (FTXA10)
IA State Tax Estimate Envelope - #10 (IAEST10)
CA State Tax Envelope for Refunds - 6" x 9" (E701)