Home > MEDICAL / CHIROPRACTIC > Medical Forms > CMS, UB-04,ADA-Medical Claim > UB-04 Claim Forms >

UB-04 Claim Form
UB-04 Claim Form
 
Your Price: $51.00
Unit Qty: 2500
Unit: case
Overall Dimensions: 9-1/2”W x 11”H


Product Code: UB-04-1
Qty:

Description Freight, Returns & Sales Tax Policies
 
CMS 1450 Continuous 1 Part

Products Frequently Bought Together
Numeric Label 36" Wide File Shelving QuickStrip File Folder Labels, 6-up on 8.5 x 11 Sheet Custom 6 Tab Fileback Set
Your Price: $22.95

Add Free Shipping
Your Price: $725.00

Add Free Shipping
Your Price: $185.00

Add Free Shipping
Your Price: $3.18

Add Free Shipping
Numeric Label 36 Single Entry Letter Size 4 Post Starter Unit QuickStrip File Folder Labels, 6-up on 8.5 x 11 Sheet <!004>Custom 6 Tab Fileback Set
Double Ply Top Tab Pocket Radiology Jacket Month Label TAB Match Year Label
Your Price: $79.95

Add Free Shipping
Your Price: $185.00

Add Free Shipping
Your Price: $10.95

Add Free Shipping
Your Price: $13.95

Add
Double Ply Top Tab Pocket Radiology Jacket Non-Color Coded Month Label Year Label
Bilingual Privacy Patient Sign-In Custom 6 Tab Divider Set Heavy Duty Vinyl Stick-On Pockets Times 2 Speed Cabinet
Your Price: $85.95

Add Free Shipping
Your Price: $2.43

Add Free Shipping
Your Price: $55.95

Add Free Shipping
Your Price: $4,500.00

Add
Bilingual Privacy Patient Sign-In <!004>Custom 6 Tab Divider Set Heavy Duty Vinyl Stick-On Pockets Times 2 Speed Files
Outguides Medi-Clip/Docu-Clip End Tab Expansion Pockets Custom 8 Tab Poly Divider Set
Your Price: $79.50

Add Free Shipping
Your Price: $49.95

Add Free Shipping
Your Price: $79.00

Add Free Shipping
Your Price: $4.69

Add Free Shipping
Outguides Docuclip  Fastener <!001>End Tab Expansion Pockets <!010>Custom 8  Tab Poly Divider Set
11 pt 2 Ply Color End Tab Folders 14 pt Manila 2 Ply End Tab 11 pt Manila 2 Ply End Tab Poly Stick-On Pockets
Your Price: $240.00

Add Free Shipping
Your Price: $56.95

Add Free Shipping
Your Price: $48.95

Add
Your Price: $45.95

Add Free Shipping
11pt Reinforced Solid Color End Tab Folders Heavy Duty 14 pt Manila 2 Ply End Tab Folder Sturdy Rigid 11 pt Manila 2 Ply End Tab Folder Poly Stick-On Pockets
ACS Sliding Lateral Track Alpha Label Barkley Match ALLERGY LABEL
Your Price: $6,500.00

Add Free Shipping
Your Price: $13.95

Add
Your Price: $10.95

Add Free Shipping
ACS Lateral Track Movable Shelving Systems Barkley FABKM Match ALLERGY LABEL

Share your knowledge of this product with other customers... Be the first to write a review

Browse for more products in the same category as this item:

MEDICAL / CHIROPRACTIC > Medical Forms > CMS, UB-04,ADA-Medical Claim > UB-04 Claim Forms
DENTAL > Dental Forms > Dental Claim (ADA & CMS) > UB-04 Claim Forms
Medical Forms and Books > Medical Claim Forms (CMS, HCFA, UB92) > UB-04 Claim Forms
MEDICAL / CHIROPRACTIC > Medical Forms > CMS, UB-04,ADA-Medical Claim
DENTAL > Dental Forms > Dental Claim (ADA & CMS)
Medical Forms and Books > Medical Claim Forms (CMS, HCFA, UB92)
MEDICAL / CHIROPRACTIC > Medical Forms
DENTAL > Dental Forms
Medical Forms and Books

Product price is not filled in. This product cannot be purchased.



$16.95
$14.95
$24.95
$10.95