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: $89.00
Unit Qty: 1000
Unit: case
Overall Dimensions: 9-1/2”W x 11”H


Product Code: UB-04-3
Qty:

Description Freight, Returns & Sales Tax Policies
 
CMS 1450  Continuous 3 Parts

Products Frequently Bought Together
11 pt 2 Ply Color End Tab Folders Custom 6 Tab Fileback Set TAB Match Year Label ACS Sliding Lateral Track
Your Price: $240.00

Add Free Shipping
Your Price: $3.18

Add Free Shipping
Your Price: $13.95

Add
Your Price: $6,500.00

Add Free Shipping
11pt Reinforced Solid Color End Tab Folders <!004>Custom 6 Tab Fileback Set Year Label ACS Lateral Track Movable Shelving Systems
Times 2 Speed Cabinet Custom 6 Tab Divider Set Custom 8 Tab Poly Divider Set Month Label
Your Price: $4,500.00

Add
Your Price: $2.43

Add Free Shipping
Your Price: $4.69

Add Free Shipping
Your Price: $10.95

Add Free Shipping
Times 2 Speed Files <!004>Custom 6 Tab Divider Set <!010>Custom 8  Tab Poly Divider Set Month Label
Heavy Duty Vinyl Stick-On Pockets 14 pt Manila 2 Ply End Tab ALLERGY LABEL 11 pt Manila 2 Ply End Tab
Your Price: $55.95

Add Free Shipping
Your Price: $56.95

Add Free Shipping
Your Price: $10.95

Add Free Shipping
Your Price: $48.95

Add
Heavy Duty Vinyl Stick-On Pockets Heavy Duty 14 pt Manila 2 Ply End Tab Folder ALLERGY LABEL Sturdy Rigid 11 pt Manila 2 Ply End Tab Folder
36" Wide File Shelving Radiology Jacket Numeric Label Alpha Label Barkley Match
Your Price: $725.00

Add Free Shipping
Your Price: $185.00

Add Free Shipping
Your Price: $22.95

Add Free Shipping
Your Price: $13.95

Add
36 Single Entry Letter Size 4 Post Starter Unit Radiology Jacket Non-Color Coded Numeric Label Barkley FABKM Match
End Tab Expansion Pockets QuickStrip File Folder Labels, 6-up on 8.5 x 11 Sheet Outguides Medi-Clip/Docu-Clip
Your Price: $79.00

Add Free Shipping
Your Price: $185.00

Add Free Shipping
Your Price: $79.50

Add Free Shipping
Your Price: $49.95

Add Free Shipping
<!001>End Tab Expansion Pockets QuickStrip File Folder Labels, 6-up on 8.5 x 11 Sheet Outguides Docuclip  Fastener
Bilingual Privacy Patient Sign-In Double Ply Top Tab Pocket Poly Stick-On Pockets
Your Price: $85.95

Add Free Shipping
Your Price: $79.95

Add Free Shipping
Your Price: $45.95

Add Free Shipping
Bilingual Privacy Patient Sign-In Double Ply Top Tab Pocket Poly Stick-On Pockets

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)


$12.47
$525.00
$12.95