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UB-04 Hospital Claim Form for Dot-Matrix Printers, 4-Part
UB-04 Hospital Claim Form for Dot-Matrix Printers, 4-Part

UB-04 Hospital Claim Form for Dot-Matrix Printers, 4-Part

Price:
$72.99
500/Box

Currently Out of Stock.

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  • Item: 683685
  • Model: UB044
57.99Easily file a medical claim with a patient's insurance carrierFile a hard copy of each claim with patient records in case you need to resubmit a claimAvailable in one, two, three and four-part formsUB-04 Hospital Claim Form for Dot-Matrix Printershttp://s7d5.scene7.com/is/image/Staples/s0200809_sc7?$std$http://s7d5.scene7.com/is/image/Staples/s0200809_sc7?$thb$http://s7d5.scene7.com/is/image/Staples/s0200809/UB-04-Hospital-Claim-Form-for-Dot-Matrix-Printers/product_SS1034853UB-04 Hospital Claim Form for Dot-Matrix Printers0.00 57.99Easily file a medical claim with a patient's insurance carrierFile a hard copy of each claim with patient records in case you need to resubmit a claim1-Part formsUB-04 Hospital Claim Form for Dot-Matrix Printers, 1-Parthttp://s7d5.scene7.com/is/image/Staples/s0200809_sc7?$std$http://s7d5.scene7.com/is/image/Staples/s0200809_sc7?$thb$http://s7d5.scene7.com/is/image/Staples/s0200809/UB-04-Hospital-Claim-Form-for-Dot-Matrix-Printers-1-Part/product_683688UB-04 Hospital Claim Form for Dot-Matrix Printers, 1-Part0.00 62.99Easily file a medical claim with a patient's insurance carrierFile a hard copy of each claim with patient records in case you need to resubmit a claim2-Part formsUB-04 Hospital Claim Form for Dot-Matrix Printers, 2-Parthttp://s7d5.scene7.com/is/image/Staples/s0200809_sc7?$std$http://s7d5.scene7.com/is/image/Staples/s0200809_sc7?$thb$http://s7d5.scene7.com/is/image/Staples/s0200809/UB-04-Hospital-Claim-Form-for-Dot-Matrix-Printers-2-Part/product_683687UB-04 Hospital Claim Form for Dot-Matrix Printers, 2-Part0.00 109.99Easily file a medical claim with a patient's insurance carrierFile a hard copy of each claim with patient records in case you need to resubmit a claim3-Part formsUB-04 Hospital Claim Form for Dot-Matrix Printers, 3-Parthttp://s7d5.scene7.com/is/image/Staples/s0200809_sc7?$std$http://s7d5.scene7.com/is/image/Staples/s0200809_sc7?$thb$http://s7d5.scene7.com/is/image/Staples/s0200809/UB-04-Hospital-Claim-Form-for-Dot-Matrix-Printers-3-Part/product_683686UB-04 Hospital Claim Form for Dot-Matrix Printers, 3-Part0.00 72.99Easily file a medical claim with a patient's insurance carrierFile a hard copy of each claim with patient records in case you need to resubmit a claim4-Part formsUB-04 Hospital Claim Form for Dot-Matrix Printers, 4-Parthttp://s7d5.scene7.com/is/image/Staples/s0200809_sc7?$std$http://s7d5.scene7.com/is/image/Staples/s0200809_sc7?$thb$http://s7d5.scene7.com/is/image/Staples/s0200809/UB-04-Hospital-Claim-Form-for-Dot-Matrix-Printers-4-Part/product_683685UB-04 Hospital Claim Form for Dot-Matrix Printers, 4-Part0.00

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  • Easily file a medical claim with a patient's insurance carrier
  • File a hard copy of each claim with patient records in case you need to resubmit a claim
  • 4-Part forms
  • Continuous forms, compatible with Dot-Matrix printers
Parts CD, 16x Max*
Quantity 500/Box
Model # UB044
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UB-04 Hospital Claim Form for Dot-Matrix Printers, 3-Part

UB-04 Hospital Claim Form for Dot-Matrix Printers, 3-Part

Price:$109.991,000/Box
Add to Favorites
  • Item qualifies for free delivery
  • Expected Delivery 7-14 Business Days
  • Item qualifies for free delivery to a store near you. (Learn more)
  • Delivery Only
  • Item: 683686
  • Model: UB043


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