ComplyRight UB-04 Hospital Claim Form, 500 Forms/Pack (UB04LC5)
$29.39
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Highlights
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- Designed for hospitals to file a medical claim with the patient's insurance carrier
- One-part health insurance forms
- Printed with OCR dropout red ink on white paper
MADE IN AMERICA
ComplyRight UB-04 Hospital Claim Form, 500 Forms/Pack (UB04LC5)
Item #: 24614845Model #: UB04LC5
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$29.39
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Your product ComplyRight UB-04 Hospital Claim Form, 500 Forms/Pack (UB04LC5) Price is $29.39 | |||||
| Reviews | |||||
| Delivery Information | Delivery by Fri, Nov 07 | Free delivery by Tue, Nov 04 | Delivery by Tue, Nov 04 | Next-Day Delivery by tomorrow | Free delivery by Thu, Nov 06 |
| Available in my store | No | No | No | No | No |
| Medical Form Pack Size | 500 | 1000 | 100 | 250 | 25 |
| Width in Inches | 8.5 | 8.5 | 8.5 | 8.5 | 9.375 |
| Medical Form Type | Health Insurance Claims | Dental Claims | Dental Claims | Health Insurance Claims | Medical Records Folders |
| Length in Inches | 11 | 11 | 11 | 11 | 11.75 |
| Print Type | Laser | Laser | Laser | Laser | Data not available |
| Acid Free | Acid Free | Acid Free | Acid Free | Data not available | Data not available |
| Price Per Unit | Data not available | Data not available | Data not available | Data not available | Data not available |
| Add To Cart | Add To Cart | Add To Cart | Add To Cart |