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Item Number: UB04LC

Pricing:

Price per
Case of 2500
2+
Cases
5+
Cases
10+
Cases
20+
Cases
$94.27 $91.67$89.72$87.89$77.73
Savings2.8%4.8%6.8%17.5%

3 reviews

Make sure your medical billing procedures adhere to universal standards with these UB-04 Hospital Claim Forms from The Supplies Shops. The UB-04 is the uniform medical billing form that is standardized across the entire healthcare industry. It ensures that any inpatient or outpatient claims are billed correctly, which is why it’s so important to have high-quality UB-04s in stock in your office. Printed with red “dropout” ink, this form is a must-have for any healthcare setting and will deliver the excellent quality you want for your patient records.

  • UB-04 Hospital Claim Form Laser-Cut Sheets
  • Printed in OCR red "dropout" ink
  • White 20# Environmental Paper Alliance (EPA) Recycled Paper
  • 2,500/case
ASIN:B004GBTNXO
Brand:TFP Data Systems
Claim Type:Hospital
Color:White
Condition:New
Currency:USD
Form Number:UB-04
Holes Punched:No
Pre-Printed:Yes
Package Weight:25.00 LB
Material:Paper
Country of Origin:USA
Manufacturer Part Number:UB04LC
Number of Items:2500
Numbered:No
Paper Size:Letter
Ships in:4 to 5 Business Days (Plus time in transit)
Size:in
Style:Laser Cut Sheet