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UB-04 Hospital Claim Form Laser-Cut Sheet (500/case)

Item Number: UB04LC5
3 reviews

Pricing:

Price per
Case of 500
2+
Cases
5+
Cases
10+
Cases
20+
Cases

$24.61 $21.39$20.30$20.00$19.81

Volume Savings13.1%17.5%18.7%19.5%

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    Description:

    Make sure your medical office or healthcare facility has the right paperwork for your patients when you purchase UB-04 forms from The Supplies Shops. Each case includes 500 hospital claim form laser-cut sheets, so it’s easy to stock up on must-have documentation for medical billing purposes. Use these forms to note important details for inpatient and outpatient claims. Featuring red “dropout” ink, the forms are easy to scan and feature a design that conforms to the UB04 printing specifications accepted by major health insurance providers.

    Specifications:

    • UB-04 Hospital Claim Form Laser-Cut Sheet
    • Printed in OCR red "dropout" ink
    • 20# Environmental Paper Alliance (EPA) Recycled Paper (White)
    • 500/case
    Specifications:
    ASIN:B004GBYV3QBrand:ComplyRight
    Claim Type:HospitalColor:White
    Condition:NewCurrency:USD
    Form Number:UB-04Pre-Printed:Yes
    Package Weight:5.00 LBMaterial:Paper
    Country of Origin:USAManufacturer Part Number:UB04LC5
    Number of Items:500Paper Size:Letter
    Ships in:4 to 5 Business Days (Plus time in transit)Size:in
    Style:Laser Cut Sheet
    ASIN:B004GBYV3Q
    Brand:ComplyRight
    Claim Type:Hospital
    Color:White
    Condition:New
    Currency:USD
    Form Number:UB-04
    Pre-Printed:Yes
    Package Weight:5.00 LB
    Material:Paper
    Country of Origin:USA
    Manufacturer Part Number:UB04LC5
    Number of Items:500
    Paper Size:Letter
    Ships in:4 to 5 Business Days (Plus time in transit)
    Size:in
    Style:Laser Cut Sheet
    Reviews:
    5
    Out of 5.0
    Overall Rating
    100%
    of customers that
    buy this product give
    it a 4 or 5-Star rating.
    Five Star Excellence Award
    Verified Buyer
    March 29, 2019 by elizabeth b
    “Great product.”
    Verified Buyer
    July 9, 2018 by Mary W (FL, United States)
    “great price. fast shipping. better value”
    Verified Buyer
    August 22, 2017 by Paul L (IL, United States)
    “Extremely fast service.”

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