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| Price per Case of 500 | 2+ Cases | 5+ Cases | 10+ Cases | 20+ Cases |
| $24.61 | $21.39 | $20.30 | $20.00 | $19.81 |
| Volume Savings | 13.1% | 17.5% | 18.7% | 19.5% |
| Need 30+ Cases? Click here for Pricing | ||||
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:
| 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 |
| 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 |