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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 |
| $26.22 | $22.23 | $20.73 | $20.42 | $20.26 |
| Volume Savings | 15.2% | 20.9% | 22.1% | 22.7% |
| Need 30+ Cases? Click here for Pricing | ||||
Customers also Purchased
Customers also Purchased...
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: | 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 |
Reviews:
5
Out of 5.0
Overall Rating
100%
of customers that buy this product give
it a 4 or 5-Star rating.
March 29, 2019 by elizabeth b
“Great product.”
July 9, 2018 by Mary W (FL, United States)
“great price. fast shipping. better value”
August 22, 2017 by Paul L (IL, United States)
“Extremely fast service.”
