Shopping Cart

0 item(s) in cart/ total: $0    view cart
Home > Claim Forms CMS/UB04/ADA  >  UB-04 Forms, Laser, 8.5 x 11
UB-04 Forms, Laser, 8.5 x 11
Laser UB-04 Form

UB-04 Forms, Laser, 8.5 x 11

review
1 Review(s)
5
 | Questions about this item? Be the first to ask here.
Your Price:$36.95
In Stock.
Part Number:WEB-NLCF-UB04-1
Quantity Pricing
Quantity
Price
  • 5 - 9
  • $34.95
  • 10 - 19
  • $33.95
  • 20+
  • $32.95
Laser- 8 1/2" x 11" for laser or inkjet printers
Box quantity: 2500

Printed in red, OCR scannable ink in compliance with government standards
Medicare approved for billing Medicare Part A claims
5 Stars
accounting assistant
good
Did you find this helpful?  1 of 1 Found Helpful
Reviewed by: (Verified Buyer)  from oakland. on 11/17/2015
5/5

Related Items

CMS-1500 Form (New 02/12 version), Laser, 8.5 x 11, 2500/bx
CMS-1500 Form (New 02/12 version), Laser, 8.5 x 11, 2500/bx
Average Rating(6)
$36.95
In Stock.
Jumbo UB-04 Envelope, Left Window, Self Seal- BLANK 500/bx
Jumbo UB-04 Envelope, Left Window, Self Seal- BLANK 500/bx
$82.00
In Stock.
CMS-1500 Form (New 02/12 version), Unit Set, 8.5 x 11
CMS-1500 Form (New 02/12 version), Unit Set, 8.5 x 11
$35.00
In Stock.
CMS-1500 Form (New 02/12 version), 1 Part Continuous, 2500/box
CMS-1500 Form (New 02/12 version), 1 Part Continuous, 2500/box
$31.95
In Stock.
Jumbo CMS-1500 Envelope, Right Window, Self Seal- BLANK 100/pk
Jumbo CMS-1500 Envelope, Right Window, Self Seal- BLANK 100/pk
$24.95
In Stock.
NEW 2019 Dental Claim Form Laser 1 part version 2500 per carton
NEW 2019 Dental Claim Form Laser 1 part version 2500 per carton
$39.95
Out of Stock.

Recently Viewed Items

Browse Similar Items