Logo
Adams UB-04 Continuous Hospital Insurance Claim Form, 1 Part, Laser, 8.5 x 11 Inches, 2500 Sets per Carton, White (59870R)

Adams UB-04 Continuous Hospital Insurance Claim Form, 1 Part, Laser, 8.5 x 11 Inches, 2500 Sets per Carton, White (59870R)

ADVERTISEMENT

Compare Buying Options

  • Tops Ub-04 Hospital Claim Form - 1 Part - 11" X 8.50" Form Size - 2500
    177.52
    eBay

    Tops Ub-04 Hospital Claim Form - 1 Part - 11" X 8.50" Form Size - 2500

    Delivery date & cost shown at checkout

  • Tops Ub04 Hospital Insurance Claim Form 8 1/2 X 11 Laser Printer 2500
    124.23
    eBay

    Tops Ub04 Hospital Insurance Claim Form 8 1/2 X 11 Laser Printer 2500

    Delivery date & cost shown at checkout

  • Ub-04 Claim Form, Cms-1450 Hospital Claim Form, 8-1/2 X 11", Pack Of
    21.99
    eBay

    Ub-04 Claim Form, Cms-1450 Hospital Claim Form, 8-1/2 X 11", Pack Of

    Delivery date & cost shown at checkout

  • TOPS UB04 Hospital Insurance Claim Form, 8.5 x 11, 1/Page, 2,500 Forms (TOP59870R)
    223.44
    ReStockIt

    TOPS UB04 Hospital Insurance Claim Form, 8.5 x 11, 1/Page, 2,500 Forms (TOP59870R)

    Delivery date & cost shown at checkout

  • TOPS UB04 Hospital Insurance Claim Form, 8.5 x 11, 1/Page, 2,500 Forms (59870R)
    175.28
    Bluedogink

    TOPS UB04 Hospital Insurance Claim Form, 8.5 x 11, 1/Page, 2,500 Forms (59870R)

    Delivery date & cost shown at checkout

  • Tops Ub04 Hospital Insurance Claim Form, 8-1/2 X 11, 2,500 Forms
    155.56
    Ace Office Machines

    Tops Ub04 Hospital Insurance Claim Form, 8-1/2 X 11, 2,500 Forms

    Delivery date & cost shown at checkout

  • UB04 Hospital Insurance Claim Form for Laser Printers, One-Part (No Copies), 8.5 x 11, 2,500 Forms Total
    188.41
    AllianceSupply.com

    UB04 Hospital Insurance Claim Form for Laser Printers, One-Part (No Copies), 8.5 x 11, 2,500 Forms Total

    Delivery date & cost shown at checkout

  • Adams UB-04 Continuous Hospital Insurance Claim Form, 1 Part, Laser, 8.5 x 11 Inches, 2500 Sets per Carton, White (59870R)
    103.52
    Amazon.com

    Adams UB-04 Continuous Hospital Insurance Claim Form, 1 Part, Laser, 8.5 x 11 Inches, 2500 Sets per Carton, White (59870R)

    Delivery date & cost shown at checkout

  • Tops 59870R UB04 Hospital Insurance Claim Form, 8-1/2 x 11, 2,500 Forms
    184.99
    Newegg.com

    Tops 59870R UB04 Hospital Insurance Claim Form, 8-1/2 x 11, 2,500 Forms

    Delivery date & cost shown at checkout

  • UB-04 Claim Form, CMS-1450
    20.99
    Nordisco

    UB-04 Claim Form, CMS-1450

    Delivery date & cost shown at checkout

  • TOPS UB-04 Forms, 1 Part, White, 8 1/2" x 11", Box Of 2,500
    261.49
    Office Depot

    TOPS UB-04 Forms, 1 Part, White, 8 1/2" x 11", Box Of 2,500

    Delivery date & cost shown at checkout

  • Tops UB-04 Hospital Claim Form 59870R
    185.32
    compsource.com

    Tops UB-04 Hospital Claim Form 59870R

    Delivery date & cost shown at checkout

  • Tops UB04 Hospital Insurance Claim Form - TOP59870R at Shoplet
    140.16
    Shoplet

    Tops UB04 Hospital Insurance Claim Form - TOP59870R at Shoplet

    Delivery date & cost shown at checkout

  • TOPS 1-part UB-04 Laser-cut Forms - 1 Part - 11" x 8.50" Form Size - Red Print Color - 2500 / Carton
    255.15
    ForMyDesk.com

    TOPS 1-part UB-04 Laser-cut Forms - 1 Part - 11" x 8.50" Form Size - Red Print Color - 2500 / Carton

    Delivery date & cost shown at checkout

  • UB04 Hospital Insurance Claim Form for Laser Printers, One-Part (No Copies), 8.5 x 11, 2,500 Forms Total
    337.80
    Supply Warehouse

    UB04 Hospital Insurance Claim Form for Laser Printers, One-Part (No Copies), 8.5 x 11, 2,500 Forms Total

    Delivery date & cost shown at checkout

View more

Product Details

UB-04 claim forms used by hospitals file a claim with the patient's insurance company, replaces the UB-92 form
Forms are printed to GPO standards in OCR ink on 20 pound stock bond
Laser cut sheets
2,500 sets per carton
8.5 x 11 inch sheet size

Popular Products