Medical Forms*ComplyRight UB-04 Hospital Claim Form, 500 Forms/Pack (UB04LC5)
Original price was: $26.00.$19.89Current price is: $19.89.
Ensure proper processing of medical procedures and patient care with these hospital claim forms. The 20-pound bond paper offers added durability and is easy to load in office printers, while the one-part format creates a crisp, high-quality master copy. Each of these TFP UB-04 hospital claim forms features preprinted sections for services, codes, and rates, along with each patient’s personal information for accurate reporting.
- Designed for hospitals to file a medical claim with the patient’s insurance carrier
- One-part health insurance forms
- Printed with OCR dropout red ink on white paper
- Developed in conjunction with all the governing agencies
- Comes in laser-cut sheet format
| Attribute name | Attribute value |
|---|---|
| Medical Form Pack Size | 11 |
| Acid Free The overall width of the product, measured left to right. | 8.5 |
| Medical Form Type | Laser |
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