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

by Adams

List Price: $198.36
Price: $92.77 & FREE Shipping. Details
You Save: $105.59 (53%)
Only 19 left in stock (more on the way).
Ships from and sold by Amazon.com. Gift-wrap available.
  • 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
20 new from $74.99 1 used from $73.49

Explore Custom Business Cards from Vistaprint Explore Custom Business Cards from Vistaprint

$92.77 & FREE Shipping. Details Only 19 left in stock (more on the way). Ships from and sold by Amazon.com. Gift-wrap available.

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Product Description

Adams Business Forms provide the tools to help keep track of messages, finances, transactions, employees, taxes, and customers to businesses throughout the world. The Adams UB-04 Hospital Insurance Claim forms are used by hospitals to file claims with the patient's insurance company. Each form is printed to GPO standards in OCR ink on a 8.5 x 11 inch laser cut sheet size, with 2,500 form sets per carton. These UB-04 forms are made to replace the UB-92 forms. These business forms are the perfect way to create and maintain a professional image for small businesses and service providers. Whether it's a multi-part form, notebooks, writing pads, record books, or any of the hundreds of items we offer, you can count on Adams products to help!


Product Information

Technical Details
Brand NameAdams
Item Weight27 pounds
Product Dimensions11 x 8.5 x 4.4 inches
Item model number59870R
ColorWhite
Number of Items1
Size8 1/2 In X 11 In
Manufacturer Part Number59870R
  
Additional Information
ASINB001E662W4
Best Sellers Rank #153,734 in Office Products (See top 100)
Shipping Weight26.7 pounds (View shipping rates and policies)
Domestic Shipping Item can be shipped within U.S.
International Shipping This item can be shipped to select countries outside of the U.S. Learn More
Date First AvailableJune 2, 2007
  
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Adams UB-04 Continuous Hospital Insurance Claim Form, 1 Part, Laser, 8.5 x 11 Inches, 2500 Sets per Carton, White (59870R)
This item: Adams UB-04 Continuous Hospital Insurance Claim Form, 1 Part, Laser, 8.5 x 11 Inches, 2500 Sets per Carton, White (59870R)
Price: $92.77
Ships from and sold by Amazon.com
Want to discover more products? Check out these pages to see more: taxes forms, small business supplies