UB-92 changing to UB-04 (click
for info)
FREE
Shipping !!
UB-92
Forms |
|
|
| As
of April 1, 1994, the UB-92 replaced UB-82. The form is
designed for hospitals to file a medical claim with the
patient's insurance carrier. Our UB-92 Hospital Claim Forms
are available in a laser cut-sheet and one- to five part
continuous forms printed in OCR 'dropout" red ink with
all copies on high quality white paper. |
|
When would you like delivery?
* 1-2 or 5 day
|
|
RUSH! - 500
***UB-92 Laser Forms |
|
Rush!
500 UB-92 Forms
(includes
Ship) (Business
days) |
 |
|
|
2 Day delivery |
$49.95 |
|
| 5 Day delivery |
$34.95 |
|
|
UB-92
- LASER
 I
(Tractor is shown -- Click Picture for larger view)
|
***Laser
UB-92 Hospital Claim form
Form #
920 |
|
|
Quantity Per Box:
2500 Sheets |
|
$
56.95 per box
FREE
Shipping included on above item!! |
UB-92
- 1 part Tractor Feed
 I
(Tractor is shown -- Click Picture for larger view)
|
***UB-92
Hospital Claim form 1 Part Continuous
Form #
921 |
|
|
Quantity Per Box:
2500 Sheets |
|
$
56.95 per box
FREE
Shipping included on above item!! |
UB-92
- 2 part Tractor Feed
 I
(Tractor is shown -- Click Picture for larger view)
|
***UB-92
Hospital Claim form 2 Part Continuous
Form #
922 |
|
|
Quantity Per Box:
1000 Sets |
|
$
45.95 per box
FREE
Shipping included on above item!! |
UB-92
- 3 part Tractor Feed
I
(Tractor is shown -- Click Picture for larger view)
|
***UB-92
Hospital Claim form 3 Part Continuous
Form #
923 |
|
|
Quantity Per Box:
1000 Sets |
|
$
72.95 per box
FREE
Shipping included on above item!! |
UB-92
- 4 part Tractor Feed
I
(Tractor is shown -- Click Picture for larger view)
|
***UB-92
Hospital Claim form 4 Part Continuous
Form #
924 |
|
|
Quantity Per Box:
500 Sets |
|
$
46.95 per box
FREE
Shipping included on above item!! |
UB-92
- 5 part Tractor Feed
I
(Tractor is shown -- Click Picture for larger view)
|
***UB-92
Hospital Claim form 5 Part Continuous
Form #
925 |
|
|
Quantity Per Box:
500 Sets |
|
$
55.95 per box
FREE
Shipping included on above item!! |
|
***
returns not accepted on the 12/90 CMS/UB-92 Forms
after June 1, 2007 |
