Guaranteed Lowest Prices In The Nation On Medical Office Supplies

| Phone: 800.307.7717

Create Account | Login | Download Order Forms

Customer Service Hours: M-F 9am - 9pm EST

Shop By Product

Home | My Account | Order Status | Reorder | Contact Us

Current Secure
Prescription Pad
Regulatory Updates

California Florida Oklahoma Texas

Home > Billing & Insurance > Hospital Claim

Hospital Claim

Filerx.com offers a variety of Medicare and Medicaid claim forms, these forms meet all of CMSs latest printing standards, and are printed in OCR-scannable red ink.

UB-04 Hospital Claim Form 1-Part Continuous	UB-04 Hospital Claim Form 2-Part Continuous	UB-04 Hospital Claim Form 3-Part Continuous	UB-04 Hospital Claim Form 4-Part Continuous
UB-04 Hospital Claim Form 5-Part Continuous	UB-04 Hospital Claim Form Laser Cutsheet

Incomplete Items Found

You were previously working on ordering a product. Would you like to view this item?

Note: For security reasons, any account information found may be
removed from these products and might need to be re-entered.