Office Products > Office & School Supplies > Forms, Recordkeeping & Money Handling > Human Resources Forms > Insurance Claim Forms
NextDayLabels - UB-04 (CMS 1450) Health Hospital Insurance Claim Form, Laser 8-1/2 x 11 (250)
Product ID: B01NBURGJX
Condition: New
Payflex: Pay in 4 interest-free payments of R375.00. Read the FAQ
Available in other options.
R 1,500
includes Duties & VAT
Delivery: 10-20 working days
Ships from USA warehouse.
Secure Transaction
VISA
Mastercard
payflex
ozow
Product Description
NextDayLabels - UB-04 (CMS 1450) Health Hospital Insurance Claim Form, Laser 8-1/2 x 11 (250)
- UB-04 (CMS 1450) Health Insurance Claim Form, Laser / Ink-JetFormat
- 1 Part 8-1/2 x 11 (Letter Size)
- Accommodates reporting of the National Provider Identifier (NPI) number
- 100% compliant with the approved update to the HCFA / CMS1450 health claim form
- Made in the USA by Next Day Labels TM
Technical Specifications
Country
USA
Brand
NextDayLabels
Manufacturer
Next Day Labels
Binding
Office Product
PartNumber
UB04-250
Model
UB04-250
Color
Red
Size
250
