UB-04 (CMS 1450) Health Hospital Insurance Claim Form, Laser 8-1/2 x 11" 500 Per Pack
Product Description
UB-04 (CMS 1450) Health Hospital Insurance Claim Form, Laser 8-1/2 x 11" 500 Per Pack
- UB-04 (CMS 1450) Health Insurance Claim Form
- Laser / Ink-JetFormat
- 1 Part 24# 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
Pack of 500
Technical Specifications
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