Office Products > Office & School Supplies > Forms, Recordkeeping & Money Handling > Human Resources Forms > Insurance Claim Forms
UB-04 Hospital Claim Form Laser-Cut Sheet (1,000/case)
Product ID: B005DTEO8W
Condition: New
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Product Description
UB-04 Hospital Claim Form Laser-Cut Sheet (1,000/case)
- UB04 / CMS 1450 Medical Claim Forms, 500 Single Sheets
- These are the latest UB04 claim forms (also called CMS 1450 and formerly the UB92 form)
- This is the latest/newest form that accommodates reporting of the National Provider Identifier (NPI) number
- Meets all Government Standards
UBO4 Medical claim forms have replaced the UB92 forms and are used by hospitals, clinics, laser surgery centers, and ambulatory surgery centers to bill medical insurance claims to the insurance carriers.
Technical Specifications
Country
USA
Brand
The Filing Supplies Shop
Manufacturer
TFP Data Systems
Binding
Office Product
ItemPartNumber
UB04LC1
Color
White
Size
in
UnitCount
1000









