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UB-04 (CMS-1450) Health Hospital Insurance Claim Form, Laser 8-1/2" x 11" - Pack of 100 Forms

KWD 9

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Special Features

  • UB-04 (CMS-1450) Health Insurance Claim Form
  • Laser / Inkjet Format
  • 24-lb, 8.5 x 11-inch (Letter Size)
  • 100% Compliant with Approved Update to HCFA / CMS 1450 Health Claim Form

Description

UB-04 (CMS-1450) Health Hospital Insurance Claim Form, Laser 8-1/2" x 11" - Pack of 100 Forms

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