UB-04 (CMS 1450) Health Hospital Insurance Claim Form, Laser 8-1/2 x 11" 100 Forms Per Pack
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<b>[Product Information]</b><br>
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<li>UB-04 (CMS 1450) Health Insurance Claim Form</li>
<li>Laser / Ink-JetFormat</li>
<li>1 Part 24# 8-1/2 x 11 (Letter Size)</li>
<li>Accommodates reporting of the National Provider Identifier (NPI) number</li>
<li>100% compliant with the approved update to the HCFA / CMS1450 health claim form</li>
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