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

Technical Details

Product Details

Product Dimensions

Package Dimensions
Width : 8.1 inch
Height : 0.6 inch
Length : 11 inch

Item Weight: 15.2 ounce (View shipping rates and policies)
Shipping Weight: 5.5 pounds (View shipping rates and policies)

ASIN : B01AS68O62