UB-04 Hospital Claim Form Laser-Cut Sheet (1,000/case);
UB-04 Hospital Claim Form Laser-Cut Sheet (1,000/case)

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.

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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.

  • 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
  • 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

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