UB-04 (CMS 1450) Health Hospital Insurance Claim Form, Laser 8-1/2 x 11 500 Per Pack by Next Day Labels at Pulmonomics. MPN: UB-04. Hurry! Limited time offer. Offer valid only while supplies last. Pack of
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mpn: UB04-1, ean: 0646437700368,
Pack of 100 FormsUB-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 / ...