New 2500 CMS 1500 Claim Forms – Current HCFA 02/2012 Version (OMB-0938-1197)- Forms Will line up with Billing Software and Laser Compatible- 2500 Sheets – 8.5’’ x 11

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

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Pack of 500

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Product Review

Pack of 500

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

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New 2500 CMS 1500 Claim Forms – Current HCFA 02/2012 Version (OMB-0938-1197)- Forms Will line up with Billing Software and Laser Compatible- 2500 Sheets – 8.5’’ x 11