500 UB04 Claim Forms, CMS 1450 Health Insurance Claim Forms for Hospitals and Medical Facilities, Standard Uniform Billing Form for Major Insurance Providers Including Medicare, 500 Pack, 8.5 x 11 in
US$11.80
Price when purchased online
Free shipping
Free 30-day returns
Sold and shipped by libyansincanada.org
We aim to show you accurate product information. Manufacturers, suppliers and others provide what you see here.
US$11.80
Price when purchased online
Free shipping
Free 30-day returns
Sold and shipped by libyansincanada.org
Free 30-day returns Details
Product details
| Management number | 217957239 | Release Date | 2026/05/03 | List Price | US$11.80 | Model Number | 217957239 | ||
|---|---|---|---|---|---|---|---|---|---|
| Category | |||||||||
- Hospitals, nursing facilities, and other in-patient providers can easily get reimbursed by insurance companies with UB-04 forms (CMS1450) that are 100% compliant with HIPAA with all correct content, red ink, and 1 part printing style (OMB-0938-0997)
- All printed fields will align with the correct boxes of your UB 04 claim forms when using your templates or billing software with our consistently high quality medical forms that are manufactured in the USA
- Our UB-04 (CMS 1450) forms are manufactured using 20 lb paper that meets all NUBC standards and easily feeds through both laser and inkjet printers without jamming
- Our UB-04 (CMS-1450) 100% compliant with HIPAA Act with all forms printed in the USA by US government certified printers
- Institutional providers can use a paper copy of the UBO4 claims form for facility and ancillary paper billing by medical and mental health care facilities
| Brand | Blue Summit Supplies |
|---|---|
| Item Weight | 5.19 pounds |
| Manufacturer | Blue Summit Supplies |
| Material Type | Paper |
| Package Dimensions | 11.26 x 8.66 x 2.2 inches |
| Manufacturer Part Number | BSS-92588-376 |
Customers who viewed this product also viewed
Crampons
Correction of product information
If you notice any omissions or errors in the product information on this page, please use the correction request form below.
Correction Request Form