New
Arrivals/Restock
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
4.1 (64 items)
Limited Time SaleUntil the end
04
43
55
$17.69 cheaper than the new price!!
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New $29.49
Product details
| Management number | 217957239 | Release Date | 2026/05/03 | List Price | $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 |
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