Office Products > Office & School Supplies > Forms, Recordkeeping & Money Handling > Human Resources Forms > Insurance Claim Forms
UB-04 (CMS 1450) Health Hospital Insurance Claim Form, Laser 8-1/2 x 11 2500 Per Carton
Product ID: 199355948
Condition: New
Payflex: Pay in 4 interest-free payments of R2,094.50. Learn more
R 8,378
includes Duties & VAT
Delivery: 10-20 working days
Ships from USA warehouse.
Secure Transaction
VISA
Mastercard
payflex
ozow
Product Description
UB-04 (CMS 1450) Health Hospital Insurance Claim Form, Laser 8-1/2 x 11 2500 Per Carton
- Carton of 2500 Sheets of UB-04 (CMS 1450) Health Insurance Claim Forms
- 1 Part 24# 8-1/2 x 11 (Letter Size) Laser / Ink-JetFormat
- Printed in RED droput ink
- 100% compliant with the approved update to the HCFA / CMS1450 health claim form
- Accommodates reporting of the National Provider Identifier (NPI) number
Technical Specifications
Country
USA
Brand
Stockchecks
Manufacturer
StockChecks
Binding
Office Product
ItemPartNumber
NLCFUB041
Model
74522
Size
500
You might also like
Linen Travel Pants Womens Resort Wear 2025 Summer Outfits for Women 2025 Women's Clothes Summer Outfits Big Spring The Deal Women’S Pants Linen Jersey Shore Spring Fashion Dark Gray Xx-Large
KONG Air Squeaker Tennis Balls Two Pack
Preparing the Modern Meal: Urban Capitalism and Working-Class Food in Kenya's Port City
Red Strangers: The White Tribe of Kenya
Beyond Obscurity: Exploring the Origins of The Luo People of Kenya and Tanzania and their Cultural Heritage
A Brief History of Kenya (A Brief History - Around the World Edition)
Kenya's Soft Power Long Distance Champions
And Home Was Kariakoo: A Memoir of East Africa