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CMS 2 Part Continuous UB04-2 Claim Form

ub-04

CMS 2 Part Continuous UB04-2 Claim Form

$53.79

CMS 2 Part Continuous UB04-2 Medicare Claim Forms is guaranteed to meet government regulations.

  • 1000 UB04 forms (2 Part Continuous) for Pinfeed or Dot-Matrix
  • Approved CMS 1450 / UB04 Form (08/05) OMB0938-0997
  • This is the latest/newest form that accommodates reporting of the National Provider Identifier (NPI) number
  • Jam-free performance and are printed in OCR-scannable red ink
  • Meets all Government Standards


 

Product Description

CMS 2 Part Continuous UB04-2 Medicare Claim Forms

  • 1000 UB04 forms (2 Part Continuous) for Pinfeed or Dot-Matrix
  • Approved CMS 1450 / UB04 Form (08/05) OMB0938-0997
  • This is the latest/newest form that accommodates reporting of the National Provider Identifier (NPI) number
  • Jam-free performance and are printed in OCR-scannable red ink
  • Meets all Government Standards


 

Additional Information

Weight 34 lbs
Dimensions 11 x 9.5 x .5 in