UB-04 CMS-1450 Universal Billing Form - Patterson Office Supplies

The UB-04 CMS-1450 is the uniform claim form used by institutions such as hospitals and nursing homes. Printed in OCR red ink, this form meets all CMS current printing standards.
Only one item can be personalized at a time. Please update your selection to one item.
Title/Description
Patterson Item #
Mfg Item #
Price
Qty
UB-04 CMS-1450 Universal Billing Form, Laser Compatible Single-Sheets, Nonpersonalized, 8-1/2" W x 11" H, 500/Pkg
The item(s) denoted below (*) cannot be added to your cart. For more information, click HERE Please unselect this item(s) to proceed to your cart.
Legend
Promotion
Auto Free Good
My Catalog
My Catalog (Rep)
On Formulary
On Contract
Prescription
Hazmat-Chargeable
Hazmat-No Charge
MSDS / SDS
Schedule 2 and 2N
Schedule 3, 3N, 4 and 5
List 1
Prices in Green indicate discounted price.