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CMS - 1450 Form

Part Number: NLCF-UBO4
Price2+5+
$24.95$19.99$14.99

Required by CMS from institutional providers excluded from the mandatory electronic claims submission requirements by ASCA (Administrative Simplification Compliance Act).

  • Use for a variety of Medicare and Medicaid claims
  • Meets all of CMSs latest printing standards
  • Printed in OCR-scannable red ink
  • Goverened by the National Uniform Billing Committee (NUBC)
  • Size: 8-1/2x11" 

500/pk

CMS - 1450 Form
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