UB 04 Forms

UB-04 / CMS-1450 CLAIM FORMS

UB-04 / CMS-1450 Claim Forms

Claim forms for institutional and facility billing workflows. Available quantities and approved pricing are shown below. Contact 4M Superior Solutions for ordering assistance.

UB-04 Claim Forms, Laser, Box of 2,500
UB-04 Claim Forms, Laser, Pack of 1,000
UB-04 Claim Forms, Laser, Pack of 500