Nextdaylabels
UB-04 (CMS 1450) Health Hospital Insurance Claim Form | Laser & Inkjet Compatible | 8-1/2 x 11 Letter Size | 100 Forms Per Pack | Made in USA
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R 1,003
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Delivered in 10–20 working days —
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Description
- PROUDLY MADE IN USA — Manufactured in the United States by NextDayLabels, a trusted name in professional forms and labels since 1996. Quality you can count on, every time.
- STANDARD UB-04 / CMS 1450 FORM — The official uniform billing format required by hospitals, skilled nursing facilities, and other institutional providers for submitting health insurance claims to Medicare, Medicaid, and major insurers.
- LASER & INKJET COMPATIBLE — Engineered for seamless printing on virtually any standard laser or inkjet printer. Crisp, clean output ensures accurate claim submission and reduces rejection risk.
- LETTER SIZE | PERFECT SPECIFICATIONS — 1-Part, 24 lb. paper, 8½ x 11" (letter size). Accommodates reporting of the National Provider Identifier (NPI) and all required billing fields for full compliance.
- GREAT VALUE PACK — Includes 100 forms per pack, ideal for medical offices, billing departments, and healthcare facilities that need a reliable, cost-effective supply of claim forms.
Pack of 100 Forms
Technical Specifications
Manufacturer
Next Day Labels
Model
OP-7410
Color
Red
Size
100
Height
1.5 cm
Length
27.9 cm
Width
20.6 cm
Weight
0 kg
Shipping & Delivery
Your order is shipped from the USA and delivered to your door in South Africa in 10–20 working days. All items are fully tracked.
Returns & Exchanges
We offer a 30-day return window. If something isn't right, contact our support team and we'll make it right.