UB-04 (CMS 1450) Health Hospital Insurance Claim Form | Laser & Inkjet Compatible | 8-1/2 x 11" Letter Size | 500 Forms Per Pack | Made in USA
Description
- PROUDLY MADE IN USA — Manufactured in the United States by NextDayLabels, a trusted name in professional forms and labels since 1996. Built to the highest quality standards to support the most demanding healthcare billing operations.
- STANDARD UB-04 / CMS 1450 FORM — The official uniform billing format required by hospitals, skilled nursing facilities, and institutional providers for submitting health insurance claims to Medicare, Medicaid, and all major commercial insurers. Fully NUBC compliant.
- LASER & INKJET COMPATIBLE — Engineered for flawless, jam-free performance on virtually any standard laser or inkjet printer. Clean, precise red-ink printing ensures every field is legible and claim-ready, reducing costly rejections and delays.
- EXACT SPECIFICATIONS FOR FULL COMPLIANCE — 1-Part, 24 lb. paper, 8½ x 11" letter size. Accommodates all required billing data fields including the National Provider Identifier (NPI) — meeting HIPAA, CMS, and NUBC formatting standards.
- 500-FORM BULK PACK— MAXIMUM VALUE FOR HIGH-VOLUME FACILITIES — A full box of 500 forms delivers outstanding cost-per-form value, ideal for large hospitals, multi-provider billing centers, and healthcare networks that need a steady, dependable supply without constant reordering.
CMS-1450 / UB-04 FormÂ
Next Day Labels UB04 / CMS 1450 forms are completely compliant with NUBC format and coding requirements:
- Pack of 500 Sheets 8-1/2 x 11, Letter Size 1 part Laser / Ink-Jet Form
- All fields, boxes, and Layout consistently to line up 100% with billing softwareÂ
- Printed in the USA by Next Day Labels TM with red OCR ink GPO standardsÂ
- All forms adhere to strict government standards developed by HIPAA in accordance with American Hospital Association
- Our 92 Bright White 20# lb paper meets all standard requirements for UB-04 forms and allows for easily feeding through laser or inkjet printers without worrying about jamming
100% Refund
Our clients’ happiness is our priority. We absolutely stand behind our products and will make sure you are completely satisfied. Buying items virtually may be more challenging than buying the physical product in a store, since you cannot see the actual item. We at Next Day Labels understand that. If our product isn’t everything you were hoping for, simply return it to us for a 100% refund.
Technical Specifications
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.