Insurance Claim Form Wizard for Healthcare
HEALTH - DENTAL - HOSPITAL
The Form CMS-1450, also known as the UB-04, is the standard claim form to bill Medicare Administrative Contractors (MACs) when a paper claim is allowed.
The Office of Management and Budget and the National Uniform Billing Committee have approved the UB-04 claim form, also known as the CMS-1450 form.
UB-04 (CMS-1450) Claim Form