UB04

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100% guaranteed compliance. For hospitals, the UB04 meets The Centers for Medicare and Medicaid Services guidelines.
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Additional Details

Wilmer's extensive line of claim forms are available in laser cut sheets, 1 part continuous and 2 part continuous forms to meet your clients needs.

To see a complete listing of claim forms, see our Compatible filing catalog, or call Customer Service and request your copy of the W-CFP-CAT. (Available with and without the net price list)

More Resources

Healthcare flyer