CMS 1450 (UB04) Claim Form
This is the CMS 1450, also known as the UB04, and is used solely for CMH-Approved hospital inpatient/outpatient billing. Click the 'Download' button to view the CMS 1450 form.
This is the CMS 1450, also known as the UB04, and is used solely for CMH-Approved hospital inpatient/outpatient billing. Click the 'Download' button to view the CMS 1450 form.