Form UB-92 HCFA-1450 UB-92 HCFA-1450 Health Insurance Claim Form
Health Insurance Claim Form, HCFA 1450
UB-92 HCFA-1450
Health Insurance Claim Form, HCFA 1450
OMB: 0720-0013
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0720-0013 can be found here:
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