Dynamic List Information
Dynamic List Data
Form #
CMS 1450
Form Title
UB-04 Uniform Bill
Revision Date
2007-03-01
O.M.B. #
0938-0997
O.M.B. Expiration Date
2027-01-31
Special Instructions
Instructions on where/how to obtain the Form 1450 can be obtained from the provider’s servicing Medicare Administrative Contractor (MAC).