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UB04 Claim Forms, 1 Part Continuous White, 9 1/2 x 11, 2500 Forms

Manufacturer: Paris Business Products

Item Number: PRB05109

  • Expedite Medicare, Medicaid or private insurance claims processing.
  • Forms meet all Federal regulations.
  • Formerly known as HCFA-1500 forms.

$200.84

per CT

  • Made in the USA
    • Made in the USA
Details

Expedite Medicare, Medicaid or private insurance claims processing. Forms meet all Federal regulations. Formerly known as HCFA-1500 forms. Form Size: 9 1/2 x 11; Forms Per Page: 1; Form Quantity: 2500; Sheet Size: 9 1/2 x 11.

Expedite Medicare, Medicaid or private insurance claims processing. Forms meet all Federal regulations. Formerly known as HCFA-1500 forms. Form Size: 9 1/2 x 11; Forms Per Page: 1; Form Quantity: 2500; Sheet Size: 9 1/2 x 11.

Paper Color(s) White 
Sheet Size 9 1/2 x 11 
Global Product Type Forms-Medicare/Medicaid 
Copy Types Continuous Feed 
Paper Stock 20 lb. 
Special Features UB04 Hospital Insurance Claim Forms 
Quantity 2,500 per carton 
Form Quantity 2500 
Form Size 9 1/2 x 11 
Forms Per Page
Footnote 1 One-part continuous feed, white 
Reviewer Product Comments