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UB04 Claim Forms, 2 Part Continuous White/Canary, 9 1/2 x 11, 1000 Forms

Manufacturer: Paris Business Products

Item Number: PRB05110

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

$216.29

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: 1000; 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: 1000; Sheet Size: 9 1/2 x 11.

Paper Color(s) Canary, 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 1,000 per carton 
Form Quantity 1000 
Form Size 9 1/2 x 11 
Forms Per Page
Footnote 1 Two-part continuous feed, white/white. Carbonless 
Reviewer Product Comments