UB04 Insurance Claim Form, 2-Part, White/Canary, 9 1/2 x 11, 1000 Forms
UB04 Insurance Claim Form, 2-Part, White/Canary, 9 1/2 x 11, 1000 Forms UB04 Insurance Claim Form, 2-Part, White/Canary, 9 1/2 x 11, 1000 Forms

UB04 Insurance Claim Form, 2-Part, White/Canary, 9 1/2 x 11, 1000 Forms

Brand: Paris Corporation
Item Number: PRB05110

Paris Corporation Insurance Claim Forms

Government regulated health insurance forms.
  • Expedite Medicare, Medicaid or private insurance claims processing.
  • Forms meet all Federal regulations.
  • Formerly known as HCFA-1500 forms.
MSRP: $170.77
Qty:
$169.99 per CT
Conventional

Recycled Content

No Matching Criteria

Biodegradable/Compostable

No Matching Criteria

Reduced Chemical Content

No Matching Criteria

Third Party Certifications

No Matching Criteria

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.

Global Product Type Forms-Insurance
Form Size 9 1/2 x 11
Forms Per Page 1
Form Quantity 1000
Sheet Size 9 1/2 x 11
Copy Types Continuous Feed
Paper Stock 20 lb.
Paper Color(s) White; Canary
Footnote 1 Two-part continuous feed, white/white. Carbonless
Special Features UB04 Hospital Insurance Claim Forms
Unit of Measure: CARTON
Item Weight With Packaging 31.0 lbs.
Item Depth With Packaging 11.5"
Item Height With Packaging 9.0"
Item Width With Packaging 10.0"
Carton Weight With Packaging 10.0 lbs.
Carton Package Width 10.0"
Carton Package Depth 11.5"
Carton Package Height 9.0"
Carton Package Quantity 1000
Packaging Unit Contained In The Carton SH
Returnable? YES
UNSPSC (United Nations Standard Products and Services Code) 14111806
UPC 090146051103
No product line items
192572

CMS 02/12 Insurance Claim Form, 8 1/2 x 11, 250 Forms

Paris Corporation
PRB07104
$11.23
Qty:
Conventional
132114

UB04 Insurance Claim Form, 2-Part, White/Canary, 9 1/2 x 11, 1000 Forms

Paris Corporation
PRB05110
$169.99
Qty:
Conventional
177500

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

Paris Corporation
PRB05109
$159.99
Qty:
Conventional
132146

UB04 Insurance Claim Form, 8 1/2 x 11, 2500 Forms

Paris Corporation
PRB05108
$154.99
Qty:
Conventional
192479

CMS 02/12 Insurance Claim Form, 2-Part, White/Canary, 9 1/2 x 11, 1000 Forms

Paris Corporation
PRB07116
$169.99
Qty:
Conventional
192475

CMS 02/12 Insurance Claim Form, 2-Part, White/White, 9 1/2 x 11, 1000 Forms

Paris Corporation
PRB07114
$87.99
Qty:
Conventional
192586

CMS 02/12 Insurance Claim Form, 1-Part Continuous White, 9 1/2 x 11, 2500 Forms

Paris Corporation
PRB07102
$94.61
Qty:
Conventional
198452

CMS 02/12 Insurance Claim Form, 8 1/2 x 11, 500 Forms

Paris Corporation
PRB07106
$28.99
Qty:
Conventional