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

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

Brand: Paris Corporation
Item Number: PRB05109

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: $160.46
Qty:
$159.99 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: 2500; 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 2500
Sheet Size 9 1/2 x 11
Copy Types Continuous Feed
Paper Stock 20 lb.
Paper Color(s) White
Footnote 1 One-part continuous feed, white
Special Features UB04 Hospital Insurance Claim Forms
Unit of Measure: CARTON
Item Weight With Packaging 30.0 lbs.
Item Depth With Packaging 11.5"
Item Height With Packaging 10.0"
Item Width With Packaging 9.0"
Carton Weight With Packaging 9.0 lbs.
Carton Package Width 9.0"
Carton Package Depth 11.5"
Carton Package Height 10.0"
Carton Package Quantity 2500
Packaging Unit Contained In The Carton SH
Returnable? YES
UNSPSC (United Nations Standard Products and Services Code) 14111806
UPC 090146051097
No product line items
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