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Paris Products Claim Forms, 2 Part White/Canary, 1000 Forms (PRB05110)

Paris Products Claim Forms, 2 Part White/Canary, 1000 Forms (PRB05110)
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$171.38 /Carton

$135.40 /Carton

(Save 21%)


$128.63 /Carton

(Save 25%)

Paris Business Products UB04 Claim Forms, 2 Part Continuous White/Canary, 1000 Forms
  • Product SKU: PRB05110
  • Expedite Medicare, Medicaid or private insurance claims processing.
  • Forms meet all Federal regulations.
  • Formerly known as HCFA-1500 forms.

Product Description

UB04 Claim Forms

Expedite Medicare, Medicaid or private insurance claims processing. Forms meet all Federal regulations. Formerly known as HCFA-1500 forms. Two-part continuous feed, white/canary. Form Size: 9 1/2 x 11; Forms Per Page: 1.

Product Specifications

  • Global Product Type: Forms-Medicare/Medicaid
  • 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
  • Quantity: 1,000 per carton
  • Footnote 1: Two-part continuous feed, white/white. Carbonless
  • Special Features: UB04 Hospital Insurance Claim Forms
 
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