UB04 Insurance Claim Form, 2-Part, White/Canary, 9 1/2 x 11, 1000 Forms
- Product Type : Forms
- Item # : PRB05110
Quick Overview
- Expedite Medicare, Medicaid or private insurance claims processing.
- Forms meet all Federal regulations.
- Formerly known as HCFA-1500 forms.
Add Line NoteGeneral Information
Manufacturer
PARIS CORPORATION
Manufacturer Part Number
05110
Manufacturer Website Address
www.pariscorp.com
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
Package Includes
Includes 1,000 forms.
Footnote 1
Two-part continuous feed, white/white. Carbonless
Special Features
UB04 Hospital Insurance Claim Forms
Country of Origin
US
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