Paris Corporation 05109 UB04 Insurance Claim Form, 1-Part Continuous White, 9 1/2 x 11, 2500 Forms

Paris Corporation

Paris Corporation 05109 UB04 Insurance Claim Form, 1-Part Continuous White, 9 1/2 x 11, 2500 Forms

  • MPN #: 05109
  • FSPN #: 20393159
  • UPC #: 090146051097

  • Min Order Qty: 1
  • Qty Interval: 1

  • Availability:



  • DESCRIPTION

    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.

  • SPECIFICATIONS
    Availability Special Order
    Copy Types Continuous Feed
    Footnote 1 One-part continuous feed, white
    Form Quantity 2500
    Form Size 9 1/2 x 11
    Forms Per Page 1
    Global Product Type Forms-Insurance
    Paper Color(s) White
    Paper Stock 20 lb.
    Sheet Size 9 1/2 x 11
    Special Features UB04 Hospital Insurance Claim Forms

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