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Paris Corporation UB04 Insurance Claim Form, Two-Part Continuous Feed, 9.5 x 11, 1/Page,1,000 Forms
Product Number: PRB05110
Sold Out
This product is sold out and we do not know when we will be getting another shipment. We apologize for any inconvenience this may cause.
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Product Description
Paris Corporation UB04 Insurance Claim Form, Two-Part Continuous Feed, 9.5 x 11, 1/Page,1,000 Forms
Description:
Expedite Medicare, Medicaid or private insurance benefits. Conforms with federal regulations.
- Conform to government regulations.
- Used for Medicaid, Medicare and federal insurance regulations.
Product Specifications
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Assembly RequiredNo
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Brand NameParis Corporation
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Copy Paper Color(s)Canary
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Copy TypesTwo-Part Continuous Feed
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Country of OriginUnited States
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Footnote 1Two-part continuous feed, white/white. Carbonless
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Form Quantity1,000
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Form Size9.5 x 11 9.5 x 11
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Forms Per Page1
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Global Product TypeForms-Insurance
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Paper Color(s)White
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Paper Stock20 lb
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Print and Ruling Color(s)Red
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RecycledNo
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Sheet Size9.5 x 11
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Special FeaturesUB04 Hospital Insurance Claim Forms