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Paris Corporation UB04 Insurance Claim Form, 1-Part Continuous White, 9 1/2 x 11, 2500 Forms
Product Number: PRB05109
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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, 1-Part Continuous White, 9 1/2 x 11, 2500 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 TypesContinuous Feed
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Country of OriginUnited States
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Footnote 1One-part continuous feed, white
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Form Quantity2500
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Form Size9 1/2 x 11 9 1/2 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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RecycledNo
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Sheet Size9 1/2 x 11
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Special FeaturesUB04 Hospital Insurance Claim Forms