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Paris Corporation PRB05110 UB04 Insurance Claim Form, 2-Part, White/Canary, 9 1/2 x 11, 1000 Forms
Manufacturer: Paris Corporation
UPC: 090146051103
SKU: PRB05110
Condition: New
Paris Corporation PRB05110 UB04 Insurance Claim Form, 2-Part, White/Canary, 9 1/2 x 11, 1000 Forms
Global Product TypeForms-Insurance
Form Size9 1/2 x 11
Forms Per Page1
Form Quantity1000
Sheet Size9 1/2 x 11
Copy TypesContinuous Feed
Paper Stock20 lb.
Paper ColorWhite; Canary
Footnote 1Two-part continuous feed, white/white. Carbonless
Special FeaturesUB04 Hospital Insurance Claim Forms
Expedite Medicare, Medicaid or private insurance claims processing.
Forms meet all Federal regulations.
Formerly known as HCFA-1500 forms.