OnTimeSupplies.com

Cart: $0.00

My Account
OnTimeSupplies.com
1-866-501-6055
We wish you a happy 4th of July! Our customer service will be closed on Tuesday, July 4. Deliveries will not be made on this day and will resume on Wednesday, July 5.

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

Item #: PRB05109
by Paris Corporation
Made in USA
FREE Shipping on Orders over $75!
Delivery in 1 - 2 business days
Nationwide Stock: 35 CT
FREE Shipping on Orders over $75!
QTY PRICE DELIVERY
Buy 5+ $71.58 /CT 5 - 10 business days
Ordering over $500? Need larger quantities?
Use our Bulk Request Form

Compare Us to Big Box Retailers!
Office Depot
checked on 06/27/17
$188.99 + shipping
*Disclaimer

Share:

This product is also available in...


Product Details

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

Expedite Medicare, Medicaid or private insurance claims processing. Forms meet all Federal regulations. Formerly known as HCFA-1500 forms.


Product Specifications

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

Dimensions / Specifications
Unit of Measure CT
Item Weight 30.000 lbs
Ships via UPS? y
Carton Pack Quantity 2500 SH
This item is sold by the CT which contains 2500 SH

Catalog Information
Catalog Page No.'s EVERYTHING FOR THE WORKPLACE 2012: Page 954
EVERYTHING FOR THE WORKPLACE 2013: Page 955
EVERYTHING FOR THE WORKPLACE 2014: Page 967
EVERYTHING FOR THE WORKPLACE 2015: Page 983
EVERYTHING FOR THE WORKPLACE NON-VIRTUAL 2015: Page 983
EVERYTHING FOR THE WORKPLACE NON-VIRTUAL 2016: Page 979
EVERYTHING FOR THE WORKPLACE NON-VIRTUAL 2017: Page 911
Manufacturer Info
Brand Paris Corporation  (website)
Brand Contact 800-523-6454
Manufacturer Stock No. 05109
Retail UPC 090146051097
Country of Origin US
Tariff (Inbound) Code
UNSPSC Number 14111806
Meets ANSI/BIFMA? 090146051097
OTS Product ID 9147919

Customer Questions and Answers

 
Your question has been received, and we will work to answer it quickly! If you need immediate assistance, please call us at 1-866-501-6055.

Customer Reviews

No written reviews yet for this product. Help others by writing one!


Join Our Mailing List!
Connect With Us
Shop With Confidence!
Document printed / saved on 06/28/2017. Prices subject to change.