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

Item #: PRB05109
by Paris Corporation
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Nationwide Stock: 31 CT
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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? Yes
Carton Pack Quantity 2500 SH
This item is sold by the CT which contains 2500 SH
Warranty Offered? No
Manufacturer Info
Brand Paris Corporation  (website)
Brand Contact 800-523-6454
Warranty Offered? n
Manufacturer Stock No. 05109
Staples Equivalent SKU 194244
Office Max Equivalent SKU 23813287
Office Depot Equivalent SKU 376348
Retail UPC 090146051097
Country of Origin US
UNSPSC Number 14111806
Meets ANSI/BIFMA? 090146051097
OTS Product ID 9147919

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Document printed / saved on 05/27/2018. Prices subject to change.