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UB04 Insurance Claim Form, 2-Part, White/Canary, 9 1/2 x 11, 1000 Forms

Item #: PRB05110
by Paris Corporation
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Nationwide Stock: 72 CT
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Product Details

UB04 Insurance Claim Form, 2-Part, White/Canary, 9 1/2 x 11, 1000 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 1000
Sheet Size 9 1/2 x 11
Copy Types Continuous Feed
Paper Stock 20 lb.
Paper Color(s) Canary, White
Footnote 1 Two-part continuous feed, white/white. Carbonless
Special Features UB04 Hospital Insurance Claim Forms

Dimensions / Specifications
Unit of Measure CT
Item Weight 31.000 lbs
Ships via UPS? y
Carton Pack Quantity 1000 SH
This item is sold by the CT which contains 1000 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. 05110
Retail UPC 090146051103
Country of Origin US
Tariff (Inbound) Code
UNSPSC Number 14111806
Meets ANSI/BIFMA? 090146051103
OTS Product ID 9147901

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Document printed / saved on 11/22/2017. Prices subject to change.