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Paris Corporation UB04 Insurance Claim Form, Two-Part Continuous Feed, 9.5 x 11, 1/Page,1,000 Forms

Product Number: PRB05110
  • Conform to government regulations.
  • Used for Medicaid, Medicare and federal insurance regulations.
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Product Description

Paris Corporation UB04 Insurance Claim Form, Two-Part Continuous Feed, 9.5 x 11, 1/Page,1,000 Forms - Expedite Medicare, Medicaid or private insurance benefits. Conforms with federal regulations.

  • Conform to government regulations.
  • Used for Medicaid, Medicare and federal insurance regulations.
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Product Specifications

  • Assembly Required
    No
  • Brand Name
    Paris Corporation
  • Copy Paper Color(s)
    Canary
  • Copy Types
    Two-Part Continuous Feed
  • Country of Origin
    United States
  • Footnote 1
    Two-part continuous feed, white/white. Carbonless
  • Form Quantity
    1,000
  • Form Size
    9.5 x 11 9.5 x 11
  • Forms Per Page
    1
  • Global Product Type
    Forms-Insurance
  • Paper Color(s)
    White
  • Paper Stock
    20 lb
  • Print and Ruling Color(s)
    Red
  • Recycled
    No
  • Sheet Size
    9.5 x 11
  • Special Features
    UB04 Hospital Insurance Claim Forms
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