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

132114   Paris Business Products
Free Shipping on Orders over $99!
SKU # PRB-05110
Your Price:
$169.52

Quantity:

QTY 2 to 5
$168.32

QTY 6 to 10
$167.72

QTY 11+
$167.12

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


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Expedite Medicare, Medicaid or private insurance claims processing. Forms meet all Federal regulations. Formerly known as HCFA-1500 forms. Form Size: 9 1/2 x 11; Forms Per Page: 1; Form Quantity: 1000; Sheet Size: 9 1/2 x 11.

Global Product Type
Forms-Insurance
Global Product Type
Forms-Insurance
Global Product Type
Forms-Insurance
Global Product Type
Forms-Insurance
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)
White
Paper Color(s)
Canary
Footnote 1
Two-part continuous feed, white/white. Carbonless
Footnote 1
Two-part continuous feed, white/white. Carbonless
Footnote 1
Two-part continuous feed, white/white. Carbonless
Footnote 1
Two-part continuous feed, white/white. Carbonless
Footnote 1
Two-part continuous feed, white/white. Carbonless
Special Features
UB04 Hospital Insurance Claim Forms
Special Features
UB04 Hospital Insurance Claim Forms
Special Features
UB04 Hospital Insurance Claim Forms
Special Features
UB04 Hospital Insurance Claim Forms
Special Features
UB04 Hospital Insurance Claim Forms
Mfg. Part No.
05110
UPC
090146051103


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Your Price: $15.94
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SKU # TOP-59870R
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