Hero image 0 of PRB05109 - Paris Business Products UB04 Claim Forms, 0 of 3
PRB05109 - Paris Business Products UB04 Claim Forms
(No ratings yet)
Key item features
- Form_Size - 9 1/2 x 11
- Forms_Per_Page - 1
- Form_Quantity - 2,500
- Sheet_Size - 9 1/2 x 11
- Copy_Types - Continuous Feed
Specs
- Standard form & application typeClaim Form
- ModelUB04
- Paper size9 1/2 x 11
- BrandParis Business Products
- Sheets2500
- Piece count2500
More seller options (1)
Starting from $101.54
Similar items you might like
Based on what customers bought
Cosco Patient Bilingual Confidential Sign-In Forms 3-Part 125 Forms/Pack (074042) $57.28
$5728current price $57.28Cosco Patient Bilingual Confidential Sign-In Forms 3-Part 125 Forms/Pack (074042)
VERSACHECK UV SECURE BUSINESS CHECK REFILLS FORM # 1000 - MULTI $83.85
$8385current price $83.85VERSACHECK UV SECURE BUSINESS CHECK REFILLS FORM # 1000 - MULTI
ComplyRight 2024 ADA Dental Claim Forms 1 000 Forms/Pack (202411) $35.73
$3573current price $35.73ComplyRight 2024 ADA Dental Claim Forms 1 000 Forms/Pack (202411)
RED44301 - Bill of Lading Short Form $54.23
$5423current price $54.23RED44301 - Bill of Lading Short Form
Work Order Form - 2 Part Carbonless Form (100 Pack) $36.99 Was $44.99
2 optionsAvailable in additional 2 options$3699current price $36.99, Was $44.99$44.99Work Order Form - 2 Part Carbonless Form (100 Pack)
CMS 1500 Claim Form, 2500 Sheets $82.00
$8200current price $82.00CMS 1500 Claim Form, 2500 Sheets
ComplyRight Carbonless Employee Warning Notice Forms, 3-Part, 8 1/2" x 11", White, Pack Of 50 $76.37
$7637current price $76.37ComplyRight Carbonless Employee Warning Notice Forms, 3-Part, 8 1/2" x 11", White, Pack Of 50
H11 9.5 x 5.5 in -1-Part White 20# Bond Forms w. No Perfs, Folds at 11 in. $85.29
$8529current price $85.29H11 9.5 x 5.5 in -1-Part White 20# Bond Forms w. No Perfs, Folds at 11 in.
Automotive Repair Order and Invoice Receipt Form - 2 Part Carbonless Form (250 Pack) $59.99 Was $71.99
$5999current price $59.99, Was $71.99$71.99Automotive Repair Order and Invoice Receipt Form - 2 Part Carbonless Form (250 Pack)
Employee Time Off Request Forms on 2 Part Carbonless Paper (Pack of 250) $39.99
3 optionsAvailable in additional 3 options$3999current price $39.99Employee Time Off Request Forms on 2 Part Carbonless Paper (Pack of 250)
ABC Computer Checks, Standard Business Format, Top Check Style, Compatible with QuickBooks, Linen Green (250 Sheets) $124.69
$12469current price $124.69ABC Computer Checks, Standard Business Format, Top Check Style, Compatible with QuickBooks, Linen Green (250 Sheets)
CMS 1500 Medical Claim Forms, 1 Part Continuous White, 9 1/2 X 11 - 2500 Forms $94.86
$9486current price $94.86CMS 1500 Medical Claim Forms, 1 Part Continuous White, 9 1/2 X 11 - 2500 Forms
OFFIGAM 2Pcs Business Receipt Book White with Sturdy Backing for Clear Writing and Order Tracking $60.52 Was $69.80
$6052current price $60.52, Was $69.80$69.80OFFIGAM 2Pcs Business Receipt Book White with Sturdy Backing for Clear Writing and Order Tracking
Sunlite Repair Tags w/o Imprint 250/pk Compact Repair 250 4-1/4in x 9-1/8` $97.57
$9757current price $97.57Sunlite Repair Tags w/o Imprint 250/pk Compact Repair 250 4-1/4in x 9-1/8`
ComplyRight Employee Warning Notice Forms 50/Pack (AR0395) $33.71
$3371current price $33.71ComplyRight Employee Warning Notice Forms 50/Pack (AR0395)
Job Proposal Form for Contractors - 2 Part Carbonless Form (100 Pack) $36.99 Was $44.99
2 optionsAvailable in additional 2 options$3699current price $36.99, Was $44.99$44.99Job Proposal Form for Contractors - 2 Part Carbonless Form (100 Pack)
H80 9.5 x 8.5 in. -1-Part White 20# Bond Forms w.Perfs $74.49
$7449current price $74.49H80 9.5 x 8.5 in. -1-Part White 20# Bond Forms w.Perfs
VersaCheck ValueChex - Form #1000 - Blue - Prestige - 1000 Sheets $85.84 Was $96.19
$8584current price $85.84, Was $96.19$96.19VersaCheck ValueChex - Form #1000 - Blue - Prestige - 1000 Sheets
15 out of 5 Stars. 1 reviewsCMS 1500 Claim Forms - HCFA (Version 02/12) - 2500 Sheets / CASE $82.00
$8200current price $82.00CMS 1500 Claim Forms - HCFA (Version 02/12) - 2500 Sheets / CASE
#10 Economy Airmail Regular Wesco Tint, 4-1/8" x 9-1/2", 20# White, Blue Wesco Inside Tint, Red&Blue Border (Box of 500) $116.07
$11607current price $116.07#10 Economy Airmail Regular Wesco Tint, 4-1/8" x 9-1/2", 20# White, Blue Wesco Inside Tint, Red&Blue Border (Box of 500)
About this item
Product details
Expedite Medicare, Medicaid or private insurance claims processing. Forms meet all Federal regulations. Formerly known as HCFA-1500 forms. One-part continuous feed, white. Form Size: 9 1/2 x 11 Forms Per Page: 1.
- Form_Size - 9 1/2 x 11
- Forms_Per_Page - 1
- Form_Quantity - 2,500
- Sheet_Size - 9 1/2 x 11
- Copy_Types - Continuous Feed
info:
We aim to show you accurate product information. Manufacturers, suppliers and others provide what you see here, and we have not verified it. Â
Specifications
Standard form & application type
Claim Form
Model
UB04
Paper size
9 1/2 x 11
Brand
Paris Business Products
Warranty
Warranty information
Please be aware that the warranty terms on items offered for sale by third party Marketplace sellers may differ from those displayed in this section (if any). To confirm warranty terms on an item offered for sale by a third party Marketplace seller, please use the 'Contact seller' feature on the third party Marketplace seller's information page and request the item's warranty terms prior to purchase.
Customer ratings & reviews
0 ratings|0 reviews
This item does not have any reviews yet
