UB04 Insurance Claim Form, 8 1/2 x 11, 2500 Forms

Product ID:

190865

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$96.80 / CT
$93.80 / CT
when buying 4+
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List Price: $165.05
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  Estimated delivery time 2-3 business days
  • Expedite Medicare, Medicaid or private insurance claims processing.
  • Forms meet all Federal regulations.
  • Formerly known as HCFA-1500 forms.

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

Includes 2,500 forms.

Specifications

Global Product Type Forms-Insurance
Forms Per Page 1
Paper Color White
Form Quantity 2500
Sheet Size 8 1/2 x 11
Form Size 8 1/2 x 11
Special Features UB04 Hospital Insurance Claim Forms
Paper Stock 20 lb.
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