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

Product ID:

190865

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$101.70 / CT
$91.67 / CT
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List Price: $165.05
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  Estimated delivery time 1-3 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

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