Nationwide Industrial Supply, LLC Nationwide Industrial Supply, LLC
10 Park Place
Butler, NJ 07405

Phone: 800-757-1064

Home > > Forms > Paris Business Products Insurance Claim Forms > PRB05109

Paris Business Products - UB04 Claim Forms, 1 Part Continuous White, 9 1/2 x 11, 2500 Forms

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UB04 Claim Forms, 1 Part Continuous White, 9 1/2 x 11, 2500 Forms

Product No. PRB05109
Global Product Type Forms-Medicare/Medicaid
Form Size 9 1/2 x 11
Forms Per Page 1
Form Quantity 2500
Sheet Size 9 1/2 x 11
Copy Types Continuous Feed
Paper Stock 20 lb.
Paper Color(s) White
Form Special Features UB04 Claim Forms
quantity 2,500 per carton
Footnote 1 One-part continuous feed, white
Special Features UB04 Hospital Insurance Claim Forms
Availability Unavailable
ups
List Price N/A
CT N/A


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