UB04 Insurance Claim Form, 2-Part, White/Canary, 9 1/2 x 11, 1000 Forms
New
Required by Centers for Medicaid and Medicare Services (CMS) and by most private healthcare organizations, these forms speed up claims processing and meet all federal guidelines.
| $152.58 Retail $170.77 |
You may be also interested
$10.91
$18.72
$62.14
$78.62
$3.89
$12.10
$9.94
$16.47
Product Specifications
| Bus Speed | White |
| Bus Speed | Canary |
| Compressor Power | 1 |
| Copy Types | Continuous Feed |
| Fan Location | 1000 |
| Footnote 1 | Two-part continuous feed white/white. Carbonless |
| Form Quantity | 1000 |
| Form Size | 9 1/2 x 11 |
| Forms Per Page | 1 |
| Input Voltage Type | 9 1/2 x 11 |
| Maximum Proximity Range | Includes 1000 forms. |
| Number of Dispenser Valves | Continuous Feed |
| Package_Includes | Includes 1000 forms. |
| Paper Color(s) | Canary |
| Paper Stock | 20 lb. |
| Product Type | Forms-Insurance |
| Sheet Size | 9 1/2 x 11 |
| Special Features | UB04 Hospital Insurance Claim Forms |
Material Safety Data Sheet
A Material Safety Data Sheet (MSDS) is a document that contains information on the potential hazards (health, fire, reactivity and environmental) and how to work safely with the chemical product.
Sorry this product does not have any reviews at this time.
Time to Rendor : 0.359375
Powered by Power-eCommerce.com