UB-04 Claim Forms; 2 Part Continuous Pinfeed

Use for a variety of Medicare and Medicaid claims Meets all of CMS's latest printing standards Printed in OCR-scannable red ink Goverened by the National Uniform Billing Committee (NUBC) Certified Chain of Custody; Promoting Sustainable Forest Management Size: 9-1/2x11" (overall), 8-1/2x11" (detached)

Product Information

Form Type :

Insurance

Format :

Health Insurance Claim Form

Sheet Size :

9-1/2" x 11"

Form Size :

8-1/2" x 11"

Media Quantity :

1000

Binding Type :

Continuous

Paper Color :

WhiteYellow

Number of Parts :

2

Carbonless :

Yes

# Up Per Sheet/Page :

1

NCR Paper :

Yes

Numbered :

No

Holes Punched :

None

Personalization :

No

Security Features :

No

Environmental Information

Certifications & Standards :

SFI Sustainable Forestry Iniative

Miscellaneous

Brand Name :

Medical Arts Press

Country of Origin :

USA

Weight

Weight :

21.00 lbs. per Box