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Paris Corporation UB04 Insurance Claim Form, 2-Part, White/Canary, 9 1/2 x 11, 1000 Forms

Paris Corporation UB04 Insurance Claim Form, 2-Part, White/Canary, 9 1/2 x 11, 1000 Forms

SAF5110
Workbench nylon-reinforced stool with black upholstered seat has self-skinning polyurethane foam arms. Includes adjustable seat height and footring plus five-star base with nylon-reinforced glides.
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Expedite Medicare, Medicaid or private insurance claims processing. Forms meet all Federal regulations. Formerly known as HCFA-1500 forms.