---
product_id: 120244594
title: "UB04 Insurance Claim Form, 2-Part, White/Canary, 9 1/2 x 11, 1000 Forms"
brand: "pariscorporation"
price: "VT183958"
currency: VUV
in_stock: false
url: https://www.desertcart.vu/products/120244594-ub04-insurance-claim-form-2-part-white-canary-9-1
store_origin: VU
region: Vanuatu
---

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

**Brand:** pariscorporation
**Price:** VT183958
**Availability:** ❌ Out of Stock

## Quick Answers

- **What is this?** UB04 Insurance Claim Form, 2-Part, White/Canary, 9 1/2 x 11, 1000 Forms by pariscorporation
- **How much does it cost?** VT183958 with free shipping
- **Is it available?** Currently out of stock
- **Where can I buy it?** [www.desertcart.vu](https://www.desertcart.vu/products/120244594-ub04-insurance-claim-form-2-part-white-canary-9-1)

## Best For

- pariscorporation enthusiasts

## Why This Product

- Trusted pariscorporation brand quality
- Free international shipping included
- Worldwide delivery with tracking
- 15-day hassle-free returns

## Description

Expedite Medicare, Medicaid or private insurance claims processing. Forms meet all Federal regulations. Formerly known as HCFA-1500 forms. Form Size: 9 1/2 x 11; Forms Per Page: 1; Form Quantity: 1000; Sheet Size: 9 1/2 x 11.
            
          
          
            
                  
                    Global Product Type
                    Forms-Insurance
                  
                  
                    Form Size
                    9 1/2 x 11
                  
                  
                    Forms Per Page
                    1
                  
                  
                    Form Quantity
                    1000
                  
                  
                    Sheet Size
                    9 1/2 x 11
                  
                  
                    Copy Types
                    Continuous Feed
                  
                  
                    Paper Stock
                    20 lb.
                  
                  
                    Paper Color(s)
                    White; Canary
                  
                  
                    Footnote 1
                    Two-part continuous feed, white/white. Carbonless
                  
                  
                    Special Features
                    UB04 Hospital Insurance Claim Forms
                  
              
                Unit of Measure:
                CARTON
              

              
                Item Weight With Packaging
                31.0 lbs.
              

              
                Item Depth With Packaging
                11.5"
              
              
                Item Height With Packaging
                9.0"
              
              
                Item Width With Packaging
                10.0"
              
                      
                        Carton Weight With Packaging
                        10.0 lbs.
                      
                      
                        Carton Package Width
                        10.0"
                      
                      
                        Carton Package Depth
                        11.5"
                      
                      
                        Carton Package Height
                        9.0"
                      
                      
                        Carton Package Quantity
                        1000
                      
                      
                        Packaging Unit Contained In The Carton
                        SH
                      

              
                Returnable?
                YES
              
              
                UNSPSC (United Nations Standard Products and Services Code)
                14111806
              
              
                UPC
                090146051103

## Features

- UPC:090146051103
- Paris Corporation Insurance Claim Forms
        
        
          Expedite Medicare, Medicaid or private insurance claims processing.
          Forms meet all Federal regulations.
          Formerly known as HCFA-1500 forms.

## Images

![UB04 Insurance Claim Form, 2-Part, White/Canary, 9 1/2 x 11, 1000 Forms - Image 1](https://ik.imagekit.io/91ubcvvnh3k/103/Master_Images/Master_Variants/Variant_500/132114.JPG)
![UB04 Insurance Claim Form, 2-Part, White/Canary, 9 1/2 x 11, 1000 Forms - Image 2](https://ik.imagekit.io/91ubcvvnh3k/103/Master_Images/Master_Variants/Variant_500/NOA.JPG)

---

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**Shop now:** [https://www.desertcart.vu/products/120244594-ub04-insurance-claim-form-2-part-white-canary-9-1](https://www.desertcart.vu/products/120244594-ub04-insurance-claim-form-2-part-white-canary-9-1)

---

*Product available on Desertcart Vanuatu*
*Store origin: VU*
*Last updated: 2026-03-14*