UB-04 Billing Package
The UB 04 PDF Form Filler and 200 paper claim forms. Ideal for completing the standard claim form used by institutional health care providers to bill for services.
Type, Print & Save as PDF
Create unlimited claims/templates
Install on up to 2 Computers
Automatic Form Calculations – adds up the charges for you
200 Red Paper Claim Forms
Free Priority Mail Shipping
Immediate Download of UB-04 PDF after purchase with Credit Card or PayPal. 200 Count Paper Claims shipped priority Mail. Purchase of the UB-04 PDF entitles the user to perpetual use of the form, for an unlimited amount of time. The purchased files may not be shared, transferred or used by others.