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
A perfect solution for providers submitting UB-04 paper claims. Used by hospitals, clinics, ambulatory surgery centers and rehabilitation centers billing insurance companies for services rendered.
- Immediate Download of UB-04 PDF after purchase with Credit Card or PayPal.
- 200 Count Paper Claims Shipped Priority Mail.
The UB-04 Billing Claim Form (CMS-1450) is used for facility and ancillary paper billing. Approved by the Centers for Medicare & Medicaid Services (CMS) and the National Uniform Billing Committee (NUBC).