The UB 04 PDF Form Filler is 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
Prints Text Only on Pre-Printed Claim Forms
Install on up to 2 Computers
Download UB-04 PDF immediately after purchase with Credit Card or PayPal account. 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.
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