UB-04 Billing Package – 500 Forms w PDF – FREE priority shipping

$85.00 $65.00

The UB-04 Billing Package includes the Fillable UB 04 PDF Form and 500 paper claim forms. Also known as the CMS 1450, used by institutional healthcare providers.

  Type, Print & Save as PDF
Create unlimited claims/templates
 Install on up to 2 Computers
 Automatic Form Calculations – adds up the charges for you
 500 Red Paper Claim Forms
 Free Priority Mail Shipping

Out of stock


A perfect solution for providers submitting Uniform Bill (UB-04) paper claims, otherwise known as the CMS 1450. 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.
  • 500 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).

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