UB 04 PDF Insurance Claim Form Filler

Fill in a UB-04 health insurance claim form.
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UB 04 PDF Insurance Claim Form Filler Ranking & Summary

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  • Rating:
  • Price:
  • Free to try
  • Publisher Name:
  • By Fiachra Forms
  • Operating Systems:
  • Windows, Windows 7, Windows 8, Windows 10
  • Additional Requirements:
  • Adobe Reader 11
  • Total Downloads:
  • 92

UB 04 PDF Insurance Claim Form Filler Tags


UB 04 PDF Insurance Claim Form Filler Description

The Fillable PDF template for the UB-04 health insurance claim form (also known as the CMS 1450) allows the user to create and save unlimited claims. User may type, print and save the claim as a PDF. With a single purchase, user may install the software on two computers. The form is designed to add up charges automatically.


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