UB 04 PDF Insurance Claim Form Filler

By Fiachra Forms Free to try

Developer's 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.

Full Specifications

What's new in version 0938-0997


Release June 10, 2019
Date Added June 10, 2019
Version 0938-0997

Operating Systems

Operating Systems Windows, Windows 7, Windows 8, Windows 10
Additional Requirements Adobe Reader 11


Total Downloads 92
Downloads Last Week 19
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