UB 04 Form Filler© - for ICD-10     email

EASYCMS 1500 Form Filler


UB 04 Software

CMS 1500 Claim Forms

UB 04 Claim Forms

Insurance Tracker Software

EASYHCFA 485 Form Filler

Shipping Envelopes


Updated for ICD-10 codes

UB 04 Form Filler presents you with a series of fields on your screen corresponding to each of the boxes on the UB 04 claim form. Each location includes a prompt informing you of the appropriate content. You just type in the data and hit the tab key to move to the next field. When complete, save the form and print it onto a blank UB 04in your printer. Each form can be individually saved and used again quickly by just changing dates of services, dollar amounts, etc. Program requires Microsoft Windows and Microsoft Word.



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This site was last updated 1/18/2019

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