Custom Format UB04

Designed specifically to meet your needs, our UB04 and HCFA custom formats save you countless hours of programming, positioning, and report designing in Medisoft.

Retail Price: $199.00

Our Price: $199.00

Features

• The UB04 format allows you to print a UB04 form to a file to insurance carriers
• The IL Public Aid form allows you to print the IL DPA 2360 format for submitting paper claims to IL Medicaid.