The Form CMS-1450, also known as the UB-04, is the standard claim form to bill Medicare Administrative Contractors (MACs) when a paper claim is allowed.


The Office of Management and Budget and the National Uniform Billing Committee have approved the UB-04 claim form, also known as the CMS-1450 form.

WizClaim™ Pro 2018

​​Universal Medical Claim App 

HEALTH    -     DENTAL     -      HOSPITAL 

Healthcare - UB-04 (CMS-1450) Claim Form

​(Product Road Map Add-on Feature planned for Future Release)