How to claim UIIP reimbursement — and autofill 014-4372-64 with my-id.ca
Submit influenza immunization reimbursement without retyping pharmacy billing details
Pharmacies claiming reimbursement for publicly funded influenza immunizations under the Universal Influenza Immunization Program repeat pharmacy name, billing number, address, and pharmacist contact on every reimbursement claim. This guide is an example of storing them once in my-id.ca.
Official form and source
Start from the official source and always use the current version — form numbers and links can change:
- Service page: Vaccines and immunization — ontario.ca
- Form (Central Forms Repository): Universal Influenza Immunization Program Reimbursement Form — 014-4372-64
What this form is about
Form 014-4372-64 is the Universal Influenza Immunization Program Reimbursement Form, used by participating pharmacies to claim fees for administering publicly funded influenza vaccine — confirm fee schedules and claim periods on ontario.ca.
Before you start: what to gather
- Pharmacy legal name and address.
- Pharmacy billing or program identifier assigned for UIIP.
- Pharmacist-in-charge name and registration.
- Immunization counts and service dates for the claim period — confirm on ontario.ca.
Confirm the current process on ontario.ca.
How my-id.ca makes it faster
- Save it once. Store your pharmacy name, address, and billing contact in your my-id.ca profile.
- Keep documents ready. Upload supporting documents to my-id.ca Files so you are not searching at form time.
- Autofill the form. Use the my-id.ca Chrome extension on a web form, or fill a PDF from your saved profile inside my-id.ca.
- Review and submit yourself through the official channel.
Why do it in my-id.ca
Related Ontario forms repeat the same personal details. Captured once in my-id.ca — stored in Canada, with AI on its own servers — every form starts mostly complete.
Frequently asked questions
- When do pharmacies file reimbursement?
- Confirm claim periods and deadlines for each influenza season on ontario.ca.
- How does my-id.ca help?
- It autofills pharmacy identity and contact fields; enter immunization counts yourself.
- How does this relate to form 014-4455-64?
- 014-4455-64 is the pharmacy participation form; 014-4372-64 is the reimbursement claim.
Fill it once. Reuse it everywhere.
Save your information in my-id.ca once, then autofill this form and the next one — web forms with the Chrome extension, PDFs right in the app. Your data is stored in Canada and AI runs on my-id.ca's own servers, never sent to third-party AI providers.