LOCAL HCFA 1500 (AUTO-ADDED) (10000) BILL FORM TYPE (353)

Name	Value
NAME	LOCAL HCFA 1500 (AUTO-ADDED)
BASE FILE	BILL/CLAIMS
FORMAT TYPE	PRINTED FORM
FORM LENGTH	66
NATIONAL FORM	NO
PARENT FORM	LEGACY HCFA-1500
SHORT DESCRIPTION	LOCAL HCFA 1500 (AUTO-ADDED)