CMS-1500 (1455) IB FORM SKELETON DEFINITION (364.6)
Name
Value
BILL FORM
CMS-1500
SECURITY LEVEL
NATIONAL,NO EDIT
PAGE OR SEQUENCE
1
FIRST LINE NUMBER
31
LOCAL OVERRIDE ALLOWED
YES
STARTING COLUMN OR PIECE
6
LENGTH
25
SHORT DESCRIPTION
PATIENT SIGNATURE (BX-12)
