UB-04 (1550) IB FORM SKELETON DEFINITION (364.6)

Name	Value
BILL FORM	UB-04
SECURITY LEVEL	NATIONAL,NO EDIT
PAGE OR SEQUENCE	1
FIRST LINE NUMBER	1
LOCAL OVERRIDE ALLOWED	YES
STARTING COLUMN OR PIECE	.9
SHORT DESCRIPTION	UB-04 PRE-FORM HOUSEKEEPING
CALCULATE ONLY OR OUTPUT	CALCULATE ONLY