UB-04 (1551) 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
35
LENGTH
35
SHORT DESCRIPTION
PRINT STAT (UB-04 TOP LINE)
