UB-04 (1564)    IB FORM SKELETON DEFINITION (364.6)

Name Value
BILL FORM UB-04
SECURITY LEVEL NATIONAL,NO EDIT
PAGE OR SEQUENCE 1
FIRST LINE NUMBER 4
LOCAL OVERRIDE ALLOWED YES
STARTING COLUMN OR PIECE 46
LENGTH 5
SHORT DESCRIPTION Pay-to Provider Zip (FL-2/3/3)