UB-04 (1568) IB FORM SKELETON DEFINITION (364.6)
Name
Value
BILL FORM
UB-04
SECURITY LEVEL
NATIONAL,NO EDIT
PAGE OR SEQUENCE
1
FIRST LINE NUMBER
3
LOCAL OVERRIDE ALLOWED
YES
STARTING COLUMN OR PIECE
54
LENGTH
24
SHORT DESCRIPTION
MEDICAL RECORD NUMBER (FL-3B)
