UB-04 (1576)    IB FORM SKELETON DEFINITION (364.6)

Name Value
BILL FORM UB-04
SECURITY LEVEL NATIONAL,NO EDIT
PAGE OR SEQUENCE 1
FIRST LINE NUMBER 6
LOCAL OVERRIDE ALLOWED YES
STARTING COLUMN OR PIECE 12
LENGTH 19
SHORT DESCRIPTION PATIENT ID (FL-8A)
CALCULATE ONLY OR OUTPUT OUTPUT