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
