UB-04 (1583) IB FORM SKELETON DEFINITION (364.6)

Name	Value
BILL FORM	UB-04
SECURITY LEVEL	NATIONAL,NO EDIT
PAGE OR SEQUENCE	1
FIRST LINE NUMBER	11
LOCAL OVERRIDE ALLOWED	YES
STARTING COLUMN OR PIECE	5
LENGTH	6
SHORT DESCRIPTION	OCCURRENCE DATE (FL-31/2)