UB-04 (1584) 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
11
LENGTH
3
SHORT DESCRIPTION
OCCURRENCE CODE (FL-32/1)
