UB-04 (1585) 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
15
LENGTH
6
SHORT DESCRIPTION
OCCURRENCE DATE (FL-32/2)