UB-04 (1593) IB FORM SKELETON DEFINITION (364.6)
Name
Value
BILL FORM
UB-04
SECURITY LEVEL
NATIONAL,NO EDIT
PAGE OR SEQUENCE
1
FIRST LINE NUMBER
7
LOCAL OVERRIDE ALLOWED
YES
STARTING COLUMN OR PIECE
80
LENGTH
3
SHORT DESCRIPTION
PATIENT ADDR. - CNTRY (FL-9E)
CALCULATE ONLY OR OUTPUT
OUTPUT
