UB-04 (1594) 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	58
LENGTH	3
SHORT DESCRIPTION	OCCURRENCE SPAN CODE (FL-36/1)