UB-04 (1595) 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
62
LENGTH
6
SHORT DESCRIPTION
OCC SPAN DATE FROM (FL-36/2)
