UB-04 (1601) IB FORM SKELETON DEFINITION (364.6)
Name
Value
BILL FORM
UB-04
SECURITY LEVEL
NATIONAL,NO EDIT
PAGE OR SEQUENCE
1
FIRST LINE NUMBER
12
LOCAL OVERRIDE ALLOWED
YES
STARTING COLUMN OR PIECE
75
LENGTH
8
SHORT DESCRIPTION
NOT USED (FL-37/2)