UB-04 (1603) IB FORM SKELETON DEFINITION (364.6)
Name
Value
BILL FORM
UB-04
SECURITY LEVEL
NATIONAL,NO EDIT
PAGE OR SEQUENCE
1
FIRST LINE NUMBER
9
LOCAL OVERRIDE ALLOWED
YES
STARTING COLUMN OR PIECE
1
LENGTH
8
SHORT DESCRIPTION
PATIENT DOB (FL-10)
CALCULATE ONLY OR OUTPUT
OUTPUT
