UB-04 (1617)    IB FORM SKELETON DEFINITION (364.6)

Name Value
BILL FORM UB-04
SECURITY LEVEL NATIONAL,NO EDIT
PAGE OR SEQUENCE 1
FIRST LINE NUMBER 14
LOCAL OVERRIDE ALLOWED YES
STARTING COLUMN OR PIECE 41
SHORT DESCRIPTION VALUE CODE SORT (FL-39:41)
CALCULATE ONLY OR OUTPUT CALCULATE ONLY