UB-04 (1618) 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
42
SHORT DESCRIPTION
VALUE CODE REBUILD (FL-39:41)
CALCULATE ONLY OR OUTPUT
CALCULATE ONLY
