UB-04 (1639) IB FORM SKELETON DEFINITION (364.6)
Name
Value
BILL FORM
UB-04
SECURITY LEVEL
NATIONAL,NO EDIT
PAGE OR SEQUENCE
1
FIRST LINE NUMBER
42
LOCAL OVERRIDE ALLOWED
YES
STARTING COLUMN OR PIECE
68
LENGTH
15
SHORT DESCRIPTION
BILLING PROVIDER NPI (FL-56)
CALCULATE ONLY OR OUTPUT
OUTPUT
