UB-04 (1644)    IB FORM SKELETON DEFINITION (364.6)

Name Value
BILL FORM UB-04
SECURITY LEVEL NATIONAL,NO EDIT
PAGE OR SEQUENCE 1
FIRST LINE NUMBER 43
LOCAL OVERRIDE ALLOWED YES
STARTING COLUMN OR PIECE 44
LENGTH 10
SHORT DESCRIPTION PRIOR PAYMENTS (FL-54A:C)
CALCULATE ONLY OR OUTPUT OUTPUT