UB-04 (1662) IB FORM SKELETON DEFINITION (364.6)
Name
Value
BILL FORM
UB-04
SECURITY LEVEL
NATIONAL,NO EDIT
PAGE OR SEQUENCE
1
FIRST LINE NUMBER
47
LOCAL OVERRIDE ALLOWED
YES
STARTING COLUMN OR PIECE
27
LENGTH
3
SHORT DESCRIPTION
PATIENT RELATION (FL-59A:C)
