UB-04 (1665) 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
65
LENGTH
18
SHORT DESCRIPTION
INSURANCE GROUP NO (FL-62A:C)
CALCULATE ONLY OR OUTPUT
OUTPUT
