UB-04 (1670) IB FORM SKELETON DEFINITION (364.6)
Name
Value
BILL FORM
UB-04
SECURITY LEVEL
NATIONAL,NO EDIT
PAGE OR SEQUENCE
1
FIRST LINE NUMBER
56
LOCAL OVERRIDE ALLOWED
YES
STARTING COLUMN OR PIECE
5
LENGTH
7
SHORT DESCRIPTION
ADM DIAG CODE (FL-69)
