UB-04 (1702) IB FORM SKELETON DEFINITION (364.6)
Name
Value
BILL FORM
UB-04
SECURITY LEVEL
NATIONAL,NO EDIT
PAGE OR SEQUENCE
1
FIRST LINE NUMBER
55
LOCAL OVERRIDE ALLOWED
YES
STARTING COLUMN OR PIECE
74
LENGTH
9
SHORT DESCRIPTION
RESERVED BY NUBC (FL-68/2)
