UB-04 (1717) IB FORM SKELETON DEFINITION (364.6)
Name
Value
BILL FORM
UB-04
SECURITY LEVEL
NATIONAL,NO EDIT
PAGE OR SEQUENCE
1
FIRST LINE NUMBER
19
LOCAL OVERRIDE ALLOWED
YES
STARTING COLUMN OR PIECE
31
LENGTH
15
SHORT DESCRIPTION
HCPCS/RATES (FL-44)
