UB-04 (1721) IB FORM SKELETON DEFINITION (364.6)
Name
Value
BILL FORM
UB-04
SECURITY LEVEL
NATIONAL,NO EDIT
PAGE OR SEQUENCE
1
FIRST LINE NUMBER
59
LOCAL OVERRIDE ALLOWED
YES
STARTING COLUMN OR PIECE
46
LENGTH
4
SHORT DESCRIPTION
RESERVED BY NUBC (FL-75/3)
