UB-04 (1727) IB FORM SKELETON DEFINITION (364.6)
Name
Value
BILL FORM
UB-04
SECURITY LEVEL
NATIONAL,NO EDIT
PAGE OR SEQUENCE
1
FIRST LINE NUMBER
61
LOCAL OVERRIDE ALLOWED
YES
STARTING COLUMN OR PIECE
27
LENGTH
2
SHORT DESCRIPTION
CODE CODE LEFT (FL-81/1/1)
