UB-04 (1728) 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
29
LENGTH
10
SHORT DESCRIPTION
CODE CODE MIDDLE (FL-81/1/2)
