UB-04 (1733) IB FORM SKELETON DEFINITION (364.6)
Name
Value
BILL FORM
UB-04
SECURITY LEVEL
NATIONAL,NO EDIT
PAGE OR SEQUENCE
1
FIRST LINE NUMBER
60
LOCAL OVERRIDE ALLOWED
YES
STARTING COLUMN OR PIECE
71
LENGTH
12
SHORT DESCRIPTION
OPERATING NAME (FL-77/2/2)
