UB-04 (1741) IB FORM SKELETON DEFINITION (364.6)
Name
Value
BILL FORM
UB-04
SECURITY LEVEL
NATIONAL,NO EDIT
PAGE OR SEQUENCE
1
FIRST LINE NUMBER
57
LOCAL OVERRIDE ALLOWED
YES
STARTING COLUMN OR PIECE
72
LENGTH
2
SHORT DESCRIPTION
ATTENDING ID QUAL (FL-76/1/2)
