UB-04 (1744) 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
72
LENGTH
2
SHORT DESCRIPTION
OPERATING ID QUAL (FL-77/1/2)
