UB-04 (1746) 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
59
LENGTH
11
SHORT DESCRIPTION
OTHER PROVIDER NPI (FL-78/1/2)
