UB-04 (1756) IB FORM SKELETON DEFINITION (364.6)
Name
Value
BILL FORM
UB-04
SECURITY LEVEL
NATIONAL,NO EDIT
PAGE OR SEQUENCE
1
FIRST LINE NUMBER
41
LOCAL OVERRIDE ALLOWED
YES
STARTING COLUMN OR PIECE
1
LENGTH
4
SHORT DESCRIPTION
RESERVED (FL-41/23)
CALCULATE ONLY OR OUTPUT
OUTPUT
