| Name | Value |
|---|---|
| BILL FORM | LEGACY HCFA-1500 |
| SECURITY LEVEL | NATIONAL,NO EDIT |
| PAGE OR SEQUENCE | 1 |
| FIRST LINE NUMBER | 2 |
| LOCAL OVERRIDE ALLOWED | YES |
| STARTING COLUMN OR PIECE | 1 |
| LENGTH | 80 |
| SHORT DESCRIPTION | MAILING ADDRESS NM (FORM LN 2) |
| CALCULATE ONLY OR OUTPUT | OUTPUT |