LEGACY HCFA-1500 (497)    IB FORM SKELETON DEFINITION (364.6)

Name Value
BILL FORM LEGACY HCFA-1500
SECURITY LEVEL NATIONAL,NO EDIT
PAGE OR SEQUENCE 1
FIRST LINE NUMBER 11
LOCAL OVERRIDE ALLOWED YES
STARTING COLUMN OR PIECE 31
LENGTH 10
SHORT DESCRIPTION PATIENT DOB (BX-3/1)