LEGACY HCFA-1500 (501)    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 13
LOCAL OVERRIDE ALLOWED YES
STARTING COLUMN OR PIECE 1
LENGTH 28
SHORT DESCRIPTION PATIENT STR ADDRESS (BX-5/1)