LEGACY HCFA-1500 (505) 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
47
LENGTH
1
SHORT DESCRIPTION
PT REL TO INSRD=OTHER (BX-6)