LEGACY HCFA-1500 (507) 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	15
LOCAL OVERRIDE ALLOWED	YES
STARTING COLUMN OR PIECE	1
LENGTH	28
SHORT DESCRIPTION	PATIENT CITY ADDRESS (BX-5/2A)