LEGACY HCFA-1500 (517)    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 21
LOCAL OVERRIDE ALLOWED YES
STARTING COLUMN OR PIECE 1
LENGTH 28
SHORT DESCRIPTION OTH INSURED POLICY # (BX-9A)