LEGACY HCFA-1500 (520) 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
54
LENGTH
10
SHORT DESCRIPTION
INSUREDS DOB (BX-11A/1)
