LEGACY HCFA-1500 (523) 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
23
LOCAL OVERRIDE ALLOWED
YES
STARTING COLUMN OR PIECE
2
LENGTH
10
SHORT DESCRIPTION
OTH INSURED DOB (BX-9B/1)
