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)