LEGACY HCFA-1500 (528) 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
45
LENGTH
2
SHORT DESCRIPTION
AUTO ACCIDENT STATE (BX-10B/C)
