LEGACY HCFA-1500 (538) 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
31
LOCAL OVERRIDE ALLOWED
YES
STARTING COLUMN OR PIECE
57
LENGTH
22
SHORT DESCRIPTION
INSUREDS SIGNATURE (BX-13)