LEGACY HCFA-1500 (539)    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 33
LOCAL OVERRIDE ALLOWED YES
STARTING COLUMN OR PIECE 2
LENGTH 10
SHORT DESCRIPTION DATE OF CURR ILLNESS (BX-14)