LEGACY HCFA-1500 (540) 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
37
LENGTH
10
SHORT DESCRIPTION
DATE OF SIMLAR ILLNESS (BX-15)
