LEGACY HCFA-1500 (552) 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
41
LOCAL OVERRIDE ALLOWED
YES
STARTING COLUMN OR PIECE
50
LENGTH
30
SHORT DESCRIPTION
PRIOR AUTH NUMBER (BX-23)
