LEGACY HCFA-1500 (554) 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
44
LOCAL OVERRIDE ALLOWED
YES
STARTING COLUMN OR PIECE
1
LENGTH
9
SHORT DESCRIPTION
DATE OF SERV FR (BX-24A/A)
