LEGACY HCFA-1500 (573) 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
61
LOCAL OVERRIDE ALLOWED
YES
STARTING COLUMN OR PIECE
50
LENGTH
30
SHORT DESCRIPTION
AG CA CITY/ST/ZIP (BX-33/LN 3)
