| Name | Value |
|---|---|
| BILL FORM | LEGACY HCFA-1500 |
| SECURITY LEVEL | NATIONAL,NO EDIT |
| PAGE OR SEQUENCE | 1 |
| FIRST LINE NUMBER | 60 |
| LOCAL OVERRIDE ALLOWED | YES |
| STARTING COLUMN OR PIECE | 22.8 |
| SHORT DESCRIPTION | FACILITY STR ADDR 1 EXTRACT |
| CALCULATE ONLY OR OUTPUT | CALCULATE ONLY |