| Name | Value |
|---|---|
| BILL FORM | LEGACY HCFA-1500 |
| SECURITY LEVEL | NATIONAL,NO EDIT |
| PAGE OR SEQUENCE | 1 |
| FIRST LINE NUMBER | 63 |
| LOCAL OVERRIDE ALLOWED | NO |
| STARTING COLUMN OR PIECE | 1.9 |
| SHORT DESCRIPTION | MULTIPLE PAGE CHECK/POPULATE |
| CALCULATE ONLY OR OUTPUT | CALCULATE ONLY |