LEGACY HCFA-1500 (599) 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
35
LOCAL OVERRIDE ALLOWED
YES
STARTING COLUMN OR PIECE
1
LENGTH
26
SHORT DESCRIPTION
BOX 17 HCFA 1500