LEGACY HCFA-1500 (602)    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 39
LOCAL OVERRIDE ALLOWED YES
STARTING COLUMN OR PIECE 50
LENGTH 11
SHORT DESCRIPTION MEDICAID RESUB CODE (BX-22/A)