LEGACY HCFA-1500 (603) 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
62
LENGTH
18
SHORT DESCRIPTION
ORIGINAL REF NO (BX-22/B)