LEGACY UB-92 (640) IB FORM SKELETON DEFINITION (364.6)
Name
Value
BILL FORM
LEGACY UB-92
SECURITY LEVEL
NATIONAL,NO EDIT
PAGE OR SEQUENCE
1
FIRST LINE NUMBER
9
LOCAL OVERRIDE ALLOWED
YES
STARTING COLUMN OR PIECE
31
LENGTH
2
SHORT DESCRIPTION
DISCHARGE HR (FL-21)