Name | Value |
---|---|
BILL FORM | LEGACY UB-92 |
SECURITY LEVEL | NATIONAL,NO EDIT |
PAGE OR SEQUENCE | 1 |
FIRST LINE NUMBER | 19 |
LOCAL OVERRIDE ALLOWED | YES |
STARTING COLUMN OR PIECE | .9 |
SHORT DESCRIPTION | REV CODE EXTRACT (FL-42:49) |
CALCULATE ONLY OR OUTPUT | CALCULATE ONLY |