LEGACY UB-92 (697) 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
19
LOCAL OVERRIDE ALLOWED
YES
STARTING COLUMN OR PIECE
67
LENGTH
11
SHORT DESCRIPTION
NON-COVERED CHARGES (FL-48)
