LEGACY UB-92 (705) 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
43
LOCAL OVERRIDE ALLOWED
YES
STARTING COLUMN OR PIECE
27
LENGTH
13
SHORT DESCRIPTION
PROVIDER NUMBER (FL-51A:C)