LEGACY UB-92 (712) 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	46
LOCAL OVERRIDE ALLOWED	YES
STARTING COLUMN OR PIECE	57
LENGTH	11
SHORT DESCRIPTION	DUE FRM PATIENT FL55 (FL-55/4)