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)
