LEGACY UB-92 (714)    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 48
LOCAL OVERRIDE ALLOWED YES
STARTING COLUMN OR PIECE 27
LENGTH 3
SHORT DESCRIPTION PATIENT RELATION (FL-59A:C)