LEGACY UB-92 (724)    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 56
LOCAL OVERRIDE ALLOWED YES
STARTING COLUMN OR PIECE 1
LENGTH 7
SHORT DESCRIPTION PRIN DIAG CODE (FL-67)