LEGACY UB-92 (728) 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
29
LENGTH
7
SHORT DESCRIPTION
OTHER DIAG CODE 4 (FL-71)
