LEGACY HCFA-1500 (781)    IB FORM SKELETON DEFINITION (364.6)

Name Value
BILL FORM LEGACY HCFA-1500
SECURITY LEVEL NATIONAL,NO EDIT
PAGE OR SEQUENCE 1
FIRST LINE NUMBER 13
LOCAL OVERRIDE ALLOWED YES
STARTING COLUMN OR PIECE 49.9
LENGTH 72
SHORT DESCRIPTION CURR INSURED'S FULL ADDR EXTR
CALCULATE ONLY OR OUTPUT CALCULATE ONLY