| Name | Value |
|---|---|
| BILL FORM | IB 837 TRANSMISSION |
| SECURITY LEVEL | NATIONAL,NO EDIT |
| PAGE OR SEQUENCE | 107 |
| FIRST LINE NUMBER | 1 |
| LOCAL OVERRIDE ALLOWED | NO |
| STARTING COLUMN OR PIECE | 9 |
| LENGTH | 50 |
| SHORT DESCRIPTION | Other Payer Prior Auth/Referral # |
| TRANSMIT IGNORES IF NULL | TRUE |