CMS-1500 (1153)    IB FORM FIELD CONTENT (364.7)

Name Value
FORM FIELD REFERENCE CMS-1500
SECURITY LEVEL NATIONAL,NO EDIT
DATA ELEMENT N-HCFA 1500 BOX 12
PAD CHARACTER NO PAD REQUIRED
FORMAT CODE N IBZ D F^IBCEF("N-ROI INDICATOR","IBZ") S:IBZ IBXDATA="MODIFIED/RESTRICTED RELEASE "_IBXDATA S:$L(IBXDATA)<35 IBXDATA=$J("",3)_IBXDATA