| Name | Value |
|---|---|
| FORM FIELD REFERENCE | CMS-1500 |
| SECURITY LEVEL | NATIONAL,NO EDIT |
| DATA ELEMENT | N-GET FROM PREVIOUS EXTRACT |
| PAD CHARACTER | NO PAD REQUIRED |
| FORMAT CODE | S IBXDATA=$G(IBXSAVE("BOX33","ADDR1"))_" "_$G(IBXSAVE("BOX33","ADDR2")) |
| FORMAT CODE DESCRIPTION | cms-1500, Box 33 Billing provider address lines 1&2. |