| Name | Value |
|---|---|
| FORM FIELD REFERENCE | UB-04 |
| SECURITY LEVEL | NATIONAL,NO EDIT |
| DATA ELEMENT | N-GET FROM PREVIOUS EXTRACT |
| PAD CHARACTER | NO PAD REQUIRED |
| FORMAT CODE | S IBXDATA=$P($G(IBXSAVE("UBFL2")),U,5)_" "_$P($G(IBXSAVE("UBFL2")),U,6) |
| FORMAT CODE DESCRIPTION | UB-04, FL-2 Pay-to provider street address Concatenate address line 1 and line 2 together and try to fit as much as possible within the given 25 characters. |