| 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,9) |
| FORMAT CODE DESCRIPTION | UB-04, FL-2 pay-to provider zip code |