UB-04 (1272)    IB FORM FIELD CONTENT (364.7)

Name Value
FORM FIELD REFERENCE UB-04
SECURITY LEVEL NATIONAL,NO EDIT
DATA ELEMENT N-STATEMENT COVERS FROM DATE
PAD CHARACTER NO PAD REQUIRED
FORMAT CODE S IBXDATA=$$DATE^IBCF2(IBXDATA,,1)
FORMAT CODE DESCRIPTION
Format date in MMDDYY format.