| Name | Value |
|---|---|
| FORM FIELD REFERENCE | UB-04 |
| SECURITY LEVEL | NATIONAL,NO EDIT |
| DATA ELEMENT | N-PATIENT STREET ADDRESS 1-3 |
| PAD CHARACTER | NO PAD REQUIRED |
| FORMAT CODE | S IBXDATA=$G(^UTILITY("VAPA",$J,1))_" "_$G(^UTILITY("VAPA",$J,2))_" "_$G(^UTILITY("VAPA",$J,3)) |
| FORMAT CODE DESCRIPTION | Patient address - street address |