UB-04 (1361) IB FORM FIELD CONTENT (364.7)
Name
Value
FORM FIELD REFERENCE
UB-04
SECURITY LEVEL
NATIONAL,NO EDIT
DATA ELEMENT
N-ALL INSURED FULL NAMES
PAD CHARACTER
NO PAD REQUIRED
FORMAT CODE
N Z F Z=1:1:3 I $G(IBXDATA(Z))'="",IBXDATA(Z)'["," S Q=$$NAME^IBCEFG1(IBXDATA(Z),1),IBXDATA(Z)=$P(Q,U)_$S($P(Q,U,2)'="":","_$P(Q,U,2),1:"")