| 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 | N Z,Z0 S Z0=$P($G(^DGCR(399,IBXIEN,"UF3")),U,4,6) K IBXDATA F Z=1,2,3 S IBXDATA(Z)=$P(Z0,U,Z) |
| FORMAT CODE DESCRIPTION | Document control numbers from file 399/fields 453-455. |