UB-04 (1414)    IB FORM FIELD CONTENT (364.7)

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=$TR($P($G(IBXSAVE("DX-E",3)),U),".")
FORMAT CODE DESCRIPTION
This is the third 'E-code' diagnosis found.