UB-04 (1432)    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=$P($$GETPRV^IBCEF83(IBXIEN,,2,"A1"),",",1)
FORMAT CODE DESCRIPTION
Operating Provider last name