UB-04 (1436) 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=$P($P(IBXSAVE("BOX 78"),U,1),",",1)
FORMAT CODE DESCRIPTION
Other Provider last name
