UB-04 (1438) 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 79"),U,1),",",1)
FORMAT CODE DESCRIPTION
OTHER PROVIDER LAST NAME