IB 837 TRANSMISSION (1513)    IB FORM FIELD CONTENT (364.7)

Name Value
FORM FIELD REFERENCE IB 837 TRANSMISSION
SECURITY LEVEL NATIONAL,NO EDIT
DATA ELEMENT N-HCFA J430D SERV LINE (EDI)
PAD CHARACTER NO PAD REQUIRED
FORMAT CODE I $$FT^IBCEF(IBXIEN)=7 D DEN^IBCEF12