| Name | Value |
|---|---|
| FORM FIELD REFERENCE | LEGACY HCFA-1500 |
| SECURITY LEVEL | NATIONAL,NO EDIT |
| DATA ELEMENT | N-PATIENT NAME |
| PAD CHARACTER | NO PAD REQUIRED |
| FORMAT CODE | N Z S Z=$$NAME^IBCEFG1(IBXDATA),IBXDATA=$P(Z,U,2)_" "_$S($P(Z,U,3)'="":$E($P(Z,U,3))_" ",1:"")_$P(Z,U) |
| FORMAT CODE DESCRIPTION | Output the patient's name as the signature first middle last name. |