LEGACY HCFA-1500 (332)    IB FORM FIELD CONTENT (364.7)

Name Value
FORM FIELD REFERENCE LEGACY HCFA-1500
SECURITY LEVEL NATIONAL,NO EDIT
DATA ELEMENT N-GET FROM PREVIOUS EXTRACT
PAD CHARACTER NO PAD REQUIRED
FORMAT CODE I '$D(^DGCR(399,IBXIEN,"PRV",0)) S IBXDATA=$E($P($G(IBXSAVE("BOX31")),U),43,63)
FORMAT CODE DESCRIPTION
This line is no longer printed on the standard HCFA 1500.