LEGACY UB-92 (504)    IB FORM FIELD CONTENT (364.7)

Name Value
FORM FIELD REFERENCE LEGACY UB-92
SECURITY LEVEL NATIONAL,NO EDIT
DATA ELEMENT N-NON-COVERED DAYS
PAD CHARACTER NO PAD REQUIRED
FORMAT CODE I 'IBXDATA S IBXDATA=""
FORMAT CODE DESCRIPTION
Display a blank if non-covered days field is zero.