LEGACY UB-92 (623)    IB FORM FIELD CONTENT (364.7)

Name Value
FORM FIELD REFERENCE LEGACY UB-92
SECURITY LEVEL NATIONAL,NO EDIT
DATA ELEMENT N-GET FROM PREVIOUS EXTRACT
PAD CHARACTER NO PAD REQUIRED
FORMAT CODE D:'$D(IBXSAVE("PRV-82")) BOX82NM^IBCEU4(IBXIEN,.IBXSAVE) K IBXDATA S IBXDATA=$E($G(IBXSAVE("PRV-82",2)),1,30+$G(^TMP("IBXSAVE",$J,"RM")))
FORMAT CODE DESCRIPTION
If not already done, extract all the possible providers into the
appropriate line for box 82 on the UB-92 print claim form.  This is the
second line extracted.