Parent File | Name | Number | Package |
---|---|---|---|
ERX HOLDING QUEUE(#52.49) | PAYER INFORMATION | 52.4918 | Outpatient Pharmacy |
Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | SEQUENCE | 0;1 | NUMBER |
|
.02 | GROUP ID | 0;2 | FREE TEXT |
|
.03 | PAYER NAME | 0;3 | FREE TEXT |
|
.04 | PAYER IDENTIFICATION NUMBER | 0;4 | FREE TEXT |
|
1 | LAST NAME | 1;1 | FREE TEXT |
|
2 | FIRST NAME | 1;2 | FREE TEXT |
|
3 | PAYER MIDDLE NAME | 1;3 | FREE TEXT |
|
4 | PAYER SUFFIX | 1;4 | FREE TEXT |
|
5 | PAYER PREFIX | 1;5 | FREE TEXT |
|
6 | IDENTIFICATION | 6;0 | Multiple #52.49186 | 52.49186
|
7 | CARDHOLDER ID | 2;1 | FREE TEXT |
|