| 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 | 
  |