| Name | Description | Type | Additional information |
|---|---|---|---|
| LocationCode | string |
None. |
|
| PatientKey | string |
None. |
|
| InsuranceKey | string |
None. |
|
| InsuranceName | string |
None. |
|
| InsuranceType | string |
None. |
|
| InsurancePhone | string |
None. |
|
| InsuranceAddress1 | string |
None. |
|
| InsuranceAddress2 | string |
None. |
|
| InsuranceCity | string |
None. |
|
| InsuranceState | string |
None. |
|
| InsuranceZip | string |
None. |
|
| PolicyNumber | string |
None. |
|
| PolicyGroup | string |
None. |
|
| TypeOfPlan | string |
None. |
|
| EffectiveDate | date |
None. |
|
| TerminationDate | date |
None. |
|
| PolicyHolder | string |
None. |
|
| InsuredEmployer | string |
None. |
|
| InsuredName | string |
None. |
|
| InsuredSocial | string |
None. |
|
| InsuredDateOfBirth | date |
None. |
|
| InsuredGender | string |
None. |
|
| IsActive | boolean |
None. |
|
| ElectronicPayerId | string |
None. |
|
| InsuranceNumber | integer |
None. |