00455
Verification By
2003-08-22
Definition: Refers to the person who verified the benefits. Multiple names for the same insured person may be sent in this field. The legal name is assumed to be in the first repetition. When the legal name is not sent, a repeat delimiter must be sent first for the first repetition.
Length≤250
23 components
| 1 | O | - | ID Number | |
| 2 | O | - | Family Name | |
| 3 | O | - | Given Name | |
| 4 | O | - | Second and Further Given Names or Initials Thereof | |
| 5 | O | - | Suffix (e.g., JR or III) | |
| 6 | O | - | Prefix (e.g., DR) | |
| 7 | B | Degree (e.g., MD) | ||
| 8 | C | Source Table | ||
| 9 | O | Assigning Authority | ||
| 10 | O | Name Type Code | ||
| 11 | O | - | Identifier Check Digit | |
| 12 | C | Check Digit Scheme | ||
| 13 | O | Identifier Type Code | ||
| 14 | O | - | Assigning Facility | |
| 15 | O | Name Representation Code | ||
| 16 | O | Name Context | ||
| 17 | B | - | Name Validity Range | |
| 18 | O | Name Assembly Order | ||
| 19 | O | - | Effective Date | |
| 20 | O | - | Expiration Date | |
| 21 | O | - | Professional Suffix | |
| 22 | O | - | Assigning Jurisdiction | |
| 23 | O | - | Assigning Agency or Department |