01942
Payee Identification List
2013-03-10
Definition: Conditional or empty: if Payee Type in list ("PPER", "ORG"), then Required, else Not Permitted.
Payee or Business Arrangement identification information; up to 5; defined by Payer/Provider agreement.
LengthNot specified
10 components
| 1 | O | - | Organization Name | |
| 2 | O | Organization Name Type Code | ||
| 3 | W | - | ID Number | |
| 4 | O | - | Identifier Check Digit | |
| 5 | O | Check Digit Scheme | ||
| 6 | O | Assigning Authority | ||
| 7 | O | Identifier Type Code | ||
| 8 | O | - | Assigning Facility | |
| 9 | O | Name Representation Code | ||
| 10 | O | - | Organization Identifier |