00455
Verification By
2020-01-06
Definition: Refers to the person who verified the benefits. Multiple names for the same insured person may be sent in this field Specification of meaning based on sequence is deprecated.
LengthNot specified
25 components
| 1 | C | - | Person Identifier | |
| 2 | C | - | 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 | W | - | Degree (e.g., MD) | |
| 8 | B | Source Table | ||
| 9 | C | Assigning Authority | ||
| 10 | C | Name Type Code | ||
| 11 | O | - | Identifier Check Digit | |
| 12 | C | Check Digit Scheme | ||
| 13 | C | Identifier Type Code | ||
| 14 | O | - | Assigning Facility | |
| 15 | O | Name Representation Code | ||
| 16 | O | Name Context | ||
| 17 | W | - | Name Validity Range | |
| 18 | O | Name Assembly Order | ||
| 19 | O | - | Effective Date | |
| 20 | O | - | Expiration Date | |
| 21 | O | - | Professional Suffix | |
| 22 | C | - | Assigning Jurisdiction | |
| 23 | C | - | Assigning Agency or Department | |
| 24 | O | - | Security Check | |
| 25 | O | Security Check Scheme |