Field # | Field Name | Format | Min | Max | Req'd | Comment |
---|---|---|---|---|---|---|
1 | RecordID | 6 | 6 | Y | ||
2 | PatientAccountNumer | AN | 1 | 80 | O | |
3 | ClientID | AN | 1 | 80 | O | |
4 | PatientLastName | AN | 1 | 35 | O | |
5 | PatientFirstName | AN | 1 | 25 | O | |
6 | PatientMiddleName | DT | 1 | 25 | O | |
7 | PatientDOB | DT | 1 | 35 | O | |
8 | PatientEmail | AN | 1 | 50 | O | |
9 | Provider ID | AN | 1 | 80 | O | |
10 | APC Enrolled | A | 1 | 1 | O | Y / N |
11 | eStatement Enrolled | A | 1 | 1 | O | Y / N |