Amount | DEC | Y | | | Greater than 0. |
AddressVerificationInfo | See below fields | N | | | Complex element type. |
Street1 | AN | N | 1 | 150 | The primary street address associated with the card. |
Street2 | AN | N | 1 | 150 | Secondary street address associated with the card. |
Street3 | AN | N | 1 | 150 | |
City | AN | N | 1 | 50 | The city associated with the address of the card. |
State | AN | N | 1 | 2 | The state associated with the address of the card. |
Zip | AN | N | 1 | 15 | |
Country | AN | N | 1 | 30 | See Country Codes. |
Company | AN | N | 1 | 30 | |
MerchantID | AN | Y | 1 | 50 | The unique ID associated with your InstaMed Outlet, which will be given by your Implementations Manager. |
StoreID | AN | Y | 1 | 50 | See MerchantID comments. |
TerminalID | AN | Y | 1 | 50 | See MerchantID comments. |
TransactionID | AN | N | 1 | 50 | Not currently used. |
TransactionNumber | AN | N | 1 | 50 | Not currently used. |
BatchID | AN | N | 1 | 20 | Not currently used. |
Patient | | N | | | Complex element type. |
PatientID | AN | N | 1 | 50 | A unique identifier for the patient, which is typically sourced from the Patient Accounting System. |
PatientFirstName | AN | N | 1 | 50 | |
PatientLastName | AN | N | 1 | 50 | |
PatientMiddleName | AN | N | 1 | 50 | |
AdditionalInfo1 | AN | N | 1 | 100 | User-defined fields to be captured with the payment transaction. |
AdditionalInfo2 | AN | N | 1 | 100 | See AdditionalInfo1 comments. |
AdditionalInfo3 | AN | N | 1 | 100 | See AdditionalInfo1 comments. |
AdditionalInfo4 | AN | N | 1 | 100 | See AdditionalInfo1 comments. |
AdditionalInfo5 | AN | N | 1 | 100 | See AdditionalInfo1 comments. |
AdditionalInfo6 | AN | N | 1 | 100 | See AdditionalInfo1 comments. |
ReasonCode | AN | N | 1 | 50 | Not currently used. |
ReasonText | AN | N | 1 | 400 | Not currently used. |
PaymentType | AN | N | 1 | 20 | I.e., Cash or Check. |
Payee | AN | N | 1 | 50 | Not currently used. |
MarketSegment | AN | N | 1 | 50 | Not currently used. |
TransactionStatus | AN | N | 1 | 50 | Not currently used. |
TransactionCode | AN | N | 1 | 50 | |
PaymentPlanID | AN | N | 1 | 50 | Not currently used. |
InstaMedAccountID | AN | N | 1 | 100 | Not currently used. |