| Name | Description | Type | Additional information |
|---|---|---|---|
| PatientInsuranceIdentifierType | PatientInsuranceIdentifierType |
Required |
|
| PatientInsuranceIdentifier | string |
Required String length: inclusive between 0 and 35 |
|
| PersonCode | string |
String length: inclusive between 0 and 2 |
|
| PayerName | string |
None. |
|
| CustomEligibilityDetails | Collection of CustomEligibilityInfo |
None. |