| Seq |
Description |
German Interpretation |
Length |
C.LEN |
Table |
r/o/c |
Rep# |
Item |
Data Structure |
Section |
| 1 |
SET ID - GUARANTOR |
GT1-Segmentnummer |
..4 |
|
|
R |
N |
00321 |
SI |
|
| 2 |
GUARANTOR NUMBER |
Garantornummer des Patienten |
..20 |
|
|
O |
N |
00322 |
ID |
|
| 3 |
GUARANTOR NAME |
Garantorname |
..48 |
|
|
R |
N |
00323 |
PN |
|
| 4 |
GUARANTOR SPOUSE NAME |
Ehegatte des Garantors |
..48 |
|
|
O |
N |
00707 |
PN |
|
| 5 |
GUARANTOR ADDRESS |
Anschrift des G. |
..106 |
|
|
O |
N |
00324 |
AD |
|
| 6 |
GUARANTOR PH. NUM.- HOME |
Telefonnummer des G. privat |
..40 |
|
|
O |
N |
00329 |
TN |
|
| 7 |
GUARANTOR PH. NUM-BUSINESS |
Telefunnummer des G. beruflich |
..40 |
|
|
O |
N |
00330 |
TN |
|
| 8 |
GUARANTOR DATE OF BIRTH |
Geburtsname des G. |
..8 |
|
|
O |
N |
00331 |
DT |
|
| 9 |
GUARANTOR SEX |
Geschlecht d. Garantors |
..1 |
|
0001 |
O |
N |
00332 |
ID |
|
| 10 |
GUARANTOR TYPE |
Garantortyp |
..2 |
|
0068 |
O |
N |
00333 |
ID |
|
| 11 |
GUARANTOR RELATIONSHIP |
Verhältnis zum Patienten |
..2 |
|
0063 |
O |
N |
00334 |
ID |
|
| 12 |
GUARANTOR SSN |
Sozialversicherungsnummer des G. |
..11 |
|
|
O |
N |
00335 |
ST |
|
| 13 |
GUARANTOR DATE - BEGIN |
Beginn der Kostenübernahme durch d. Versicherten |
..8 |
|
|
O |
N |
00338 |
DT |
|
| 14 |
GUARANTOR DATE - END |
Ende der Kostenübernahme durch d. Versicherten |
..8 |
|
|
O |
N |
00339 |
DT |
|
| 15 |
GUARANTOR PRIORITY |
Rangfolge d. Garantoren |
..2 |
|
|
O |
N |
00340 |
NM |
|
| 16 |
GUARANTOR EMPLOYER NAME |
Name des Arbeitgebers |
..45 |
|
|
O |
N |
00341 |
ST |
|
| 17 |
GUARANTOR EMPLOYER ADDRESS |
Anschrift des Arbeitsgebers |
..106 |
|
|
O |
N |
00342 |
AD |
|
| 18 |
GUARANTOR EMPLOY PHONE # |
Telefonnummer des Arbeitgebers |
..40 |
|
|
O |
N |
00347 |
TN |
|
| 19 |
GUARANTOR EMPLOYEE ID NUM |
ID des Arbeitgebers |
..20 |
|
|
O |
N |
00391 |
ST |
|
| 20 |
GUARANTOR EMPLOYMENT STATUS |
Status |
..2 |
|
0066 |
O |
N |
00392 |
ID |
|