`4F„2‡„MSH0\Ec:\tempHL7 JavaConsoleö›í«‚â@#7ƒg ÿÿÿÿÿÿÿÿ#7ƒg|~FR#7ƒg^Sÿÿÿÿ#7ƒg&Tÿÿÿÿ HL7Ȳ9…›M‡¶b4“¨ï—ü¯-·ÙK€w6š!þ·`#c™Patient_#c™4 MMaidenTitle MMaidenFirst MMaidenMiddle MMaidenLast MMaidenSuffix MMaidenDegreeMMaidenTypeCodeDOBSexRace1Race2Race3StreetStreet2CityStateZipCountry AddressTypeOtherGeoDesignationCountyParishCode CensusTractRepCode CountryCode LanguageIDLanguageDescripLanguageCoding MaritalStatusReligionSSN EthnicGroup CitizenshipCitizenshipDescripCitizenshipCoding NationalityNationalityDescripNationalityCoding AcctNumIDAcctNumCheckDigAcctNumCheckDigSchemeAcctNumAssignID AcctNumUnivIDAcctNumUnivIDTypeAcctNumTypeCodeAcctNumAssignFacIDAcctNumAssignFacUnivIDAcctNumAssignFacUnivType BirthPlace MultipleBirth BirthOrder PatDeathDT PatDeathIDPatient Demographic Information4G68’™x#G68’™x#G68’™x#G68’™x#G68’™x#G68’™x#G68’™x#G68’™x#G68’™x#G68’™x# G68’™x# G68’™x# G68’™x# G68’™x# G68’™x# G68’™x# G68’™x# G68’™x# G68’™x# G68’™x# G68’™x# G68’™x# G68’™x# G68’™x# 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Name852’Insurance Company Address52’Insurance Co. 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Contact Reasonˆ52’!Insurance Co Contact Phone Number52’ Policy Scopeˆ52’ Policy Sourceˆ52’Patient Member Numberé52’#Guarantor’s Relationship To Insuredˆ52’!Insured’s Telephone Number - Home52’#Insured’s Employer Telephone Number52’Military Handicapped Program©52’ Suspend FlagŒ52’Copay Limit FlagŒ52’Stoploss Limit FlagŒ52’ Insured Organization Name And ID852’)Insured Employer Organization Name And ID852’Raceˆ52’$HCFA Patient Relationship to Insured© Insurance Additional InformationE53T9'IN352’ Set ID - IN3æ52’Certification Numberé52’ Certified ByÏ52’Certification RequiredŒ52’Penalty»52’Certification Date/Time’52’Certification Modify Date/Time’52’OperatorÏ52’Certification Begin Date52’Certification End Date52’Days»52’Non-Concur Code/Description©52’Non-Concur Effective Date/Time’52’Physician ReviewerÏ52’Certification Contact52’"Certification Contact Phone Number52’ Appeal Reason©52’Certification Agency©52’!Certification Agency Phone Number52’Pre-Certification Req/Window»52’ Case Manager52’Second Opinion Date52’Second Opinion Statusˆ52’%Second Opinion Documentation Receivedˆ52’Second Opinion PhysicianÏ/Insurance Additional Information, certificationGRP2E53T9'ACC52’Accident Date/Time’52’ Accident Code©52’Accident Location52’Auto Accident State©52’Accident Job Related IndicatorŒ52’Accident Death IndicatorŒAccidentE53T9'UB152’ Set ID - 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