| Name | Description | Type | Additional information |
|---|---|---|---|
| PBOtherInsuranceKey | integer |
None. |
|
| MemberPBEntityKey | integer |
None. |
|
| PBAffiliationKey | integer |
None. |
|
| CoordinationOfBenefitsDesc | string |
None. |
|
| CoordinationOfBenefitsValueId | integer |
None. |
|
| PayerResponsibilityDesc | string |
None. |
|
| PayerResponsibilityValueId | integer |
None. |
|
| MedicarePlanTypeDesc | string |
None. |
|
| MedicarePlanTypeValueId | integer |
None. |
|
| InsuranceTypeDesc | string |
None. |
|
| InsuranceTypeValueId | integer |
None. |
|
| InEffect | date |
None. |
|
| OutOfEffect | date |
None. |
|
| PolicyNumber | string |
None. |
|
| CarrierName | string |
None. |
|
| CarrierPBEntityKey | integer |
None. |
|
| CarrierAddress | Address |
None. |
|
| EffectiveDates | string |
None. |