| Name | Description | Type | Additional information |
|---|---|---|---|
| PracticeType |
This element indicates whether this structure refers to a group, partnership or single practice. Valid values for this element are: • Group • Partnership • Single |
string |
None. |
| PracticeName |
This element is a free-text element with the human-readable name of the Group or Partnership practice. |
string |
None. |
| SpecialityCode |
This element is the speciality code for the billing practice. |
string |
None. |
| SubSpecialityCode |
This element stores the sub speciality code for the billing practice. Default is "000" |
string |
None. |
| PracticeNumber |
If it's ‘Group’ or ‘Partnership,’ this element is populated with the practice number of the main practice, i.e. the practice number used for billing purposes. If it's ‘Single,’ this element must be populated with the TreatingDoctorPracticeNumber |
string |
None. |
| TreatingDoctorName |
This element contains the treating doctor's name. |
string |
None. |
| TreatingDoctorPracticeNumber |
This element contains the treating doctor’s practice number. |
string |
None. |
| DispensingDoctor |
This element indicates if the treating doctor is a dispensing doctor. "Yes" or "No". Default is "No". |
string |
None. |
| DispensingLicenseNumber |
This element stores the treating doctor's dispensing license number. Required if DispensingDoctor = "Yes". |
string |
None. |
| HPCSANumber |
This element stores the treating doctor's dispensing license number. Required if DispensingDoctor = "Yes". |
string |
None. |