| 1 | set_id_gt1 | SI | Required | No | - |
| 2 | ▶guarantor_number | CX | Optional | Yes | - |
| 2.1 | ├.id_number | ST | Optional | No | - |
| 2.2 | ├.identifier_check_digit | ST | Optional | No | - |
| 2.3 | ├.check_digit_scheme | ID | Optional | No | - |
| 2.4 | ├.assigning_authority | HD | Optional | No | - |
| 2.5 | ├.identifier_type_code | ID | Optional | No | - |
| 2.6 | ├.assigning_facility | HD | Optional | No | - |
| 2.7 | ├.effective_date | DT | Optional | No | - |
| 2.8 | ├.expiration_date | DT | Optional | No | - |
| 2.9 | ├.assigning_jurisdiction | CWE | Optional | No | - |
| 2.10 | ├.assigning_agency_or_department | CWE | Optional | No | - |
| 2.11 | ├.security_check | ST | Optional | No | - |
| 2.12 | └.security_check_scheme | ID | Optional | No | - |
| 3 | ▶guarantor_name | XPN | Required | Yes | - |
| 3.1 | ├.family_name | FN | Optional | No | - |
| 3.2 | ├.given_name | ST | Optional | No | - |
| 3.3 | ├.second_and_further_given_names_or_initials_thereof | ST | Optional | No | - |
| 3.4 | ├.suffix | ST | Optional | No | - |
| 3.5 | ├.prefix | ST | Optional | No | - |
| 3.6 | ├.degree | ST | Optional | No | - |
| 3.7 | ├.name_type_code | ID | Optional | No | - |
| 3.8 | ├.name_representation_code | ID | Optional | No | - |
| 3.9 | ├.name_context | CWE | Optional | No | - |
| 3.10 | ├.name_validity_range | DR | Optional | No | - |
| 3.11 | ├.name_assembly_order | ID | Optional | No | - |
| 3.12 | ├.effective_date | DTM | Optional | No | - |
| 3.13 | ├.expiration_date | DTM | Optional | No | - |
| 3.14 | ├.professional_suffix | ST | Optional | No | - |
| 3.15 | └.called_by | ST | Optional | No | - |
| 4 | ▶guarantor_spouse_name | XPN | Optional | Yes | - |
| 4.1 | ├.family_name | FN | Optional | No | - |
| 4.2 | ├.given_name | ST | Optional | No | - |
| 4.3 | ├.second_and_further_given_names_or_initials_thereof | ST | Optional | No | - |
| 4.4 | ├.suffix | ST | Optional | No | - |
| 4.5 | ├.prefix | ST | Optional | No | - |
| 4.6 | ├.degree | ST | Optional | No | - |
| 4.7 | ├.name_type_code | ID | Optional | No | - |
| 4.8 | ├.name_representation_code | ID | Optional | No | - |
| 4.9 | ├.name_context | CWE | Optional | No | - |
| 4.10 | ├.name_validity_range | DR | Optional | No | - |
| 4.11 | ├.name_assembly_order | ID | Optional | No | - |
| 4.12 | ├.effective_date | DTM | Optional | No | - |
| 4.13 | ├.expiration_date | DTM | Optional | No | - |
| 4.14 | ├.professional_suffix | ST | Optional | No | - |
| 4.15 | └.called_by | ST | Optional | No | - |
| 5 | ▶guarantor_address | XAD | Optional | Yes | - |
| 5.1 | ├.street_address | SAD | Optional | No | - |
| 5.2 | ├.other_designation | ST | Optional | No | - |
| 5.3 | ├.city | ST | Optional | No | - |
| 5.4 | ├.state_or_province | ST | Optional | No | - |
| 5.5 | ├.zip_or_postal_code | ST | Optional | No | - |
| 5.6 | ├.country | ID | Optional | No | - |
| 5.7 | ├.address_type | ID | Optional | No | - |
| 5.8 | ├.other_geographic_designation | ST | Optional | No | - |
| 5.9 | ├.county_parish_code | CWE | Optional | No | - |
| 5.10 | ├.census_tract | CWE | Optional | No | - |
| 5.11 | ├.address_representation_code | ID | Optional | No | - |
| 5.12 | ├.address_validity_range | DR | Optional | No | - |
| 5.13 | ├.effective_date | DTM | Optional | No | - |
| 5.14 | ├.expiration_date | DTM | Optional | No | - |
| 5.15 | ├.expiration_reason | CWE | Optional | No | - |
| 5.16 | ├.temporary_indicator | ID | Optional | No | - |
| 5.17 | ├.bad_address_indicator | ID | Optional | No | - |
| 5.18 | ├.address_usage | ID | Optional | No | - |
| 5.19 | ├.addressee | ST | Optional | No | - |
| 5.20 | ├.comment | ST | Optional | No | - |
| 5.21 | ├.preference_order | NM | Optional | No | - |
| 5.22 | ├.protection_code | CWE | Optional | No | - |
| 5.23 | └.address_identifier | EI | Optional | No | - |
| 6 | ▶guarantor_ph_num_home | XTN | Optional | Yes | - |
| 6.1 | ├.telephone_number | ST | Optional | No | - |
| 6.2 | ├.telecommunication_use_code | ID | Optional | No | - |
| 6.3 | ├.telecommunication_equipment_type | ID | Optional | No | - |
| 6.4 | ├.communication_address | ST | Optional | No | - |
| 6.5 | ├.country_code | SNM | Optional | No | - |
| 6.6 | ├.area_city_code | SNM | Optional | No | - |
| 6.7 | ├.local_number | SNM | Optional | No | - |
| 6.8 | ├.extension | SNM | Optional | No | - |
| 6.9 | ├.any_text | ST | Optional | No | - |
| 6.10 | ├.extension_prefix | ST | Optional | No | - |
| 6.11 | ├.speed_dial_code | ST | Optional | No | - |
| 6.12 | ├.unformatted_telephone_number | ST | Optional | No | - |
| 6.13 | ├.effective_start_date | DTM | Optional | No | - |
| 6.14 | ├.expiration_date | DTM | Optional | No | - |
| 6.15 | ├.expiration_reason | CWE | Optional | No | - |
| 6.16 | ├.protection_code | CWE | Optional | No | - |
| 6.17 | ├.shared_telecommunication_identifier | EI | Optional | No | - |
| 6.18 | └.preference_order | NM | Optional | No | - |
| 7 | ▶guarantor_ph_num_business | XTN | Optional | Yes | - |
| 7.1 | ├.telephone_number | ST | Optional | No | - |
| 7.2 | ├.telecommunication_use_code | ID | Optional | No | - |
| 7.3 | ├.telecommunication_equipment_type | ID | Optional | No | - |
| 7.4 | ├.communication_address | ST | Optional | No | - |
| 7.5 | ├.country_code | SNM | Optional | No | - |
| 7.6 | ├.area_city_code | SNM | Optional | No | - |
| 7.7 | ├.local_number | SNM | Optional | No | - |
| 7.8 | ├.extension | SNM | Optional | No | - |
| 7.9 | ├.any_text | ST | Optional | No | - |
| 7.10 | ├.extension_prefix | ST | Optional | No | - |
| 7.11 | ├.speed_dial_code | ST | Optional | No | - |
| 7.12 | ├.unformatted_telephone_number | ST | Optional | No | - |
| 7.13 | ├.effective_start_date | DTM | Optional | No | - |
| 7.14 | ├.expiration_date | DTM | Optional | No | - |
| 7.15 | ├.expiration_reason | CWE | Optional | No | - |
| 7.16 | ├.protection_code | CWE | Optional | No | - |
| 7.17 | ├.shared_telecommunication_identifier | EI | Optional | No | - |
| 7.18 | └.preference_order | NM | Optional | No | - |
| 8 | guarantor_date_time_of_birth | DTM | Optional | No | - |
| 9 | ▶guarantor_administrative_sex | CWE | Optional | No | HL70001 |
| 9.1 | ├.identifier | ST | Optional | No | - |
| 9.2 | ├.text | ST | Optional | No | - |
| 9.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 9.4 | ├.alternate_identifier | ST | Optional | No | - |
| 9.5 | ├.alternate_text | ST | Optional | No | - |
| 9.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 9.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 9.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 9.9 | ├.original_text | ST | Optional | No | - |
| 9.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 9.11 | ├.second_alternate_text | ST | Optional | No | - |
| 9.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 9.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 9.14 | ├.coding_system_oid | ST | Optional | No | - |
| 9.15 | ├.value_set_oid | ST | Optional | No | - |
| 9.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 9.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 9.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 9.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 9.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 9.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 9.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 10 | ▶guarantor_type | CWE | Optional | No | HL70068 |
| 10.1 | ├.identifier | ST | Optional | No | - |
| 10.2 | ├.text | ST | Optional | No | - |
| 10.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 10.4 | ├.alternate_identifier | ST | Optional | No | - |
| 10.5 | ├.alternate_text | ST | Optional | No | - |
| 10.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 10.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 10.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 10.9 | ├.original_text | ST | Optional | No | - |
| 10.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 10.11 | ├.second_alternate_text | ST | Optional | No | - |
| 10.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 10.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 10.14 | ├.coding_system_oid | ST | Optional | No | - |
| 10.15 | ├.value_set_oid | ST | Optional | No | - |
| 10.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 10.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 10.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 10.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 10.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 10.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 10.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 11 | ▶guarantor_relationship | CWE | Optional | No | HL70063 |
| 11.1 | ├.identifier | ST | Optional | No | - |
| 11.2 | ├.text | ST | Optional | No | - |
| 11.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 11.4 | ├.alternate_identifier | ST | Optional | No | - |
| 11.5 | ├.alternate_text | ST | Optional | No | - |
| 11.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 11.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 11.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 11.9 | ├.original_text | ST | Optional | No | - |
| 11.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 11.11 | ├.second_alternate_text | ST | Optional | No | - |
| 11.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 11.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 11.14 | ├.coding_system_oid | ST | Optional | No | - |
| 11.15 | ├.value_set_oid | ST | Optional | No | - |
| 11.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 11.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 11.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 11.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 11.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 11.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 11.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 12 | guarantor_ssn | ST | Optional | No | - |
| 13 | guarantor_date_begin | DT | Optional | No | - |
| 14 | guarantor_date_end | DT | Optional | No | - |
| 15 | guarantor_priority | NM | Optional | No | - |
| 16 | ▶guarantor_employer_name | XPN | Optional | Yes | - |
| 16.1 | ├.family_name | FN | Optional | No | - |
| 16.2 | ├.given_name | ST | Optional | No | - |
| 16.3 | ├.second_and_further_given_names_or_initials_thereof | ST | Optional | No | - |
| 16.4 | ├.suffix | ST | Optional | No | - |
| 16.5 | ├.prefix | ST | Optional | No | - |
| 16.6 | ├.degree | ST | Optional | No | - |
| 16.7 | ├.name_type_code | ID | Optional | No | - |
| 16.8 | ├.name_representation_code | ID | Optional | No | - |
| 16.9 | ├.name_context | CWE | Optional | No | - |
| 16.10 | ├.name_validity_range | DR | Optional | No | - |
| 16.11 | ├.name_assembly_order | ID | Optional | No | - |
| 16.12 | ├.effective_date | DTM | Optional | No | - |
| 16.13 | ├.expiration_date | DTM | Optional | No | - |
| 16.14 | ├.professional_suffix | ST | Optional | No | - |
| 16.15 | └.called_by | ST | Optional | No | - |
| 17 | ▶guarantor_employer_address | XAD | Optional | Yes | - |
| 17.1 | ├.street_address | SAD | Optional | No | - |
| 17.2 | ├.other_designation | ST | Optional | No | - |
| 17.3 | ├.city | ST | Optional | No | - |
| 17.4 | ├.state_or_province | ST | Optional | No | - |
| 17.5 | ├.zip_or_postal_code | ST | Optional | No | - |
| 17.6 | ├.country | ID | Optional | No | - |
| 17.7 | ├.address_type | ID | Optional | No | - |
| 17.8 | ├.other_geographic_designation | ST | Optional | No | - |
| 17.9 | ├.county_parish_code | CWE | Optional | No | - |
| 17.10 | ├.census_tract | CWE | Optional | No | - |
| 17.11 | ├.address_representation_code | ID | Optional | No | - |
| 17.12 | ├.address_validity_range | DR | Optional | No | - |
| 17.13 | ├.effective_date | DTM | Optional | No | - |
| 17.14 | ├.expiration_date | DTM | Optional | No | - |
| 17.15 | ├.expiration_reason | CWE | Optional | No | - |
| 17.16 | ├.temporary_indicator | ID | Optional | No | - |
| 17.17 | ├.bad_address_indicator | ID | Optional | No | - |
| 17.18 | ├.address_usage | ID | Optional | No | - |
| 17.19 | ├.addressee | ST | Optional | No | - |
| 17.20 | ├.comment | ST | Optional | No | - |
| 17.21 | ├.preference_order | NM | Optional | No | - |
| 17.22 | ├.protection_code | CWE | Optional | No | - |
| 17.23 | └.address_identifier | EI | Optional | No | - |
| 18 | ▶guarantor_employer_phone_number | XTN | Optional | Yes | - |
| 18.1 | ├.telephone_number | ST | Optional | No | - |
| 18.2 | ├.telecommunication_use_code | ID | Optional | No | - |
| 18.3 | ├.telecommunication_equipment_type | ID | Optional | No | - |
| 18.4 | ├.communication_address | ST | Optional | No | - |
| 18.5 | ├.country_code | SNM | Optional | No | - |
| 18.6 | ├.area_city_code | SNM | Optional | No | - |
| 18.7 | ├.local_number | SNM | Optional | No | - |
| 18.8 | ├.extension | SNM | Optional | No | - |
| 18.9 | ├.any_text | ST | Optional | No | - |
| 18.10 | ├.extension_prefix | ST | Optional | No | - |
| 18.11 | ├.speed_dial_code | ST | Optional | No | - |
| 18.12 | ├.unformatted_telephone_number | ST | Optional | No | - |
| 18.13 | ├.effective_start_date | DTM | Optional | No | - |
| 18.14 | ├.expiration_date | DTM | Optional | No | - |
| 18.15 | ├.expiration_reason | CWE | Optional | No | - |
| 18.16 | ├.protection_code | CWE | Optional | No | - |
| 18.17 | ├.shared_telecommunication_identifier | EI | Optional | No | - |
| 18.18 | └.preference_order | NM | Optional | No | - |
| 19 | ▶guarantor_employee_id_number | CX | Optional | Yes | - |
| 19.1 | ├.id_number | ST | Optional | No | - |
| 19.2 | ├.identifier_check_digit | ST | Optional | No | - |
| 19.3 | ├.check_digit_scheme | ID | Optional | No | - |
| 19.4 | ├.assigning_authority | HD | Optional | No | - |
| 19.5 | ├.identifier_type_code | ID | Optional | No | - |
| 19.6 | ├.assigning_facility | HD | Optional | No | - |
| 19.7 | ├.effective_date | DT | Optional | No | - |
| 19.8 | ├.expiration_date | DT | Optional | No | - |
| 19.9 | ├.assigning_jurisdiction | CWE | Optional | No | - |
| 19.10 | ├.assigning_agency_or_department | CWE | Optional | No | - |
| 19.11 | ├.security_check | ST | Optional | No | - |
| 19.12 | └.security_check_scheme | ID | Optional | No | - |
| 20 | ▶guarantor_employment_status | CWE | Optional | No | HL70066 |
| 20.1 | ├.identifier | ST | Optional | No | - |
| 20.2 | ├.text | ST | Optional | No | - |
| 20.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 20.4 | ├.alternate_identifier | ST | Optional | No | - |
| 20.5 | ├.alternate_text | ST | Optional | No | - |
| 20.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 20.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 20.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 20.9 | ├.original_text | ST | Optional | No | - |
| 20.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 20.11 | ├.second_alternate_text | ST | Optional | No | - |
| 20.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 20.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 20.14 | ├.coding_system_oid | ST | Optional | No | - |
| 20.15 | ├.value_set_oid | ST | Optional | No | - |
| 20.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 20.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 20.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 20.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 20.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 20.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 20.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 21 | ▶guarantor_organization_name | XON | Optional | Yes | - |
| 21.1 | ├.organization_name | ST | Optional | No | - |
| 21.2 | ├.organization_name_type_code | CWE | Optional | No | - |
| 21.3 | ├.id_number | NM | Optional | No | - |
| 21.4 | ├.identifier_check_digit | ST | Optional | No | - |
| 21.5 | ├.check_digit_scheme | ID | Optional | No | - |
| 21.6 | ├.assigning_authority | HD | Optional | No | - |
| 21.7 | ├.identifier_type_code | ID | Optional | No | - |
| 21.8 | ├.assigning_facility | HD | Optional | No | - |
| 21.9 | ├.name_representation_code | ID | Optional | No | - |
| 21.10 | └.organization_identifier | ST | Optional | No | - |
| 22 | guarantor_billing_hold_flag | ID | Optional | No | HL70136 |
| 23 | ▶guarantor_credit_rating_code | CWE | Optional | No | HL70341 |
| 23.1 | ├.identifier | ST | Optional | No | - |
| 23.2 | ├.text | ST | Optional | No | - |
| 23.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 23.4 | ├.alternate_identifier | ST | Optional | No | - |
| 23.5 | ├.alternate_text | ST | Optional | No | - |
| 23.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 23.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 23.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 23.9 | ├.original_text | ST | Optional | No | - |
| 23.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 23.11 | ├.second_alternate_text | ST | Optional | No | - |
| 23.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 23.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 23.14 | ├.coding_system_oid | ST | Optional | No | - |
| 23.15 | ├.value_set_oid | ST | Optional | No | - |
| 23.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 23.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 23.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 23.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 23.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 23.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 23.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 24 | guarantor_death_date_and_time | DTM | Optional | No | - |
| 25 | guarantor_death_flag | ID | Optional | No | HL70136 |
| 26 | ▶guarantor_charge_adjustment_code | CWE | Optional | No | HL70218 |
| 26.1 | ├.identifier | ST | Optional | No | - |
| 26.2 | ├.text | ST | Optional | No | - |
| 26.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 26.4 | ├.alternate_identifier | ST | Optional | No | - |
| 26.5 | ├.alternate_text | ST | Optional | No | - |
| 26.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 26.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 26.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 26.9 | ├.original_text | ST | Optional | No | - |
| 26.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 26.11 | ├.second_alternate_text | ST | Optional | No | - |
| 26.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 26.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 26.14 | ├.coding_system_oid | ST | Optional | No | - |
| 26.15 | ├.value_set_oid | ST | Optional | No | - |
| 26.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 26.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 26.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 26.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 26.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 26.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 26.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 27 | ▶guarantor_household_annual_income | CP | Optional | No | - |
| 27.1 | ├.price | MO | Optional | No | - |
| 27.2 | ├.price_type | ID | Optional | No | - |
| 27.3 | ├.from_value | NM | Optional | No | - |
| 27.4 | ├.to_value | NM | Optional | No | - |
| 27.5 | ├.range_units | CWE | Optional | No | - |
| 27.6 | └.range_type | ID | Optional | No | - |
| 28 | guarantor_household_size | NM | Optional | No | - |
| 29 | ▶guarantor_employer_id_number | CX | Optional | Yes | - |
| 29.1 | ├.id_number | ST | Optional | No | - |
| 29.2 | ├.identifier_check_digit | ST | Optional | No | - |
| 29.3 | ├.check_digit_scheme | ID | Optional | No | - |
| 29.4 | ├.assigning_authority | HD | Optional | No | - |
| 29.5 | ├.identifier_type_code | ID | Optional | No | - |
| 29.6 | ├.assigning_facility | HD | Optional | No | - |
| 29.7 | ├.effective_date | DT | Optional | No | - |
| 29.8 | ├.expiration_date | DT | Optional | No | - |
| 29.9 | ├.assigning_jurisdiction | CWE | Optional | No | - |
| 29.10 | ├.assigning_agency_or_department | CWE | Optional | No | - |
| 29.11 | ├.security_check | ST | Optional | No | - |
| 29.12 | └.security_check_scheme | ID | Optional | No | - |
| 30 | ▶guarantor_marital_status_code | CWE | Optional | No | HL70002 |
| 30.1 | ├.identifier | ST | Optional | No | - |
| 30.2 | ├.text | ST | Optional | No | - |
| 30.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 30.4 | ├.alternate_identifier | ST | Optional | No | - |
| 30.5 | ├.alternate_text | ST | Optional | No | - |
| 30.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 30.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 30.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 30.9 | ├.original_text | ST | Optional | No | - |
| 30.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 30.11 | ├.second_alternate_text | ST | Optional | No | - |
| 30.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 30.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 30.14 | ├.coding_system_oid | ST | Optional | No | - |
| 30.15 | ├.value_set_oid | ST | Optional | No | - |
| 30.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 30.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 30.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 30.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 30.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 30.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 30.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 31 | guarantor_hire_effective_date | DT | Optional | No | - |
| 32 | employment_stop_date | DT | Optional | No | - |
| 33 | ▶living_dependency | CWE | Optional | No | HL70223 |
| 33.1 | ├.identifier | ST | Optional | No | - |
| 33.2 | ├.text | ST | Optional | No | - |
| 33.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 33.4 | ├.alternate_identifier | ST | Optional | No | - |
| 33.5 | ├.alternate_text | ST | Optional | No | - |
| 33.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 33.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 33.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 33.9 | ├.original_text | ST | Optional | No | - |
| 33.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 33.11 | ├.second_alternate_text | ST | Optional | No | - |
| 33.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 33.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 33.14 | ├.coding_system_oid | ST | Optional | No | - |
| 33.15 | ├.value_set_oid | ST | Optional | No | - |
| 33.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 33.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 33.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 33.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 33.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 33.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 33.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 34 | ▶ambulatory_status | CWE | Optional | Yes | HL70009 |
| 34.1 | ├.identifier | ST | Optional | No | - |
| 34.2 | ├.text | ST | Optional | No | - |
| 34.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 34.4 | ├.alternate_identifier | ST | Optional | No | - |
| 34.5 | ├.alternate_text | ST | Optional | No | - |
| 34.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 34.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 34.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 34.9 | ├.original_text | ST | Optional | No | - |
| 34.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 34.11 | ├.second_alternate_text | ST | Optional | No | - |
| 34.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 34.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 34.14 | ├.coding_system_oid | ST | Optional | No | - |
| 34.15 | ├.value_set_oid | ST | Optional | No | - |
| 34.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 34.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 34.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 34.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 34.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 34.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 34.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 35 | ▶citizenship | CWE | Optional | Yes | HL70171 |
| 35.1 | ├.identifier | ST | Optional | No | - |
| 35.2 | ├.text | ST | Optional | No | - |
| 35.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 35.4 | ├.alternate_identifier | ST | Optional | No | - |
| 35.5 | ├.alternate_text | ST | Optional | No | - |
| 35.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 35.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 35.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 35.9 | ├.original_text | ST | Optional | No | - |
| 35.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 35.11 | ├.second_alternate_text | ST | Optional | No | - |
| 35.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 35.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 35.14 | ├.coding_system_oid | ST | Optional | No | - |
| 35.15 | ├.value_set_oid | ST | Optional | No | - |
| 35.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 35.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 35.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 35.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 35.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 35.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 35.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 36 | ▶primary_language | CWE | Optional | No | HL70296 |
| 36.1 | ├.identifier | ST | Optional | No | - |
| 36.2 | ├.text | ST | Optional | No | - |
| 36.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 36.4 | ├.alternate_identifier | ST | Optional | No | - |
| 36.5 | ├.alternate_text | ST | Optional | No | - |
| 36.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 36.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 36.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 36.9 | ├.original_text | ST | Optional | No | - |
| 36.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 36.11 | ├.second_alternate_text | ST | Optional | No | - |
| 36.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 36.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 36.14 | ├.coding_system_oid | ST | Optional | No | - |
| 36.15 | ├.value_set_oid | ST | Optional | No | - |
| 36.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 36.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 36.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 36.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 36.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 36.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 36.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 37 | ▶living_arrangement | CWE | Optional | No | HL70220 |
| 37.1 | ├.identifier | ST | Optional | No | - |
| 37.2 | ├.text | ST | Optional | No | - |
| 37.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 37.4 | ├.alternate_identifier | ST | Optional | No | - |
| 37.5 | ├.alternate_text | ST | Optional | No | - |
| 37.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 37.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 37.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 37.9 | ├.original_text | ST | Optional | No | - |
| 37.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 37.11 | ├.second_alternate_text | ST | Optional | No | - |
| 37.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 37.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 37.14 | ├.coding_system_oid | ST | Optional | No | - |
| 37.15 | ├.value_set_oid | ST | Optional | No | - |
| 37.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 37.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 37.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 37.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 37.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 37.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 37.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 38 | ▶publicity_code | CWE | Optional | No | HL70215 |
| 38.1 | ├.identifier | ST | Optional | No | - |
| 38.2 | ├.text | ST | Optional | No | - |
| 38.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 38.4 | ├.alternate_identifier | ST | Optional | No | - |
| 38.5 | ├.alternate_text | ST | Optional | No | - |
| 38.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 38.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 38.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 38.9 | ├.original_text | ST | Optional | No | - |
| 38.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 38.11 | ├.second_alternate_text | ST | Optional | No | - |
| 38.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 38.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 38.14 | ├.coding_system_oid | ST | Optional | No | - |
| 38.15 | ├.value_set_oid | ST | Optional | No | - |
| 38.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 38.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 38.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 38.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 38.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 38.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 38.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 39 | protection_indicator | ID | Optional | No | HL70136 |
| 40 | ▶student_indicator | CWE | Optional | No | HL70231 |
| 40.1 | ├.identifier | ST | Optional | No | - |
| 40.2 | ├.text | ST | Optional | No | - |
| 40.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 40.4 | ├.alternate_identifier | ST | Optional | No | - |
| 40.5 | ├.alternate_text | ST | Optional | No | - |
| 40.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 40.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 40.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 40.9 | ├.original_text | ST | Optional | No | - |
| 40.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 40.11 | ├.second_alternate_text | ST | Optional | No | - |
| 40.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 40.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 40.14 | ├.coding_system_oid | ST | Optional | No | - |
| 40.15 | ├.value_set_oid | ST | Optional | No | - |
| 40.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 40.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 40.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 40.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 40.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 40.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 40.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 41 | ▶religion | CWE | Optional | No | HL70006 |
| 41.1 | ├.identifier | ST | Optional | No | - |
| 41.2 | ├.text | ST | Optional | No | - |
| 41.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 41.4 | ├.alternate_identifier | ST | Optional | No | - |
| 41.5 | ├.alternate_text | ST | Optional | No | - |
| 41.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 41.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 41.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 41.9 | ├.original_text | ST | Optional | No | - |
| 41.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 41.11 | ├.second_alternate_text | ST | Optional | No | - |
| 41.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 41.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 41.14 | ├.coding_system_oid | ST | Optional | No | - |
| 41.15 | ├.value_set_oid | ST | Optional | No | - |
| 41.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 41.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 41.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 41.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 41.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 41.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 41.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 42 | ▶mothers_maiden_name | XPN | Optional | Yes | - |
| 42.1 | ├.family_name | FN | Optional | No | - |
| 42.2 | ├.given_name | ST | Optional | No | - |
| 42.3 | ├.second_and_further_given_names_or_initials_thereof | ST | Optional | No | - |
| 42.4 | ├.suffix | ST | Optional | No | - |
| 42.5 | ├.prefix | ST | Optional | No | - |
| 42.6 | ├.degree | ST | Optional | No | - |
| 42.7 | ├.name_type_code | ID | Optional | No | - |
| 42.8 | ├.name_representation_code | ID | Optional | No | - |
| 42.9 | ├.name_context | CWE | Optional | No | - |
| 42.10 | ├.name_validity_range | DR | Optional | No | - |
| 42.11 | ├.name_assembly_order | ID | Optional | No | - |
| 42.12 | ├.effective_date | DTM | Optional | No | - |
| 42.13 | ├.expiration_date | DTM | Optional | No | - |
| 42.14 | ├.professional_suffix | ST | Optional | No | - |
| 42.15 | └.called_by | ST | Optional | No | - |
| 43 | ▶nationality | CWE | Optional | No | HL70212 |
| 43.1 | ├.identifier | ST | Optional | No | - |
| 43.2 | ├.text | ST | Optional | No | - |
| 43.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 43.4 | ├.alternate_identifier | ST | Optional | No | - |
| 43.5 | ├.alternate_text | ST | Optional | No | - |
| 43.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 43.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 43.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 43.9 | ├.original_text | ST | Optional | No | - |
| 43.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 43.11 | ├.second_alternate_text | ST | Optional | No | - |
| 43.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 43.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 43.14 | ├.coding_system_oid | ST | Optional | No | - |
| 43.15 | ├.value_set_oid | ST | Optional | No | - |
| 43.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 43.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 43.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 43.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 43.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 43.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 43.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 44 | ▶ethnic_group | CWE | Optional | Yes | HL70189 |
| 44.1 | ├.identifier | ST | Optional | No | - |
| 44.2 | ├.text | ST | Optional | No | - |
| 44.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 44.4 | ├.alternate_identifier | ST | Optional | No | - |
| 44.5 | ├.alternate_text | ST | Optional | No | - |
| 44.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 44.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 44.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 44.9 | ├.original_text | ST | Optional | No | - |
| 44.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 44.11 | ├.second_alternate_text | ST | Optional | No | - |
| 44.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 44.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 44.14 | ├.coding_system_oid | ST | Optional | No | - |
| 44.15 | ├.value_set_oid | ST | Optional | No | - |
| 44.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 44.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 44.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 44.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 44.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 44.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 44.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 45 | ▶contact_persons_name | XPN | Optional | Yes | - |
| 45.1 | ├.family_name | FN | Optional | No | - |
| 45.2 | ├.given_name | ST | Optional | No | - |
| 45.3 | ├.second_and_further_given_names_or_initials_thereof | ST | Optional | No | - |
| 45.4 | ├.suffix | ST | Optional | No | - |
| 45.5 | ├.prefix | ST | Optional | No | - |
| 45.6 | ├.degree | ST | Optional | No | - |
| 45.7 | ├.name_type_code | ID | Optional | No | - |
| 45.8 | ├.name_representation_code | ID | Optional | No | - |
| 45.9 | ├.name_context | CWE | Optional | No | - |
| 45.10 | ├.name_validity_range | DR | Optional | No | - |
| 45.11 | ├.name_assembly_order | ID | Optional | No | - |
| 45.12 | ├.effective_date | DTM | Optional | No | - |
| 45.13 | ├.expiration_date | DTM | Optional | No | - |
| 45.14 | ├.professional_suffix | ST | Optional | No | - |
| 45.15 | └.called_by | ST | Optional | No | - |
| 46 | ▶contact_persons_telephone_number | XTN | Optional | Yes | - |
| 46.1 | ├.telephone_number | ST | Optional | No | - |
| 46.2 | ├.telecommunication_use_code | ID | Optional | No | - |
| 46.3 | ├.telecommunication_equipment_type | ID | Optional | No | - |
| 46.4 | ├.communication_address | ST | Optional | No | - |
| 46.5 | ├.country_code | SNM | Optional | No | - |
| 46.6 | ├.area_city_code | SNM | Optional | No | - |
| 46.7 | ├.local_number | SNM | Optional | No | - |
| 46.8 | ├.extension | SNM | Optional | No | - |
| 46.9 | ├.any_text | ST | Optional | No | - |
| 46.10 | ├.extension_prefix | ST | Optional | No | - |
| 46.11 | ├.speed_dial_code | ST | Optional | No | - |
| 46.12 | ├.unformatted_telephone_number | ST | Optional | No | - |
| 46.13 | ├.effective_start_date | DTM | Optional | No | - |
| 46.14 | ├.expiration_date | DTM | Optional | No | - |
| 46.15 | ├.expiration_reason | CWE | Optional | No | - |
| 46.16 | ├.protection_code | CWE | Optional | No | - |
| 46.17 | ├.shared_telecommunication_identifier | EI | Optional | No | - |
| 46.18 | └.preference_order | NM | Optional | No | - |
| 47 | ▶contact_reason | CWE | Optional | No | HL70222 |
| 47.1 | ├.identifier | ST | Optional | No | - |
| 47.2 | ├.text | ST | Optional | No | - |
| 47.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 47.4 | ├.alternate_identifier | ST | Optional | No | - |
| 47.5 | ├.alternate_text | ST | Optional | No | - |
| 47.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 47.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 47.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 47.9 | ├.original_text | ST | Optional | No | - |
| 47.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 47.11 | ├.second_alternate_text | ST | Optional | No | - |
| 47.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 47.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 47.14 | ├.coding_system_oid | ST | Optional | No | - |
| 47.15 | ├.value_set_oid | ST | Optional | No | - |
| 47.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 47.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 47.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 47.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 47.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 47.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 47.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 48 | ▶contact_relationship | CWE | Optional | No | HL70063 |
| 48.1 | ├.identifier | ST | Optional | No | - |
| 48.2 | ├.text | ST | Optional | No | - |
| 48.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 48.4 | ├.alternate_identifier | ST | Optional | No | - |
| 48.5 | ├.alternate_text | ST | Optional | No | - |
| 48.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 48.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 48.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 48.9 | ├.original_text | ST | Optional | No | - |
| 48.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 48.11 | ├.second_alternate_text | ST | Optional | No | - |
| 48.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 48.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 48.14 | ├.coding_system_oid | ST | Optional | No | - |
| 48.15 | ├.value_set_oid | ST | Optional | No | - |
| 48.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 48.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 48.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 48.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 48.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 48.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 48.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 49 | job_title | ST | Optional | No | - |
| 50 | ▶job_code_class | JCC | Optional | No | - |
| 50.1 | ├.job_code | CWE | Optional | No | - |
| 50.2 | ├.job_class | CWE | Optional | No | - |
| 50.3 | └.job_description_text | ID | Optional | No | - |
| 51 | ▶guarantor_employers_organization_name | XON | Optional | Yes | - |
| 51.1 | ├.organization_name | ST | Optional | No | - |
| 51.2 | ├.organization_name_type_code | CWE | Optional | No | - |
| 51.3 | ├.id_number | NM | Optional | No | - |
| 51.4 | ├.identifier_check_digit | ST | Optional | No | - |
| 51.5 | ├.check_digit_scheme | ID | Optional | No | - |
| 51.6 | ├.assigning_authority | HD | Optional | No | - |
| 51.7 | ├.identifier_type_code | ID | Optional | No | - |
| 51.8 | ├.assigning_facility | HD | Optional | No | - |
| 51.9 | ├.name_representation_code | ID | Optional | No | - |
| 51.10 | └.organization_identifier | ST | Optional | No | - |
| 52 | ▶handicap | CWE | Optional | No | HL70295 |
| 52.1 | ├.identifier | ST | Optional | No | - |
| 52.2 | ├.text | ST | Optional | No | - |
| 52.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 52.4 | ├.alternate_identifier | ST | Optional | No | - |
| 52.5 | ├.alternate_text | ST | Optional | No | - |
| 52.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 52.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 52.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 52.9 | ├.original_text | ST | Optional | No | - |
| 52.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 52.11 | ├.second_alternate_text | ST | Optional | No | - |
| 52.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 52.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 52.14 | ├.coding_system_oid | ST | Optional | No | - |
| 52.15 | ├.value_set_oid | ST | Optional | No | - |
| 52.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 52.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 52.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 52.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 52.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 52.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 52.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 53 | ▶job_status | CWE | Optional | No | HL70311 |
| 53.1 | ├.identifier | ST | Optional | No | - |
| 53.2 | ├.text | ST | Optional | No | - |
| 53.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 53.4 | ├.alternate_identifier | ST | Optional | No | - |
| 53.5 | ├.alternate_text | ST | Optional | No | - |
| 53.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 53.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 53.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 53.9 | ├.original_text | ST | Optional | No | - |
| 53.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 53.11 | ├.second_alternate_text | ST | Optional | No | - |
| 53.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 53.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 53.14 | ├.coding_system_oid | ST | Optional | No | - |
| 53.15 | ├.value_set_oid | ST | Optional | No | - |
| 53.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 53.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 53.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 53.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 53.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 53.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 53.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 54 | ▶guarantor_financial_class | FC | Optional | No | - |
| 54.1 | ├.financial_class_code | CWE | Optional | No | - |
| 54.2 | └.effective_date | DTM | Optional | No | - |
| 55 | ▶guarantor_race | CWE | Optional | Yes | HL70005 |
| 55.1 | ├.identifier | ST | Optional | No | - |
| 55.2 | ├.text | ST | Optional | No | - |
| 55.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 55.4 | ├.alternate_identifier | ST | Optional | No | - |
| 55.5 | ├.alternate_text | ST | Optional | No | - |
| 55.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 55.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 55.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 55.9 | ├.original_text | ST | Optional | No | - |
| 55.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 55.11 | ├.second_alternate_text | ST | Optional | No | - |
| 55.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 55.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 55.14 | ├.coding_system_oid | ST | Optional | No | - |
| 55.15 | ├.value_set_oid | ST | Optional | No | - |
| 55.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 55.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 55.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 55.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 55.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 55.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 55.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 56 | guarantor_birth_place | ST | Optional | No | - |
| 57 | ▶vip_indicator | CWE | Optional | No | HL70099 |
| 57.1 | ├.identifier | ST | Optional | No | - |
| 57.2 | ├.text | ST | Optional | No | - |
| 57.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 57.4 | ├.alternate_identifier | ST | Optional | No | - |
| 57.5 | ├.alternate_text | ST | Optional | No | - |
| 57.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 57.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 57.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 57.9 | ├.original_text | ST | Optional | No | - |
| 57.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 57.11 | ├.second_alternate_text | ST | Optional | No | - |
| 57.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 57.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 57.14 | ├.coding_system_oid | ST | Optional | No | - |
| 57.15 | ├.value_set_oid | ST | Optional | No | - |
| 57.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 57.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 57.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 57.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 57.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 57.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 57.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |