| Name | Description | Type | Additional information |
|---|---|---|---|
| ClaimName | string |
String length: inclusive between 0 and 100 |
|
| ClaimAddress1 | string |
String length: inclusive between 0 and 60 |
|
| ClaimAddress2 | string |
String length: inclusive between 0 and 60 |
|
| ClaimCity | string |
String length: inclusive between 0 and 30 |
|
| ClaimState | string |
String length: inclusive between 0 and 20 |
|
| ClaimZip | string |
String length: inclusive between 0 and 10 |
|
| ClaimCountry | string |
String length: inclusive between 0 and 20 |
|
| ClaimPhoneNumber | string |
String length: inclusive between 0 and 20 |
|
| ClaimFaxNumber | string |
String length: inclusive between 0 and 20 |