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seqtypeoptdescriptionvalue
3.1OGuarantor Last Name
3.2OGuarantor First Name
3.3OGuarantor Middle Initial
5.1OGuarantor Address (Line 1)
5.2OGuarantor Address (Line 2)
5.3OGuarantor City
5.4OGuarantor State
5.5OGuarantor Zip Code
6OGuarantor Phone Number
11OGuarantor Relationship to Patient’1’ - Self ‘2’ - Spouse ‘3’ - Other
If no guarantor is explicitly specified in Elation then the segment will default to the patient’s information.
GT1|1||LAST^FIRST^M||100 ANY ST^APT B^CITY^CA^12345|1112223333|||||1|||||