Saturday, February 25, 2017

EDI 270–5010 Documentation– Loop 2100C SUBSCRIBER Name

EDI 270–5010 Documentation– Loop 2100C SUBSCRIBER Name


2100C Subscriber Name

        


Use this segment to identify an entity by name and/or identification number. Use this NM1 loop to identify the insured or subscriber

 
Loop Seg ID Segment Name Format Length Ref# Req Value
2100C NM1 Subscriber Name ID 3 R NM1
Element Separator AN 1 *
NM101 Entity Identifier Code ID 2/3 98 R IL
Element Separator AN 1 *
NM102 Entity Type qualifier ID 1/1 1065 R 1
Element Separator AN 1 *
NM103 Name Last or Organization Name AN 1/60 1035 R Insured Person Last Name
Element Separator AN 1 *
NM104 Name First AN 1/35 1036 S Insured Person First Name
Element Separator AN 1 *
NM105 Name Middle AN 1/25 1037 S Insured Person Middle Name
Element Separator AN 1 *
NM106 Name Prefix AN 1/10 1038 Not used
Element Separator AN 1 *
NM107 Name Suffix AN 1/10 1039 S Insured Person Suffix
Element Separator AN 1 *
NM108 Identification code Qualifier ID 1/2 66 R MI
Element Separator AN 1 *
NM109 Identification code AN 2/80 67 R Insured Policy No
Segment Terminator ~
               
 
 
NM102 - Entity Type Qualifier
Code qualifying the type of entity
Code Definition
1 Person
2 Non-Person Entity

 
Sample
NM1*IL*1*MULLIN*DANIEL****MI*XJBH12345678~

Segment Structure
image


image




SUBSCRIBER DEMOGRAPHIC INFORMATION

Use this segment to convey the birth date or gender demographic information for the subscriber. Use this segment only if the subscriber is the patient and if this information is available from the Information Source’s database.

Available link for download

Posted by at
Labels: , , , , , ,