2010BB Payer Name
In this loop, all the information will be taken from Insurance master screen. Take a look of our sample screen here how insurance information are stored in the system.
NM102 - Entity Type Qualifier
2010BB Payer Name – Sample
NM1*PR*2*AETNA HEALTH INC*****PI*9393~
N3*P.O. BOX 1125~
N4*Blue Bell*PA*19422~
In this loop, all the information will be taken from Insurance master screen. Take a look of our sample screen here how insurance information are stored in the system.
Loop | Seg ID | Segment Name | Format | Length | Ref# | Req | Value |
2010BB | NM1 | Payer Name | ID | 3 | R | NM1 | |
Element Separator | AN | 1 | * | ||||
NM101 | Entity Identifier Code | ID | 2/3 | 98 | R | PR | |
Element Separator | AN | 1 | * | ||||
NM102 | Entity Type qualifier | ID | 1/1 | 1065 | R | 2 | |
Element Separator | AN | 1 | * | ||||
NM103 | Name Last or Organization Name | AN | 1/60 | 1035 | R | Insurance Name | |
Element Separator | AN | 1 | * | ||||
NM104 | Name First | AN | 1/35 | 1036 | Not used | ||
Element Separator | AN | 1 | * | ||||
NM105 | Name Middle | AN | 1/25 | 1037 | Not Used | ||
Element Separator | AN | 1 | * | ||||
NM106 | Name Prefix | AN | 1/10 | 1038 | Not used | ||
Element Separator | AN | 1 | * | ||||
NM107 | Name Suffix | AN | 1/10 | 1039 | Not Used | ||
Element Separator | AN | 1 | * | ||||
NM108 | Identification code Qualifier | ID | 1/2 | 66 | R | PI | |
Element Separator | AN | 1 | * | ||||
NM109 | Identification code | AN | 2/80 | 67 | R | Payer ID | |
Segment Terminator | ~ | ||||||
NM102 - Entity Type Qualifier
Code qualifying the type of entity
Code | Definition |
1 | Person |
2 | Non-Person Entity |
2010BB Payer Address
Loop | Seg ID | Segment Name | Format | Length | Ref# | Req | Value |
2010BB | N3 | Payer Address | AN | 2 | R | N3 | |
Element Separator | AN | 1 | * | ||||
N301 | Address Line 1 | AN | 1/55 | 166 | R | Insurance Address 1 | |
Element Separator | AN | 1 | * | ||||
N302 | Address Line 2 | AN | 1/55 | 1065 | S | Insurance Address Line 2 if exists | |
Segment Terminator | ~ |
2010BB Payer City/State/Zip code
Loop | Seg ID | Segment Name | Format | Length | Ref# | Req | Value |
2010BB | N4 | Payer City / State / Zip Code | AN | 2 | R | N4 | |
Element Separator | AN | 1 | * | ||||
N401 | City Name | AN | 2/30 | 19 | R | Insurance City Name | |
Element Separator | AN | 1 | * | ||||
N402 | State or Province Code | ID | 2/2 | 156 | R | Insurance State Code | |
Element Separator | AN | 1 | * | ||||
N403 | Postal Code | ID | 3/15 | 116 | R | Insurance Zip Code | |
Segment Terminator | ~ |
2010BB Payer Name – Sample
Insurance Master Information.
Field | Value |
Insurance Name | CIGNA |
Insurance Payer ID | 9086 |
Insurance Address line 1 | PO BOX 5200 |
Insurance Address Line 2 | |
Insurance City | Scranton |
Insurance State | PA |
Insurance Zip Code | 185051111 |
NM1*PR*2*AETNA HEALTH INC*****PI*9393~
N3*P.O. BOX 1125~
N4*Blue Bell*PA*19422~
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