Healthcare IT EMR PMS: EDI 5010 Documentation 837 Professional

1000A - Submitter Name.

Loop	Seg ID	Segment Name	Format	Length	Ref#	Req	Value
Header	NM1	Submitter Name	ID	3		R	NM1
		Element Separator	AN	1			*
	NM101	Entity Identifier Code	ID	2/3	98	R	41
		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	Practice name.
		Element Separator	AN	1			*
	NM104	Name First	AN	1/35	1036	S	This is required only when NM102 is 1 (person). In our case, we used as 2 (Non Person Entity), so nothing will be printed.
		Element Separator	AN	1			*
	NM105	Name Middle	AN	1/25	1037	S	This is required only when NM102 is 1 (person). In our case, we used as 2 (Non Person Entity), so nothing will be printed.
		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	46
		Element Separator	AN	1			*
	NM109	Identification code	AN	2/80	67	R	Print the same value of ISA06 Interchange Sender ID
		Segment Terminator					~

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Sample:

NM1*41*2*XYZ Practice*****46*Ciramed~

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NM102 - Entity Type Qualifier

Code qualifying the type of entity

Code	Definition
1	Person
2	Non-Person Entity

NM108 – Identification code Qualifier.

Code qualifying the type of entity

Code	Definition
46	Electronic Transmitter identification Number (ETIN) Established by trading partner agreement.

1000A - Submitter EDI Contact information.

Loop	Seg ID	Segment Name	Format	Length	Ref#	Req	Value
Header	PER	Submitter EDI Contact Information	ID	3		R	PER
		Element Separator	AN	1			*
	PER01	Contact Function Code	ID	2/2	366	R	IC
		Element Separator	AN	1			*
	PER02	Name	AN	1/60	93	R	Print Practice contact Person Name for EDI Transmission issues. If no such field in the system, it is ok to print the same Practice name itself.
		Element Separator	AN	1			*
	PER03	Communication Number qualifier	ID	2/2	365	R	See below for more information.
		Element Separator	AN	1			*
	PER04	Communication Number	AN	1/256	364	R	Print Complete number including country code or area code when applicable.
		Element Separator	AN	1			*
	PER05	Communication Number qualifier	ID	2/2	365	R	See below for more information.
		Element Separator	AN	1			*
	PER06	Communication Number	AN	1/256	364	R	Print Complete number including country code or area code when applicable.
	PER07	Communication Number qualifier	ID	2/2	365	R	See below for more information.
		Element Separator	AN	1			*
	PER08	Communication Number	AN	1/256	364	R	Print Complete number including country code or area code when applicable.
		Segment Terminator					~

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Sample:

The following sample shows if the practice has both fax number and Phone number.

PER*IC*XYZ Practice*TE*1234567899*FX*9878978978~

The following sample shows if the practice has both only fax number.

PER*IC*XYZ Practice*FX*9878978978~

The following sample shows if the practice has only phone number.

PER*IC*XYZ Practice*TE*1234567899~

Maximum three numbers can be send in the EDI. But at least one number is mandatory. So if the practice does not have either Phone or Fax Number , then system should should show this as warning message while generating the EDI File.
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Example 2 :

NM1*41*2*Mayo Clinic*****46*S32433~
PER*IC*Mayo Clinic*TE*9547487111*FX*9547487222~