2330A Other Subscriber Name
This loop is required only if current insurance sequence > 1. i.e. for secondary, tertiary, etc.
Say for example, if the current insurance is secondary, then we should run this loop for the primary insurance. If the current insurance is tertiary, then we should run this loop for the primary and then secondary insurance. And also so on. In general, take the sequence number of the current insurance, and run this loop for all the previous sequence insurance.
Now let’s start the detail implementation.
| Loop | Seg ID | Segment Name | Format | Length | Ref# | Req | Value |
| 2330A | NM1 | Other 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 |
2330A Other Subscriber Address
| Loop | Seg ID | Segment Name | Format | Length | Ref# | Req | Value |
| 2330A | N3 | Subscriber Address | AN | 2 | R | N3 | |
| Element Separator | AN | 1 | * | ||||
| N301 | Address Line 1 | AN | 1/55 | 166 | R | Insured Person Address Line 1 | |
| Element Separator | AN | 1 | * | ||||
| N302 | Address Line 2 | AN | 1/55 | 1065 | S | Insured Person Address Line 2 if exists | |
| Segment Terminator | ~ |
2330A Other Subscriber City/State/Zip code
| Loop | Seg ID | Segment Name | Format | Length | Ref# | Req | Value |
| 2330A | N4 | Subscriber City / State / Zip Code | AN | 2 | R | N4 | |
| Element Separator | AN | 1 | * | ||||
| N401 | City Name | AN | 2/30 | 19 | R | Insured Person City Name | |
| Element Separator | AN | 1 | * | ||||
| N402 | State or Province Code | ID | 2/2 | 156 | R | Insured Person State Code | |
| Element Separator | AN | 1 | * | ||||
| N403 | Postal Code | ID | 3/15 | 116 | R | Insured Person Zip Code | |
| Segment Terminator | ~ |
Example.
SBR*P*18*******CI
AMT*D*52.01
OI***Y***Y
NM1*IL*1*Dianna*Jody****MI*XY31232
N3*4 B Blue Ridge Blvd
N4*Hamilton*OH*45011
For complete Example, please refer to use case 9 ,11, 12 in the Home page
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