2310C Service Facility Location Name
In this loop, all the information will be taken from Practice location master. Take a look of our sample screen here how Practice location information are stored in the system.
Loop | Seg ID | Segment Name | Format | Length | Ref# | Req | Value |
2310C | NM1 | Service Facility Location | ID | 3 | S | NM1 | |
Element Separator | AN | 1 | * | ||||
NM101 | Entity Identifier Code | ID | 2/3 | 98 | R | 77 | |
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 | Location 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 | XX | |
Element Separator | AN | 1 | * | ||||
NM109 | Identification code | AN | 2/80 | 67 | R | Print NPI Number. | |
Segment Terminator | ~ | ||||||
Code | Definition |
1 | Person |
2 | Non-Person Entity |
Loop | Seg ID | Segment Name | Format | Length | Ref# | Req | Value |
2310C | N3 | Location Address | AN | 2 | R | N3 | |
Element Separator | AN | 1 | * | ||||
N301 | Address Line 1 | AN | 1/55 | 166 | R | Print location address 1 line | |
Element Separator | AN | 1 | * | ||||
N302 | Address Line 2 | AN | 1/55 | 1065 | S | Print location address 2 line if available | |
Segment Terminator | ~ |
Loop | Seg ID | Segment Name | Format | Length | Ref# | Req | Value |
2310C | N4 | Location City / State / Zip Code | AN | 2 | R | N4 | |
Element Separator | AN | 1 | * | ||||
N401 | City Name | AN | 2/30 | 19 | R | Print Location City | |
Element Separator | AN | 1 | * | ||||
N402 | State or Province Code | ID | 2/2 | 156 | R | Print Location State Code | |
Element Separator | AN | 1 | * | ||||
N403 | Postal Code | ID | 3/15 | 116 | R | Print Location 9 digit Zip code | |
Segment Terminator | ~ |
Loop | Seg ID | Segment Name | Format | Length | Ref# | Req | Value |
2310C | REF | Location Secondary Identification | ID | 3 | R | REF | |
Element Separator | AN | 1 | * | ||||
REF01 | Reference identification | ID | 2/3 | 128 | R | See below for more information | |
Element Separator | AN | 1 | * | ||||
REF02 | Reference identification | AN | 1/50 | 127 | R | Print the Reference number | |
Segment Terminator | ~ |
REF01 - Reference Identification Qualifier
Code | Definition |
0B | State License Number |
G2 | Provider Commercial Number |
LU | Location Number |
2310C Service Facility Location Name - Example
Assume that claim service location Name is “Demo Location” and Address1 is “Address1” and City is “Tampa” and State is “NY” and Zipcode is “44444” and there is NO Address2 and there is No NPI and there is NO Secondary Identification for this location.
NM1*FA*2*Demo Location******~
N3*Address1~
N4*Tampa*NY*44444~
Now Add address2 for the Location such as “Address2”
NM1*FA*2*Demo Location******~
N3*Address1*Address2~
N4*Tampa*NY*44444~
Now Add NPI for the Facility.
NM1*FA*2*Demo Location*****XX*1234567890~
N3*Address1*Address2~
N4*Tampa*NY*44444~
Now add a secondary identification number such as “G2 - Provider Commercial Number” and let the number be “AC1234999” for the facility.
NM1*FA*2*Demo Location*****XX*1234567890~
N3*Address1*Address2~
N4*Tampa*NY*44444~
REF*G2*AC1234999~