N4

Dependent City/State/ZIP Code

Pos: 070	Max: 1
Detail - Optional
Loop: 2100D	Elements: 4

Ref

Id

Element Name

Req

Type

Min/Max

Usage

N401

19

City Name
Description: Free-form text for city name
Industry: Dependent City Name
Use this text for the city name of the dependent’s address.

O

AN

2/30

Situational

N402

156

State or Province Code
Description: Code (Standard State/Province) as defined by appropriate government agency
Industry: Dependent State Code
CODE SOURCE: 22: States and Outlying Areas of the U.S.
Use this code for the state code of the dependent’s address.

O

ID

2/2

Situational

ExternalCodeList

Name: 22

Description: States and Outlying Areas of the U.S.

N403

116

Postal Code
Description: Code defining international postal zone code excluding punctuation and blanks (zip code for United States)
Industry: Dependent Postal Zone or ZIP Code
CODE SOURCE: 51: ZIP Code
Use this code for the ZIP or Postal Code of the dependent’s address.

O

ID

3/15

Situational

ExternalCodeList

Name: 51

Description: ZIP Code

N404

26

Country Code
Description: Code identifying the country
CODE SOURCE: 5: Countries, Currencies and Funds
Use this code to specify the country of the dependent’s address, if other than the United States.

O

ID

2/3

Situational

ExternalCodeList

Name: 5

Description: Countries, Currencies and Funds

1.

C0605 - If N406 is present, then all of N405 are required

1.

A combination of either N401 through N404, or N405 and N406 may be adequate to specify a location.

2.

N402 is required only if city name (N401) is in the U.S. or Canada.

Notes:

1. Use this segment when needed to convey the city, state, and ZIP code for the dependent. Use if information is known and will assist in identification of the person named, particularly when not utilizing the HIPAA search option.

Example:

N4*NEW YORK*NY*10003~