NM1

Subscriber Name

Pos: 050	Max: 1
Detail - Optional
Loop: 2100D	Elements: 9

Ref

Id

Element Name

Req

Type

Min/Max

Usage

NM101

98

Entity Identifier Code
Description: Code identifying an organizational entity, a physical location, property or an individual

M

ID

2/3

Required

Code

Name

IL

Insured or Subscriber

QC

Patient

Use this only when the subscriber is the patient.

NM102

1065

Entity Type Qualifier
Description: Code qualifying the type of entity

M

ID

1/1

Required

Code

Name

1

Person

2

Non-Person Entity

Use the value “2" in an employer-subscriber situation, such as Worker’s Compensation. In this case, the value ”IL" would appear in NM101.

NM103

1035

Name Last or Organization Name
Description: Individual last name or organizational name
Industry: Subscriber Last Name

O

AN

1/35

Required

NM104

1036

Name First
Description: Individual first name
Industry: Subscriber First Name
The first name is required when the value in NM102 is ‘1’ and the person has a first name.

O

AN

1/25

Situational

NM105

1037

Name Middle
Description: Individual middle name or initial
Industry: Subscriber Middle Name
The middle name or initial is required when the value in NM102 is ‘1’ and the person has a middle name or initial.

O

AN

1/25

Recommended

NM106

1038

Name Prefix
Description: Prefix to individual name
Industry: Subscriber Name Prefix
Required if additional name information is needed to identify the subscriber. Recommended if the value in the entity type qualifier is a person.

O

AN

1/10

Situational

NM107

1039

Name Suffix
Description: Suffix to individual name
Industry: Subscriber Name Suffix
Required if additional name information is needed to identify the subscriber. Recommended if the value in the entity type qualifier is a person.

O

AN

1/10

Situational

NM108

66

Identification Code Qualifier
Description: Code designating the system/method of code structure used for Identification Code (67)

C

ID

1/2

Required

Code

Name

24

Employer's Identification Number

MI

Member Identification Number

ZZ

Mutually Defined

The value ’ZZ’ when used in this data element shall be defined as ’HIPAA Individual Identifier’ once this identifier has been adopted. Under the Health Insurance Portability and Accountability Act of 1996, the Secretary of the Department of Health and Human Services must adopt a standard individual identifier for use in this transaction.

NM109

67

Identification Code
Description: Code identifying a party or other code
Industry: Subscriber Identifier

C

AN

2/80

Required

1.

P0809 - If either NM108,NM109 is present, then all are required

2.

C1110 - If NM111 is present, then all of NM110 are required

1.

NM102 qualifies NM103.

1.

NM110 and NM111 further define the type of entity in NM101.

Example:

NM1*QC*1*SMITH*FRED****MI*123456789A~ or
NM1*IL*1*SMITH*ROBERT****MI*9876543210~