Loop 2010B |
|
||||||
|
Pos |
Id |
Segment Name |
Req |
Max Use |
Repeat |
Usage |
|
170 |
NM1 |
Requester Name |
O |
1 |
|
Required |
|
180 |
REF |
Requester Supplemental Identification |
O |
8 |
|
Situational |
|
200 |
N3 |
Requester Address |
O |
1 |
|
Situational |
|
210 |
N4 |
Requester City/State/ZIP Code |
O |
1 |
|
Situational |
|
220 |
PER |
Requester Contact Information |
O |
1 |
|
Situational |
|
240 |
PRV |
Requester Provider Information |
O |
1 |
|
Situational |
1. |
NM102 qualifies NM103. |
1. |
NM110 and NM111 further define the type of entity in NM101. |
Notes: |
1. Use this NM1 loop to identify the receiver of information. In the case of a request transaction, the receiver would normally be the provider who will ultimately be receiving the decision. |
Example: |
NM1*1P*1*GARDENER*JAMES****24*000012345~ |