NM1

Dependent Name

Pos: 170	Max: 1
Detail - Optional
Loop: 2010DA	Elements: 6

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

QC

Patient

NM102

1065

Entity Type Qualifier
Description: Code qualifying the type of entity

M

ID

1/1

Required

Code

Name

1

Person

NM103

1035

Name Last or Organization Name
Description: Individual last name or organizational name
Industry: Dependent Last Name
Use if name information is needed to identify the dependent.

O

AN

1/35

Situational

NM104

1036

Name First
Description: Individual first name
Industry: Dependent First Name
Use if name information is needed to identify the dependent.

O

AN

1/25

Situational

NM105

1037

Name Middle
Description: Individual middle name or initial
Industry: Dependent Middle Name
Use if name information is needed to identify the dependent and the middle name/initial of the dependent is known.

O

AN

1/25

Situational

NM107

1039

Name Suffix
Description: Suffix to individual name
Industry: Dependent Name Suffix
Use this for the suffix of an individual’s name; e.g., Sr., Jr., or III.

O

AN

1/10

Situational

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.

Notes:

1. Use this segment to convey the name of the dependent who is the patient.
2. The maximum data elements in Loop 2010D that can be required by a UMO to identify a dependent are as follows:
Dependent Last Name (NM103)
Dependent First Name (NM104)
Dependent Birth Date (DMG01 and DMG02)
3. Refer to Section 2.2.2.1 Identifying the Patient for specific information on how to identify an individual to a UMO.

Example:

NM1*QC*1*SMITH*MARY~