N1

Premium Receiver's Name

Pos: 070	Max: 1
Heading - Optional
Loop: 1000A	Elements: 4

Ref

Id

Element Name

Req

Type

Min/Max

Usage

N101

98

Entity Identifier Code
Description: Code identifying an organizational entity, a physical location, property or an individual
For HIPAA Health Premium Payments this element is REQUIRED.

M

ID

2/3

Required

Code

Name

PE

Payee

N102

93

Name
Description: Free-form name
Health Care Industry: Information Receiver Last or Organization Name
For HIPAA Health Premium Payments this element is REQUIRED.
This is required when the sender needs to relay the receiver’s name.

C

AN

1/60

Situational

N103

66

Identification Code Qualifier
Description: Code designating the system/method of code structure used for Identification Code (67)
This is required when the sender needs to relay a unique identifier for the receiver.
For HIPAA Health Premium Payments this element is REQUIRED.

C

ID

1/2

Situational

Code

Name

1

D-U-N-S Number, Dun & Bradstreet

CODE SOURCE:

16: D-U-N-S Number

9

D-U-N-S+4, D-U-N-S Number with Four Character Suffix

CODE SOURCE:

16: D-U-N-S Number

EQ

Insurance Company Assigned Identification Number

FI

Federal Taxpayer's Identification Number

XV

Health Care Financing Administration National Payer Identification Number (PAYERID)

This is Required for a HIPAA compliant implementation when the National PlanID is mandated. Until that time, code FI is the alternate HIPAA compliant identifier.

CODE SOURCE:

540: Health Care Financing Administration National PlanID

N104

67

Identification Code
Description: Code identifying a party or other code
Health Care Industry: Receiver Identifier
For HIPAA Health Premium Payments this element is REQUIRED.

C

AN

2/80

Situational

ExternalCodeList

Name: 16

Description: D-U-N-S Number

ExternalCodeList

Name: 540

Description: Health Care Financing Administration National PlanID

1.

R0203 - At least one of N102,N103 is required

2.

P0304 - If either N103,N104 is present, then all are required

1.

This segment, used alone, provides the most efficient method of providing organizational identification. To obtain this efficiency the "ID Code" (N104) must provide a key to the table maintained by the transaction processing party.

2.

N105 and N106 further define the type of entity in N101.

Notes:

1. This segment is used to relay the name and an identifier of the premium receiver.

Example:

N1*PE*XYZ INSURANCE*1*123456789~