N1

Premium Payer's Name

Pos: 070	Max: 1
Heading - Optional
Loop: 1000B	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

PR

Payer

N102

93

Name
Description: Free-form name
Health Care Industry: Premium Payer Name
This is required when the receiver needs the sender’s name.
For HIPAA Health Premium Payments this element is REQUIRED.

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 receiver needs a unique identification for the sender.
For HIPAA Health Premium Payments this element is REQUIRED.

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

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

24

Employer's Identification Number

75

State or Province Assigned Number

Used by States when remitting Medicare premium payments (in participation with a “State Buy- In” program).

EQ

Insurance Company Assigned Identification Number

FI

Federal Taxpayer's Identification Number

PI

Payor Identification

Used by the federal government to identify a federal agency’s payroll office.

N104

67

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

C

AN

2/80

Situational

ExternalCodeList

Name: 16

Description: D-U-N-S Number

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 payer.

Example:

N1*PR*ABC COMPANY*1*123456789~