N4

Member Residence City, State, ZIP Code

Pos: 060	Max: 1
Detail - Optional
Loop: 2100A	Elements: 6

Ref

Id

Element Name

Req

Type

Min/Max

Usage

N401

19

City Name
Description: Free-form text for city name
Industry: Subscriber City Name

O

AN

2/30

Required

N402

156

State or Province Code
Description: Code (Standard State/Province) as defined by appropriate government agency
Industry: Subscriber State Code
CODE SOURCE: 22: States and Outlying Areas of the U.S.

O

ID

2/2

Required

ExternalCodeList

Name: 22

Description: States and Outlying Areas of the U.S.

N403

116

Postal Code
Description: Code defining international postal zone code excluding punctuation and blanks (zip code for United States)
Industry: Subscriber Postal Zone or ZIP Code
CODE SOURCE: 51: ZIP Code

O

ID

3/15

Required

ExternalCodeList

Name: 51

Description: ZIP Code

N404

26

Country Code
Description: Code identifying the country
CODE SOURCE: 5: Countries, Currencies and Funds
Required only if country is not USA.

O

ID

2/3

Situational

ExternalCodeList

Name: 5

Description: Countries, Currencies and Funds

N405

309

Location Qualifier
Description: Code identifying type of location
Send when required by X12 syntax.

C

ID

1/2

Situational

Code

Name

60

Area

The area code indicates that N406 will contain an out-of-area indicator for this member. The meaning of that indicator is defined in the trading partner agreement.

CY

County/Parish

N406

310

Location Identifier
Description: Code which identifies a specific location
Industry: Location Identification Code
This data should only be transmitted when such transmission is required under the insurance contract between the sponsor andpayer and allowed by federal and state regulations. This element is NOT USED when the member identified in the related INS segment is not the subscriber. See section 2.7, “Coverage Levels and Dependents”, for additional information.

O

AN

1/30

Situational

1.

C0605 - If N406 is present, then all of N405 are required

1.

A combination of either N401 through N404, or N405 and N406 may be adequate to specify a location.

2.

N402 is required only if city name (N401) is in the U.S. or Canada.

Notes:

1. REQUIRED when enrolling subscriber, when enrolling a dependent and the dependent’s address is different from the subscriber and when changing a member’s address.

Example:

N4*ROCK HILL*FL*33131~