NM1

Patient Name

Pos: 030

Max: 1

Detail - Mandatory

Loop: 2100

Elements: 8

User Option (Usage): Required

To supply the full name of an individual or organizational entity

Element Summary:

	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

1/1

Required

	Code	Name
	1	Person

NM103	1035	Name Last or Organization Name Description: Individual last name or organizational name Industry: Patient Last Name	O	AN	1/35	Required
NM104	1036	Name First Description: Individual first name Industry: Patient First Name	O	AN	1/25	Required
NM105	1037	Name Middle Description: Individual middle name or initial Industry: Patient Middle Name If this data element is used and contains only one character, it is assumed to represent the middle initial. The middle name or initial is required when the individual has a middle name or initial and it is known.	O	AN	1/25	Situational
NM107	1039	Name Suffix Description: Suffix to individual name Industry: Patient Name Suffix The Suffix should be reported whenever this information is necessary for identification of the individual, for instance when a Junior and Senior are covered under the same subscriber.	O	AN	1/10	Not recommended
NM108	66	Identification Code Qualifier Description: Code designating the system/method of code structure used for Identification Code (67) Required if the patient identifier is known or was reported on the health care claim.	C	ID	1/2	Recommended

Code

Name

Social Security Number

Health Insurance Claim (HIC) Number

ADVISED

United States National Individual Identifier

This code is not part of the ASC X12 004010 release. Use this code if mandated in a final Federal Rule.

Member Identification Number

Medicaid Recipient Identification Number

NM109

Identification Code
Description: Code identifying a party or other code
Industry: Patient Identifier
Required if the patient identifier is known or was reported on the health care claim.

2/80

Recommended

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. Provide the patient�s identification number in NM109.

Example:

NM1*QC*1*SHEPHARD*SAM*O***HN*666666666A~