N4

Billing Provider City/State/ZIP Code

Pos: 030	Max: 1
Detail - Optional
Loop: 2010AA	Elements: 4

Ref

Id

Element Name

Req

Type

Min/Max

Usage

N401

19

City Name
Description: Free-form text for city name
Industry: Billing Provider City Name
UB-92 Ref. [UB-Name]: 1, Line 3 [Provider Name, Address and Telephone Number]
EMC v.6.0 Reference: Record Type 10 Field No. 14

O

AN

2/30

Required

N402

156

State or Province Code
Description: Code (Standard State/Province) as defined by appropriate government agency
Industry: Billing Provider State or Province Code
UB-92 Ref. [UB-Name]: 1, Line 3 [Provider Name, Address and Telephone Number]
EMC v.6.0 Reference: Record Type 10 Field No. 15

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: Billing Provider Postal Zone or ZIP Code
UB-92 Ref. [UB-Name]: 1, Line 3 [Provider Name, Address and Telephone Number]
EMC v.6.0 Reference: Record Type 10 Field No. 16

O

ID

3/15

Required

ExternalCodeList

Name: 51

Description: ZIP Code

N404

26

Country Code
Description: Code identifying the country
UB-92 Ref. [UB-Name]: 1, Line 4, Positions 23-25 [Provider Name, Address and Telephone Number]
EMC v.6.0 Reference: Record Type 10 Field No. 18
This data element is required when the address is outside of the U.S.

O

ID

2/3

Situational

ExternalCodeList

Name: 5

Description: Countries, Currencies and Funds

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.

Example:

N4*CENTERVILLE*PA*17111~