NM1

Other Subscriber Name

Pos: 325	Max: 1
Detail - Optional
Loop: 2330A	Elements: 8

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

IL

Insured or Subscriber

NM102

1065

Entity Type Qualifier
Description: Code qualifying the type of entity

M

ID

1/1

Required

Code

Name

1

Person

2

Non-Person Entity

NM103

1035

Name Last or Organization Name
Description: Individual last name or organizational name
Industry: Other Insured Last Name
Alias: Other Insured’s Last Name
NSF Reference: DA0-19.0

O

AN

1/35

Required

NM104

1036

Name First
Description: Individual first name
Industry: Other Insured First Name
Alias: Other Insured’s First Name
NSF Reference: DA0-20.0

O

AN

1/25

Required

NM105

1037

Name Middle
Description: Individual middle name or initial
Industry: Other Insured Middle Name
Alias: Other Insured’s Middle Name
NSF Reference: DA0-21.0
Required if NM102 = 1 and the middle name/initial of the person is known.

O

AN

1/25

Situational

NM107

1039

Name Suffix
Description: Suffix to individual name
Industry: Other Insured Name Suffix
Alias: Other Insured’s Generation
Examples: I, II, III, IV, Jr, Sr
Required if known.

O

AN

1/10

Situational

NM108

66

Identification Code Qualifier
Description: Code designating the system/method of code structure used for Identification Code (67)

C

ID

1/2

Required

Code

Name

24

Employer's Identification Number

MI

Member Identification Number

ZZ

Mutually Defined

The value “ZZ”, when used in this data element shall be defined as “HIPAA Individual Identifier” once this identifier has been adopted. Under the Health Insurance Portability and Accountability Act of 1996, the Secretary of the Department of Health and Human Services must adopt a standard individual identifier for use in this transaction.

NM109

67

Identification Code
Description: Code identifying a party or other code
Industry: Other Insured Identifier
Alias: Other Insured’s Identification Number

C

AN

2/80

Required

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. Submitters are required to send information on all known other subscribers in Loop ID-2330.
2. The 2330A loop is required when Loop ID-2320 - Other Subscriber Information, is used. Otherwise, the loop is not used.

Example:

NM1*IL*1*DOE*JOHN*T**JR*MI*333224444~