Loop 2330B

Pos: 325

Repeat: 1

Optional

Loop: 2330B

Elements: N/A

To supply the full name of an individual or organizational entity

Loop Summary:

Pos	Id	Segment Name	Req	Max Use	Repeat	Usage
325	NM1	Other Payer Name	O	1		Required
345	PER	Other Payer Contact Information	O	2		Situational
350	DTP	Claim Paid Date	O	1		Situational
355	REF	Other Payer Secondary Identifier	O	3		Situational
355	REF	Other Payer Prior Authorization or Referral Number	O	2		Situational
355	REF	Other Payer Claim Adjustment Indicator	O	1		Situational

Semantics:

1.	NM102 qualifies NM103.

Comments:

1.	NM110 and NM111 further define the type of entity in NM101.

Notes:

1. Submitters are required to send all known information on other payers in this loop ID-2330.

Example:

NM1*PR*2*UNION MUTUAL OF OREGON*****XV*43~

Next