NM1

Subscriber Name

Pos: 015	Max: 1
Detail - Optional
Loop: 2010BA	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: Subscriber Last Name
NSF Reference: CA0-04.0, DA0-19.0

O

AN

1/35

Required

NM104

1036

Name First
Description: Individual first name
Industry: Subscriber First Name
NSF Reference: CA0-05.0, DA0-20.0
Required if NM102=1 (person).

O

AN

1/25

Situational

NM105

1037

Name Middle
Description: Individual middle name or initial
Industry: Subscriber Middle Name
NSF Reference: CA0-06.0, 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: Subscriber Name Suffix
Alias: Subscriber Generation
NSF Reference: CA0-07.0, DA0-22.0
Required if known.
Examples: I, II, III, IV, Jr, Sr

O

AN

1/10

Situational

NM108

66

Identification Code Qualifier
Description: Code designating the system/method of code structure used for Identification Code (67)
Required if NM102 = 1 (person)

C

ID

1/2

Situational

Code

Name

MI

Member Identification Number

The code MI is intended to be the subscriber’s identification number as assigned by the payer. Payers use different terminology to convey the same number. Therefore the 837 Professional Workgroup recommends using MI - Member Identification Number to convey the following terms: Insured’s ID, Subscriber’s ID, Health Insurance Claim Number (HIC), etc. MI is also intended to be used in claims submitted to the Indian Health Service/Contract Health Services (IHS/CHS) Fiscal Intermediary for the purpose of reporting the Tribe Residency Code (Tribe County State). In the event that a Social Security Number is also available on an IHS/CHS claim, put the SSN in REF02.

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: Subscriber Primary Identifier
NSF Reference: DA0-18.0, CA1-05.0, CA1-06.0
Required if the Subscriber is the patient. If the subscriber is not the patient, use if known. An identifier must be present in either the subscriber or the patient loop.

C

AN

2/80

Situational

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. In worker’s compensation or other property and casualty claims, the “subscriber” may be a non-person entity (i.e., the employer). However, this varies by state.
2. Because this is a required segment, this is a required loop. See Appendix A for further details on ASC X12 syntax rules.

Example:

NM1*IL*1*DOE*JOHN*T**JR*MI*123456~