NM1

Purchased Service Provider Name

Pos: 250	Max: 1
Detail - Optional
Loop: 2310C	Elements: 7

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

QB

Purchase Service Provider

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

O

AN

1/35

Required

NM104

1036

Name First
Description: Individual first name
Required if NM102 = 1.

O

AN

1/25

Situational

NM105

1037

Name Middle
Description: Individual middle name or initial
Required if NM102=1 and the middle name/initial of the person is known.

O

AN

1/25

Situational

NM108

66

Identification Code Qualifier
Description: Code designating the system/method of code structure used for Identification Code (67)
Required if either Employer’s Identification/Social Security Number or National Provider Identifier is known.

C

ID

1/2

Situational

Code

Name

24

Employer's Identification Number

34

Social Security Number

XX

Health Care Financing Administration National Provider Identifier

NM109

67

Identification Code
Description: Code identifying a party or other code
Industry: Purchased Service Provider Identifier
Alias: Purchased Service Provider Primary Identifier
NSF Reference: FB0-11.0
Required if either Employer’s Identification/Social Security Number or National Provider Identifier is known.

C

AN

2/80

Situational

ExternalCodeList

Name: 537

Description: Health Care Financing Administration National Provider Identifier

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. Information in Loop ID-2310 applies to the entire claim unless overridden on a service line by the presence of Loop ID-2420 with the same value in NM101.
2. Because the usage of this segment is “Situational” this is not a syntactically required loop. If this loop is used, then this segment is a “Required” segment. See Appendix A for further details on ASC X12 syntax rules.
3. Required if purchased services are being billed/reported on this claim. Purchased services are situations where (for example) a physician purchases a diagnostic exam from an outside entity. Purchased services do not include substitute (locum tenens) provider situations. All payer-specific identifying numbers belong to the destination payer identified in the 2010BB loop.

Example:

NM1*QB*2******FI*111223333~