Thursday, January 26, 2017
271–5010 Health Care Eligibility Benefit Response – Loop 2100C Subscriber Name
271–5010 Health Care Eligibility Benefit Response – Loop 2100C Subscriber Name
Use this segment to identify an entity by name and/or identification number. Use this NM1 loop to identify the insured or subscriber
| Loop | Seg ID | Segment Name | Format | Length | Ref# | Req | Value |
| 2100C | NM1 | Subscriber Name | ID | 3 | R | NM1 | |
| Element Separator | AN | 1 | * | ||||
| NM101 | Entity Identifier Code | ID | 2/3 | 98 | R | IL | |
| Element Separator | AN | 1 | * | ||||
| NM102 | Entity Type qualifier | ID | 1/1 | 1065 | R | 1 | |
| Element Separator | AN | 1 | * | ||||
| NM103 | Name Last or Organization Name | AN | 1/60 | 1035 | R | Insured Person Last Name | |
| Element Separator | AN | 1 | * | ||||
| NM104 | Name First | AN | 1/35 | 1036 | S | Insured Person First Name | |
| Element Separator | AN | 1 | * | ||||
| NM105 | Name Middle | AN | 1/25 | 1037 | S | Insured Person Middle Name | |
| Element Separator | AN | 1 | * | ||||
| NM106 | Name Prefix | AN | 1/10 | 1038 | Not used | ||
| Element Separator | AN | 1 | * | ||||
| NM107 | Name Suffix | AN | 1/10 | 1039 | S | Insured Person Suffix | |
| Element Separator | AN | 1 | * | ||||
| NM108 | Identification code Qualifier | ID | 1/2 | 66 | R | MI | |
| Element Separator | AN | 1 | * | ||||
| NM109 | Identification code | AN | 2/80 | 67 | R | Insured Policy No | |
| Segment Terminator | ~ | ||||||
NM102 - Entity Type Qualifier
Code qualifying the type of entity
| Code | Definition |
| 1 | Person |
| 2 | Non-Person Entity |
NM1*IL*1*MULLIN*DANIEL****MI*XJBH12345678~
Segment Structure
SUBSCRIBER Additional identification
| Loop | Seg ID | Segment Name | Format | Length |
