EDI 5010 Documentation 837 Professional - Loop 2330A Other Subscriber Name

2330A Other Subscriber Name

This loop is required only if current insurance sequence > 1. i.e. for secondary, tertiary, etc.

Say for example, if the current insurance is secondary, then we should run this loop for the primary insurance. If the current insurance is tertiary, then we should run this loop for the primary and then secondary insurance. And also so on. In general, take the sequence number of the current insurance, and run this loop for all the previous sequence insurance.

Now let’s start the detail implementation.

Loop	Seg ID	Segment Name	Format	Length	Ref#	Req	Value
2330A	NM1	Other 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

 

2330A Other Subscriber Address

 

Loop	Seg ID	Segment Name	Format	Length	Ref#	Req	Value
2330A	N3	Subscriber Address	AN	2		R	N3
		Element Separator	AN	1			*
	N301	Address Line 1	AN	1/55	166	R	Insured Person Address Line 1
		Element Separator	AN	1			*
	N302	Address Line 2	AN	1/55	1065	S	Insured Person Address Line 2 if exists
		Segment Terminator					~

2330A Other Subscriber City/State/Zip code

Loop	Seg ID	Segment Name	Format	Length	Ref#	Req	Value
2330A	N4	Subscriber City / State / Zip Code	AN	2		R	N4
		Element Separator	AN	1			*
	N401	City Name	AN	2/30	19	R	Insured Person City Name
		Element Separator	AN	1			*
	N402	State or Province Code	ID	2/2	156	R	Insured Person State Code
		Element Separator	AN	1			*
	N403	Postal Code	ID	3/15	116	R	Insured Person Zip Code
		Segment Terminator					~

 

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