| | | | | | | | | | | |
| | _Ref_ | Id | _________Element Name__________ | Req | Type | Min/Max | | |
| | NM101 | 98 | Entity Identifier Code | M | ID | 2/3 | | |
| | | | Description: Code identifying an organizational entity, a physical location, property or an individual |
| | | | | Code | Name_______________________________ |
| | | | | EY | Employee Name |
| | | | | QE | Policyholder |
| | NM102 | 1065 | Entity Type Qualifier | M | ID | 1/1 | | |
| | | | Description: Code qualifying the type of entity |
| | | | | Code | Name_______________________________ |
| | | | | 1 | Person |
| | NM103 | 1035 | Name Last or Organization Name | O | AN | 1/35 | | |
| | | | Description: Individual last name or organizational name |
| | NM104 | 1036 | Name First | O | AN | 1/25 | | |
| | | | Description: Individual first name |
| | NM105 | 1037 | Name Middle | O | AN | 1/25 | | |
| | | | Description: Individual middle name or initial |
| | NM106 | 1038 | Name Prefix | O | AN | 1/10 | | |
| | | | Description: Prefix to individual name |
| | NM107 | 1039 | Name Suffix | O | AN | 1/10 | | |
| | | | Description: Suffix to individual name |
| | NM108 | 66 | Identification Code Qualifier | C | ID | 1/2 | | |
| | | | Description: Code designating the system/method of code structure used for Identification Code (67) |
| | | | | Code | Name_______________________________ |
| | | | | N | Insured's Unique Identification Number |
| | | | | 34 | Social Security Number |
| | | | | EI | Employee Identification Number |
| | NM109 | 67 | Identification Code | C | AN | 2/80 | | |
| | | | Description: Code identifying a party or other code |
