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_Ref_ |
Id |
_________Element Name__________ |
Req |
Type |
Min/Max |
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NM101 |
98 |
Entity Identifier Code |
M |
ID |
2/3 |
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| |
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Description: Code identifying an organizational entity, a physical location, property or an individual |
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Code |
Name_______________________________ |
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E1 |
Person or Other Entity Legally Responsible for a Child |
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EI |
Executor of Estate |
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GD |
Guardian |
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J6 |
Power of Attorney |
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QD |
Responsible Party |
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Description: Person responsible for the affairs of the person having services rendered |
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EXS |
Ex-spouse |
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NM102 |
1065 |
Entity Type Qualifier |
M |
ID |
1/1 |
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| |
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Description: Code qualifying the type of entity |
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|
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|
Code |
Name_______________________________ |
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1 |
Person |
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NM103 |
1035 |
Name Last or Organization Name |
O |
AN |
1/35 |
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| |
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Description: Individual last name or organizational name |
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NM104 |
1036 |
Name First |
O |
AN |
1/25 |
|
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|
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Description: Individual first name |
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NM105 |
1037 |
Name Middle |
O |
AN |
1/25 |
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| |
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Description: Individual middle name or initial |
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NM106 |
1038 |
Name Prefix |
O |
AN |
1/10 |
|
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| |
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Description: Prefix to individual name |
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NM107 |
1039 |
Name Suffix |
O |
AN |
1/10 |
|
|
| |
|
|
Description: Suffix to individual name |
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NM108 |
66 |
Identification Code Qualifier |
C |
ID |
1/2 |
|
|
| |
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Description: Code designating the system/method of code structure used for Identification Code (67) |
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Code |
Name_______________________________ |
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34 |
Social Security Number |
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ZZ |
Mutually Defined |
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NM109 |
67 |
Identification Code |
C |
AN |
2/80 |
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Description: Code identifying a party or other code |
