Segment: NM1
Loop: 2010BB Segment: NM1
Element: NM101 (Payer Name Entity Identifier Code)
Hard Coded to 'PR'
Element: NM102 (Payer Name Entity Type Qualifier)
Hard Coded to '2'
Element: NM103 (Payer Name Organization Name)
Tools->Insurance Companies->Company Name
Element: NM108 (Payer Name Identification Code Qualifier)
Hard Coded
Element: NM109 (Payer Name Identification Code)
Tools->Insurance Companies->Payer ID