Segment: NM1
Loop: 2330A Segment: NM1
Element: NM101 (Other Subscriber Entity Identifier Code)
Hard coded to 'IL'.
Element: NM102 (Other Subscriber Entity Type Qualifier)
Patient Account->Insurance Tab-Insurance Policy
Hard coded to '2'.
Element: NM103 (Other Subscriber Last Name)
Patient Account->Insurance Tab->View Insurance Policy->Last Name
Size limited to 60 characters.
Element: NM104 (Other Subscriber First Name)
Patient Account->Insurance Tab->View Insurance Policy->First Name
Size limited to 35 characters.
Element: NM105 (Other Subscriber Middle Name)
Patient Account->Insurance Tab->View Insurance Policy->MiddleName
Size limited to 25 characters.
Element: NM107 (Other Subscriber Suffix)
Patient Account->Insurance Tab->View Insurance Policy->Suffix
Size limited to 10 characters.
Element: NM108 (Other Subscriber Identification Code Qualifier)
Patient Account->Insurance Tab->View Insurance Policy->Policy Number Type
Element: NM109 (Other Subscriber Identification Code)
Patient Account->Insurance Tab->View Insurance Policy->Policy Number
Size limited to 80 characters.