Segment: NM1
Loop: 2330B Segment: NM1
Element: NM101 (Other Payer Entity Identifier Code)
Hard coded to 'PR'.
Element: NM102 (Other Payer Entity Type Qualifier)
Hard coded to '2'.
Element: NM103 (Other Payer Name)
Tools menu->Insurance Companies-Edit Insurance Company->Company Name
Size limited to 60 characters.
Element: NM108 (Other Payer Identification Code Qualifier)
'PI' for Payer Identification or 'XV' for Centers for Medicare and Medicaid Servcies Plan ID
Element: NM109 (Other Payer Identification Code)
Tools menu->Insurance Companies-Edit Insurance Company->Payer ID or National Plan ID (Not yet implemented).
Size limited to 80 characters.