Segment: NM1
Loop: 2420D Segment: NM1
Element: NM101 (Supervising Provider Entity Identifier Code)
Hard coded to 'DQ'.
Element: NM102 (Supervising Provider Entity Type Qualifier)
Hard coded to '1'.
Element: NM103 (Supervising Provider Last Name)
Contacts->Last Name
Provider Manager->Provider->Last Name
Element: NM104 (Supervising Provider First Name)
Contacts->First Name
Provider Manager->Provider->First Name
Element: NM104 (Supervising Provider Middle Name)
Contacts->Middle Name
Provider Manager->Provider->Middle Name
Element: NM104 (Supervising Provider Suffix)
Contacts->Suffix
Provider Manager->Provider->Suffix
Element: NM108 (Supervising Identification Code Qualifier)
Hard coded to 'XX'.
Element: NM109 (Supervising Provider NPI)
Contact->NPI
Provider Manager->Provider->NPI