Segment: NM1
Loop: 2420F Segment: NM1
Element: NM101 (Referring Provider Entity Identifier Code)
Hard coded to 'DN'.
Element: NM102 (Referring Provider Entity Type Qualifier)
Hard coded to '1'.
Element: NM103 (Referring Provider Last Name)
Contact/Provider->Last Name
Element: NM104 (Referring Provider First Name)
Contact/Provider->First Name
Element: NM105 (Referring Provider Middle Name)
Contact/Provider->Middle Name
Element: NM107 (Referring Provider Suffix)
Contact/Provider->Suffix
Element: NM107 (Referring Provider Suffix)
Contact/Provider->Suffix
Element: NM108 (Referring Provider Identification Code Qualifier)
Hard coded to 'XX'.
Element: NM109 (Referring Provider Identification Code)
Contact/Provider->NPI
Element: NM101 (Primary Care Provider Entity Identifier Code)
Hard coded to 'P3'.
Element: NM102 (Primary Care Provider Entity Type Qualifier)
Hard coded to '1'.
Element: NM103 (Primary Care Provider Last Name)
Contact/Provider->Last Name
Element: NM104 (Primary Care Provider First Name)
Contact/Provider->First Name
Element: NM105 (Primary Care Provider Middle Name)
Contact/Provider->Middle Name
Element: NM107 (Primary Care Provider Suffix)
Contact/Provider->Suffix
Element: NM108 (Primary Care Provider Identification Code Qualifier)
Hard coded to 'XX'.
Element: NM109 (Primary Care Provider Identification Code)
Contact/Provider->NPI