DELIMITER $$
DROP PROCEDURE IF EXISTS `Loop2010BB`$$
CREATE DEFINER=`root`@`localhost` PROCEDURE `Loop2010BB`(pclaimNo INT, patientInsID LONG)
BEGIN
DECLARE varReturnValue VARCHAR(5000);
DECLARE fieldSep VARCHAR(10);
DECLARE varname VARCHAR(100);
DECLARE varaddress1 VARCHAR(100);
DECLARE varaddress2 VARCHAR(100);
DECLARE varcity VARCHAR(30);
DECLARE varstate VARCHAR(10);
DECLARE varzip VARCHAR(20);
DECLARE varpayerID VARCHAR(50);
DECLARE varLastBilledInfo VARCHAR(500);
DECLARE varInsCode VARCHAR(50);
SET fieldSep= '*';
SET varReturnValue = '';
SELECT
IFNULL(ins.Code,''), IFNULL(ins.name,''),IFNULL(ins.address1,''),IFNULL(ins.address2,''),
IFNULL(ins.city,''),IFNULL(ins.state,''),IFNULL(ins.zip,''),IFNULL(ins.payerID,'')
INTO
varInsCode, varname,varaddress1,varaddress2,varcity,varstate,varzip,varpayerID
FROM
patientinsurance patins, insurance ins
WHERE
patins.ID = patientInsID
AND
patins.insuranceID = ins.ID;
SET varLastBilledInfo = CONCAT(':',varInsCode,':',varname,':',varpayerID);
SET varReturnValue = CONCAT(varReturnValue,'NM1',fieldSep);
/*
Page No : 131
Loop No : 2010BB
Loop Name : PAYER NAME
Segment Name : NM1 Individual or Organizational Name
Data Element : NM101 - Entity Identifier Code
*/
SET varReturnValue = CONCAT(varReturnValue,'PR',fieldSep);
/*
Page No : 131
Loop No : 2010BB
Loop Name : PAYER NAME
Segment Name : NM1 Individual or Organizational Name
Data Element : NM102 - Entity Type Qualifier
*/
SET varReturnValue = CONCAT(varReturnValue,'2',fieldSep);
SET varReturnValue = CONCAT(varReturnValue,varname,fieldSep);
/*
Page No : 131
Loop No : 2010BB
Loop Name : PAYER NAME
Segment Name : NM1 Individual or Organizational Name
Data Element : NM104,NM105,NM106,NM107
NOT USED
*/
SET varReturnValue = CONCAT(varReturnValue,fieldSep);
SET varReturnValue = CONCAT(varReturnValue,fieldSep);
SET varReturnValue = CONCAT(varReturnValue,fieldSep);
SET varReturnValue = CONCAT(varReturnValue,fieldSep);
/*
Page No : 131
Loop No : 2010BB
Loop Name : PAYER NAME
Segment Name : NM1 Individual or Organizational Name
Data Element : NM108,NM109
*/
SET varReturnValue = CONCAT(varReturnValue,'PI',fieldSep);
SET varReturnValue = CONCAT(varReturnValue,varpayerID,'~');
IF varAddress1 <> '' THEN
#2010BB Payer Address
SET varReturnValue = CONCAT(varReturnValue,'N3',fieldSep);
#N301 Address Line 1
SET varReturnValue = CONCAT(varReturnValue,varAddress1);
#N302 Address Line 2
IF IFNULL(varAddress2,'') <> '' THEN
SET varReturnValue = CONCAT(varReturnValue,fieldSep,varAddress2,'~');
ELSE
SET varReturnValue = CONCAT(varReturnValue,'~');
END IF;
END IF;
IF varCity <> '' THEN
#2010BB Payer City/State/Zip code
SET varReturnValue = CONCAT(varReturnValue,'N4',fieldSep);
#N401 City Name
SET varReturnValue = CONCAT(varReturnValue,varCity,fieldSep);
#N402 State
SET varReturnValue = CONCAT(varReturnValue,varState,fieldSep);
#N402 Zip
SET varReturnValue = CONCAT(varReturnValue,varzip,'~');
END IF;
UPDATE claimheader SET tmpLastBilledInfo = CONCAT(IFNULL(tmpLastBilledInfo,'') ,varLastBilledInfo)
WHERE claimNo = pclaimNo;
UPDATE claimdetail SET tmpLastBilledInfo = CONCAT(IFNULL(tmpLastBilledInfo,'') ,varLastBilledInfo)
WHERE claimNo = pclaimNo AND claimTranModeInsID = patientInsID;
SELECT varReturnValue;
END$$
DELIMITER ;
Tuesday, 27 May 2014
MYSQL Stored Procedure for EDI 837 P 5010 Version
Here is a sample Stored Procedure which is used to generate Loop 2010BB. For complete List, please email me at vbsenthilinnet@gmail.com
SQL Server Stored Procedure for EDI 837 P 5010 Version
Here is a sample Stored Procedure which is used to generate Loop 2010BB. For complete List, please email me at vbsenthilinnet@gmail.com
set ANSI_NULLS ON
set QUOTED_IDENTIFIER ON
GO
/********************************************************************************
Page No : 130
Purpose : PAYER NAME
********************************************************************************/
ALTER PROCEDURE [dbo].[ProcHCEDI_Loop2010BB]
@plngClaimNo Bigint = NULL,
@pstrSegDelim VARCHAR(1) = Null,
@plngInsPlanRowID Bigint = NULL
AS
DECLARE
@strValidText VARCHAR(8000),
@strInValidText VARCHAR(8000),
@StrInsName VARCHAR(100),
@strAddress1 VARCHAR(100),
@strAddress2 VARCHAR(100),
@strCity VARCHAR(50),
@strState VARCHAR(50),
@strZip VARCHAR(50),
@strPayerID VARCHAR(50),
@strNHPI VARCHAR(80)
BEGIN
SET @strValidText = ''
SET @strInvalidText = ''
SELECT @pstrSegDelim = IsNull(@pstrSegDelim,'*')
SET @strValidText = 'NM1' + @pstrSegDelim
/*
Page No : 131
Loop No : 2010BB
Loop Name : PAYER NAME
Segment Name : NM1 Individual or Organizational Name
Data Element : NM101 - Entity Identifier Code
*/
SET @strValidText = @strValidText + 'PR' + @pstrSegDelim
/*
Page No : 131
Loop No : 2010BB
Loop Name : PAYER NAME
Segment Name : NM1 Individual or Organizational Name
Data Element : NM102 - Entity Type Qualifier
*/
SET @strValidText = @strValidText + '2' + @pstrSegDelim
SELECT
@StrInsName = LTRIM(RTRIM(ISNULL(InsuranceName,''))),
@strAddress1 = LTRIM(RTRIM(ISNULL(Address1,''))),
@strAddress2 = LTRIM(RTRIM(ISNULL(Address2,''))),
@strCity = LTRIM(RTRIM(ISNULL(City,''))),
@strState = LTRIM(RTRIM(ISNULL(State,''))),
@strZip = LTRIM(RTRIM(ISNULL(Zip,''))),
@strPayerID = LTRIM(RTRIM(ISNULL(PayerID,'')))
FROM
ViewHCInsurance
WHERE
Code = (SELECT InsCode From ViewHCPatientPolicy Where InsPlanRowID =@plngInsPlanRowID)
SELECT @strNHPI = LTRIM(RTRIM(ISNULL(NHPI,'')))
FROM
ViewHCInsurancePlan
WHERE
PlanRowID = (SELECT PlanRowID From ViewHCPatientPolicy Where InsPlanRowID =@plngInsPlanRowID)
IF @StrInsName= ''
SET @strInValidText = @strInValidText + 'E2010BB_NM103' + @pstrSegDelim
ELSE IF LEN(@StrInsName) > 35
SET @strInValidText = @strInValidText + 'E2010BB_NM103_01' + @pstrSegDelim
ELSE
SET @StrValidText = @strValidText + @StrInsName + @pstrSegDelim
/*
Page No : 131
Loop No : 2010BB
Loop Name : PAYER NAME
Segment Name : NM1 Individual or Organizational Name
Data Element : NM104,NM105,NM106,NM107
NOT USED
*/
SET @StrValidText = @strValidText + @pstrSegDelim + @pstrSegDelim + @pstrSegDelim + @pstrSegDelim
/*
Page No : 131
Loop No : 2010BB
Loop Name : PAYER NAME
Segment Name : NM1 Individual or Organizational Name
Data Element : NM108,NM109
*/
IF @strPayerID = '' AND @strNHPI = ''
SET @strInValidText = @strInValidText + 'E2010BB_NM109' + @pstrSegDelim
ELSE
BEGIN
IF @strNHPI <> ''
SET @StrValidText = @strValidText + 'XV' + @pstrSegDelim + @strNHPI
ELSE IF @strPayerID <> ''
SET @StrValidText = @strValidText + 'PI' + @pstrSegDelim + @strPayerID
END
SELECT @strValidText as EDIinfo, @strInvalidText as ErrInfo,1 as RowNum,'2010BB - Payer Name' +space(200) AS LoopNo,'NM1' as SegmentName, '130' as PageNo into #temp
--**************************************************************************************************
/*
Page No : 134
Loop No : 2010BB
Loop Name : PAYER NAME
Segment Name : N3 Address Information
*/
SET @strValidText = ''
SET @strInvalidText =''
/*
Page No : 134
Loop No : 2010BB
Loop Name : PAYER NAME
Segment Name : N3 Address Information
Data Element : N301 - ALIAS: Payer Address 1
*/
SET @strValidText = 'N3' + @pstrSegDelim
IF @strAddress1 =''
SET @strInValidText = @strInValidText + 'E2010BB_N301' + @pstrSegDelim
ELSE
SET @StrValidText = @strValidText + @strAddress1
/*
Page No : 134
Loop No : 2010BB
Loop Name : PAYER NAME
Segment Name : N3 Address Information
Data Element : N302 - ALIAS: Payer Address 2
*/
IF @strAddress2 <> ''
SET @StrValidText = @strValidText + @pstrSegDelim + @strAddress2
Insert into #temp SELECT @strValidText as EDIinfo, @strInvalidText ,2,'2010BB - Payer Name Address','N3', '134'
--**************************************************************************************************
/*
Page No : 135
Loop No : 2010BB
Loop Name : PAYER NAME
Segment Name : N4 Geographic Location PAYER CITY/STATE/ZIP CODE
*/
SET @strValidText = ''
SET @strInvalidText =''
SET @StrValidText = 'N4' + @pstrSegDelim
-- Page No 135
IF @strCity = ''
SET @strInValidText = @strInValidText + 'E2010BB_N401' + @pstrSegDelim
ELSE
SET @StrValidText = @strValidText + @strCity + @pstrSegDelim
-- Page No 135
IF @strState = ''
SET @strInValidText = @strInValidText + 'E2010BB_N402' + @pstrSegDelim
ELSE
SET @StrValidText = @strValidText + @strState + @pstrSegDelim
if @strZip <> ''
SET @strZip = REPLACE(@strZip,'-','')
-- Page No 135
IF @strZip = ''
SET @strInValidText = @strInValidText + 'E2010BB_N403' + @pstrSegDelim
ELSE
SET @StrValidText = @strValidText + @strZip
Insert into #temp SELECT @strValidText as EDIinfo, @strInvalidText ,3,'2010BB - Payer City/State/ZipCode','N4', '135'
--**************************************************************************************************
SELECT EDIinfo, ErrInfo,LoopNo,SegmentName,PageNo FROM #temp order by RowNum
IF @@ERROR = 0
RETURN 0
ELSE
RETURN 1
END
EDI 835 Health Care Claim Payment/Advice
Looking for best Practice Management software ? Please email at vbsenthilinnet@gmail.com
If you are new to Medical Billing, then please read this article first.
If you are new to EDI, then read the following articles
1. What is an EDI ?
2. EDI Transactions
3. Understanding EDI Structure
4. EDI Instruction
EDI 835 Health Care Claim Payment/Advice
The 835 is used primarily by Healthcare insurance plans to make payments to healthcare providers, to provide Explanations of Benefits (EOBs), or both. When a healthcare service provider submits an 837 Health Care Claim, the insurance plan uses the 835 to detail the payment to that claim, including:
- What charges were paid, reduced or denied
- Whether there was a deductible, co-insurance, co-pay, etc.
- Any bundling or splitting of claims or line items
- How the payment was made, such as through a clearinghouse
A particular 835 document may not necessarily match up one-for-one with a specific 837. In fact, it is not uncommon for multiple 835 transactions to be used in response to a single 837, or for one 835 to address multiple 837 submissions. As a result, the 835 is important to healthcare providers, to track what payments were received for services they provided and billed. And also one EDI 835 File, may contain multiple Checks i.e Multiple EOBs
Before going into detail, Let us understand how insurance Payer make the Payment. Please understand and have good understanding on the following topics.
1. What is Copay, Co Insurance and Deductible in Insurance Payment Posting ?
2. EOB – Explanation of Benefits
I have developed a small Parsing tool in VB.NET/VB.6/Java . This tool will take the EDI File and convert into PDF File as shown here.
Looking for best Practice Management software ? Please email at vbsenthilinnet@gmail.com
Questions or feedback are always welcome. You can email me at vbsenthilinnet@gmail.com
Monday, 26 May 2014
ZK MVVM List box with Dynamic Template
Requirement.
In a screen, want to show the list of records with three different layout. Say for example, for layout1, we want to display three columns, for layouy2, we want to display four columns and so on.
Here is the code.
<?page title="new page title" contentType="text/html;charset=UTF-8"?>
<zk>
<window id="listboxdynamic" border="none"
apply="org.zkoss.bind.BindComposer"
viewModel="@id('vm') @init('com.product.webapp.examples.ListBoxDynamicVM')">
<custom-attributes listenKeys="willlistenforKeys" />
<separator />
<button label="Template 1" onClick="@command('onTemplate',type='simple')"></button>
<space></space>
<button label="Template 2" onClick="@command('onTemplate',type='simple2')"></button>
<space></space>
<button label="Template 3" onClick="@command('onTemplate',type='simple3')"></button>
<space></space>
<separator></separator>
<div children="@load('1') @template(vm.templatetype)">
<template name="simple">
<listbox id="" mold="paging"
model="@load(vm.persons)">
<listhead sizable="true">
<listheader label="First Name" />
<listheader label="Last Name" />
</listhead>
<template name="model" var="p1">
<listitem>
<listcell label="@load(p1.firstName)" />
<listcell label="@load(p1.lastName)" />
</listitem>
</template>
</listbox>
</template>
<template name="simple2">
<listbox id="" mold="paging"
model="@load(vm.persons)">
<listhead sizable="true">
<listheader label="First Name" />
<listheader label="Last Name" />
<listheader label="Address1" />
</listhead>
<template name="model" var="p1">
<listitem>
<listcell label="@load(p1.firstName)" />
<listcell label="@load(p1.lastName)" />
<listcell label="@load(p1.address1)" />
</listitem>
</template>
</listbox>
</template>
<template name="simple3">3333</template>
</div>
</window>
</zk>
View Model
package com.product.webapp.examples;
import java.util.ArrayList;
import java.util.List;
import org.zkoss.bind.annotation.AfterCompose;
import org.zkoss.bind.annotation.BindingParam;
import org.zkoss.bind.annotation.Command;
import org.zkoss.bind.annotation.ContextParam;
import org.zkoss.bind.annotation.ContextType;
import org.zkoss.bind.annotation.NotifyChange;
import org.zkoss.zk.ui.Component;
import org.zkoss.zk.ui.select.Selectors;
import org.zkoss.zul.Messagebox;
public class ListBoxDynamicVM {
private String templatetype;
private List<Person> persons;
public List<Person> getPersons() {
return persons;
}
public void setPersons(List<Person> persons) {
this.persons = persons;
}
public String getTemplatetype() {
return templatetype;
}
public void setTemplatetype(String templatetype) {
this.templatetype = templatetype;
}
@AfterCompose
public void initSetup(@ContextParam(ContextType.VIEW) Component view) {
Selectors.wireComponents(view, this, false);
System.out.println("starting creating list");
persons = new ArrayList<Person>();
for (int i = 0; i < 10; i++) {
persons.add(new Person("firstname_" + i, "lastname_" + i,
"address_" + i, "city_" + i));
}
this.templatetype = "simple";
}
@NotifyChange("templatetype")
@Command
public void onTemplate(@BindingParam("type") String type) {
this.templatetype = type;
Messagebox.show(" " + templatetype);
}
public static class Person {
private String firstName;
private String lastName;
private String address1;
private String city;
public Person(String firstName, String lastName, String address1,
String city) {
this.firstName = firstName;
this.lastName = lastName;
this.address1 = address1;
this.city = city;
}
public String getFirstName() {
System.out.println(" " + this.firstName);
return firstName;
}
public void setFirstName(String firstName) {
this.firstName = firstName;
}
public String getLastName() {
return lastName;
}
public void setLastName(String lastName) {
this.lastName = lastName;
}
public String getAddress1() {
return address1;
}
public void setAddress1(String address1) {
this.address1 = address1;
}
public String getCity() {
return city;
}
public void setCity(String city) {
this.city = city;
}
}
}
Monday, 19 May 2014
MySQL query reference
To list all the databases;
show databases;
String to Date
SELECT dob, STR_TO_DATE(dob, "%d-%M-%y") FROM patdemofloridalab
Query which contains future date.
SELECT * FROM patient WHERE dob >= CURDATE()
Example for Date_Sub
UPDATE patient SET dob = DATE_SUB(dob,INTERVAL 100 YEAR) WHERE dob >= CURDATE()
This will convert 01/01/2045 to 01/01/1945
Update mysql table with data from another table
UPDATE table1 t1, table2 t2
SET t1.field_to_change = t2.field_with_data
WHERE t1.field1 = t2.field2;
Add new column with default value
ALTER TABLE insurance ADD primaryedi INTEGER DEFAULT 1;
ALTER TABLE appsettings ADD claimstatusnew BIGINT NULL;
Drop Foreign Key constraint and Column
ALTER TABLE patientreceipt DROP FOREIGN KEY FK_patientreceipt_practiceID;
ALTER TABLE patientreceipt DROP practiceID;
Update from another select
UPDATE tmpreport AS a
JOIN
(SELECT
this_.accountCode AS accountcode,
SUM(this_.billedAmount) AS amount
FROM
viewreporttranheader this_
WHERE
this_.DOSYear=2014 AND this_.DOSMonth = 3
GROUP BY
this_.accountCode) b
ON
a.datacode = b.accountcode
SET billedAmt1 = b.amount
Wednesday, 14 May 2014
271–5010 Health Care Eligibility Benefit Response - Subscriber Demographic Information and Subscriber Date –Loop 2100C
Subscriber Demographic Information.
| Loop | Seg ID | Segment Name | Format | Length | Ref# | Req | Value |
| 2100C | DMG | Demographic Information | ID | 3 | S | DMG | |
| Element Separator | AN | 1 | * | ||||
| DMG01 | Date Time Period format Qualifier | ID | 2 | 1250 | S | D8 = Date format | |
| Element Separator | AN | 1 | * | ||||
| DMG02 | Date Time Period | AN | 8 | 1251 | S | <CCYYMMDD - Recipient Date of Birth> | |
| Segment Terminator | ~ |
DMG*D8*19571112
| Loop | Seg ID | Segment Name | Format | Length | Ref# | Req | Value |
| 2100C | DTP | Subscriber Date | ID | 3 | R | DTP | |
| Element Separator | AN | 1 | * | ||||
| DTP01 | Date Time Qualifier | ID | 2 | 374 | R | See values below | |
| Element Separator | AN | 1 | * | ||||
| DTP02 | Date Time Period Format Qualifier | ID | 2/3 | 1250 | R | D8 or RD8 | |
| Segment Terminator | ~ |
DTP 01 – Date Time Qualifier
| Code | Definition |
| 096 | Discharge |
| 102 | Issue |
| 152 | Effective Date of Change |
| 291 | Plan |
| 307 | Eligibility |
| 340 | Consolidated Omnibus Budget Reconciliation Act (COBRA) Begin |
| 341 | Consolidated Omnibus Budget Reconciliation Act (COBRA) End |
| 342 | Premium Paid to Date Begin |
| 343 | Premium Paid to Date End |
| 346 | Plan Begin |
| 347 | Plan End |
| 356 | Eligibility Begin |
| 357 | Eligibility End |
| 382 | Enrolment |
| 435 | Admission |
| 442 | Date of Death |
| 458 | Certification |
| 472 | Service |
| 539 | Policy Effective |
| 540 | Policy Expiration |
| 636 | Date of Last Update |
| 771 | Status |
DTP 02 – Date Time Period Qualifier
| Code | Definition |
| D8 | Date Expressed in Format CCYYMMDD |
| RD8 | Range of Dates Expressed in Format CCYYMMDD-CCYYMMDD |
Sample
DTP*356*D8*20110101
DTP*346*D8*20140101
DTP*347*D8*20141231
Questions or feedback are always welcome. You can email me at vbsenthilinnet@gmail.com.
271–5010 Health Care Eligibility Benefit Response – Loop 2100C Subscriber Name
Use this segment to identify an entity by name and/or identification number. Use this NM1 loop to identify the insured or subscriber
| Loop | Seg ID | Segment Name | Format | Length | Ref# | Req | Value |
| 2100C | NM1 | Subscriber Name | ID | 3 | R | NM1 | |
| Element Separator | AN | 1 | * | ||||
| NM101 | Entity Identifier Code | ID | 2/3 | 98 | R | IL | |
| Element Separator | AN | 1 | * | ||||
| NM102 | Entity Type qualifier | ID | 1/1 | 1065 | R | 1 | |
| Element Separator | AN | 1 | * | ||||
| NM103 | Name Last or Organization Name | AN | 1/60 | 1035 | R | Insured Person Last Name | |
| Element Separator | AN | 1 | * | ||||
| NM104 | Name First | AN | 1/35 | 1036 | S | Insured Person First Name | |
| Element Separator | AN | 1 | * | ||||
| NM105 | Name Middle | AN | 1/25 | 1037 | S | Insured Person Middle Name | |
| Element Separator | AN | 1 | * | ||||
| NM106 | Name Prefix | AN | 1/10 | 1038 | Not used | ||
| Element Separator | AN | 1 | * | ||||
| NM107 | Name Suffix | AN | 1/10 | 1039 | S | Insured Person Suffix | |
| Element Separator | AN | 1 | * | ||||
| NM108 | Identification code Qualifier | ID | 1/2 | 66 | R | MI | |
| Element Separator | AN | 1 | * | ||||
| NM109 | Identification code | AN | 2/80 | 67 | R | Insured Policy No | |
| Segment Terminator | ~ | ||||||
NM102 - Entity Type Qualifier
Code qualifying the type of entity
| Code | Definition |
| 1 | Person |
| 2 | Non-Person Entity |
NM1*IL*1*MULLIN*DANIEL****MI*XJBH12345678~
Segment Structure
SUBSCRIBER Additional identification
| Loop | Seg ID | Segment Name | Format | Length | Ref# | Req | Value |
| 2100C | REF | Reference Identification | ID | 3 | R | REF | |
| Element Separator | AN | 1 | * | ||||
| REF01 | Reference Identification qualifier | ID | 2/3 | 128 | R | See below for valid values | |
| Element Separator | AN | 1 | * | ||||
| REF02 | Reference Identification | AN | 1/50 | 127 | R | Identification value | |
| Element Separator | AN | 1 | * | ||||
| REF03 | Description | AN | 1/80 | 352 | S | Free form description as optional |
REF01- Reference Identification Type Qualifier
| Code | Definition |
| 18 | Plan Number |
| 1L | Group Policy Number |
| 1W | Member Identification Number |
| 3H | Case Number |
| 49 | Family Unit Number |
| 6P | Group Number |
| CE | Class of Contract |
| CT | Contract Number |
| EA | Medical Record Identification Number |
| EJ | Patient Account Number |
| F6 | Health Insurance Claim (HIC) Number |
| GH | Identification Card Serial Number |
| HJ | Identify Card Number |
| IF | Issue Number |
| IG | Insurance Policy Number |
| N6 | Plan Network Identification Number |
| NQ | Medicaid Recipient Identification Number |
| Q4 | Prior Identifier Number |
| SY | Social Security Number |
| Y4 | Agency Claim Number |
Sample
REF*6P*1111119*XXXXXXX XXXXXXXXXX XXXXXXXXX, INC.
REF*EJ*660415~
2100C Subscriber Address
| Loop | Seg ID | Segment Name | Format | Length | Ref# | Req | Value |
| 2100C | N3 | Subscriber Address | AN | 2 | R | N3 | |
| Element Separator | AN | 1 | * | ||||
| N301 | Address Line 1 | AN | 1/55 | 166 | R | Insured Person Address Line 1 | |
| Element Separator | AN | 1 | * | ||||
| N302 | Address Line 2 | AN | 1/55 | 166 | S | Insured Person Address Line 2 if exists | |
| Segment Terminator | ~ |
2100C Subscriber City/State/Zip code
| Loop | Seg ID | Segment Name | Format | Length | Ref# | Req | Value |
| 2100C | N4 | Subscriber City / State / Zip Code | AN | 2 | R | N4 | |
| Element Separator | AN | 1 | * | ||||
| N401 | City Name | AN | 2/30 | 19 | R | Insured Person City Name | |
| Element Separator | AN | 1 | * | ||||
| N402 | State or Province Code | ID | 2/2 | 156 | R | Insured Person State Code | |
| Element Separator | AN | 1 | * | ||||
| N403 | Postal Code | ID | 3/15 | 116 | R | Insured Person Zip Code | |
| Segment Terminator | ~ |
2100C Subscriber Demographic Information.
| Loop | Seg ID | Segment Name | Format | Length | Ref# | Req | Value |
| 2100C | DMG | Subscriber Demographic | ID | 3 | R | DMG | |
| Element Separator | AN | 1 | * | ||||
| DMG01 | Date time Period Format Qualifier | ID | 2/3 | 1250 | R | D8 | |
| Element Separator | AN | 1 | * | ||||
| DMG02 | Date time Period | AN | 1/35 | 1251 | R | Insured Date of birth in the Format CCYYMMDD | |
| Element Separator | AN | 1 | * | ||||
| DMG03 | Gender Code | ID | 1 | 1068 | R | Print M for Male Print F for Female Print U for unknown | |
| Segment Terminator |
Sample
N3*254 Holly ST
N4*HYDE PARK*NY*011111117
DMG*D8*19521212*M
Questions or feedback are always welcome. You can email me at vbsenthilinnet@gmail.com.
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