ANSI X12 837P - 4010 2310E NM1 - Supervising Provider Name

The purpose of the 2310E NM1 Supervising Provider Name Loop is to supply the name and id of the supervising provider.

The 4010 specifications for the NM1 segment can be found below as it pertains to the 2310E loop.

Sample 837P (4010) - 2310E NM1 - Supervising Provider Name

  • Supervising Provider Name (2310E)
  • NM1*DQ*1*LAST*FIRST*M***XX*1234567893~

HIPAA Guide - 837P [4010]


RNM101Entity Identifier CodeMID3
DQSupervising Physician
RNM102Entity Type QualifierMID1
RNM103Name Last or Organization Name
[Supervising Provider Last Name]
RNM104Name First
[Supervising Provider First Name]
SNM105Name Middle
[Supervising Provider Middle Name]
NNM106Name PrefixOAN10
SNM107Name Suffix
[Supervising Provider Name Suffix]
SNM108Identification Code QualifierXID2
24Employer's Identification Number
34Social Security Number
XXHealth Care Financing Administration National Provider Identifier
SNM109Identification Code
[Supervising Provider Identifier]
NNM110Entity Relationship CodeXID2
NNM111Entity Identifier CodeOID3

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