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Data Element Name:  Submitter Name
Format-Length:  A/N - 21 Required For:  AS, ED, IP
Effective Date:  1/1/94 Revision Date:  September 2003

National Standard Mapping:

Electronic - 837I

X12 Loop

Ref. Des.

Data Element

Code

Description
Version 4050R 1000A NM101 98 41 Entity Identifier Code (Submitter)
NM102 1065 2 Entity Type Qualifier (Non-Person)
NM103 1035 Organization Name

Paper Form Locator Code Qualifier Description
Institutional - UB-04 N/A N/A Does Not Apply - needed only for Electronic submission

Definition:

The name of the facility or vendor (data collector) submitting the SPARCS data. This name must correspond with SPARCS Collector Code.

Codes and Values:

  1. Must be a valid name in accordance with the SPARCS Hospital Profile Reference File maintained by the SPARCS Administrative Unit.

Edit Applications:

  1. Must be a valid entry.
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