KY MMIS 834 Companion Guide - Kymmis.com
KY MMIS 834 Companion Guide - Kymmis.com
KY MMIS 834 Companion Guide - Kymmis.com
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Commonwealth of Kentucky – <strong>MMIS</strong><strong>KY</strong> <strong>MMIS</strong> <strong>834</strong> <strong>Companion</strong> <strong>Guide</strong><strong>834</strong> Benefit Enrollment and Maintenance154 2310 NM1 NM102 – Entity Type Qualifier ‘1’ - Person154 2310 NM1 NM108 – Identification CodeQualifierSV - Service Provider (foratypical providers only)XX - National ProviderIdentifier155 2310 NM1 NM109 – Provider Identifier For SV in NM108 - 8 or 10digit Kentucky Medicaid IDNumberFor XX in NM108 - 10 digitNational Provider Identifier155 2310 NM1 NM110 – Entity RelationshipCode'72' - UnknownDMS Approved 12/02/2011 Page 21
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