Sample EDI 834 Data for the Benefit Enrollment And Maintenance Transaction Set


AgencySet IDFGTransaction DescriptionSubcommittee
ANSI834BEBenefit Enrollment And Maintenance Insurance


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Research and Development:
Below is a sample EDI 834 transaction set. The Jobisez.com site has an online translation tool that converts the EDI 834 (Benefit Enrollment And Maintenance) document into a CSV file. If you are researching the 834s, you can view other trading partner's mapping specifications. You can also gain knowledge by researching all EDI document types. Jobisez LLC can also provide assistance if you need additional help.

Sample of an EDI 834 Transaction Set

ST*834*12345*005010X220A1
BGN*00*12345*20161108*100649****RX
N1*P5*Sun Dental*FI*812265799
N1*IN*Network Health*FI*391442058
INS*Y*18*021**A
REF*0F*S1234567
REF*1L*EMPXXXXX
REF*23*Sun Dental Plan
NM1*IL*1*Doe*John****34*123456789
PER*IP**TE*3052222222
N3*123 SW 152 AVE
N4*MIAMI*FL*33199
DMG*D8*19800101*F
HD*001**DEN**IND
DTP*348*D8*20161101
SE*16*12345

Solutions:
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