EDI 267 Segments and Elements for the Individual Life, Annuity And Disability Application Standard


AgencySet IDFGTransaction DescriptionSubcommitteeStandard
ANSI267ADIndividual Life, Annuity And Disability Application InsuranceDownload


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Research and Development:
See the list of EDI 267 segments and elements in below data grid. The Jobisez.com site has an online translation tool that converts the EDI 267 (Individual Life, Annuity And Disability Application) document into a CSV file. If you are researching the 267s, 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.

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The EDI 267 Segments and Elements

SegmentDescriptionSectReqMax LoopMax UsagePos
BGNBeginning SegmentHM011
DTPDate Or Time Or PeriodHO09999992
NM1Individual Or Organizational NameHO99999913
N3Party LocationHO034
N4Geographic LocationHO015
REFReference InformationHO096
PERAdministrative Communications ContactHO037
N1Party IdentificationDM99999918
N2Additional Name InformationDO039
N3Party LocationDO0310
N4Geographic LocationDO0111
N9Extended Reference InformationDO099999912
DTMDate/Time ReferenceDO099999913
ACTAccount IdentificationDM999999114
ASIAction Or Status IndicatorDO0115
PERAdministrative Communications ContactDO099999916
C3Currency IdentifierDO0117
LUILanguage UseDO099999918
DTPDate Or Time Or PeriodDO099999919
BLIBasic Baseline Item DataDO0120
LINItem IdentificationDO099999921
PDLPayment DetailsDO099999922
AM1Informational ValuesDO099999923
AMTMonetary Amount InformationDO099999924
QTYQuantity InformationDO099999925
YNQYes/No QuestionDO099999926
REFReference InformationDO099999927
LQIndustry Code IdentificationDO999999128
N4Geographic LocationDO099999929
LUILanguage UseDO099999930
SIService Characteristic IdentificationDO999999131
AMTMonetary Amount InformationDO099999932
DTPDate Or Time Or PeriodDO099999933
REFReference InformationDO099999934
NM1Individual Or Organizational NameDO0135
N4Geographic LocationDO0136
MSGMessage TextDO099999937
PIDProduct/Item DescriptionDO999999138
BLIBasic Baseline Item DataDO0139
SPAStatus Of Product Or ActivityDO0140
UDUnderwriting StatusDO0141
AMTMonetary Amount InformationDO099999942
AM1Informational ValuesDO099999943
PDLPayment DetailsDO099999944
QTYQuantity InformationDO099999945
DTPDate Or Time Or PeriodDO099999946
MSGMessage TextDO099999947
INVInvestment Vehicle SelectionDO999999148
AM1Informational ValuesDO099999949
DTPDate Or Time Or PeriodDO099999950
QTYQuantity InformationDO099999951
LINItem IdentificationDO0252
RPARate Amounts Or PercentsDO099999953
BENBeneficiary Or Owner InformationDO999999154
NM1Individual Or Organizational NameDO0155
N2Additional Name InformationDO0356
N3Party LocationDO0357
N4Geographic LocationDO0158
REFReference InformationDO099999959
DTPDate Or Time Or PeriodDO099999960
IIIInformationDO099999961
QTYQuantity InformationDO099999962
AMTMonetary Amount InformationDO099999963
LUILanguage UseDO0164
MSGMessage TextDO099999965
ENTEntityDO999999166
NX1Property Or Entity IdentificationDO0267
REFReference InformationDO099999968
LINItem IdentificationDO0969
DMGDemographic InformationDO0170
DMAAdditional Demographic InformationDO0171
INDAdditional Individual Demographic InformationDO0172
LUILanguage UseDO0173
ERIEntity RelationshipDO0174
DTPDate Or Time Or PeriodDO099999975
AMTMonetary Amount InformationDO099999976
AM1Informational ValuesDO099999977
RPARate Amounts Or PercentsDO099999978
YNQYes/No QuestionDO099999979
QTYQuantity InformationDO099999980
MSGMessage TextDO099999981
NM1Individual Or Organizational NameDO999999182
N2Additional Name InformationDO0383
REFReference InformationDO099999984
AM1Informational ValuesDO099999985
N3Party LocationDO999999186
N4Geographic LocationDO0187
COMCommunication Contact InformationDO0988
DTPDate Or Time Or PeriodDO099999989
QTYQuantity InformationDO0190
LQIndustry Code IdentificationDO999999191
SPAStatus Of Product Or ActivityDO0192
DTPDate Or Time Or PeriodDO099999993
MSGMessage TextDO099999994
NM1Individual Or Organizational NameDO999999195
N3Party LocationDO0396
N4Geographic LocationDO0197
REFReference InformationDO099999998
COMCommunication Contact InformationDO0399
LUILanguage UseDO01100
DTPDate Or Time Or PeriodDO0999999101
MSGMessage TextDO0999999102
BENBeneficiary Or Owner InformationDO9999991103
NM1Individual Or Organizational NameDO01104
N2Additional Name InformationDO03105
N3Party LocationDO03106
N4Geographic LocationDO01107
REFReference InformationDO0999999108
DTPDate Or Time Or PeriodDO0999999109
IIIInformationDO0999999110
QTYQuantity InformationDO0999999111
AMTMonetary Amount InformationDO0999999112
LUILanguage UseDO01113
MSGMessage TextDO0999999114
PIDProduct/Item DescriptionDO9999991115
BLIBasic Baseline Item DataDO09116
SPAStatus Of Product Or ActivityDO01117
AMTMonetary Amount InformationDO0999999118
QTYQuantity InformationDO0999999119
DTPDate Or Time Or PeriodDO0999999120
YNQYes/No QuestionDO0999999121
MSGMessage TextDO0999999122
PDLPayment DetailsDO9999991123
REFReference InformationDO0999999124
INVInvestment Vehicle SelectionDO9999991125
AM1Informational ValuesDO0999999126
DTPDate Or Time Or PeriodDO0999999127
RPARate Amounts Or PercentsDO0999999128
BENBeneficiary Or Owner InformationDO9999991129
NM1Individual Or Organizational NameDO01130
N2Additional Name InformationDO03131
N3Party LocationDO03132
N4Geographic LocationDO01133
REFReference InformationDO0999999134
DTPDate Or Time Or PeriodDO0999999135
IIIInformationDO0999999136
QTYQuantity InformationDO0999999137
AMTMonetary Amount InformationDO0999999138
LUILanguage UseDO01139
MSGMessage TextDO0999999140
UCUnderwriting CategoryDO9999991141
HLHierarchical LevelDO9999991142
UQSUnderwriting QuestionDO01143
YNQYes/No QuestionDO0999999144
NM1Individual Or Organizational NameDO01145
N3Party LocationDO03146
N4Geographic LocationDO01147
COMCommunication Contact InformationDO09148
DTPDate Or Time Or PeriodDO0999999149
QTYQuantity InformationDO0999999150
MSGMessage TextDO0999999151
AM1Informational ValuesDO0999999152
AMTMonetary Amount InformationDO0999999153
IIIInformationDO0999999154
ECEmployment ClassDO01155
EMSEmployment PositionDO01156
EMPEmployerDO01157
PCTPercent AmountsDO0999999158
SOISource Of IncomeDO0999999159
LINItem IdentificationDO02160
REFReference InformationDO0999999161
ASLAsset LiabilityDO0999999162
TOAType Of ActivityDO0999999163
TOVVehicle Use InformationDO0999999164
VEHVehicle InformationDO0999999165
CDSCase DescriptionDO0999999166
CEDAdministration Of Justice Event DescriptionDO0999999167
SINSubstance UseDO0999999168
UCSUnderwriting ConsiderationsDO0999999169
FHFamily HistoryDO0999999170
SPAStatus Of Product Or ActivityDO01171
MPIMilitary Personnel InformationDO01172
PWKPaperworkDO9999991173
NM1Individual Or Organizational NameDO01174
N4Geographic LocationDO01175
REFReference InformationDO0999999176
DTPDate Or Time Or PeriodDO0999999177
SPAStatus Of Product Or ActivityDO01178
EFIElectronic Format IdentificationDO9999991179
BINBinary Data SegmentDM01180
LXTransaction Set Line NumberDO9999991181
PDLPayment DetailsDO9999991182
REFReference InformationDO0999999183
LSLoop HeaderDO01184
AMTMonetary Amount InformationDO9999991185
N1Party IdentificationDO01186
N3Party LocationDO02187
N4Geographic LocationDO01188
LINItem IdentificationDO02189
DTPDate Or Time Or PeriodDO0999999190
QTYQuantity InformationDO0999999191
MSGMessage TextDO0999999192
AM1Informational ValuesDO9999991193
INVInvestment Vehicle SelectionDO9999991194
QTYQuantity InformationDO0999999195
DTPDate Or Time Or PeriodDO0999999196
RPARate Amounts Or PercentsDO0999999197
LELoop TrailerDO01198
K2Administrative MessageDO9999991199
DTPDate Or Time Or PeriodDO01200
NM1Individual Or Organizational NameDO01201


SegmentElementDescriptionReqMin LengthMax LengthType
BGN1Transaction Set Purpose CodeM22ID
BGN2Reference IdentificationM150AN
BGN3DateM88DT
BGN4TimeC48TM
BGN5Time CodeO22ID
BGN6Reference IdentificationO150AN
BGN7Transaction Type CodeO22ID
BGN8Action CodeO12ID
BGN9Security Level CodeO22ID
DTP1Date/Time QualifierM33ID
DTP2Date Time Period Format QualifierM23ID
DTP3Date Time PeriodM135AN
NM11Entity Identifier CodeM23ID
NM12Entity Type QualifierM11ID
NM13Name Last Or Organization NameC160AN
NM14Name FirstO135AN
NM15Name MiddleO125AN
NM16Name PrefixO110AN
NM17Name SuffixO110AN
NM18Identification Code QualifierC12ID
NM19Identification CodeC280AN
NM110Entity Relationship CodeC22ID
NM111Entity Identifier CodeO23ID
NM112Name Last Or Organization NameO160AN
N31Address InformationM155AN
N32Address InformationO155AN
N41City NameO230AN
N42State Or Province CodeC22ID
N43Postal CodeO315ID
N44Country CodeC23ID
N45Location QualifierC12ID
N46Location IdentifierO130AN
N47Country Subdivision CodeC13ID
REF1Reference Identification QualifierM23ID
REF2Reference IdentificationC150AN
REF3DescriptionC180AN
REF4Reference Identification QualifierO23ID
REF5Reference IdentificationO150AN
REF6Reference Identification QualifierO23ID
REF7Reference IdentificationO150AN
REF8Reference Identification QualifierO23ID
REF9Reference IdentificationO150AN
PER1Contact Function CodeM22ID
PER2NameO160AN
PER3Communication Number QualifierC22ID
PER4Communication NumberC1256AN
PER5Communication Number QualifierC22ID
PER6Communication NumberC1256AN
PER7Communication Number QualifierC22ID
PER8Communication NumberC1256AN
PER9Contact Inquiry ReferenceO120AN
N11Entity Identifier CodeM23ID
N12NameC160AN
N13Identification Code QualifierC12ID
N14Identification CodeC280AN
N15Entity Relationship CodeO22ID
N16Entity Identifier CodeO23ID
N21NameM160AN
N22NameO160AN
N31Address InformationM155AN
N32Address InformationO155AN
N41City NameO230AN
N42State Or Province CodeC22ID
N43Postal CodeO315ID
N44Country CodeC23ID
N45Location QualifierC12ID
N46Location IdentifierO130AN
N47Country Subdivision CodeC13ID
N91Reference Identification QualifierM23ID
N92Reference IdentificationC150AN
N93Free-Form DescriptionC145AN
N94DateO88DT
N95TimeC48TM
N96Time CodeO22ID
N97Reference Identification QualifierO23ID
N98Reference IdentificationO150AN
N99Reference Identification QualifierO23ID
N910Reference IdentificationO150AN
N911Reference Identification QualifierO23ID
N912Reference IdentificationO150AN
DTM1Date/Time QualifierM33ID
DTM2DateC88DT
DTM3TimeC48TM
DTM4Time CodeO22ID
DTM5Date Time Period Format QualifierC23ID
DTM6Date Time PeriodC135AN
ACT1Account NumberM135AN
ACT2NameO160AN
ACT3Identification Code QualifierC12ID
ACT4Identification CodeC280AN
ACT5Account Number QualifierC13ID
ACT6Account NumberC135AN
ACT7DescriptionO180AN
ACT8Payment Method Type CodeO12ID
ACT9Benefit Status CodeO11ID
ASI1Action CodeM12ID
ASI2Maintenance Type CodeM33ID
ASI3Status Reason CodeO33ID
PER1Contact Function CodeM22ID
PER2NameO160AN
PER3Communication Number QualifierC22ID
PER4Communication NumberC1256AN
PER5Communication Number QualifierC22ID
PER6Communication NumberC1256AN
PER7Communication Number QualifierC22ID
PER8Communication NumberC1256AN
PER9Contact Inquiry ReferenceO120AN
C31Currency CodeM33ID
C32Exchange RateO410R
C33Currency CodeO33ID
C34Currency CodeO33ID
LUI1Identification Code QualifierC12ID
LUI2Identification CodeC280AN
LUI3DescriptionC180AN
LUI4Use Of Language IndicatorO12ID
LUI5Language Proficiency IndicatorO11ID
DTP1Date/Time QualifierM33ID
DTP2Date Time Period Format QualifierM23ID
DTP3Date Time PeriodM135AN
BLI1Product/Service Id QualifierM22ID
BLI2Product/Service IdM148AN
BLI3QuantityC115R
BLI4Unit Or Basis For Measurement CodeO22ID
BLI5Price Identifier CodeC33ID
BLI6Unit PriceC117R
BLI7Unit Or Basis For Measurement CodeO22ID
BLI8Product/Service Id QualifierC22ID
BLI9Product/Service IdC148AN
BLI10Product/Service Id QualifierC22ID
BLI11Product/Service IdC148AN
BLI12Product/Service Id QualifierC22ID
BLI13Product/Service IdC148AN
BLI14Product Option CodeO12ID
BLI15Product Option CodeO12ID
BLI16Product Option CodeO12ID
BLI17Product Option CodeO12ID
BLI18Frequency CodeO11ID
LIN1Assigned IdentificationO120AN
LIN2Product/Service Id QualifierM22ID
LIN3Product/Service IdM148AN
LIN4Product/Service Id QualifierC22ID
LIN5Product/Service IdC148AN
LIN6Product/Service Id QualifierC22ID
LIN7Product/Service IdC148AN
LIN8Product/Service Id QualifierC22ID
LIN9Product/Service IdC148AN
LIN10Product/Service Id QualifierC22ID
LIN11Product/Service IdC148AN
LIN12Product/Service Id QualifierC22ID
LIN13Product/Service IdC148AN
LIN14Product/Service Id QualifierC22ID
LIN15Product/Service IdC148AN
LIN16Product/Service Id QualifierC22ID
LIN17Product/Service IdC148AN
LIN18Product/Service Id QualifierC22ID
LIN19Product/Service IdC148AN
LIN20Product/Service Id QualifierC22ID
LIN21Product/Service IdC148AN
LIN22Product/Service Id QualifierC22ID
LIN23Product/Service IdC148AN
LIN24Product/Service Id QualifierC22ID
LIN25Product/Service IdC148AN
LIN26Product/Service Id QualifierC22ID
LIN27Product/Service IdC148AN
LIN28Product/Service Id QualifierC22ID
LIN29Product/Service IdC148AN
LIN30Product/Service Id QualifierC22ID
LIN31Product/Service IdC148AN
PDL1Payment Method CodeM33ID
PDL2Amount Qualifier CodeC13ID
PDL3Monetary AmountC118R
PDL4Percentage As DecimalC110R
PDL5Credit/Debit Flag CodeO11ID
PDL6Frequency CodeO11ID
PDL7(Dfi) Id Number QualifierC22ID
PDL8(Dfi) Identification NumberC312AN
PDL9Account Number QualifierC13ID
PDL10Account NumberC135AN
PDL11Date Time Period Format QualifierC23ID
PDL12Date Time PeriodC135AN
AM11Code CategoryM22ID
AM12Product/Service Id QualifierM22ID
AM13Product/Service IdM148AN
AM14Monetary AmountO118R
AM15QuantityO115R
AM16Percentage As DecimalO110R
AMT1Amount Qualifier CodeM13ID
AMT2Monetary AmountM118R
AMT3Credit/Debit Flag CodeO11ID
QTY1Quantity QualifierM22ID
QTY2QuantityC115R
QTY3Unit Or Basis For Measurement CodeO22ID
QTY4ExponentO115R
QTY5MultiplierO110R
QTY6Unit Or Basis For Measurement CodeO22ID
QTY7ExponentO115R
QTY8MultiplierO110R
QTY9Unit Or Basis For Measurement CodeO22ID
QTY10ExponentO115R
QTY11MultiplierO110R
QTY12Unit Or Basis For Measurement CodeO22ID
QTY13ExponentO115R
QTY14MultiplierO110R
QTY15Unit Or Basis For Measurement CodeO22ID
QTY16ExponentO115R
QTY17MultiplierO110R
QTY18Free-Form InformationC130AN
YNQ1Condition IndicatorC23ID
YNQ2Yes/No Condition Or Response CodeM11ID
YNQ3Date Time Period Format QualifierC23ID
YNQ4Date Time PeriodC135AN
YNQ5Free-Form Message TextO1264AN
YNQ6Free-Form Message TextO1264AN
YNQ7Free-Form Message TextO1264AN
YNQ8Code List Qualifier CodeC13ID
YNQ9Industry CodeC130AN
YNQ10Free-Form Message TextC1264AN
REF1Reference Identification QualifierM23ID
REF2Reference IdentificationC150AN
REF3DescriptionC180AN
REF4Reference Identification QualifierO23ID
REF5Reference IdentificationO150AN
REF6Reference Identification QualifierO23ID
REF7Reference IdentificationO150AN
REF8Reference Identification QualifierO23ID
REF9Reference IdentificationO150AN
LQ1Code List Qualifier CodeO13ID
LQ2Industry CodeC130AN
N41City NameO230AN
N42State Or Province CodeC22ID
N43Postal CodeO315ID
N44Country CodeC23ID
N45Location QualifierC12ID
N46Location IdentifierO130AN
N47Country Subdivision CodeC13ID
LUI1Identification Code QualifierC12ID
LUI2Identification CodeC280AN
LUI3DescriptionC180AN
LUI4Use Of Language IndicatorO12ID
LUI5Language Proficiency IndicatorO11ID
SI1Agency Qualifier CodeM22ID
SI2Service Characteristics QualifierM23AN
SI3Product/Service IdM148AN
SI4Service Characteristics QualifierC23AN
SI5Product/Service IdC148AN
SI6Service Characteristics QualifierC23AN
SI7Product/Service IdC148AN
SI8Service Characteristics QualifierC23AN
SI9Product/Service IdC148AN
SI10Service Characteristics QualifierC23AN
SI11Product/Service IdC148AN
SI12Service Characteristics QualifierC23AN
SI13Product/Service IdC148AN
SI14Service Characteristics QualifierC23AN
SI15Product/Service IdC148AN
SI16Service Characteristics QualifierC23AN
SI17Product/Service IdC148AN
SI18Service Characteristics QualifierC23AN
SI19Product/Service IdC148AN
SI20Service Characteristics QualifierC23AN
SI21Product/Service IdC148AN
AMT1Amount Qualifier CodeM13ID
AMT2Monetary AmountM118R
AMT3Credit/Debit Flag CodeO11ID
DTP1Date/Time QualifierM33ID
DTP2Date Time Period Format QualifierM23ID
DTP3Date Time PeriodM135AN
REF1Reference Identification QualifierM23ID
REF2Reference IdentificationC150AN
REF3DescriptionC180AN
REF4Reference Identification QualifierO23ID
REF5Reference IdentificationO150AN
REF6Reference Identification QualifierO23ID
REF7Reference IdentificationO150AN
REF8Reference Identification QualifierO23ID
REF9Reference IdentificationO150AN
NM11Entity Identifier CodeM23ID
NM12Entity Type QualifierM11ID
NM13Name Last Or Organization NameC160AN
NM14Name FirstO135AN
NM15Name MiddleO125AN
NM16Name PrefixO110AN
NM17Name SuffixO110AN
NM18Identification Code QualifierC12ID
NM19Identification CodeC280AN
NM110Entity Relationship CodeC22ID
NM111Entity Identifier CodeO23ID
NM112Name Last Or Organization NameO160AN
N41City NameO230AN
N42State Or Province CodeC22ID
N43Postal CodeO315ID
N44Country CodeC23ID
N45Location QualifierC12ID
N46Location IdentifierO130AN
N47Country Subdivision CodeC13ID
MSG1Free-Form Message TextM1264AN
MSG2Printer Carriage Control CodeC22ID
MSG3NumberO19N0
PID1Item Description TypeM11ID
PID2Product/Process Characteristic CodeO23ID
PID3Agency Qualifier CodeC22ID
PID4Product Description CodeC112AN
PID5DescriptionC180AN
PID6Surface/Layer/Position CodeO22ID
PID7Source SubqualifierO115AN
PID8Yes/No Condition Or Response CodeO11ID
PID9Language CodeO23ID
BLI1Product/Service Id QualifierM22ID
BLI2Product/Service IdM148AN
BLI3QuantityC115R
BLI4Unit Or Basis For Measurement CodeO22ID
BLI5Price Identifier CodeC33ID
BLI6Unit PriceC117R
BLI7Unit Or Basis For Measurement CodeO22ID
BLI8Product/Service Id QualifierC22ID
BLI9Product/Service IdC148AN
BLI10Product/Service Id QualifierC22ID
BLI11Product/Service IdC148AN
BLI12Product/Service Id QualifierC22ID
BLI13Product/Service IdC148AN
BLI14Product Option CodeO12ID
BLI15Product Option CodeO12ID
BLI16Product Option CodeO12ID
BLI17Product Option CodeO12ID
BLI18Frequency CodeO11ID
SPA1Status CodeM22ID
SPA2Date Time Period Format QualifierC23ID
SPA3Date Time PeriodC135AN
SPA4Amount Qualifier CodeC13ID
SPA5Monetary AmountC118R
SPA6Status Reason CodeO33ID
SPA7Status Reason CodeO33ID
SPA8Status Reason CodeO33ID
SPA9Agency Qualifier CodeC22ID
SPA10Product Description CodeC112AN
SPA11Source SubqualifierO115AN
UD1Status CodeM22ID
UD2Status CodeO22ID
UD3Underwriting Decision CodeO11ID
UD4DateO88DT
UD5DescriptionO180AN
UD6Offer Basis CodeO23ID
UD7Assigned NumberO16N0
UD8Offer Basis CodeO23ID
UD9Assigned NumberO16N0
UD10DescriptionO180AN
UD11Percentage As DecimalC110R
UD12AmountC115N2
UD13NumberO19N0
UD14State Or Province CodeO22ID
UD15Country CodeO23ID
UD16State Or Province CodeO22ID
UD17Country CodeO23ID
AMT1Amount Qualifier CodeM13ID
AMT2Monetary AmountM118R
AMT3Credit/Debit Flag CodeO11ID
AM11Code CategoryM22ID
AM12Product/Service Id QualifierM22ID
AM13Product/Service IdM148AN
AM14Monetary AmountO118R
AM15QuantityO115R
AM16Percentage As DecimalO110R
PDL1Payment Method CodeM33ID
PDL2Amount Qualifier CodeC13ID
PDL3Monetary AmountC118R
PDL4Percentage As DecimalC110R
PDL5Credit/Debit Flag CodeO11ID
PDL6Frequency CodeO11ID
PDL7(Dfi) Id Number QualifierC22ID
PDL8(Dfi) Identification NumberC312AN
PDL9Account Number QualifierC13ID
PDL10Account NumberC135AN
PDL11Date Time Period Format QualifierC23ID
PDL12Date Time PeriodC135AN
QTY1Quantity QualifierM22ID
QTY2QuantityC115R
QTY3Unit Or Basis For Measurement CodeO22ID
QTY4ExponentO115R
QTY5MultiplierO110R
QTY6Unit Or Basis For Measurement CodeO22ID
QTY7ExponentO115R
QTY8MultiplierO110R
QTY9Unit Or Basis For Measurement CodeO22ID
QTY10ExponentO115R
QTY11MultiplierO110R
QTY12Unit Or Basis For Measurement CodeO22ID
QTY13ExponentO115R
QTY14MultiplierO110R
QTY15Unit Or Basis For Measurement CodeO22ID
QTY16ExponentO115R
QTY17MultiplierO110R
QTY18Free-Form InformationC130AN
DTP1Date/Time QualifierM33ID
DTP2Date Time Period Format QualifierM23ID
DTP3Date Time PeriodM135AN
MSG1Free-Form Message TextM1264AN
MSG2Printer Carriage Control CodeC22ID
MSG3NumberO19N0
INV1DescriptionM180AN
INV2Percentage As DecimalC110R
INV3Monetary AmountC118R
INV4QuantityC115R
INV5State Or Province CodeO22ID
INV6DescriptionO180AN
INV7Monetary AmountO118R
AM11Code CategoryM22ID
AM12Product/Service Id QualifierM22ID
AM13Product/Service IdM148AN
AM14Monetary AmountO118R
AM15QuantityO115R
AM16Percentage As DecimalO110R
DTP1Date/Time QualifierM33ID
DTP2Date Time Period Format QualifierM23ID
DTP3Date Time PeriodM135AN
QTY1Quantity QualifierM22ID
QTY2QuantityC115R
QTY3Unit Or Basis For Measurement CodeO22ID
QTY4ExponentO115R
QTY5MultiplierO110R
QTY6Unit Or Basis For Measurement CodeO22ID
QTY7ExponentO115R
QTY8MultiplierO110R
QTY9Unit Or Basis For Measurement CodeO22ID
QTY10ExponentO115R
QTY11MultiplierO110R
QTY12Unit Or Basis For Measurement CodeO22ID
QTY13ExponentO115R
QTY14MultiplierO110R
QTY15Unit Or Basis For Measurement CodeO22ID
QTY16ExponentO115R
QTY17MultiplierO110R
QTY18Free-Form InformationC130AN
LIN1Assigned IdentificationO120AN
LIN2Product/Service Id QualifierM22ID
LIN3Product/Service IdM148AN
LIN4Product/Service Id QualifierC22ID
LIN5Product/Service IdC148AN
LIN6Product/Service Id QualifierC22ID
LIN7Product/Service IdC148AN
LIN8Product/Service Id QualifierC22ID
LIN9Product/Service IdC148AN
LIN10Product/Service Id QualifierC22ID
LIN11Product/Service IdC148AN
LIN12Product/Service Id QualifierC22ID
LIN13Product/Service IdC148AN
LIN14Product/Service Id QualifierC22ID
LIN15Product/Service IdC148AN
LIN16Product/Service Id QualifierC22ID
LIN17Product/Service IdC148AN
LIN18Product/Service Id QualifierC22ID
LIN19Product/Service IdC148AN
LIN20Product/Service Id QualifierC22ID
LIN21Product/Service IdC148AN
LIN22Product/Service Id QualifierC22ID
LIN23Product/Service IdC148AN
LIN24Product/Service Id QualifierC22ID
LIN25Product/Service IdC148AN
LIN26Product/Service Id QualifierC22ID
LIN27Product/Service IdC148AN
LIN28Product/Service Id QualifierC22ID
LIN29Product/Service IdC148AN
LIN30Product/Service Id QualifierC22ID
LIN31Product/Service IdC148AN
RPA1Rate Or Value Type CodeM12ID
RPA2Monetary AmountC118R
RPA3RateC19R9
RPA4Unit Or Basis For Measurement CodeO22ID
RPA5ExponentO115R
RPA6MultiplierO110R
RPA7Unit Or Basis For Measurement CodeO22ID
RPA8ExponentO115R
RPA9MultiplierO110R
RPA10Unit Or Basis For Measurement CodeO22ID
RPA11ExponentO115R
RPA12MultiplierO110R
RPA13Unit Or Basis For Measurement CodeO22ID
RPA14ExponentO115R
RPA15MultiplierO110R
RPA16Unit Or Basis For Measurement CodeO22ID
RPA17ExponentO115R
RPA18MultiplierO110R
RPA19Percentage As DecimalC110R
BEN1Primary Or Contingent CodeO11ID
BEN2Percentage As DecimalO110R
BEN3Individual Relationship CodeO22ID
BEN4Yes/No Condition Or Response CodeO11ID
BEN5Yes/No Condition Or Response CodeO11ID
BEN6Type Of Account CodeO22ID
NM11Entity Identifier CodeM23ID
NM12Entity Type QualifierM11ID
NM13Name Last Or Organization NameC160AN
NM14Name FirstO135AN
NM15Name MiddleO125AN
NM16Name PrefixO110AN
NM17Name SuffixO110AN
NM18Identification Code QualifierC12ID
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NM110Entity Relationship CodeC22ID
NM111Entity Identifier CodeO23ID
NM112Name Last Or Organization NameO160AN
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LUI1Identification Code QualifierC12ID
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LUI3DescriptionC180AN
LUI4Use Of Language IndicatorO12ID
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REF5Reference IdentificationO150AN
REF6Reference Identification QualifierO23ID
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REF8Reference Identification QualifierO23ID
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LIN16Product/Service Id QualifierC22ID
LIN17Product/Service IdC148AN
LIN18Product/Service Id QualifierC22ID
LIN19Product/Service IdC148AN
LIN20Product/Service Id QualifierC22ID
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LIN22Product/Service Id QualifierC22ID
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LIN25Product/Service IdC148AN
LIN26Product/Service Id QualifierC22ID
LIN27Product/Service IdC148AN
LIN28Product/Service Id QualifierC22ID
LIN29Product/Service IdC148AN
LIN30Product/Service Id QualifierC22ID
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DMG2Date Time PeriodC135AN
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IND3County DesignatorO55ID
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ERI5Identification CodeC280AN
ERI6Entity Relationship CodeM22ID
ERI7Entity Relationship CodeO22ID
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MSG1Free-Form Message TextM1264AN
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NM111Entity Identifier CodeO23ID
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AM12Product/Service Id QualifierM22ID
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DTP1Date/Time QualifierM33ID
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MSG1Free-Form Message TextM1264AN
MSG2Printer Carriage Control CodeC22ID
MSG3NumberO19N0
NM11Entity Identifier CodeM23ID
NM12Entity Type QualifierM11ID
NM13Name Last Or Organization NameC160AN
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NM18Identification Code QualifierC12ID
NM19Identification CodeC280AN
NM110Entity Relationship CodeC22ID
NM111Entity Identifier CodeO23ID
NM112Name Last Or Organization NameO160AN
N31Address InformationM155AN
N32Address InformationO155AN
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N42State Or Province CodeC22ID
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REF2Reference IdentificationC150AN
REF3DescriptionC180AN
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REF6Reference Identification QualifierO23ID
REF7Reference IdentificationO150AN
REF8Reference Identification QualifierO23ID
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COM1Communication Number QualifierM22ID
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COM3Communication Number QualifierO22ID
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LUI1Identification Code QualifierC12ID
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LUI3DescriptionC180AN
LUI4Use Of Language IndicatorO12ID
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DTP1Date/Time QualifierM33ID
DTP2Date Time Period Format QualifierM23ID
DTP3Date Time PeriodM135AN
MSG1Free-Form Message TextM1264AN
MSG2Printer Carriage Control CodeC22ID
MSG3NumberO19N0
BEN1Primary Or Contingent CodeO11ID
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BEN4Yes/No Condition Or Response CodeO11ID
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NM12Entity Type QualifierM11ID
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NM18Identification Code QualifierC12ID
NM19Identification CodeC280AN
NM110Entity Relationship CodeC22ID
NM111Entity Identifier CodeO23ID
NM112Name Last Or Organization NameO160AN
N21NameM160AN
N22NameO160AN
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N32Address InformationO155AN
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N42State Or Province CodeC22ID
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REF1Reference Identification QualifierM23ID
REF2Reference IdentificationC150AN
REF3DescriptionC180AN
REF4Reference Identification QualifierO23ID
REF5Reference IdentificationO150AN
REF6Reference Identification QualifierO23ID
REF7Reference IdentificationO150AN
REF8Reference Identification QualifierO23ID
REF9Reference IdentificationO150AN
DTP1Date/Time QualifierM33ID
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III1Code List Qualifier CodeC13ID
III2Industry CodeC130AN
III3Code CategoryO22ID
III4Free-Form Message TextC1264AN
III5QuantityC115R
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III8MultiplierO110R
III9Unit Or Basis For Measurement CodeO22ID
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III14MultiplierO110R
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QTY2QuantityC115R
QTY3Unit Or Basis For Measurement CodeO22ID
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QTY5MultiplierO110R
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LUI1Identification Code QualifierC12ID
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LUI3DescriptionC180AN
LUI4Use Of Language IndicatorO12ID
LUI5Language Proficiency IndicatorO11ID
MSG1Free-Form Message TextM1264AN
MSG2Printer Carriage Control CodeC22ID
MSG3NumberO19N0
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PID5DescriptionC180AN
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RPA3RateC19R9
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BEN3Individual Relationship CodeO22ID
BEN4Yes/No Condition Or Response CodeO11ID
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NM111Entity Identifier CodeO23ID
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REF1Reference Identification QualifierM23ID
REF2Reference IdentificationC150AN
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REF5Reference IdentificationO150AN
REF6Reference Identification QualifierO23ID
REF7Reference IdentificationO150AN
REF8Reference Identification QualifierO23ID
REF9Reference IdentificationO150AN
DTP1Date/Time QualifierM33ID
DTP2Date Time Period Format QualifierM23ID
DTP3Date Time PeriodM135AN
III1Code List Qualifier CodeC13ID
III2Industry CodeC130AN
III3Code CategoryO22ID
III4Free-Form Message TextC1264AN
III5QuantityC115R
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QTY18Free-Form InformationC130AN
AMT1Amount Qualifier CodeM13ID
AMT2Monetary AmountM118R
AMT3Credit/Debit Flag CodeO11ID
LUI1Identification Code QualifierC12ID
LUI2Identification CodeC280AN
LUI3DescriptionC180AN
LUI4Use Of Language IndicatorO12ID
LUI5Language Proficiency IndicatorO11ID
MSG1Free-Form Message TextM1264AN
MSG2Printer Carriage Control CodeC22ID
MSG3NumberO19N0
UC1Code CategoryM22ID
UC2Reference IdentificationO150AN
UC3Reference IdentificationC150AN
UC4Yes/No Condition Or Response CodeO11ID
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HL2Hierarchical Parent Id NumberO112AN
HL3Hierarchical Level CodeM12ID
HL4Hierarchical Child CodeO11ID
UQS1Reference IdentificationM150AN
UQS2Reference IdentificationO150AN
UQS3Free-Form Message TextO1264AN
UQS4Yes/No Condition Or Response CodeO11ID
YNQ1Condition IndicatorC23ID
YNQ2Yes/No Condition Or Response CodeM11ID
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YNQ4Date Time PeriodC135AN
YNQ5Free-Form Message TextO1264AN
YNQ6Free-Form Message TextO1264AN
YNQ7Free-Form Message TextO1264AN
YNQ8Code List Qualifier CodeC13ID
YNQ9Industry CodeC130AN
YNQ10Free-Form Message TextC1264AN
NM11Entity Identifier CodeM23ID
NM12Entity Type QualifierM11ID
NM13Name Last Or Organization NameC160AN
NM14Name FirstO135AN
NM15Name MiddleO125AN
NM16Name PrefixO110AN
NM17Name SuffixO110AN
NM18Identification Code QualifierC12ID
NM19Identification CodeC280AN
NM110Entity Relationship CodeC22ID
NM111Entity Identifier CodeO23ID
NM112Name Last Or Organization NameO160AN
N31Address InformationM155AN
N32Address InformationO155AN
N41City NameO230AN
N42State Or Province CodeC22ID
N43Postal CodeO315ID
N44Country CodeC23ID
N45Location QualifierC12ID
N46Location IdentifierO130AN
N47Country Subdivision CodeC13ID
COM1Communication Number QualifierM22ID
COM2Communication NumberM1256AN
COM3Communication Number QualifierO22ID
COM4Communication NumberO1256AN
DTP1Date/Time QualifierM33ID
DTP2Date Time Period Format QualifierM23ID
DTP3Date Time PeriodM135AN
QTY1Quantity QualifierM22ID
QTY2QuantityC115R
QTY3Unit Or Basis For Measurement CodeO22ID
QTY4ExponentO115R
QTY5MultiplierO110R
QTY6Unit Or Basis For Measurement CodeO22ID
QTY7ExponentO115R
QTY8MultiplierO110R
QTY9Unit Or Basis For Measurement CodeO22ID
QTY10ExponentO115R
QTY11MultiplierO110R
QTY12Unit Or Basis For Measurement CodeO22ID
QTY13ExponentO115R
QTY14MultiplierO110R
QTY15Unit Or Basis For Measurement CodeO22ID
QTY16ExponentO115R
QTY17MultiplierO110R
QTY18Free-Form InformationC130AN
MSG1Free-Form Message TextM1264AN
MSG2Printer Carriage Control CodeC22ID
MSG3NumberO19N0
AM11Code CategoryM22ID
AM12Product/Service Id QualifierM22ID
AM13Product/Service IdM148AN
AM14Monetary AmountO118R
AM15QuantityO115R
AM16Percentage As DecimalO110R
AMT1Amount Qualifier CodeM13ID
AMT2Monetary AmountM118R
AMT3Credit/Debit Flag CodeO11ID
III1Code List Qualifier CodeC13ID
III2Industry CodeC130AN
III3Code CategoryO22ID
III4Free-Form Message TextC1264AN
III5QuantityC115R
III6Unit Or Basis For Measurement CodeO22ID
III7ExponentO115R
III8MultiplierO110R
III9Unit Or Basis For Measurement CodeO22ID
III10ExponentO115R
III11MultiplierO110R
III12Unit Or Basis For Measurement CodeO22ID
III13ExponentO115R
III14MultiplierO110R
III15Unit Or Basis For Measurement CodeO22ID
III16ExponentO115R
III17MultiplierO110R
III18Unit Or Basis For Measurement CodeO22ID
III19ExponentO115R
III20MultiplierO110R
III21Surface/Layer/Position CodeO22ID
III22Surface/Layer/Position CodeO22ID
III23Surface/Layer/Position CodeO22ID
EC1Employment Class CodeO23ID
EC2Employment Class CodeO23ID
EC3Employment Class CodeO23ID
EC4Percentage As DecimalO110R
EC5Information Status CodeO11ID
EC6Occupation CodeO46ID
EMS1DescriptionO180AN
EMS2Employment Class CodeO23ID
EMS3Occupation CodeO46ID
EMS4Employment Status CodeO22ID
EMS5Reference Identification QualifierC23ID
EMS6Reference IdentificationC150AN
EMS7Reference IdentificationC150AN
EMS8Reference Identification QualifierC23ID
EMS9Identification Code QualifierC12ID
EMS10Identification CodeC280AN
EMS11Percent, Decimal FormatO16R6
EMS12Employment Status CodeO22ID
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EMS14Identification CodeC280AN
EMS15Employment Class CodeO23ID
EMP1DescriptionM180AN
EMP2Product/Service Id QualifierC22ID
EMP3Product/Service IdC148AN
EMP4Reference Identification QualifierC23ID
EMP5Reference IdentificationC150AN
EMP6Yes/No Condition Or Response CodeO11ID
EMP7DescriptionO180AN
EMP8Yes/No Condition Or Response CodeO11ID
EMP9Yes/No Condition Or Response CodeO11ID
EMP10Reference IdentificationO150AN
PCT1Percent QualifierM12ID
PCT2Percentage As DecimalM110R
SOI1Type Of Income CodeM22ID
SOI2Date Time Period Format QualifierC23ID
SOI3Date Time PeriodC135AN
SOI4NumberO19N0
SOI5Yes/No Condition Or Response CodeO11ID
LIN1Assigned IdentificationO120AN
LIN2Product/Service Id QualifierM22ID
LIN3Product/Service IdM148AN
LIN4Product/Service Id QualifierC22ID
LIN5Product/Service IdC148AN
LIN6Product/Service Id QualifierC22ID
LIN7Product/Service IdC148AN
LIN8Product/Service Id QualifierC22ID
LIN9Product/Service IdC148AN
LIN10Product/Service Id QualifierC22ID
LIN11Product/Service IdC148AN
LIN12Product/Service Id QualifierC22ID
LIN13Product/Service IdC148AN
LIN14Product/Service Id QualifierC22ID
LIN15Product/Service IdC148AN
LIN16Product/Service Id QualifierC22ID
LIN17Product/Service IdC148AN
LIN18Product/Service Id QualifierC22ID
LIN19Product/Service IdC148AN
LIN20Product/Service Id QualifierC22ID
LIN21Product/Service IdC148AN
LIN22Product/Service Id QualifierC22ID
LIN23Product/Service IdC148AN
LIN24Product/Service Id QualifierC22ID
LIN25Product/Service IdC148AN
LIN26Product/Service Id QualifierC22ID
LIN27Product/Service IdC148AN
LIN28Product/Service Id QualifierC22ID
LIN29Product/Service IdC148AN
LIN30Product/Service Id QualifierC22ID
LIN31Product/Service IdC148AN
REF1Reference Identification QualifierM23ID
REF2Reference IdentificationC150AN
REF3DescriptionC180AN
REF4Reference Identification QualifierO23ID
REF5Reference IdentificationO150AN
REF6Reference Identification QualifierO23ID
REF7Reference IdentificationO150AN
REF8Reference Identification QualifierO23ID
REF9Reference IdentificationO150AN
ASL1Amount Qualifier CodeM13ID
ASL2Monetary AmountM118R
ASL3Asset Liability Type CodeO22ID
ASL4Frequency CodeO11ID
TOA1Type Of Activity CodeM22ID
TOA2License Type CodeC22ID
TOA3Status CodeC22ID
TOA4Type Of Rating CodeO22ID
TOA5Type Of Rating CodeO22ID
TOV1Hazardous Vehicle Type CodeM22ID
TOV2Date/Time QualifierC33ID
TOV3Date Time Period Format QualifierC23ID
TOV4Date Time PeriodC135AN
TOV5Quantity QualifierC22ID
TOV6QuantityC115R
VEH1Assigned NumberO16N0
VEH2Vehicle Identification NumberO130AN
VEH3YearO44N0
VEH4Agency Qualifier CodeC22ID
VEH5Reference IdentificationC150AN
VEH6Reference IdentificationO150AN
VEH7Reference IdentificationC150AN
VEH8LengthO18R8
VEH9Reference IdentificationO150AN
VEH10State Or Province CodeO22ID
VEH11Location IdentifierO130AN
VEH12Yes/No Condition Or Response CodeO11ID
VEH13AmountO115N2
VEH14Yes/No Condition Or Response CodeO11ID
VEH15AmountO115N2
VEH16Action CodeO12ID
VEH17Country CodeO23ID
VEH18NameC160AN
VEH19Country CodeC23ID
CDS1Case Type CodeM12ID
CDS2Administration Of Justice Organization Type CodeM12ID
CDS3Reference Identification QualifierO23ID
CDS4Reference IdentificationC150AN
CDS5DescriptionO180AN
CDS6Identification Code QualifierC12ID
CDS7Identification CodeC280AN
CDS8Identification Code QualifierC12ID
CDS9Identification CodeC280AN
CDS10Identification Code QualifierC12ID
CDS11Identification CodeC280AN
CED1Administration Of Justice Event Type CodeM13ID
CED2Action CodeO12ID
CED3Notice Type CodeO13ID
CED4Case Type CodeO12ID
CED5DescriptionO180AN
SIN1Information Status CodeM11ID
SIN2Controlled Substance Type CodeC22ID
SIN3Free-Form Message TextC1264AN
SIN4Frequency CodeC11ID
SIN5QuantityC115R
SIN6Unit Or Basis For Measurement CodeC22ID
SIN7ExponentC115R
SIN8MultiplierC110R
SIN9Unit Or Basis For Measurement CodeC22ID
SIN10ExponentC115R
SIN11MultiplierC110R
SIN12Unit Or Basis For Measurement CodeC22ID
SIN13ExponentC115R
SIN14MultiplierC110R
SIN15Unit Or Basis For Measurement CodeC22ID
SIN16ExponentC115R
SIN17MultiplierC110R
SIN18Unit Or Basis For Measurement CodeC22ID
SIN19ExponentC115R
SIN20MultiplierC110R
UCS1Code CategoryO22ID
UCS2DescriptionO180AN
UCS3Item Description TypeC11ID
UCS4DescriptionC180AN
UCS5Product/Service Id QualifierC22ID
UCS6Product/Service IdC148AN
UCS7NumberC19N0
UCS8Unit Or Basis For Measurement CodeC22ID
UCS9ExponentC115R
UCS10MultiplierC110R
UCS11Unit Or Basis For Measurement CodeC22ID
UCS12ExponentC115R
UCS13MultiplierC110R
UCS14Unit Or Basis For Measurement CodeC22ID
UCS15ExponentC115R
UCS16MultiplierC110R
UCS17Unit Or Basis For Measurement CodeC22ID
UCS18ExponentC115R
UCS19MultiplierC110R
UCS20Unit Or Basis For Measurement CodeC22ID
UCS21ExponentC115R
UCS22MultiplierC110R
FH1Individual Relationship CodeM22ID
FH2Quantity QualifierC22ID
FH3QuantityC115R
FH4Current Health Condition CodeO11ID
SPA1Status CodeM22ID
SPA2Date Time Period Format QualifierC23ID
SPA3Date Time PeriodC135AN
SPA4Amount Qualifier CodeC13ID
SPA5Monetary AmountC118R
SPA6Status Reason CodeO33ID
SPA7Status Reason CodeO33ID
SPA8Status Reason CodeO33ID
SPA9Agency Qualifier CodeC22ID
SPA10Product Description CodeC112AN
SPA11Source SubqualifierO115AN
MPI1Information Status CodeM11ID
MPI2Employment Status CodeM22ID
MPI3Government Service Affiliation CodeM11ID
MPI4DescriptionO180AN
MPI5Military Service Rank CodeO22ID
MPI6Date Time Period Format QualifierC23ID
MPI7Date Time PeriodC135AN
PWK1Report Type CodeM22ID
PWK2Report Transmission CodeO12ID
PWK3Report Copies NeededO12N0
PWK4Entity Identifier CodeO23ID
PWK5Identification Code QualifierC12ID
PWK6Identification CodeC280AN
PWK7DescriptionO180AN
PWK8Paperwork/Report Action CodeO12ID
PWK9Paperwork/Report Action CodeO12ID
PWK10Paperwork/Report Action CodeO12ID
PWK11Paperwork/Report Action CodeO12ID
PWK12Paperwork/Report Action CodeO12ID
PWK13Request Category CodeO12ID
NM11Entity Identifier CodeM23ID
NM12Entity Type QualifierM11ID
NM13Name Last Or Organization NameC160AN
NM14Name FirstO135AN
NM15Name MiddleO125AN
NM16Name PrefixO110AN
NM17Name SuffixO110AN
NM18Identification Code QualifierC12ID
NM19Identification CodeC280AN
NM110Entity Relationship CodeC22ID
NM111Entity Identifier CodeO23ID
NM112Name Last Or Organization NameO160AN
N41City NameO230AN
N42State Or Province CodeC22ID
N43Postal CodeO315ID
N44Country CodeC23ID
N45Location QualifierC12ID
N46Location IdentifierO130AN
N47Country Subdivision CodeC13ID
REF1Reference Identification QualifierM23ID
REF2Reference IdentificationC150AN
REF3DescriptionC180AN
REF4Reference Identification QualifierO23ID
REF5Reference IdentificationO150AN
REF6Reference Identification QualifierO23ID
REF7Reference IdentificationO150AN
REF8Reference Identification QualifierO23ID
REF9Reference IdentificationO150AN
DTP1Date/Time QualifierM33ID
DTP2Date Time Period Format QualifierM23ID
DTP3Date Time PeriodM135AN
SPA1Status CodeM22ID
SPA2Date Time Period Format QualifierC23ID
SPA3Date Time PeriodC135AN
SPA4Amount Qualifier CodeC13ID
SPA5Monetary AmountC118R
SPA6Status Reason CodeO33ID
SPA7Status Reason CodeO33ID
SPA8Status Reason CodeO33ID
SPA9Agency Qualifier CodeC22ID
SPA10Product Description CodeC112AN
SPA11Source SubqualifierO115AN
EFI1Security Level CodeM22ID
EFI2Free-Form Message TextO1264AN
EFI3Security Technique CodeO22ID
EFI4Version IdentifierC130AN
EFI5Program IdentifierO130AN
EFI6Version IdentifierC130AN
EFI7Interchange FormatO130AN
EFI8Version IdentifierC130AN
EFI9Compression TechniqueO130AN
EFI10Drawing Sheet Size CodeO22AN
EFI11File NameO164AN
EFI12Block TypeO14AN
EFI13Record LengthO115N0
EFI14Block LengthO15N0
EFI15Version IdentifierC130AN
EFI16Filter Id CodeC33ID
BIN1Length Of Binary DataM115N0
BIN2Binary DataM14096B
LX1Assigned NumberM16N0
PDL1Payment Method CodeM33ID
PDL2Amount Qualifier CodeC13ID
PDL3Monetary AmountC118R
PDL4Percentage As DecimalC110R
PDL5Credit/Debit Flag CodeO11ID
PDL6Frequency CodeO11ID
PDL7(Dfi) Id Number QualifierC22ID
PDL8(Dfi) Identification NumberC312AN
PDL9Account Number QualifierC13ID
PDL10Account NumberC135AN
PDL11Date Time Period Format QualifierC23ID
PDL12Date Time PeriodC135AN
REF1Reference Identification QualifierM23ID
REF2Reference IdentificationC150AN
REF3DescriptionC180AN
REF4Reference Identification QualifierO23ID
REF5Reference IdentificationO150AN
REF6Reference Identification QualifierO23ID
REF7Reference IdentificationO150AN
REF8Reference Identification QualifierO23ID
REF9Reference IdentificationO150AN
LS1Loop Identifier CodeM14AN
AMT1Amount Qualifier CodeM13ID
AMT2Monetary AmountM118R
AMT3Credit/Debit Flag CodeO11ID
N11Entity Identifier CodeM23ID
N12NameC160AN
N13Identification Code QualifierC12ID
N14Identification CodeC280AN
N15Entity Relationship CodeO22ID
N16Entity Identifier CodeO23ID
N31Address InformationM155AN
N32Address InformationO155AN
N41City NameO230AN
N42State Or Province CodeC22ID
N43Postal CodeO315ID
N44Country CodeC23ID
N45Location QualifierC12ID
N46Location IdentifierO130AN
N47Country Subdivision CodeC13ID
LIN1Assigned IdentificationO120AN
LIN2Product/Service Id QualifierM22ID
LIN3Product/Service IdM148AN
LIN4Product/Service Id QualifierC22ID
LIN5Product/Service IdC148AN
LIN6Product/Service Id QualifierC22ID
LIN7Product/Service IdC148AN
LIN8Product/Service Id QualifierC22ID
LIN9Product/Service IdC148AN
LIN10Product/Service Id QualifierC22ID
LIN11Product/Service IdC148AN
LIN12Product/Service Id QualifierC22ID
LIN13Product/Service IdC148AN
LIN14Product/Service Id QualifierC22ID
LIN15Product/Service IdC148AN
LIN16Product/Service Id QualifierC22ID
LIN17Product/Service IdC148AN
LIN18Product/Service Id QualifierC22ID
LIN19Product/Service IdC148AN
LIN20Product/Service Id QualifierC22ID
LIN21Product/Service IdC148AN
LIN22Product/Service Id QualifierC22ID
LIN23Product/Service IdC148AN
LIN24Product/Service Id QualifierC22ID
LIN25Product/Service IdC148AN
LIN26Product/Service Id QualifierC22ID
LIN27Product/Service IdC148AN
LIN28Product/Service Id QualifierC22ID
LIN29Product/Service IdC148AN
LIN30Product/Service Id QualifierC22ID
LIN31Product/Service IdC148AN
DTP1Date/Time QualifierM33ID
DTP2Date Time Period Format QualifierM23ID
DTP3Date Time PeriodM135AN
QTY1Quantity QualifierM22ID
QTY2QuantityC115R
QTY3Unit Or Basis For Measurement CodeO22ID
QTY4ExponentO115R
QTY5MultiplierO110R
QTY6Unit Or Basis For Measurement CodeO22ID
QTY7ExponentO115R
QTY8MultiplierO110R
QTY9Unit Or Basis For Measurement CodeO22ID
QTY10ExponentO115R
QTY11MultiplierO110R
QTY12Unit Or Basis For Measurement CodeO22ID
QTY13ExponentO115R
QTY14MultiplierO110R
QTY15Unit Or Basis For Measurement CodeO22ID
QTY16ExponentO115R
QTY17MultiplierO110R
QTY18Free-Form InformationC130AN
MSG1Free-Form Message TextM1264AN
MSG2Printer Carriage Control CodeC22ID
MSG3NumberO19N0
AM11Code CategoryM22ID
AM12Product/Service Id QualifierM22ID
AM13Product/Service IdM148AN
AM14Monetary AmountO118R
AM15QuantityO115R
AM16Percentage As DecimalO110R
INV1DescriptionM180AN
INV2Percentage As DecimalC110R
INV3Monetary AmountC118R
INV4QuantityC115R
INV5State Or Province CodeO22ID
INV6DescriptionO180AN
INV7Monetary AmountO118R
QTY1Quantity QualifierM22ID
QTY2QuantityC115R
QTY3Unit Or Basis For Measurement CodeO22ID
QTY4ExponentO115R
QTY5MultiplierO110R
QTY6Unit Or Basis For Measurement CodeO22ID
QTY7ExponentO115R
QTY8MultiplierO110R
QTY9Unit Or Basis For Measurement CodeO22ID
QTY10ExponentO115R
QTY11MultiplierO110R
QTY12Unit Or Basis For Measurement CodeO22ID
QTY13ExponentO115R
QTY14MultiplierO110R
QTY15Unit Or Basis For Measurement CodeO22ID
QTY16ExponentO115R
QTY17MultiplierO110R
QTY18Free-Form InformationC130AN
DTP1Date/Time QualifierM33ID
DTP2Date Time Period Format QualifierM23ID
DTP3Date Time PeriodM135AN
RPA1Rate Or Value Type CodeM12ID
RPA2Monetary AmountC118R
RPA3RateC19R9
RPA4Unit Or Basis For Measurement CodeO22ID
RPA5ExponentO115R
RPA6MultiplierO110R
RPA7Unit Or Basis For Measurement CodeO22ID
RPA8ExponentO115R
RPA9MultiplierO110R
RPA10Unit Or Basis For Measurement CodeO22ID
RPA11ExponentO115R
RPA12MultiplierO110R
RPA13Unit Or Basis For Measurement CodeO22ID
RPA14ExponentO115R
RPA15MultiplierO110R
RPA16Unit Or Basis For Measurement CodeO22ID
RPA17ExponentO115R
RPA18MultiplierO110R
RPA19Percentage As DecimalC110R
LE1Loop Identifier CodeM14AN
K21DescriptionM180AN
DTP1Date/Time QualifierM33ID
DTP2Date Time Period Format QualifierM23ID
DTP3Date Time PeriodM135AN
NM11Entity Identifier CodeM23ID
NM12Entity Type QualifierM11ID
NM13Name Last Or Organization NameC160AN
NM14Name FirstO135AN
NM15Name MiddleO125AN
NM16Name PrefixO110AN
NM17Name SuffixO110AN
NM18Identification Code QualifierC12ID
NM19Identification CodeC280AN
NM110Entity Relationship CodeC22ID
NM111Entity Identifier CodeO23ID
NM112Name Last Or Organization NameO160AN


Official Definition:
Data contents of the Individual Life, Annuity and Disability Application Transaction Set (267) for use within the context of an Electronic Data Interchange (EDI) environment. The transaction set is used to transmit new business application information among distributors (agents, broker/dealers, etc.), insurance companies and reinsurance companies for the purpose of underwriting an individual life, annuity or disability contract.



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