EDI 274 Segments and Elements for the Healthcare Provider Information Standard


AgencySet IDFGTransaction DescriptionSubcommitteeStandard
ANSI274PWHealthcare Provider Information InsuranceDownload


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Research and Development:
See the list of EDI 274 segments and elements in below data grid. The Jobisez.com site has an online translation tool that converts the EDI 274 (Healthcare Provider Information) document into a CSV file. For more detailed information, you can view a sample EDI 274 document by analyzing a transaction set example. If you are researching the 274s, 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 274 Segments and Elements

SegmentDescriptionSectReqMax LoopMax UsagePos
BHTBeginning Of Hierarchical TransactionHM011
DTMDate/Time ReferenceHO012
PERAdministrative Communications ContactHO013
HLHierarchical LevelDM99999914
TRNTraceDO015
NM1Individual Or Organizational NameDM99999916
N2Additional Name InformationDO09999997
PERAdministrative Communications ContactDO09999998
DMGDemographic InformationDO019
AMTMonetary Amount InformationDO02010
APIActivity Or Process InformationDO099999911
DEGDegree RecordDO0912
INDAdditional Individual Demographic InformationDO0113
LUILanguage UseDO0914
DTPDate Or Time Or PeriodDO0915
MTXTextDO099999916
QTYQuantity InformationDO09917
WSWork ScheduleDO09918
CRCConditions IndicatorDO0919
HSDHealth Care Services DeliveryDO09920
BCIBasic Claim InformationDO0921
PDIPractice Detail InformationDO0122
HADHospital Affiliation DetailDO0123
NX1Property Or Entity IdentificationDO999999124
N2Additional Name InformationDO0125
N3Party LocationDO0226
N4Geographic LocationDO0127
PERAdministrative Communications ContactDO0128
LQIndustry Code IdentificationDO999999129
N1Party IdentificationDO0230
TPBBusiness Professional TitleDO099999931
DTPDate Or Time Or PeriodDO0932
QTYQuantity InformationDO0133
YNQYes/No QuestionDO099999934
HPLHealth Care Provider LicenseDO99135
DTPDate Or Time Or PeriodDO099999936
REFReference InformationDO999999137
DTPDate Or Time Or PeriodDO0938
EMSEmployment PositionDO9139
DTPDate Or Time Or PeriodDO0940


SegmentElementDescriptionReqMin LengthMax LengthType
BHT1Hierarchical Structure CodeM44ID
BHT2Transaction Set Purpose CodeM22ID
BHT3Reference IdentificationO150AN
BHT4DateO88DT
BHT5TimeO48TM
BHT6Transaction Type CodeO22ID
DTM1Date/Time QualifierM33ID
DTM2DateC88DT
DTM3TimeC48TM
DTM4Time CodeO22ID
DTM5Date Time Period Format QualifierC23ID
DTM6Date Time PeriodC135AN
PER1Contact Function CodeM22ID
PER2NameO160AN
PER3Communication Number QualifierC22ID
PER4Communication NumberC1256AN
PER5Communication Number QualifierC22ID
PER6Communication NumberC1256AN
PER7Communication Number QualifierC22ID
PER8Communication NumberC1256AN
PER9Contact Inquiry ReferenceO120AN
HL1Hierarchical Id NumberM112AN
HL2Hierarchical Parent Id NumberO112AN
HL3Hierarchical Level CodeM12ID
HL4Hierarchical Child CodeO11ID
TRN1Trace Type CodeM12ID
TRN2Reference IdentificationM150AN
TRN3Originating Company IdentifierO1010AN
TRN4Reference 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
N21NameM160AN
N22NameO160AN
PER1Contact Function CodeM22ID
PER2NameO160AN
PER3Communication Number QualifierC22ID
PER4Communication NumberC1256AN
PER5Communication Number QualifierC22ID
PER6Communication NumberC1256AN
PER7Communication Number QualifierC22ID
PER8Communication NumberC1256AN
PER9Contact Inquiry ReferenceO120AN
DMG1Date Time Period Format QualifierC23ID
DMG2Date Time PeriodC135AN
DMG3Gender CodeO11ID
DMG4Marital Status CodeO11ID
DMG5Race Or Ethnicity CodeC11ID
DMG6Code List Qualifier CodeC13ID
DMG7Industry CodeC130AN
DMG8Citizenship Status CodeO12ID
DMG9Country CodeO23ID
DMG10Basis Of Verification CodeO12ID
DMG11QuantityO115R
DMG12Code List Qualifier CodeC13ID
DMG13Industry CodeC130AN
AMT1Amount Qualifier CodeM13ID
AMT2Monetary AmountM118R
AMT3Credit/Debit Flag CodeO11ID
API1Code CategoryM22ID
API2Action CodeO12ID
API3Maintenance Type CodeO33ID
API4Status Reason CodeO33ID
API5Affected Area Or Section CodeO11ID
API6Insurance Type CodeO13ID
API7Loan Type CodeO12ID
API8Information Status CodeO11ID
DEG1Academic Degree CodeM33ID
DEG2Date Time Period Format QualifierC23ID
DEG3Date Time PeriodC135AN
DEG4DescriptionO180AN
DEG5Status Reason CodeO33ID
IND1Country CodeO23ID
IND2State Or Province CodeO22ID
IND3County DesignatorO55ID
IND4City NameO230AN
IND5Language CodeO23ID
IND6Language Proficiency IndicatorO11ID
IND7Language CodeO23ID
IND8Language CodeO23ID
IND9Identification Code QualifierC12ID
IND10Identification CodeC280AN
IND11Identification Code QualifierC12ID
IND12Identification CodeC280AN
LUI1Identification Code QualifierC12ID
LUI2Identification CodeC280AN
LUI3DescriptionC180AN
LUI4Use Of Language IndicatorO12ID
LUI5Language Proficiency IndicatorO11ID
DTP1Date/Time QualifierM33ID
DTP2Date Time Period Format QualifierM23ID
DTP3Date Time PeriodM135AN
MTX1Note Reference CodeO33ID
MTX2Textual DataC14096AN
MTX3Textual DataO14096AN
MTX4Printer Carriage Control CodeC22ID
MTX5NumberO19N0
MTX6Language CodeO23ID
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
WS1Ship/Delivery Or Calendar Pattern CodeM12ID
WS2TimeO48TM
WS3TimeO48TM
CRC1Code CategoryM22ID
CRC2Yes/No Condition Or Response CodeM11ID
CRC3Condition IndicatorM23ID
CRC4Condition IndicatorO23ID
CRC5Condition IndicatorO23ID
CRC6Condition IndicatorO23ID
CRC7Condition IndicatorO23ID
HSD1Quantity QualifierC22ID
HSD2QuantityC115R
HSD3Unit Or Basis For Measurement CodeO22ID
HSD4Sample Selection ModulusO16R6
HSD5Time Period QualifierC12ID
HSD6Number Of PeriodsO13N0
HSD7Ship/Delivery Or Calendar Pattern CodeO12ID
HSD8Ship/Delivery Pattern Time CodeO11ID
BCI1Industry CodeO130AN
BCI2Insurance Type CodeO13ID
BCI3Reference IdentificationO150AN
BCI4State Or Province CodeO22ID
BCI5Date Time Period Format QualifierC23ID
BCI6Date Time PeriodC135AN
BCI7Report Type CodeO22ID
BCI8Currency CodeO33ID
PDI1Gender CodeO11ID
PDI2Range MinimumO120R
PDI3Range MaximumO120R
PDI4Yes/No Condition Or Response CodeO11ID
HAD1Status CodeM22ID
HAD2Yes/No Condition Or Response CodeO11ID
HAD3Yes/No Condition Or Response CodeO11ID
HAD4Yes/No Condition Or Response CodeO11ID
HAD5Code List Qualifier CodeC13ID
HAD6Industry CodeC130AN
NX11Entity Identifier CodeM23ID
NX12Entity Identifier CodeO23ID
NX13Entity Identifier CodeO23ID
NX14Entity Identifier CodeO23ID
NX15Entity 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
PER1Contact Function CodeM22ID
PER2NameO160AN
PER3Communication Number QualifierC22ID
PER4Communication NumberC1256AN
PER5Communication Number QualifierC22ID
PER6Communication NumberC1256AN
PER7Communication Number QualifierC22ID
PER8Communication NumberC1256AN
PER9Contact Inquiry ReferenceO120AN
LQ1Code List Qualifier CodeO13ID
LQ2Industry CodeC130AN
N11Entity Identifier CodeM23ID
N12NameC160AN
N13Identification Code QualifierC12ID
N14Identification CodeC280AN
N15Entity Relationship CodeO22ID
N16Entity Identifier CodeO23ID
TPB1Business Professional Title CodeC13ID
TPB2Free-Form Message TextC1264AN
TPB3Agency Qualifier CodeC22ID
TPB4Source SubqualifierO115AN
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
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
HPL1Reference Identification QualifierC23ID
HPL2Reference IdentificationC150AN
HPL3Status CodeO22ID
HPL4State Or Province CodeO22ID
HPL5DescriptionO180AN
HPL6Code For Licensing, Certification, Registration, Or AccreditationC12ID
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
DTP1Date/Time QualifierM33ID
DTP2Date Time Period Format QualifierM23ID
DTP3Date Time PeriodM135AN
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
EMS13Identification Code QualifierC12ID
EMS14Identification CodeC280AN
EMS15Employment Class CodeO23ID
DTP1Date/Time QualifierM33ID
DTP2Date Time Period Format QualifierM23ID
DTP3Date Time PeriodM135AN



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