EDI 275 Segments and Elements for the Patient Information Standard


AgencySet IDFGTransaction DescriptionSubcommitteeStandard
ANSI275PIPatient Information InsuranceDownload


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Research and Development:
See the list of EDI 275 segments and elements in below data grid. The Jobisez.com site has an online translation tool that converts the EDI 275 (Patient Information) document into a CSV file. If you are researching the 275s, 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.

Solutions:
Are you looking to trade the EDI 275 transaction with one of your trading partners? Do you need an EDI VAN Savings solution to exchange the 275? Or perhaps you would like to use a Cloud-Based application, so you can plug your 275 transaction directly into your ERP and TMS systems. Even small companies have the ability to trade the EDI 275 by using the EDI Mobile Device solution.


The EDI 275 Segments and Elements

SegmentDescriptionSectReqMax LoopMax UsagePos
BGNBeginning SegmentHO011
DTMDate/Time ReferenceHO032
TRNTraceHO053
NM1Individual Or Organizational NameHO99999914
IN1Individual IdentificationHO015
DMGDemographic InformationHO036
PRVProvider InformationHO017
PERAdministrative Communications ContactHO028
REFReference InformationHO059
DTPDate Or Time Or PeriodHO0110
NX1Property Or Entity IdentificationHO5111
N3Party LocationHO0112
N4Geographic LocationHO0113
LXTransaction Set Line NumberDO999999114
TRNTraceDO0115
STCStatus InformationDO0116
NM1Individual Or Organizational NameDO0117
PRVProvider InformationDO0118
PERAdministrative Communications ContactDO0119
REFReference InformationDO0520
DTPDate Or Time Or PeriodDO999999121
CATCategory Of Patient Information ServiceDO0122
PIDProduct/Item DescriptionDO0123
EFIElectronic Format IdentificationDO1124
BINBinary Data SegmentDM0125


SegmentElementDescriptionReqMin LengthMax LengthType
BGN1Transaction Set Purpose CodeM22ID
BGN2Reference IdentificationM150AN
BGN3DateM88DT
BGN4TimeC48TM
BGN5Time CodeO22ID
BGN6Reference IdentificationO150AN
BGN7Transaction Type CodeO22ID
BGN8Action CodeO12ID
BGN9Security Level CodeO22ID
DTM1Date/Time QualifierM33ID
DTM2DateC88DT
DTM3TimeC48TM
DTM4Time CodeO22ID
DTM5Date Time Period Format QualifierC23ID
DTM6Date Time PeriodC135AN
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
IN11Entity Type QualifierM11ID
IN12Name Type CodeM22ID
IN13Entity Identifier CodeO23ID
IN14Reference Identification QualifierC23ID
IN15Reference IdentificationC150AN
IN16Individual Relationship CodeO22ID
IN17Level Of Individual, Test, Or Course CodeO22ID
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
PRV1Provider CodeM13ID
PRV2Reference Identification QualifierC23ID
PRV3Reference IdentificationC150AN
PRV4State Or Province CodeO22ID
PRV5Provider Specialty CodeO13AN
PRV6Agency Qualifier CodeO22ID
PRV7Yes/No Condition Or Response CodeO11ID
PRV8Provider Organization CodeO33ID
PER1Contact Function CodeM22ID
PER2NameO160AN
PER3Communication Number QualifierC22ID
PER4Communication NumberC1256AN
PER5Communication Number QualifierC22ID
PER6Communication NumberC1256AN
PER7Communication Number QualifierC22ID
PER8Communication NumberC1256AN
PER9Contact Inquiry ReferenceO120AN
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
NX11Entity Identifier CodeM23ID
NX12Entity Identifier CodeO23ID
NX13Entity Identifier CodeO23ID
NX14Entity Identifier CodeO23ID
NX15Entity Identifier CodeO23ID
N31Address InformationM155AN
N32Address InformationO155AN
N41City NameO230AN
N42State Or Province CodeC22ID
N43Postal CodeO315ID
N44Country CodeC23ID
N45Location QualifierC12ID
N46Location IdentifierO130AN
N47Country Subdivision CodeC13ID
LX1Assigned NumberM16N0
TRN1Trace Type CodeM12ID
TRN2Reference IdentificationM150AN
TRN3Originating Company IdentifierO1010AN
TRN4Reference IdentificationO150AN
STC1Industry CodeM130AN
STC2Industry CodeM130AN
STC3Entity Identifier CodeM23ID
STC4Code List Qualifier CodeM13ID
STC5DateO88DT
STC6Action CodeO12ID
STC7Monetary AmountO118R
STC8Monetary AmountO118R
STC9DateO88DT
STC10Payment Method CodeO33ID
STC11DateO88DT
STC12Check NumberO116AN
STC13Industry CodeO130AN
STC14Industry CodeO130AN
STC15Entity Identifier CodeO23ID
STC16Code List Qualifier CodeO13ID
STC17Industry CodeO130AN
STC18Industry CodeO130AN
STC19Entity Identifier CodeO23ID
STC20Code List Qualifier CodeO13ID
STC21Free-Form Message TextO1264AN
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
PRV1Provider CodeM13ID
PRV2Reference Identification QualifierC23ID
PRV3Reference IdentificationC150AN
PRV4State Or Province CodeO22ID
PRV5Provider Specialty CodeO13AN
PRV6Agency Qualifier CodeO22ID
PRV7Yes/No Condition Or Response CodeO11ID
PRV8Provider Organization CodeO33ID
PER1Contact Function CodeM22ID
PER2NameO160AN
PER3Communication Number QualifierC22ID
PER4Communication NumberC1256AN
PER5Communication Number QualifierC22ID
PER6Communication NumberC1256AN
PER7Communication Number QualifierC22ID
PER8Communication NumberC1256AN
PER9Contact Inquiry ReferenceO120AN
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
CAT1Report Type CodeO22ID
CAT2Report Transmission CodeC12ID
CAT3Version IdentifierO130AN
CAT4Code List Qualifier CodeC13ID
CAT5Industry CodeC130AN
CAT6Industry CodeO130AN
CAT7Version IdentifierO130AN
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
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


Official Definition:
Data contents of the Patient Information Transaction Set (275) for use within the context of an Electronic Data Interchange (EDI) environment. This transaction set can be used to communicate individual patient information requests and patient information (either solicited or unsolicited) between separate health care entities in a variety of settings to be consistent with confidentiality and use requirements. Patient information consists of demographic, clinical, and other supporting data.



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