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Sample EDI 271 Data for the Eligibility, Coverage Or Benefit Information Transaction Set
| Agency | Set ID | FG | Transaction Description | Subcommittee |
| ANSI | 271 | HB | Eligibility, Coverage Or Benefit Information | Insurance |
EDI 271 Main Page Online EDI 271 Translation Need Help?
Research and Development:
Below is a sample EDI 271 transaction set. The Jobisez.com site has an online translation tool that converts the EDI 271 (Eligibility, Coverage Or Benefit Information) document into a CSV file. 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 271 Transaction Set
| Entire Segment |
| ST*271*000000001*005010X279A1 |
| BHT*0022*11*000000221-0001*20230313*1337 |
| HL*1**20*1 |
| NM1*PR*2*DC Medicaid*****PI*77033 |
| PER*IC*District of Columbia Medicaid Provider Inquiry*TE*8667529233*FX*202906 |
| HL*2*1*21*1 |
| NM1*1P*2*COMMUNITY CONNECTIONS*****XX*1407872575 |
| HL*3*2*22*0 |
| TRN*1*202307213312377BA*977033 |
| TRN*2*200082*1521349382 |
| NM1*IL*1*BOWMAN*THELMA*P***MI*70032674 |
| REF*SY*577620045 |
| N3*5815 5TH STREET |
| N4*WASHINGTON*DC*200110000 |
| DMG*D8*19430204*F |
| DTP*307*RD8*20200801-20240531 |
| EB*1*IND*30*MC*853Q MA 1915(C) EPD WAIVER + QMB |
| DTP*307*RD8*20200801-20240531 |
| MSG*230720014311 |
| EB*1*IND*98^88^86^AL^50^48^47^35^1^UC^MH |
| DTP*307*RD8*20200801-20240531 |
| EB*R***MA |
| REF*F6*9DD3F96WR04 |
| DTP*307*RD8*20150501-99991231 |
| LS*2120 |
| NM1*PR*2*Medicare Part A |
| LE*2120 |
| EB*R***MB |
| REF*F6*9DD3F96WR04 |
| DTP*307*RD8*20080201-99991231 |
| SE*31*000000021 |
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