Sample EDI 271 Data for the Eligibility, Coverage Or Benefit Information Transaction Set

AgencySet IDFGTransaction DescriptionSubcommittee
ANSI271HBEligibility, Coverage Or Benefit Information Insurance

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Below is a sample EDI 271 transaction set. The site has an online translation tool that converts the EDI 271 (Eligibility, Coverage Or Benefit Information) document into a CSV file. If you are researching the 271s, 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 271 Transaction Set

HL*1**20*1~NM1*PR*2*Medicare - All states*****PI*10000~HL*2*1*21*1~NM1*1P*2*Test JL Medicare*****XX*1275611790~HL*3*2*22*0~TRN*2*970555*9876543210~NM1*IL*1*GOOKIN*VINCENT*I***MI*007225654A~N3*2000 N CONGRESS AVE*LOT 49~N4*WEST PALM BEACH*FL*334096330~DMG*D8*19300511*M~DTP*307*RD8*20170927-20190127~EB*I**41^54^68^82~EB*1**88~EB*1**30^10^15^42^45^48^49^65^69^76^78^83^A5^A7^AG^BT^BU^BV*MA~DTP*291*D8*19950501~MSG*CMS mailed a Medicare card with a new Medicare Beneficiary Identifier (MBI) to this ben

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