Sample EDI 278 Data for the Health Care Services Review Information Transaction Set


AgencySet IDFGTransaction DescriptionSubcommittee
ANSI278HIHealth Care Services Review Information Insurance


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Research and Development:
Below is a sample EDI 278 transaction set. The Jobisez.com site has an online translation tool that converts the EDI 278 (Health Care Services Review 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 278 Transaction Set

Entire Segment
ST*278*0001*005010X217
BHT*0007*13*AR1117602*20191220*1720
HL*1**20*1
NM1*X3*2*GLOBALHEALTH*****PI*62308
HL*2*1*21*1
NM1*1P*1*REED*CHERYL****XX*1447222914
REF*EI*621619239
N3*1915 WHITE AVE.
N4*KNOXVILLE*KY*37916
HL*3*2*22*1
NM1*IL*1*SMITH*ROGER****MI*37022514601
REF*6P*1020161
DMG*D8*19490318*M
HL*4*3*EV*0
TRN*1*AR1117602*1260014405
UM*SC*I*ON*11:B
REF*BB*AR1117602
DTP*AAH*RD8*20190613-20190713
HI*ABK:C210
HSD*VS*999
CL1*3*1
NM1*SJ*1*REED*CHERYL****XX*1447222914
N3*123 PARK WAY
N4*NEWYORK*NY*11111
SE*25*0001

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