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Sample EDI 270 Data for the Eligibility, Coverage Or Benefit Inquiry Transaction Set
| Agency | Set ID | FG | Trans Desc | Committee |
| ANSI | 270 | HS | Eligibility, Coverage Or Benefit Inquiry | Insurance |
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Research and Development:
Below is a sample EDI 270 transaction set. The Jobisez.com site has an online translation tool that converts the EDI 270 (Eligibility, Coverage Or Benefit Inquiry) 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 270 Transaction Set
| Entire Segment |
| ST*270*0020*005010X279A1 |
| BHT*0022*13*20*20250508*1302 |
| HL*1**20*1 |
| NM1*PR*2*AMERIHEALTH - MEDICAID*****PI*81671 |
| HL*2*1*21*1 |
| NM1*1P*2*FAMILY SERVICE OF THE PIEDMONT, INC.*****XX*1881773554 |
| HL*3*2*22*0 |
| TRN*1*25740*1562061741 |
| NM1*IL*1*WALLACE*ADONYA*MARIE |
| REF*SY*411494472 |
| REF*EJ*01094131 |
| N3*2019 WILLOW RD*APT 1C |
| N4*GREENSBORO*NC*27406 |
| DMG*D8*19831113*F |
| DTP*291*D8*20250509 |
| EQ*30 |
| HL*4*2*22*0 |
| TRN*1*25741*1562061741 |
| NM1*IL*1*CUMBUS*CRYSTAL |
| REF*SY*385044706 |
| REF*EJ*20008354 |
| N3*2939 W. VANDELIA RD.*APT. 3E |
| N4*GREENSBORO*NC*27407 |
| DMG*D8*19871223*F |
| DTP*291*D8*20250509 |
| EQ*30 |
| HL*5*2*22*0 |
| TRN*1*25742*1562061741 |
| NM1*IL*1*KINDORF*ROXANN |
| REF*SY*244297426 |
| REF*EJ*20002847 |
| N3*421 AMBERLY DRIVE |
| N4*JAMESTOWN*NC*27282 |
| DMG*D8*19650304*F |
| DTP*291*D8*20250509 |
| EQ*30 |
| HL*6*2*22*0 |
| TRN*1*25743*1562061741 |
| NM1*IL*1*WILLIAMS*LAURA*CHRISTINE |
| REF*SY*241656922 |
| REF*EJ*20014692 |
| N3*823 STOCKPORT WAY |
| N4*GREENSBORO*NC*27301 |
| DMG*D8*19870327*F |
| DTP*291*D8*20250509 |
| EQ*30 |
| HL*7*2*22*0 |
| TRN*1*25744*1562061741 |
| NM1*IL*1*HALL*MICAH |
| REF*EJ*20015581 |
| N3*4209 TOUCAN TRAIL |
| N4*HIGH POINT*NC*27265 |
| DMG*D8*20150303*M |
| DTP*291*D8*20250509 |
| EQ*30 |
| HL*8*2*22*0 |
| TRN*1*25745*1562061741 |
| NM1*IL*1*MORGACRUZ*LUIS |
| REF*EJ*20014615 |
| N3*1417 LARSON ST. |
| N4*GREENSBORO*NC*27407 |
| DMG*D8*20151225*M |
| DTP*291*D8*20250509 |
| EQ*30 |
| HL*9*2*22*0 |
| TRN*1*25746*1562061741 |
| NM1*IL*1*SNIDER*HUGO |
| REF*EJ*20002217 |
| N3*140 HASTY HILL RD |
| N4*THOMASVILLE*NC*27360 |
| DMG*D8*20130503*M |
| DTP*291*D8*20250509 |
| EQ*30 |
| HL*10*2*22*0 |
| TRN*1*25747*1562061741 |
| NM1*IL*1*GUZMAN*CRYSTAL*NEWSOM |
| REF*SY*241512962 |
| REF*EJ*20015453 |
| N3*311 BARKER AVE |
| N4*HIGH POINT*NC*27262 |
| DMG*D8*19861019*F |
| DTP*291*D8*20250509 |
| EQ*30 |
| HL*11*2*22*0 |
| TRN*1*25748*1562061741 |
| NM1*IL*1*DICKSON*BLAINE*SHARROD |
| REF*SY*041766219 |
| REF*EJ*20014397 |
| N3*5221H FOX HUNT DRIVE |
| N4*GREENSBORO*NC*27407 |
| DMG*D8*19831108*M |
| DTP*291*D8*20250509 |
| EQ*30 |
| HL*12*2*22*0 |
| TRN*1*25749*1562061741 |
| NM1*IL*1*FERNANDEZKNISELEY*HANNAH*JOANNE |
| REF*SY*999995222 |
| REF*EJ*20003040 |
| N3*4636 RIVER VALLEY RD. |
| N4*HIGH POINT*NC*27265 |
| DMG*D8*19620311*F |
| DTP*291*D8*20250509 |
| EQ*30 |
| HL*13*2*22*0 |
| TRN*1*25750*1562061741 |
| NM1*IL*1*GRAHAM*CAROLYN*J |
| REF*SY*444111224 |
| REF*EJ*01092365 |
| N3*2001 ETTA COURT |
| N4*GREENSBORO*NC*27406 |
| DMG*D8*19671111*F |
| DTP*291*D8*20250509 |
| EQ*30 |
| HL*14*2*22*0 |
| TRN*1*25751*1562061741 |
| NM1*IL*1*RODRIGUEZ*MICHELE*DECKER***MI*944973941M |
| REF*SY*593942475 |
| REF*EJ*20001066 |
| N3*3706 FLINT ST*APT D |
| N4*GREENSBORO*NC*27405 |
| DMG*D8*19900213*F |
| DTP*291*D8*20250509 |
| EQ*30 |
| HL*15*2*22*0 |
| TRN*1*25752*1562061741 |
| NM1*IL*1*WATSON*NANCY*B |
| REF*SY*363626508 |
| REF*EJ*01073421 |
| N3*211 WEST CORNWALLIS |
| N4*GREENSBORO*NC*27408 |
| DMG*D8*19540113*F |
| DTP*291*D8*20250509 |
| EQ*30 |
| HL*16*2*22*0 |
| TRN*1*25753*1562061741 |
| NM1*IL*1*HAMISI*FATUMA |
| REF*EJ*20015205 |
| N3*407 S. ENGLISH ST*APT H |
| N4*GREENSBORO*NC*27401 |
| DMG*D8*20000101 |
| DTP*291*D8*20250509 |
| EQ*30 |
| HL*17*2*22*0 |
| TRN*1*25754*1562061741 |
| NM1*IL*1*NAUDE*JACOB*A |
| REF*EJ*20013842 |
| N3*809 PINEBURR RD |
| N4*JAMESTOWN*NC*27282 |
| DMG*D8*20071023*M |
| DTP*291*D8*20250509 |
| EQ*30 |
| HL*18*2*22*0 |
| TRN*1*25755*1562061741 |
| NM1*IL*1*KHAN*MAKEESA |
| REF*EJ*20009569 |
| N3*1052 BEXLEY CT. |
| N4*HIGH POINT*NC*27262 |
| DMG*D8*19771116*F |
| DTP*291*D8*20250509 |
| EQ*30 |
| HL*19*2*22*0 |
| TRN*1*25756*1562061741 |
| NM1*IL*1*CHEEK*HELEN |
| REF*SY*215813389 |
| REF*EJ*20003926 |
| N3*1201 S BENBOW RD |
| N4*GREENSBORO*NC*27406 |
| DMG*D8*20051201*F |
| DTP*291*D8*20250509 |
| EQ*30 |
| HL*20*2*22*0 |
| TRN*1*25757*1562061741 |
| NM1*IL*1*WASTAK*DORIS*JEAN |
| REF*SY*242298529 |
| REF*EJ*20001350 |
| N3*1014 MEREDITH STREET |
| N4*HIGH POINT*NC*27262 |
| DMG*D8*19781222*F |
| DTP*291*D8*20250509 |
| EQ*30 |
| HL*21*2*22*0 |
| TRN*1*25758*1562061741 |
| NM1*IL*1*CLARK*PATRICIA |
| REF*SY*262925207 |
| REF*EJ*20011943 |
| N3*1829 B JOHNSON STREET |
| N4*HIGH POINT*NC*27262 |
| DMG*D8*19590518*F |
| DTP*291*D8*20250509 |
| EQ*30 |
| HL*22*2*22*0 |
| TRN*1*25759*1562061741 |
| NM1*IL*1*FARRAR*RICKEY*NELSON |
| REF*SY*241354628 |
| REF*EJ*01098216 |
| N3*108 THOMAS ST*APT D |
| N4*HIGH POINT*NC*27263 |
| DMG*D8*19801025*M |
| DTP*291*D8*20250509 |
Solutions:
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