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Sample EDI 274 Data for the Healthcare Provider Information Transaction Set
| Agency | Set ID | FG | Trans Desc | Committee |
| ANSI | 274 | PW | Healthcare Provider Information | Insurance |
EDI 274 Main Page Online EDI 274 Translation Need Help?
Research and Development:
Below is a sample EDI 274 transaction set. The Jobisez.com site has an online translation tool that converts the EDI 274 (Healthcare Provider 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 274 Transaction Set
| Entire Segment |
| ST*274*0003*004050X103A1 |
| BHT*0027*11*5BDEC3E92E244352A58A4EEB590E70FB*20200917*122857*RK |
| DTM*007*20200917 |
| PER*BJ*OCC PAYER EDI*EM*VHAOCCPAYEREDISUPPORT@VA.GOV |
| HL*1**20*1 |
| NM1*41*2*OCC PAYER EDI*****46*841469824 |
| HL*2*1*21*1 |
| NM1*40*2*OCC PAYER EDI |
| HL*3*2*19*1 |
| NM1*1P*2*RAVI K SAPRA MD*****FI*00302465838 |
| PER*AJ*ACME VENDOR INC*TE*18001234567 |
| NX1*31*8B |
| N3*826 JUNIPER DR* |
| N4*LAFAYETTE HILL*PA*194441606 |
| LQ*68*1234567890 |
| REF*1H*12345 |
| SE*17*0003 |
Solutions:
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