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EDI 275 Patient Information Specifications

EDI 275 Format

ISA*01*0000000000*01*0000000000*ZZ*ABCDEFGHIJKLMNO*ZZ*123456789012345*101127*1719*U*00400*000003438*0*P*> GS*ME*1234567890 *999999999 *20120126*1211*1*T*004010 ST*275*0001 TRN*1*Reference Identification*Originatin NM1*01*1*Name Last or Organization Name****Name Suffi*1*Identification Code*01*01 DMG*CC*Date Time Period*A*A**1*COU LX*169211 DTP*001*CC*Date Time Period CAT*01*1*Version Identifier*0*Industry Code*Industry Code*Version Identifier PID*F**10*Product Desc*Description*1S*Source Subquali*N SE*9*0001 GE*1*1 IEA*1*000000333

EDI 275 Specification

This X12 Transaction Set contains the format and establishes the data contents of the Patient Information Transaction Set (275) for use within the context of an Electronic Data Interchange (EDI) environment. This transaction set can be used to communicate individual patient information requests and patient information (either solicited or unsolicited) between separate health care entities in a variety of settings to be consistent with confidentiality and use requirements. Patient information consists of demographic, clinical, and other supporting data.


Accredited Standards Committee X12. ASC X12 Standard [Table Data]. Data Interchange Standards Association, Inc., Falls Church, VA. http://www.x12.org

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