EDI 274 Healthcare Provider Information
EDI 274是由医疗保健者发起,主要包括以下信息:
- 信息提供者
- 医疗保健者信息
- 信息接收方
EDI 274 示例报文
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ST*274*0171*004050X109 BHT*0028*27*20180208113701072*20180208*113701 DTM*507*20180208 PER*BJ*Jim Lyons*TE*8314305500 HL*1**20*1 NM1*ACV*2*Central California Alliance for Health*****FI*770395311 NM1*NN*2*Central California Alliance for Health HL*2*1*21*1 NM1*40*2*DHCS Managed Care HL*3*2*4*1 NM1*QV*2*Stars Therapy Services N2*473903605 DTP*092*D8*20150915 HL*4*3*N*1 NM1*77*2*Starts Therapy Services*****XX*1578940839 N2*473903605;10;;27;;;;0;;;N*;;;;;N PER*AJ**TE*8312614088*EM*info@beaconhealthoptions.com LUI*LE*sgn***A DTP*092*D8*20150915 PDI**0*12 NX1*77 N3*153 Cayuga Street N4*Salinas*CA*93901 LQ*68*305S00000X TPB*3G REF*N5*11417331;; NM1*30*2*Stars Therapy Services*****EQ*473903605 HL*5*4*19*0 NM1*1P*1*Williams*Erin****XX*1033485172 N2*FIRST;100;F;19500101;N;;N;;88;002000;;N;N*1149993;OTH;CA;;CA;AJ1D;1033485172 N2*EMAIL;info@beaconhealthoptions.com LUI*LE*sgn***A DTP*092*D8*20150915 LQ*68*235Z00000X REF*N5*;1;1149993 HL*6*4*19*0 NM1*1P*1*LodoliniKho*Ann****XX*1235508417 N2*FIRST;100;F;19500101;N;;N;;88;002000;;N;N*11417331;OTH;CA;;CA;1D;1235508417 N2*EMAIL;info@beaconhealthoptions.com LUI*LE*sgn***A DTP*092*D8*20151115 LQ*68*103K00000X REF*N5*;1;11417331 HL*7*4*19*0 NM1*1P*1*Palmer*David****XX*1528425469 N2*FIRST;100;M;19500101;N;;N;;88;002000;;N;N*11521261;OTH;CA;;CA;1D;1528425469 N2*EMAIL;aaron@santacruzaba.com LUI*LE*sgn***A DTP*092*D8*20160815 LQ*68*103K00000X REF*N5*;1;11521261 HL*8*2*4*1 NM1*QV*2*The Village Project Inc N2*611562515 DTP*092*D8*20151015 HL*9*8*N*1 NM1*77*2*The Village Project Inc*****XX*1073758249 N2*611562515;10;;27;;;;0;;;N*;;;;;N PER*AJ**TE*8313921500*EM*mel@villageprojectinc.org DTP*092*D8*20151015 PDI**0*99 NX1*77 N3*1069 Broadway Avenue*Suite 201 N4*Seaside*CA*93955 LQ*68*251S00000X TPB*3G REF*N5*20974;; NM1*30*2*The Village Project Inc*****EQ*611562515 HL*10*9*19*0 NM1*1P*1*Battle*Regina****XX*1508154469 N2*FIRST;100;F;19500101;N;;N;;88;002000;;N;N*67681;MFT;CA;;CAG;1DAJ;1508154469 N2*EMAIL;reginab@villageprojectinc.org DTP*092*D8*20170115 LQ*68*101YP2500X REF*N5*;1;67681 HL*11*9*19*0 NM1*1P*1*Mason*Melvin****XX*1548438419 N2*FIRST;100;M;19500101;N;;N;;88;002000;;Y;N*20974;CSW;CA;;CAG;ADSGPDIC1D;1548438419 N2*EMAIL;mel@villageprojectinc.org DTP*092*D8*20151015 LQ*68*1041C0700X REF*N5*;1;20974 HL*12*2*4*1 NM1*QV*2*ARETE PHARMACY NETWORK N2*860318370 DTP*092*D8*20061101 HL*13*12*N*0 NM1*77*2*ROMIE LANE PHARMACY INC*****XX*1558456988 N2*860318370;3P;;27;;;;0;;;N*;;;;;N PER*AJ**TE*8314240395*EM*ROSTARELLO@GMAIL.COM DTP*092*D8*19000101 NX1*77 N3*505 E ROMIE LN*STE H N4*SALINAS*CA*93901 LQ*68*333600000X REF*N5*PHY45642;; NM1*30*2*ARETE PHARMACY NETWORK*****EQ*860318370 HL*14*2*4*1 NM1*QV*2*ACCESS IV INC N2*020653265 DTP*092*D8*20050201 HL*15*14*N*0 NM1*77*2*BRIOVARX INFUSION SERVICES 401, LLC*****XX*1093716813 N2*020653265;3P;;27;;;;0;;;N*;;;;;N PER*AJ**TE*8313848080*EM*REGULATORY@BRIOVARXINFUSION.COM DTP*092*D8*20040604 NX1*77 N3*455 RESERVATION RD*STE G N4*MARINA*CA*93933 LQ*68*3336H0001X REF*N5*PHY53892;; NM1*30*2*ACCESS IV INC*****EQ*020653265 HL*16*2*4*1 NM1*QV*2*Stewart, Sheryl N2*561921250 DTP*092*D8*20140101 HL*17*16*N*1 NM1*77*2*Stewart, Sheryl*****XX*1952595134 N2*561921250;10;;27;;;;0;;;N*;;;;;N PER*AJ**TE*8313732502*EM*stewart.sheryl@att.net DTP*092*D8*20140101 PDI**0*99 NX1*77 N3*9 West Gabilan Street*Suite 8 N4*Salinas*CA*93901 LQ*68*101YM0800X TPB*3G REF*N5*46741;; NM1*30*2*Stewart, Sheryl*****EQ*561921250 HL*18*17*19*0 NM1*1P*1*Stewart*Sheryl****XX*1952595134 N2*FIRST;100;F;19500101;N;;N;;88;002000;;Y;N*46741;MFT;CA;;CAG;ADMDAJDS;1952595134 N2*EMAIL;Stewart.sheryl@att.net DTP*092*D8*20140101 LQ*68*101YM0800X REF*N5*;1;46741 HL*19*2*4*1 NM1*QV*2*Torissi, Laura N2*611325891 DTP*092*D8*20160315 HL*20*19*N*1 NM1*77*2*Torissi, Laura*****XX*1194029215 N2*611325891;10;;27;;;;0;;;N*;;;;;N PER*AJ**TE*8312003085*EM*dr.laura.torissi@gmail.com DTP*092*D8*20160315 PDI**13*64 NX1*77 N3*510 Lighthouse Avenue*Suite 6 N4*Pacific Grove*CA*93950 LQ*68*101YM0800X REF*N5*27534;; NM1*30*2*Torissi, Laura*****EQ*611325891 HL*21*20*19*0 NM1*1P*1*Torissi*Laura****XX*1194029215 N2*FIRST;100;F;19500101;N;;N;;88;002000;;Y;N*27534;PSY;CA;;CA;1DSRADAJDS;1194029215 N2*EMAIL;dr.laura.torissi@gmail.com DTP*092*D8*20160315 LQ*68*101YM0800X REF*N5*;1;27534 HL*22*2*4*1 NM1*QV*2*Kihara, Ann N2*565809447 DTP*092*D8*20140101 HL*23*22*N*1 NM1*77*2*Kihara, Ann*****XX*1497965164 N2*565809447;10;;27;;;;0;;;N*;;;;;N PER*AJ**TE*8316553954*EM*ligureanna@msn.com DTP*092*D8*20140101 PDI**0*99 NX1*77 N3*199 17th Street*Suite H N4*Pacific Grove*CA*93950 LQ*68*106H00000X TPB*3G REF*N5*41385;; NM1*30*2*Kihara, Ann*****EQ*565809447 HL*24*23*19*0 NM1*1P*1*Kihara*Ann****XX*1497965164 N2*FIRST;100;F;19500101;N;;N;;88;002000;;N;N*41385;MFT;CA;;CAG;AJ;1497965164 N2*EMAIL;ligureanna@msn.com DTP*092*D8*20141208 LQ*68*106H00000X REF*N5*;1;41385 HL*25*2*4*1 NM1*QV*2*Allen, Jennifer Lynn N2*462705713 DTP*092*D8*20160615 HL*26*25*N*1 NM1*77*2*Jennifer Allen*****XX*1134586050 N2*462705713;10;;27;;;;0;;;N*;;;;;N PER*AJ**TE*8312779348*EM*boneknowing@gmail.com DTP*092*D8*20160615 PDI**0*99 NX1*77 N3*26485 Carmel Rancho Boulevard*Suite 5 N4*Carmel*CA*93923 LQ*68*106H00000X TPB*3G REF*N5*38327;; NM1*30*2*Allen, Jennifer Lynn*****EQ*462705713 |
EDI 274规范
EDI 274包含建立医疗服务提供者信息事务集(274)的数据内容和格式,可以在电子数据交换(EDI)环境的上下文中使用。EDI 274可用于在提供者,提供者网络或维护或验证医疗保健提供者信息的任何其他实体之间交换关于医疗保健提供者的人口统计和教育/专业资格。这种交换包括发送,查询或响应查询。医疗服务提供者信息经常被交换以用于1)维护提供者数据库以用于索赔裁决,提供者目录,患者转介和报告提供者信息,2)提交加入提供者组织或提供者网络的应用程序,例如但不限于到,医院,首选提供者组织(PPO)或健康维护组织(HMO),以及3)验证证书,如教育/专业资格,许可证和医疗事故保险/历史。
常见 X12 EDI 事务类型
- EDI 830 物料需求预测
- EDI 862 交付计划
- EDI 850 采购订单
- EDI 855 采购订单确认
- EDI 860 订单变更
- EDI 865 订单变更确认
- EDI 856 发货通知/清单
- EDI 810 发票
- EDI 824 应用程序通知
- EDI 864 文本消息
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