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rdpcrystal-edi-library

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ASCII X12 EDI Library, Create, Parse, Load, Validate, View, Edit, Split, Join And Scrub EDI Data

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ISA*00* *00* *33* 54704*ZZ* PB000022*110726*1248*U*00501*000000209*0*P*>~ GS*HP*54704*0001124*20110726*23562041*344*X*005010X221A1~ ST*835*0001~ BPR*H*0*C*NON************20110726~ TRN*1*0000010305*1234567890~ DTM*405*20110706~ N1*PR*INDEPENDENCE BLUE CROSS~ N3*1901 MARKET STREET~ N4*PHILADELPHIA*PA*19103~ PER*CX*IBC Service Desk*TE*111111111~ PER*BL*John Smith*TE*111111111~ N1*PE*CHESTNUT HILL REHAB HOSPITAL*XX*NPI Number~ N3*ATTENTION JOE SAMPLE*8835 MARKET AVENUE~ N4*PHILADELPHIA*PA*191182718~ REF*PQ*Legacy Provider Number~ REF*TJ*Federal Tax ID~ LX*1~ CLP*9999999*4*385.21*0*385.21*12*999999999999*13*2~ NM1*QC*1*SAMPLE*JOAN****MI*ZAR123456789~ NM1*IL*1*SAMPLE*HARRY*J***MI*ZAR123456789~ NM1*74*1*SAMPLE*HARRY*M***C*123456789~ NM1*82*2*JEANES HOSPITAL*****XX*NPI Number~ REF*CE*OUTPATIENT-PPO~ REF*1A*Legacy Number/Federal Tax ID~ DTM*232*20110225~ DTM*233*20110225~ DTM*036*20081031~ SVC*HC>97001*385.21*0*0424*1*~ DTM*472*20031125~ CAS*PR*27*385.20*0~ REF*6R*1~ PLB*NPI Number*20111231*50>111*6173.5~ SE*31*0001~ ST*835*0001~ BPR*H*0*C*NON************20110726~ TRN*1*0000010305*1234567890~ DTM*405*20110706~ N1*PR*INDEPENDENCE BLUE CROSS~ N3*1901 MARKET STREET~ N4*PHILADELPHIA*PA*19103~ PER*CX*IBC Service Desk*TE*111111111~ PER*BL*John Smith*TE*111111111~ N1*PE*CHESTNUT HILL REHAB HOSPITAL*XX*NPI Number~ N3*ATTENTION JOE SAMPLE*8835 MARKET AVENUE~ N4*PHILADELPHIA*PA*191182718~ REF*PQ*Legacy Provider Number~ REF*TJ*Federal Tax ID~ LX*1~ CLP*9999999*4*385.20*0*385.20*12*999999999999*13*2~ NM1*QC*1*SAMPLE*JOAN****MI*ZAR123456789~ NM1*IL*1*SAMPLE*HARRY*J***MI*ZAR123456789~ NM1*74*1*SAMPLE*HARRY*M***C*123456789~ NM1*82*2*JEANES HOSPITAL*****XX*NPI Number~ REF*CE*OUTPATIENT-PPO~ REF*1A*Legacy Number/Federal Tax ID~ DTM*232*20110225~ DTM*233*20110225~ DTM*036*20081031~ SVC*HC>97001*385.20*0*0424*1*~ DTM*472*20031125~ CAS*PR*27*385.20*0~ REF*6R*1~ PLB*NPI Number*20111231*50>111*6173.4~ SE*31*0001~ GE*2*344~ IEA*1*000000209~