ASC X12 Version: 005010 | Transaction Set: 834 | TR3 ID: 005010X220
Example 05: Change subscriber information
John Doe is correcting his date of birth.
Transmission Explanation
Table 1
ST*834*12345*005010X220A1~
Used to indicate the start of a transaction set and to specify a transaction set control number.
BGN*00*12456*19980520*1200****2~
This is an original transaction uniquely identified by the sender with reference #12456. The transaction was created on 5/20/1998 at 12:00 Noon.
N1*P5*GENERIC INC*FI*000111000~
Specifies the sponsor/sender's tax ID number.
N1*IN*ABC INSURANCE*FI*654456654~
Specifies the insurance company/receiver's tax ID number.
Table 2
INS*Y*18*001*25*A***FT~
Beginning of Table 2. Indicates that the subscriber (John Doe) is updating coverage as an active employee.
REF*0F*123456789~
John's subscriber ID number.
REF*1L*123456001~
This is the group number assigned by the carrier.
NM1*IL*1*DOE*JAMES*E***34*103229876~
Members name and ssn.
DMG*D8*19500415*M~
This is John's date of birth and gender.
NM1*70*1*DOE*JAMES*E~
Subscriber's name. The NM101 = 70 indicates that this is a change to information previously sent.
DMG*D8*19500416*M~
This is John's incorrect date of birth.
SE*12*12345~
End of transaction set. 12 segments were sent and the control number in the ST segment is 12345.