Section title: X12 EDI Examples
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ASC X12 Version: 008010 | Transaction Set: 278 | TR3 ID: 008010X342

Business Scenario - Medical Drug request

A Provider submits an initial medical drug request using the X342 8010 version.

Inbound Transmission Explanation

ST*278*1001*008010X342~

Submitter transaction Identifier

BHT*0007*13*16139462398*20200624*0734~

HL*1**20*1~

Payer Loop

NM1*X3*2*PAYOR A*****PI*1234567~

HL*2*1*21*1~

Requesting Entity Loop

NM1*1P*1*PCPLASTNAME*PCPFIRSTNAME****XX*1234567899~

Requesting Entity

PER*IC*CONTACT NAME*TE*5556368147*EX*551~

Contact Name and other information

HL*3*2*22*1~

Subscriber Loop

NM1*IL*1*LASTNAME*FIRSTNAME****MI*MEMBERID~

Member Data

DMG*D8*19470701*M~

HL*4*3*EV*1~

Event Loop

UM*HS*I**12:B**E~

Health Services, Initial, Home, Elective

DTP*AAH*D8*20200702~

Event Date=7/2/20

HI*ABF:M069~

Diagnosis

MSG*ADDITIONAL INFORMATION CAN BE PROVIDED IN MSG~

Additional information

NM1*71*1*PROVIDER*ATTENDING****XX*1234567899~

Event Provider role identification

NM1*SJ*2*ABC HOME DRUG SPECIALTY*****XX*1234567888~

HL*5*4*SS*0~

Service Loop

UM*HS*I~

DTP*472*RD8*20200702-20201002~

Service Date to begin on 07/02/2020

DRA*INFLIXIMAB 10 MG*I*N4:57894003001*UN*20*INFUSE OVER AT LEAST 2 HOURS. BEGIN AT 40 ML/HR FOR 15 MINUTES, THEN INCREASE RATE TO 80 ML/HR FOR 30 MINUTES. IF TOLERATED INCREASE TO 160 ML/HR FOR THE DURATION OF INFUSION*N*N******43~

DRA segment to report drug details

SE*22*1001~

Outbound Transmission Explanation

ST*278*0001*008010X342~

Submitter transaction Identifier

BHT*0007*11*16139462398*20200624*07344807*19~

HL*1**20*1~

Payer Loop

NM1*X3*2*PAYOR A*****PI*1234567~

HL*2*1*21*1~

Requesting Entity Loop

NM1*1P*1*PCPLASTNAME*PCPFIRSTNAME****XX*1234567899~

Requesting Entity

HL*3*2*22*1~

Subscriber Loop

NM1*IL*1*LASTNAME*FIRSTNAME****MI*MEMBERID~

Member Data

DMG*D8*19470701*M~

HL*4*3*EV*1~

Event Loop

UM*HS*I**12:B**E~

Health Services, Initial, Home, Elective

HCR*A4**0V~

Certification Action Code

REF*NT*5554772110000000~

Administrative Reference number

DTP*AAH*D8*20200702~

Event Date=7/2/20

HI*ABJ:M069~

Diagnosis

NM1*71*1*PROVIDER*ATTENDING****XX*1234567898~

Event Provider role identification

NM1*SJ*2*ABC DME EQUIPMENT*****XX*1234567888~

HL*5*4*SS*0~

Service Loop

UM*HS*I~

HCR*A4**0V~

Certification Action Code

REF*NT*5554772110000000~

Administrative Reference number

DTP*472*RD8*20200702-20201002~

Service Date to begin on 07/02/2020

DRA*INFLIXIMAB 10 MG*I*N4:57894003001*UN*20*INFUSE OVER AT LEAST 2 HOURS. BEGIN AT 40 ML/HR FOR 15 MINUTES, THEN INCREASE RATE TO 80 ML/HR FOR 30 MINUTES. IF TOLERATED INCREASE TO 160 ML/HR FOR THE DURATION OF INFUSION*N*N******43~

DRA segment to report drug details

SE*24*0001~