EDI 274 医疗服务者信息

Published On: 2019年8月1日Categories: 帮助文档, 知识库Views: 1

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

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。