837 Health Care Claim (003030)

This is the standard X12 003030 spec, with 16 loops and 113 segment positions, as OpenEDI JSON, an ediFabric C# template and an ediFabric Native model. To change it for a trading partner, customize it in the EDI Spec Builder.

Loading the spec…

The spec as an OpenAPI 3 schema with x-openedi-* extensions, for ediFabric Native, ediFabric Cloud and the EDI Spec Builder. Download OpenEDI (94 KB) Generate classes

The ediFabric .NET template, class TS837. It needs the common segments, composites and codes of X12 003030, one download for every transaction in the version. Download C# (2 KB) Common files (159 KB)

The intermediary model ediFabric Native loads with set_map. Download Native (84 KB)

Use the 837 spec in your code

ediFabric .NET

Add the C# template and its common files to your project, or reference the template NuGet package, and read 837 files into TS837 objects. See ediFabric .NET.

ediFabric Native

Map version 003030 to the Native model with set_map, then parse 837 files to JSON from Python, Java, C or C#. See Convert between EDI and JSON.

OpenEDI

Select Customize in Spec Builder to copy the spec under your own name, change it for your partner, and parse files against it in EdiNation, ediFabric Native or ediFabric Cloud. Read about OpenEDI.

Generate 837 classes in Python, Java, Node.js, Go, Rust or C

ediFabric Native returns each 837 as JSON, with the property names of the OpenEDI schema. To work with that JSON as typed objects, generate classes from the OpenEDI file in your language and deserialize the JSON into TS837. Serialize the objects back to JSON to build EDI with ediFabric Native. The classes keep the loops, segments, lengths and code lists, but not the EDI data formats, so validate files with ediFabric Native. Read more in Generate a class from OpenEDI.

Python: datamodel-code-generator. Node.js: openapi-typescript. Java, Go, Rust and C: OpenAPI Generator.

837 structure

Loops and segments of the standard 837, with their usage and maximum repeats.

ID	Name	Usage	Max use
ST	Transaction Set Header	Optional	1
BGN	Beginning Segment	Optional	1
REF	Reference Numbers	Optional	3
Loop NM1	Individual or Organizational Name	Optional	10
NM1	Individual or Organizational Name	Mandatory	1
N2	Additional Name Information	Optional	2
N3	Address Information	Optional	2
N4	Geographic Location	Optional	1
REF	Reference Numbers	Optional	2
PER	Administrative Communications Contact	Optional	2
Loop PRV	Provider Information	Mandatory	100
PRV	Provider Information	Mandatory	1
CUR	Currency	Optional	1
Loop NM1	Individual or Organizational Name	Optional	2
NM1	Individual or Organizational Name	Mandatory	1
N2	Additional Name Information	Optional	2
N3	Address Information	Optional	2
N4	Geographic Location	Optional	1
REF	Reference Numbers	Optional	2
PER	Administrative Communications Contact	Optional	2
Loop SBR	Subscriber Information	Mandatory	99999
SBR	Subscriber Information	Mandatory	1
DTP	Date or Time or Period	Optional	5
Loop NM1	Individual or Organizational Name	Optional	10
NM1	Individual or Organizational Name	Mandatory	1
N2	Additional Name Information	Optional	2
N3	Address Information	Optional	2
N4	Geographic Location	Optional	1
DMG	Demographic Information	Optional	1
PER	Administrative Communications Contact	Optional	2
REF	Reference Numbers	Optional	5
Loop PAT	Patient Information	Mandatory	99
PAT	Patient Information	Mandatory	1
Loop NM1	Individual or Organizational Name	Optional	10
NM1	Individual or Organizational Name	Mandatory	1
N2	Additional Name Information	Optional	2
N3	Address Information	Optional	2
N4	Geographic Location	Optional	1
DMG	Demographic Information	Optional	1
PER	Administrative Communications Contact	Optional	2
REF	Reference Numbers	Optional	5
Loop CLM	Health Claim	Mandatory	100
CLM	Health Claim	Mandatory	1
DTP	Date or Time or Period	Optional	40
CL1	Claim Codes	Optional	1
DN1	Orthodontic Information	Optional	1
DN2	Tooth Summary	Optional	35
PWK	Paperwork	Optional	10
CN1	Contract Information	Optional	1
DSB	Disability Information	Optional	1
UR	Peer Review Organization or Utilization Review	Optional	1
AMT	Monetary Amount	Optional	40
REF	Reference Numbers	Optional	10
K3	File Information	Optional	10
NTE	Note/Special Instruction	Optional	4
CR1	Ambulance Certification	Optional	1
CR2	Chiropractic Certification	Optional	1
CR3	Durable Medical Equipment Certification	Optional	1
CR4	Enteral or Parenteral Therapy Certification	Optional	3
CR5	Oxygen Therapy Certification	Optional	1
CRC	Certification Conditions	Optional	3
PC	Procedure Codes	Optional	25
AM1	Informational Values	Optional	25
CD2	Multi-Valued Characteristics	Optional	30
QTY	Quantity	Optional	10
Loop LS	Loop Header	Optional	1
LS	Loop Header	Mandatory	1
Loop NM1	Individual or Organizational Name	Optional	9
NM1	Individual or Organizational Name	Mandatory	1
PRV	Provider Information	Optional	1
N2	Additional Name Information	Optional	2
N3	Address Information	Optional	2
N4	Geographic Location	Optional	1
PER	Administrative Communications Contact	Optional	2
LE	Loop Trailer	Mandatory	1
Loop LX	Assigned Number	Optional	10000
LX	Assigned Number	Mandatory	1
SV1	Professional Service	Optional	1
SV2	Institutional Service	Optional	1
SV3	Dental Service	Optional	1
SV4	Drug Service	Optional	1
Loop LIN	Item Identification	Optional	10
LIN	Item Identification	Mandatory	1
CTP	Pricing Information	Optional	1
SV5	Durable Medical Equipment Service	Optional	1
SV6	Anesthesia Service	Optional	1
SV7	Drug Adjudication	Optional	1
CD2	Multi-Valued Characteristics	Optional	5
PWK	Paperwork	Optional	10
CR1	Ambulance Certification	Optional	1
CR2	Chiropractic Certification	Optional	5
CR3	Durable Medical Equipment Certification	Optional	1
CR4	Enteral or Parenteral Therapy Certification	Optional	3
CR5	Oxygen Therapy Certification	Optional	1
CRC	Certification Conditions	Optional	3
DTP	Date or Time or Period	Optional	15
QTY	Quantity	Optional	5
CN1	Contract Information	Optional	1
REF	Reference Numbers	Optional	10
AMT	Monetary Amount	Optional	15
K3	File Information	Optional	10
NTE	Note/Special Instruction	Optional	10
PS1	Purchase Service	Optional	1
Loop LS	Loop Header	Optional	1
LS	Loop Header	Mandatory	1
Loop NM1	Individual or Organizational Name	Optional	9
NM1	Individual or Organizational Name	Mandatory	1
PRV	Provider Information	Optional	1
N2	Additional Name Information	Optional	2
N3	Address Information	Optional	2
N4	Geographic Location	Optional	1
PER	Administrative Communications Contact	Optional	2
LE	Loop Trailer	Mandatory	1
Loop LS	Loop Header	Optional	1
LS	Loop Header	Mandatory	1
Loop NM1	Individual or Organizational Name	Optional	10
NM1	Individual or Organizational Name	Mandatory	1
N2	Additional Name Information	Optional	2
N3	Address Information	Optional	2
N4	Geographic Location	Optional	1
PER	Administrative Communications Contact	Optional	1
SBR	Subscriber Information	Optional	1
CA1	Claim Adjudication	Optional	1
AMT	Monetary Amount	Optional	15
DMG	Demographic Information	Optional	1
DTP	Date or Time or Period	Optional	2
REF	Reference Numbers	Optional	3
LE	Loop Trailer	Mandatory	1
SE	Transaction Set Trailer	Optional	1