837 Health Care Claim (007040)

This is the standard X12 007040 spec, with 14 loops and 126 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.

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The spec as an OpenAPI 3 schema with x-openedi-* extensions, for ediFabric Native, ediFabric Cloud and the EDI Spec Builder. Download OpenEDI (208 KB) Generate classes

The ediFabric .NET template, class TS837. It needs the common segments, composites and codes of X12 007040, one download for every transaction in the version. Download C# (2 KB) Common files (233 KB)

The intermediary model ediFabric Native loads with set_map. Download Native (164 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 007040 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	Mandatory	1
BHT	BHT	Mandatory	1
REF	REF	Optional	3
Loop NM1	NM1	Optional	10
NM1	NM1	Mandatory	1
N2	N2	Optional	2
N3	N3	Optional	2
N4	N4	Optional	1
REF	REF	Optional	2
PER	PER	Optional	2
Loop HL	HL	Mandatory	99999
HL	HL	Mandatory	1
PRV	PRV	Optional	1
SBR	SBR	Optional	1
PAT	PAT	Optional	1
DTP	DTP	Optional	5
CUR	CUR	Optional	1
Loop NM1	NM1	Optional	10
NM1	NM1	Mandatory	1
N2	N2	Optional	2
N3	N3	Optional	2
N4	N4	Optional	1
DMG	DMG	Optional	1
REF	REF	Optional	20
PER	PER	Optional	2
LUI	LUI	Optional	1
Loop CLM	CLM	Optional	100
CLM	CLM	Mandatory	1
DTP	DTP	Optional	150
CL1	CL1	Optional	1
DN1	DN1	Optional	1
DN2	DN2	Optional	35
PWK	PWK	Optional	10
CN1	CN1	Optional	1
DSB	DSB	Optional	1
UR	UR	Optional	1
AMT	AMT	Optional	40
REF	REF	Optional	30
K3	K3	Optional	10
NTE	NTE	Optional	20
CR1	CR1	Optional	1
CR2	CR2	Optional	1
CR3	CR3	Optional	1
CR4	CR4	Optional	3
CR5	CR5	Optional	1
CR6	CR6	Optional	1
CR8	CR8	Optional	9
CRC	CRC	Optional	100
HI	HI	Optional	25
QTY	QTY	Optional	10
HCP	HCP	Optional	1
Loop CR7	CR7	Optional	6
CR7	CR7	Mandatory	1
HSD	HSD	Optional	12
Loop NM1	NM1	Optional	9
NM1	NM1	Mandatory	1
PRV	PRV	Optional	1
N2	N2	Optional	2
N3	N3	Optional	2
N4	N4	Optional	1
REF	REF	Optional	20
PER	PER	Optional	2
Loop SBR	SBR	Optional	10
SBR	SBR	Mandatory	1
CAS	CAS	Optional	99
RAS	RAS	Optional	99
AMT	AMT	Optional	15
DMG	DMG	Optional	1
OI	OI	Optional	1
MIA	MIA	Optional	1
MOA	MOA	Optional	1
HI	HI	Optional	1
LQ	LQ	Optional	99
Loop NM1	NM1	Optional	10
NM1	NM1	Mandatory	1
N2	N2	Optional	2
N3	N3	Optional	2
N4	N4	Optional	1
PER	PER	Optional	2
DTP	DTP	Optional	9
REF	REF	Optional	99999
Loop LX	LX	Optional	99999
LX	LX	Mandatory	1
SV1	SV1	Optional	1
SV2	SV2	Optional	1
SV3	SV3	Optional	1
TOO	TOO	Optional	32
SV4	SV4	Optional	1
SV5	SV5	Optional	1
SV6	SV6	Optional	1
SV7	SV7	Optional	1
HI	HI	Optional	25
PWK	PWK	Optional	10
CR1	CR1	Optional	1
CR2	CR2	Optional	5
CR3	CR3	Optional	1
CR4	CR4	Optional	3
CR5	CR5	Optional	1
CRC	CRC	Optional	3
DTP	DTP	Optional	15
QTY	QTY	Optional	5
MEA	MEA	Optional	20
CN1	CN1	Optional	1
REF	REF	Optional	30
AMT	AMT	Optional	15
K3	K3	Optional	10
NTE	NTE	Optional	10
PS1	PS1	Optional	1
IMM	IMM	Optional	99999
HSD	HSD	Optional	1
HCP	HCP	Optional	1
CR8	CR8	Optional	99999
Loop LIN	LIN	Optional	99999
LIN	LIN	Mandatory	1
CTP	CTP	Optional	1
REF	REF	Optional	1
SV4	SV4	Optional	1
SV7	SV7	Optional	1
Loop NM1	NM1	Optional	10
NM1	NM1	Mandatory	1
PRV	PRV	Optional	1
N2	N2	Optional	2
N3	N3	Optional	2
N4	N4	Optional	1
REF	REF	Optional	20
PER	PER	Optional	2
Loop SVD	SVD	Optional	99999
SVD	SVD	Mandatory	1
CAS	CAS	Optional	99
RAS	RAS	Optional	99
DTP	DTP	Optional	9
AMT	AMT	Optional	20
LQ	LQ	Optional	99
Loop LS	LS	Optional	1
LS	LS	Mandatory	1
Loop LQ	LQ	Mandatory	99999
LQ	LQ	Mandatory	1
FRM	FRM	Mandatory	99
LE	LE	Mandatory	1
SE	Transaction Set Trailer	Mandatory	1