x12 500 Medical Event Reporting

500 Specifications

 The x12 Transaction Set contains the format and establishes the data contents of the Medical Event Reporting Transaction Set (500) for use within the context of an Electronic Data Interchange (EDI) environment. This standard can be used to make voluntary, mandatory, baseline, annual and semi-annual reports on medication and medical device adverse effects and product problems.

500 Example

ISA*00* *00* *01*1234567890 *01*999999999 *120126*1211*U*00401*000000165*0*P~
GS*MM*1234567890 *999999999 *20120126*1211*1*T*004010~
ST*500*0001~
BGN*00*Reference Identification*20120224*1653*01*Reference Identification*01*1*00~
NM1*01*1*Name Last or Organization Name*Name First*Name Middle*Name Prefi*Name Suffi*1*Identification Code*01*01~
N2*Name*Name~
N3*Address Information*Address Information~
N3*Address Information*Address Information~
N4*City Name*ST*POSTAL CODE*COU*A*Location Identifier~
REF*01*Reference Identification*Description*01\Reference Identification\01\Reference Identification~
PER*1A*Name*AA*Communication Number*AA*Communication Number*AA*Communication Number*Contact Inquiry Refe~
DTM*001*20120224*1653*01*CC*Date Time Period~
QTY*01*338*01\2356335\19201\01\285811528424098\1\01\12954\323042961\01\13395632\3853\01\3023329193254\2~
TRN*1*Reference Identification*Originatin*Reference Identification~
LM*10*Source Subquali~
LQ*0*Industry Code~
HL*1**1*0~
LM*10*Source Subquali~
LQ*0*Industry Code~
DTM*001*20120224*1653200*01*CC*Date Time Period~
REF*01*Reference Identification*Description*01\Reference Identification~
QTY*01*2267278*01\2260603\15\01\1872347917\18691154\01\86633874238\175591839\01\207542\21857\01\102747856111\226891~
MTX*AAA*Message Text*Message Text*AA~
LIN*Assigned Identificat*A1*Product/Service ID*A1*Product/Service ID~
PID*F*01*10*Product Desc*Description*1S*Source Subquali*N*LAN~
QTY*01*124654*01\18544461532399\272422056\01\13031733523\28941\01\703729949666032\7763313\01\2\271\01\12\876~
DTM*001*20120224*1653*01*CC*Date Time Period~
REF*01*Reference Identification*Description*01\Reference Identification\01\Reference Identification~
MEA*9L*1*3228614419*01\27833\377048\01\1897209\16616\01\3215\82686\01\6567397\2001022\01\809\1*30022*232820162*01**1S*BM~
TRN*1*Reference Identification*Originatin*Reference Identification~
MTX*AAA*Message Text*Message Text*AA~
NM1*01*1*Name Last or Organization Name*Name First*Name Middle*Name Prefi*Name Suffi*1*Identification Code*01*01~
N2*Name*Name~
N3*Address Information*Address Information~
N4*City Name*ST*POSTAL CODE*COU*A*Location Identifier~
REF*01*Reference Identification*Description*01\Reference Identification\01\Reference Identification~
PER*1A*Name*AA*Communication Number*AA*Communication Number*AA*Communication Number*Contact Inquiry Refe~
DTM*001*20120224*1653200*01*CC*Date Time Period~
DMG*CC*Date Time Period*A*A*7*1*COU*1*26502~
MEA*9L*1*2182276832*01\553\474812\01\78\68\01\521547\1063173\01\86\3255\01\3222\152306*28081*26237281401317836*01**1S*BM~
PWK*01*1*6*01*1*Identification Code*Description*1\1\1\1\1*AR~
TRN*1*Reference Identification*Originatin*Reference Identification~
QTY*01*7713418*01\24\23\01\1802824\1459517287\01\273\31\01\1562611784\246741714\01\90112\4~
LM*10*Source Subquali~
LQ*0*Industry Code~
PID*F*01*10*Product Desc*Description*1S*Source Subquali*N*LAN~
DTM*001*20120224*16532100*01*CC*Date Time Period~
QTY*01*2881116*01\3220519\2\01\264912\20315591\01\23988\17\01\28243179\2657772763\01\1127126\1683495951~
MTX*AAA*Message Text*Message Text*AA~
DTM*001*20120224*165321*01*CC*Date Time Period~
CTT*214129*456275*85191521*01*7267276*01*Description~
SE*50*0001~
GE*1*1~
IEA*1*000000165~