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Editorial Team
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Asked: 2026-05-13T02:02:22+00:00

I’m looking for at least one sample file each in EDIFACT and X12 that

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I’m looking for at least one sample file each in EDIFACT and X12 that show
binary enclosures.

The EDIFACT one should include the data wrapped in UNO/UNP segments, and the X12 one needs to use one of the binary segments BIN or BDS.

Thanks for any help you can provide.

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1 Answer

  1. Editorial Team

    Here is a sample X12 message:

    ISA*00*          *01*PASSWORD00*ZZ*X03400000000108*ZZ*X00450000001001*060424*1244*^*00501*000000017*1*T*>
GS*HI*PARTICIPANTID*PAYER123*20060424*1244*17*X*005010X217
ST*278*1234*005010X217
BHT*0007*13*123*20060424*1244
HL*1**20*1
NM1*PR*2*AETNA 1234560010*****PI*PAYER123
HL*2*1*21*1
NM1*1P*1*POPDELL*ROBERT****24*4376557IM 
PER*IC**TE*6515551212*FX*6513332222
HL*3*2*22*1
NM1*IL*1*SMITH*SARA****MI*352584768003G 
N4*KANSAS CITY*MO*64108
DMG*D8*19560414*F
HL*4*3*EV*1
UM*HS*I*88
PWK*04*EL***AC*JONP56789001
HL*5*4*SS*0
SV1*N4>0173042304
MSG* Oxistat Cream, 1%, 60 gram tube
SE*18*1234
GE*1*17
GS*PI*PARTICIPANTID*PAYER123*20060424*1244*17*X*005010X211
ST*275*1234*005010X211
BGN*02*123456789*20060424*1244
NM1*1P*1*POPDELL*ROBERT****24*4376557IM
NM1*PR*2*AETNA 1234560010*****PI*PAYER123
NM1*IL*1*SMITH*SARA****MI*352584768003G
LX*1
TRN*1*JONP56789001
DTP*368*D8*20060331
CAT*AE*HL
EFI*05***************ASC
BIN*4896*<levelone xmlns="urn:hl7-org:v3/cda" xmlns:v3dt="urn:hl7-org:v3/v3dt" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="urn:hl7-org:v3/cda levelone_1.0.attachments.xsd">
    <clinical_document_header>
        <id EX="a123" RT="2.16.840.1.113883.3.933"/>
        <document_type_cd V="99999-7" DN="Imidazole-Related Antifungals Attachment"/>
        <origination_dttm V="2006-01-05"/>
        <provider>
            <provider.type_cd V="PRF"/>
            <person>
                <id EX="4376557IM" RT="2.16.840.1.113883.19.10.1"/>
                <person_name>
                    <nm>
                        <v3dt:GIV V="Robert"/>
                        <v3dt:MID V="J"/>
                        <v3dt:FAM V="Podell"/>
                        <v3dt:SFX V="MD"/>
                    </nm>
                    <person_name.type_cd V="L" S="2.16.840.1.113883.12.200"/>
                </person_name>
            </person>
        </provider>
        <patient>
            <patient.type_cd V="PATSBJ"/>
            <person>
                <id EX="352584768003G" RT="2.16.840.1.113883.19.10.2"/>
                <person_name>
                    <nm>
                        <v3dt:GIV V="Sara"/>
                        <v3dt:MID V="J"/>
                        <v3dt:FAM V="Smith"/>
                    </nm>
                    <person_name.type_cd V="L" S="2.16.840.1.113883.12.200"/>
                </person_name>
            </person>
            <is_known_by>
                <id EX="184569" RT="2.16.840.1.1138863.19.10.3"/>
                <is_known_to>
                    <id EX="352584768003G" RT="2.16.840.1.113883.19.10.2"/>
                </is_known_to>
            </is_known_by>
        </patient>
        <local_header descriptor="Att_ACN">
            <local_attr name="attachment_control_number" value="XA728302"/>
        </local_header>
    </clinical_document_header>
    <body>
        <section>
            <caption>PRESCRIBER INFORMATION</caption>
            <paragraph>
                <caption>PRESCRIBER INFORMATION, NAME</caption>
                <content>Robert J. Podell, MD</content>
            </paragraph>
            <paragraph>
                <caption>PRESCRIBER INFORMATION, IDENTIFIER</caption>
                <content>4376557IM</content>
            </paragraph>
            <paragraph>
                <caption>PRESCRIBER INFORMATION, SPECIALTY TAXONOMY</caption>
                <content>Hepatologist (207RI0008X)</content>
            </paragraph>
        </section>
        <section>
            <caption>PRESCRIBER CONTACT INFORMATION</caption>
            <paragraph>
                <caption>PRESCRIBER CONTACT INFORMATION, PHONE NUMBER</caption>
                <content>(765) 228-1234</content>
            </paragraph>
            <paragraph>
                <caption>PRESCRIBER CONTACT INFORMATION, FAX NUMBER</caption>
                <content>(765) 228-3123</content>
            </paragraph>
        </section>
        <section>
            <caption>DRUG PRESCRIBED</caption>
            <paragraph>
                <caption>DRUG PRESCRIBED, NAME</caption>
                <content>Oxistat Cream, 1%, 60g tube</content>
            </paragraph>
            <paragraph>
                <caption>DRUG PRESCRIBED, DRUG CODE</caption>
                <content>0173-0423-04 (NDC)</content>
            </paragraph>
            <paragraph>
                <caption>DRUG PRESCRIBED, THERAPY TYPE</caption>
                <content>Replacement (RPLRQ)</content>
            </paragraph>
        </section>
        <section>
            <caption>DRUG HISTORY, PRIOR THERAPY FOR DIAGNOSIS</caption>        
            <paragraph>
                <caption>DRUG HISTORY, PRIOR THERAPY FOR DIAGNOSIS - DRUG NAME</caption>
                <content>Tinactin Cream</content>
            </paragraph>
            <paragraph>
                <caption>DRUG HISTORY, PRIOR THERAPY FOR DIAGNOSIS - DRUG CODE</caption>
                <content>0085-0715-07 (NDC)</content>
            </paragraph>
            <paragraph>
                <caption>DRUG HISTORY, PRIOR THERAPY FOR DIAGNOSIS - DURATION OF THERAPY</caption>
                <content>90 days</content>
            </paragraph>
            <paragraph>
                <caption>DRUG HISTORY, PRIOR THERAPY FOR DIAGNOSIS - REASON PRIOR THERAPY DISCONTINUED</caption>
                <content>Not or no longer effective (NTEFF)</content>
            </paragraph>
        </section>
        <section>
            <caption>IMIDAZOLE-RELATED ANTIFUNGALS, RELATED DIAGNOSIS</caption>
            <paragraph>
                <caption>IMIDAZOLE-RELATED ANTIFUNGALS, RELATED DIAGNOSIS</caption>
                <content>Tinea Pedia (ICD-9-CM 110.4)</content>
            </paragraph>
            <paragraph>
                <caption>IMIDAZOLE-RELATED ANTIFUNGALS, RELATED DIAGNOSIS - CONFIRMED BY</caption>
                <content>KOH Preparation (KOH)</content>
            </paragraph>
        </section>

        <section>
            <caption>FUNGAL INFECTION LOCATION</caption>
            <paragraph>
                <content>Between Toes, right foot (OTH)</content>
            </paragraph>
        </section>
        <section>
            <caption>DRUG PRESCRIBED, REASON FOR TOPICAL THERAPY</caption>
            <paragraph>
                <content>Hepatic Dysfunction (HDS)</content>
            </paragraph>
        </section>
        <section>
            <caption>CO-MORBID CONDITION INFORMATION</caption>
            <paragraph>
                <caption>CO-MORBID CONDITION INFORMATION, LIVER DYSFUNCTION INDICATOR</caption>
                <content>yes (Y)</content>
            </paragraph>
            <paragraph>
                <caption>CO-MORBID CONDITION INFORMATION, LIVER DYSFUNCTION CONFIRMED BY</caption>
                <content>Hepatic Function Panel (HFP)</content>
            </paragraph>
        </section>

        <section>
            <caption>MEDICARE ESRD CERTIFICATION INDICATOR</caption>
            <paragraph>
                <content>Yes (Y)</content>
            </paragraph>
        </section>
        <section>
            <caption>IMIDAZOLE-RELATED ANTIFUNGALS, PRIOR THERAPY TYPE</caption>
            <paragraph>
                <content>Topical (TOP)</content>
            </paragraph>
        </section>
    </body>
</levelone>
SE*12*1234
GE*1*17
IEA*2*000000017
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