Complete EDI X12 Reference Guide for Transaction Sets, Segments, and Elements

X12 Release Version

EDI 148 Report Of Injury Illness Or Incident

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📄 What is this 148 EDI document?

📄 How is this 148 EDI document used?

  • ST (Transaction Set Header) [Min: 0, Max: 1]
  • BGN (Beginning Segment) M
  • CUR (Currency) [Min: 0, Max: 1]
  • QTY (Quantity) [Min: 0, Max: 1]
  • ▶
    NM1Loop1 () [Min: 0, Max: 999]
      • NM1 (Individual or Organizational Name) M
      • N2 (Additional Name Information) [Min: 0, Max: 1]
      • N3 (Address Information) [Min: 0, Max: 2]
      • N4 (Geographic Location) [Min: 0, Max: 1]
      • PER (Administrative Communications Contact) [Min: 0, Max: 3]
      • ACT (Account Identification) [Min: 0, Max: 9]
      • DTP (Date or Time or Period) [Min: 0, Max: 9]
      • DMG (Demographic Information) [Min: 0, Max: 1]
      • REF (Reference Identification) [Min: 0, Max: 9]
  • ▶
    HLLoop1 () M [Max: 99999]
      • HL (Hierarchical Level) M
      • ACT (Account Identification) [Min: 0, Max: 2]
      • DTP (Date or Time or Period) [Min: 0, Max: 9]
      • CUR (Currency) [Min: 0, Max: 1]
      • AMT (Monetary Amount) [Min: 0, Max: 2]
      • FC (Financial Contribution) [Min: 0, Max: 2]
      • REF (Reference Identification) [Min: 0, Max: 9]
      • DMG (Demographic Information) [Min: 0, Max: 1]
      • QTY (Quantity) [Min: 0, Max: 9]
      • CRI (Claim Report Information) [Min: 0, Max: 1]
      • EMT (Employment) [Min: 0, Max: 1]
      • CRC (Conditions Indicator) [Min: 0, Max: 999]
      • ▶
        NM1Loop2 () M [Max: 99]
          • NM1 (Individual or Organizational Name) M
          • N2 (Additional Name Information) [Min: 0, Max: 1]
          • N3 (Address Information) [Min: 0, Max: 2]
          • N4 (Geographic Location) [Min: 0, Max: 1]
          • PER (Administrative Communications Contact) [Min: 0, Max: 3]
          • ACT (Account Identification) [Min: 0, Max: 9]
          • DTP (Date or Time or Period) [Min: 0, Max: 9]
          • DMG (Demographic Information) [Min: 0, Max: 1]
          • REF (Reference Identification) [Min: 0, Max: 9]
      • ▶
        ESILoop1 () [Min: 0, Max: 9]
          • ESI (Employment Status Information) M
          • DTP (Date or Time or Period) [Min: 0, Max: 3]
          • QTY (Quantity) [Min: 0, Max: 4]
          • CRC (Conditions Indicator) [Min: 0, Max: 9]
          • ▶
            AINLoop1 () [Min: 0, Max: 9]
              • AIN (Income) M
              • CUR (Currency) [Min: 0, Max: 1]
              • TXI (Tax Information) [Min: 0, Max: 9]
              • WS (Work Schedule) [Min: 0, Max: 99]
              • DTP (Date or Time or Period) [Min: 0, Max: 1]
              • QTY (Quantity) [Min: 0, Max: 9]
      • ▶
        LNLoop1 () [Min: 0, Max: 99]
          • LN (Loan Information) M
          • REF (Reference Identification) [Min: 0, Max: 2]
          • ▶
            AMTLoop1 () [Min: 0, Max: 9]
              • AMT (Monetary Amount) M
              • DTP (Date or Time or Period) [Min: 0, Max: 1]
      • ▶
        INJLoop1 () [Min: 0, Max: 9]
          • INJ (Injury or Illness Detail) M
          • III (Information) [Min: 0, Max: 9]
          • IMP (Impairment Detail) [Min: 0, Max: 6]
          • DTP (Date or Time or Period) [Min: 0, Max: 9]
          • CRC (Conditions Indicator) [Min: 0, Max: 9]
          • ▶
            NM1Loop3 () [Min: 0, Max: 99]
              • NM1 (Individual or Organizational Name) M
              • N2 (Additional Name Information) [Min: 0, Max: 1]
              • N3 (Address Information) [Min: 0, Max: 2]
              • N4 (Geographic Location) [Min: 0, Max: 1]
              • PER (Administrative Communications Contact) [Min: 0, Max: 2]
              • ACT (Account Identification) [Min: 0, Max: 9]
              • DTP (Date or Time or Period) [Min: 0, Max: 9]
              • DMG (Demographic Information) [Min: 0, Max: 1]
              • REF (Reference Identification) [Min: 0, Max: 9]
      • ▶
        AD1Loop1 () [Min: 0, Max: 99]
          • AD1 (Adjustment Amount) M
          • CUR (Currency) [Min: 0, Max: 1]
          • DTP (Date or Time or Period) [Min: 0, Max: 3]
          • QTY (Quantity) [Min: 0, Max: 2]
          • REL (Relationship) [Min: 0, Max: 30]
          • ▶
            NM1Loop4 () [Min: 0, Max: 99]
              • NM1 (Individual or Organizational Name) M
              • N2 (Additional Name Information) [Min: 0, Max: 1]
              • N3 (Address Information) [Min: 0, Max: 2]
              • N4 (Geographic Location) [Min: 0, Max: 1]
              • PER (Administrative Communications Contact) [Min: 0, Max: 2]
              • ACT (Account Identification) [Min: 0, Max: 9]
              • DTP (Date or Time or Period) [Min: 0, Max: 9]
              • DMG (Demographic Information) [Min: 0, Max: 1]
              • REF (Reference Identification) [Min: 0, Max: 9]
  • SE (Transaction Set Trailer) [Min: 0, Max: 1]

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