111 Individual Insurance Policy and Client Information
Sample EDI 111 file
Illustrative sample with fictional parties. More EDI sample files
ISA*00* *00* *ZZ*SAMPLESENDER *ZZ*SAMPLERECEIVER *261015*0900*^*00501*000000001*0*T*:~
GS*IF*SAMPLESENDER*SAMPLERECEIVER*20261015*0900*1*X*005010~
ST*111*0001~
BHT*0006*00*PIF2026101500417*20261015*0610~
NM1*IN*2*CASCADE HOLLOW LIFE INSURANCE COMPANY*****93*CHL001~
N3*4120 TALLWATER PARKWAY~
N4*BOISE*ID*83702~
PER*IC*POLICY SERVICES*TE*2085550142*EM*POLICYSERVICES@EXAMPLE.COM~
NM1*AG*2*REDFERN FAMILY FINANCIAL GROUP*****93*AGY48213~
N3*355 SAGECREST AVENUE~
N4*TWIN FALLS*ID*83301~
HL*1**CP*1~
DMG*D8*19780322*F*M~
NM1*IL*1*OKAFOR*TERESA*N***93*CL0058231~
COM*HP*2085550187~
N3*1847 QUILL RIDGE LANE~
N4*MERIDIAN*ID*83646~
HL*2*1*IB*1~
REF*IG*CW40917735~
REF*18*WL100PAR~
SPA*16~
DTP*102*D8*20190614~
DTP*543*D8*20261014~
AMT*QP*312.4~
AMT*H7*14862.35~
PDL*PAC*QP*312.4***4*****DD*14~
NM1*WA*1*DELACROIX*MARCUS****93*AGT77104~
HL*3*2*CV*0~
UDA*NT~
SPA*16~
DTP*007*D8*20190614~
AMT*0U*312.4~
RPA*7*250000~
SE*32*0001~
GE*1*1~
IEA*1*000000001~
Structure
Individual Insurance Policy and Client Information (IF111) contains 2 tables (Heading, Detail), 8 loops, and 50 segments. Sign up free or login to view every table, loop, and element in full, as well as download it in Markdown or console (text) formats.
Heading
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