EDI 837 Key Fields — Data Dictionary

This page documents every column in the “Key Fields” output produced by the Client‑Side EDI 837 converter, including a high‑level EDI segment/element source for each field.

These are the most commonly used claim and service‑line fields for billing, RCM, and analytics.

Download the 837 Key Fields Data Map

CSV/Excel mapping of all Key Fields columns, including 837 source segments. No PHI.

Column Definitions

Applies to Client‑Side EDI 837 “Key Fields” format
Column EDI Source Description
File NameN/A (converter input metadata)Name of the input EDI file.
IDN/A (converter-generated)Stable protected row identifier generated from converter occurrence state; it is not an X12 element or a simple sequential counter.
Transaction TypeST03Exact implementation routing: 005010X222A1 = 837P, 005010X223A2 = 837I, 005010X224A2 = 837D; any other value is reported conservatively as 837.
Record TypeN/A (converter)CLAIM for a claim-level row or LINE for a service-level row. Service rows are emitted before their claim row.
Claim IndexN/A (converter)One-based physical CLM occurrence within the parsed input.
Line IndexN/A (converter)One-based mapped SV1, SV2, or SV3 occurrence within the claim; blank on CLAIM rows.
Transaction Control NumberST02Transaction-set control number from the enclosing ST segment.
Payer Identifier2010BB NM1*PR, NM108/NM109Primary payer identifier, including its source qualifier when present.
Payer Name2010BB NM1*PR, NM103Primary payer name from the primary payer loop.
Billing Provider NPI2010AA NM1*85, NM109 when NM108=XXBilling provider NPI. Other identifier qualifiers are not presented as an NPI.
Billing Provider Name2010AA NM1*85, NM103-NM105Billing provider organization or person name.
Rendering Provider NPI2420/2310 supported rendering loop, NM109 when NM108=XXService rendering NPI takes precedence on LINE rows; otherwise the supported claim rendering NPI is used. Other identifiers are not promoted to NPI.
Rendering Provider Name2420/2310 supported rendering loop, NM103-NM105Service rendering name takes precedence on LINE rows; otherwise the supported claim rendering name is used.
Subscriber Identifier2010BA NM1*IL, NM108/NM109Primary subscriber/member identifier, including its source qualifier when present.
Subscriber Last Name2010BA NM1*IL, NM103Primary subscriber last name.
Subscriber First Name2010BA NM1*IL, NM104Primary subscriber first name.
Patient Last Name2010CA NM1*QC, NM103Dependent patient last name. Blank when no 2010CA dependent-patient loop exists; subscriber data is not substituted.
Patient First Name2010CA NM1*QC, NM104Dependent patient first name. Blank when no 2010CA dependent-patient loop exists; subscriber data is not substituted.
Claim ID2300 CLM01Submitter's claim/patient control number.
Claim Charge Amount2300 CLM02Claim total billed amount as sent.
Statement Date From2300 DTP*434, DTP03 (D8 or RD8 start)Statement-period start date. RD8 ranges are split into start and end values.
Statement Date To2300 DTP*434, DTP03 (RD8 end; D8 repeats)Statement-period end derived from the same DTP*434 value. The legacy internal field name mentions 435, but no DTP*435 is read.
Place Of Service Facility Code2300 CLM05-1Facility type/place-of-service component from the CLM05 composite.
Claim Frequency Type Code2300 CLM05-3Claim frequency component from the CLM05 composite.
Institutional Type Of BillDerived from CLM05-1 and CLM05-3Convenience value formed from mapped facility and frequency components; it is not a separate X12 element or an exhaustive institutional guide interpretation.
Prior Authorization Number2300 REF02; first REF01=G1, then X4First supported claim prior-authorization/referral reference.
Medical Record Number2300 REF02; first REF01=EA, then MRFirst supported claim medical-record reference.
Line Control Number2400 REF02; first REF01=6R, then FJFirst supported service-line control reference. LX01 is not presented in this field.
Line Service Date From2400 DTP*472, DTP03 (D8 or RD8 start)Actual service date or start of the actual-service range; blank when DTP*472 is absent.
Line Service Date To2400 DTP*472, DTP03 (RD8 end; D8 repeats)End of the actual-service range; for D8 the single date is repeated; blank when DTP*472 is absent.
Line Procedure Qualifier837P SV101-1Professional product/service ID qualifier. Blank for institutional and dental rows because those qualifier columns are not declared in the public layout.
Line Procedure Code837P SV101-2; 837I SV202-2; 837D SV301-2Subtype-specific procedure code. Institutional and dental parsing also accepts component 1 as a compatibility fallback when a qualifier is omitted.
Line Modifier1837P SV101-3Professional procedure modifier 1; blank for 837I and 837D.
Line Modifier2837P SV101-4Professional procedure modifier 2; blank for 837I and 837D.
Line Modifier3837P SV101-5Professional procedure modifier 3; blank for 837I and 837D.
Line Modifier4837P SV101-6Professional procedure modifier 4; blank for 837I and 837D.
Line Diag Pointer1837P SV107-1Professional diagnosis pointer 1; blank for 837I and 837D.
Line Diag Pointer2837P SV107-2Professional diagnosis pointer 2; blank for 837I and 837D.
Line Diag Pointer3837P SV107-3Professional diagnosis pointer 3; blank for 837I and 837D.
Line Diag Pointer4837P SV107-4Professional diagnosis pointer 4; blank for 837I and 837D.
Line Place Of Service837P SV105Professional line place-of-service code; blank for 837I and 837D.
Line Revenue Code837I SV201Institutional revenue code; blank for 837P and 837D.
Line Charge Amount837P SV102; 837I SV203; 837D SV302Subtype-specific service-line billed amount.
Line Unit Count837P SV104; 837I SV205; 837D SV306Subtype-specific service-line units or quantity.
Line Remark Code12400 NTE02, occurrence 1Text from the first service-level NTE. K3 data is not mapped into this field.
Line Remark Code22400 NTE02, occurrence 2Text from the second service-level NTE. K3 data is not mapped into this field.
Line Remark Code32400 NTE02, occurrence 3Text from the third service-level NTE. K3 data is not mapped into this field.

Notes

  • Supported routing: 005010X222A1 (837P), 005010X223A2 (837I), and 005010X224A2 (837D). Other ST03 values are labeled generic 837 and expose shared claim context without subtype service mapping.
  • Row model: one LINE row per mapped SV1, SV2, or SV3, followed by its CLAIM row. A blank field can mean the source element was absent or that the column belongs to another subtype.
  • Aggregation: claim, subscriber, payer, and provider context can repeat on LINE and CLAIM rows. Use Record Type and the Summary view when aggregating claim or service amounts.
  • Scope: payer, subscriber, dependent patient, provider, claim, and service values are taken only from their documented loop. Subscriber data is not substituted for an absent 2010CA patient loop.
  • Boundaries: 2410 drug identification/pricing, PWK, CRC, CN1, and K3 are not currently mapped in Smart Mapping. Use Raw output when those source segments must be retained.
  • Privacy: when de-identification is enabled, it protects mapped Key/All, editor, and download surfaces. Raw Mode intentionally retains the original EDI.
  • Key Fields is a curated 47-column convenience view, not an implementation-guide concept or a claim that every permitted X12 element is mapped.
Looking for the full layout? See the EDI 837 All Fields data dictionary.