The following is a sample output validation report in XML format containing the XML-formatted HIPAA document, resulting HIPAA formatted data, as well as the validation status.
<?xml version="1.0" encoding="ISO-8859-1" ?>
<documents>
<ValidationReport>
<Report>
<Success/>
</Report>
</ValidationReport>
<input>
<HIPAA270>
<ISA>
<_01_Authorization_Information_Qualifier_>00</_01_Authorization_Information_Qualifier_>
<_02_Authorization_Information_>1234567890</_02_Authorization_Information_>
<_03_Security_Information_Qualifier_>00</_03_Security_Information_Qualifier_>
<_04_Security_Information_>1234567890</_04_Security_Information_>
<_05_Interchange_ID_Qualifier_>ZZ</_05_Interchange_ID_Qualifier_>
<_06_Interchange_Sender_ID_>SUBMITTERS ID12</_06_Interchange_Sender_ID_><_07_Interchange_ID_Qualifier_>ZZ</_07_Interchange_ID_Qualifier_>
<_08_Interchange_Receiver_ID_>RECEIVERS ID123</_08_Interchange_Receiver_ID_>
<_09_Interchange_Date_>010122</_09_Interchange_Date_>
<_10_Interchange_Time_>1253</_10_Interchange_Time_>
<_11_Repetition_Separator_>U</_11_Repetition_Separator_>
<_12_Interchange_Control_Version_Number_>00401</_12_Interchange_Control_Version_Number_>
<_13_Interchange_Control_Number_>000000905</_13_Interchange_Control_Number_>
<_14_Acknowledgement_Requested_>1</_14_Acknowledgement_Requested_>
<_15_Usage_Indicator_>T</_15_Usage_Indicator_>
<_16_Component_Element_Separator_>:</_16_Component_Element_Separator_>
</ISA>
<GS>
<_01_Functional_Identifier_Code_>HS</_01_Functional_Identifier_Code_>
<_02_Application_Senders_Code_>SenderID</_02_Application_Senders_Code_>
<_03_Application_Receivers_Code_>ReceiverID</_03_Application_Receivers_Code_>
<_04_Date_>20010122</_04_Date_>
<_05_Time_>1310</_05_Time_>
<_06_Group_Control_Number_>1</_06_Group_Control_Number_>
<_07_Responsible_Agency_Code_>X</_07_Responsible_Agency_Code_>
<_08_Version__Release__Industry_Identifier_Code_>004010X092A1</_08_Version__Release__
Industry_Identifier_Code_>
</GS>
<_270>
<ST>
<_01_Transaction_Set_Identifier_Code_>270</_01_Transaction_Set_Identifier_Code_>
<_02_Transaction_Set_Control_Number_>1234</_02_Transaction_Set_Control_Number_>
</ST>
<BHT>
<_01_Hierarchical_Structure_Code_>0022</_01_Hierarchical_Structure_Code_>
<_02_Transaction_Set_Purpose_Code_>13</_02_Transaction_Set_Purpose_Code_>
<_03_Reference_Identification_>10001234</_03_Reference_Identification_>
<_04_Date_>19990501</_04_Date_>
<_05_Time_>1319</_05_Time_>
</BHT>
<_2000A>
<HL>
<_01_Hierarchical_ID_Number_>1</_01_Hierarchical_ID_Number_>
<_03_Hierarchical_Level_Code_>20</_03_Hierarchical_Level_Code_>
<_04_Hierarchical_Child_Code_>1</_04_Hierarchical_Child_Code_>
</HL>
<_2100A>
<NM1>
<_01_Entity_Identifier_Code_>PR</_01_Entity_Identifier_Code_>
<_02_Entity_Type_Qualifier_>2</_02_Entity_Type_Qualifier_>
<_03_Name_Last_or_Organization_Name_>ABCCOMPANY</_03_Name_Last_or_Organization_Name_>
<_08_Identification_Code_Qualifier_>PI</_08_Identification_Code_Qualifier_>
<_09_Identification_Code_>842610001</_09_Identification_Code_>
</NM1>
</_2100A>
<_2000B>
<HL>
<_01_Hierarchical_ID_Number_>2</_01_Hierarchical_ID_Number_>
<_02_Hierarchical_Parent_ID_Number_>1</_02_Hierarchical_Parent_ID_Number_>
<_03_Hierarchical_Level_Code_>21</_03_Hierarchical_Level_Code_>
<_04_Hierarchical_Child_Code_>1</_04_Hierarchical_Child_Code_>
</HL>
<_2100B>
<NM1>
<_01_Entity_Identifier_Code_>1P</_01_Entity_Identifier_Code_>
<_02_Entity_Type_Qualifier_>1</_02_Entity_Type_Qualifier_>
<_03_Name_Last_or_Organization_Name_>JONES</_03_Name_Last_or_Organization_Name_>
<_04_Name_First_>MARCUS</_04_Name_First_>
<_08_Identification_Code_Qualifier_>SV</_08_Identification_Code_Qualifier_>
<_09_Identification_Code_>0202034</_09_Identification_Code_>
</NM1>
<REF>
<_01_Reference_Identification_Qualifier_>N5</_01_Reference_Identification_Qualifier_>
<_02_Reference_Identification_>129</_02_Reference_Identification_>
</REF>
<N3>
<_01_Address_Information_>55 HIGH STREET</_01_Address_Information_>
</N3>
<N4>
<_01_City_Name_>SEATTLE</_01_City_Name_>
<_02_State_or_Province_Code_>NY</_02_State_or_Province_Code_>
<_03_Postal_Code_>10121</_03_Postal_Code_>
</N4>
<PER>
<_01_Contact_Function_Code_>IC</_01_Contact_Function_Code_>
<_02_Name_>MARYMURPHY</_02_Name_>
<_03_Communication_Number_Qualifier_>TE</_03_Communication_Number_Qualifier_>
<_04_Communication_Number_>2065551212</_04_Communication_Number_>
<_05_Communication_Number_Qualifier_>EX</_05_Communication_Number_Qualifier_>
<_06_Communication_Number_>3694</_06_Communication_Number_>
<_07_Communication_Number_Qualifier_>FX</_07_Communication_Number_Qualifier_>
<_08_Communication_Number_>2065551214</_08_Communication_Number_>
</PER>
</_2100B>
<_2000C>
<HL>
<_01_Hierarchical_ID_Number_>3</_01_Hierarchical_ID_Number_>
<_02_Hierarchical_Parent_ID_Number_>2</_02_Hierarchical_Parent_ID_Number_>
<_03_Hierarchical_Level_Code_>22</_03_Hierarchical_Level_Code_>
<_04_Hierarchical_Child_Code_>1</_04_Hierarchical_Child_Code_>
</HL>
<_2100C>
<NM1>
<_01_Entity_Identifier_Code_>IL</_01_Entity_Identifier_Code_>
<_02_Entity_Type_Qualifier_>1</_02_Entity_Type_Qualifier_>
<_03_Name_Last_or_Organization_Name_>SMITH</_03_Name_Last_or_Organization_Name_>
<_04_Name_First_>ROBERT</_04_Name_First_>
<_05_Name_Middle_>B</_05_Name_Middle_>
<_08_Identification_Code_Qualifier_>MI</_08_Identification_Code_Qualifier_>
<_09_Identification_Code_>11122333301</_09_Identification_Code_>
</NM1>
<REF>
<_01_Reference_Identification_Qualifier_>1L</_01_Reference_Identification_Qualifier_>
<_02_Reference_Identification_>599119</_02_Reference_Identification_>
</REF>
<N3>
<_01_Address_Information_>29 FREMONT ST</_01_Address_Information_>
<_02_Address_Information_>APT# 1</_02_Address_Information_>
</N3>
<N4>
<_01_City_Name_>PEACE</_01_City_Name_>
<_02_State_or_Province_Code_>NY</_02_State_or_Province_Code_>
<_03_Postal_Code_>10023</_03_Postal_Code_>
</N4>
<DMG>
<_01_Date_Time_Period_Format_Qualifier_>D8</_01_Date_Time_Period_Format_Qualifier_>
<_02_Date_Time_Period_>19430519</_02_Date_Time_Period_>
<_03_Gender_Code_>M</_03_Gender_Code_>
</DMG>
</_2100C>
<_2000D>
<HL>
<_01_Hierarchical_ID_Number_>4</_01_Hierarchical_ID_Number_>
<_02_Hierarchical_Parent_ID_Number_>3</_02_Hierarchical_Parent_ID_Number_>
<_03_Hierarchical_Level_Code_>23</_03_Hierarchical_Level_Code_>
<_04_Hierarchical_Child_Code_>0</_04_Hierarchical_Child_Code_>
</HL>
<TRN>
<_01_Trace_Type_Code_>1</_01_Trace_Type_Code_>
<_02_Reference_Identification_>93175-012547</_02_Reference_Identification_>
<_03_Originating_Company_Identifier_>9877281234</_03_Originating_Company_Identifier_>
<_04_Reference_Identification_>RADIOLOGY</_04_Reference_Identification_>
</TRN>
<_2100D>
<NM1>
<_01_Entity_Identifier_Code_>03</_01_Entity_Identifier_Code_>
<_02_Entity_Type_Qualifier_>1</_02_Entity_Type_Qualifier_>
<_03_Name_Last_or_Organization_Name_>SMITH</_03_Name_Last_or_Organization_Name_>
<_04_Name_First_>MARYLOU</_04_Name_First_>
</NM1>
<REF>
<_01_Reference_Identification_Qualifier_>SY</_01_Reference_Identification_Qualifier_>
<_02_Reference_Identification_>003221234</_02_Reference_Identification_>
</REF>
<N3>
<_01_Address_Information_>29 FREMONT ST</_01_Address_Information_>
<_02_Address_Information_>APT# 1</_02_Address_Information_>
</N3>
<N4>
<_01_City_Name_>PEACE</_01_City_Name_>
<_02_State_or_Province_Code_>NY</_02_State_or_Province_Code_>
<_03_Postal_Code_>10023</_03_Postal_Code_>
</N4>
<DMG>
<_01_Date_Time_Period_Format_Qualifier_>D8</_01_Date_Time_Period_Format_Qualifier_>
<_02_Date_Time_Period_>19781014</_02_Date_Time_Period_>
<_03_Gender_Code_>F</_03_Gender_Code_>
</DMG>
<DTP>
<_01_Date_Time_Qualifier_>472</_01_Date_Time_Qualifier_>
<_02_Date_Time_Period_Format_Qualifier_>D8</_02_Date_Time_Period_Format_Qualifier_>
<_03_Date_Time_Period_>19990501</_03_Date_Time_Period_>
</DTP>
<_2110D>
<EQ>
<_01_Service_Type_Code_>81</_01_Service_Type_Code_>
<_03_Coverage_Level_Code_>FAM</_03_Coverage_Level_Code_>
</EQ>
</_2110D>
</_2100D>
</_2000D>
</_2000C>
</_2000B>
</_2000A>
<SE>
<_01_Number_of_Included_Segments_>26</_01_Number_of_Included_Segments_>
<_02_Transaction_Set_Control_Number_>1234</_02_Transaction_Set_Control_Number_>
</SE>
</_270>
<GE>
<_01_Number_of_Transaction_Sets_Included_>1</_01_Number_of_Transaction_Sets_Included_>
<_02_Group_Control_Number_>1</_02_Group_Control_Number_>
</GE>
<IEA>
<_01_Number_of_Included_Functional_Groups_>1</_01_Number_of_Included_Functional_Groups_>
<_02_Interchange_Control_Number_>000000905</_02_Interchange_Control_Number_>
</IEA>
</HIPAA270>
</input>
<output><![CDATA[ISA*00*1234567890*00*1234567890*ZZ*SUBMITTERS ID12*ZZ*RECEIVERS ID123*010122*1253*U*00401*000000905*1*T*:~GS*HS*
SenderID*ReceiverID*20010122*1310*1*X*004010X092A1~ST*270*1234~BHT*0022*13*10001234*19990501
*1319~HL*1**20*1~NM1*PR*2*ABCCOMPANY*****PI*842610001~HL*2*1*21*1~NM1*1P*1*JONES*
MARCUS****SV*0202034~REF*N5*129~N3*55 HIGH STREET~N4*SEATTLE*NY*10121~PER*IC*MARYMURPHY
*TE*2065551212*EX*3694*FX*2065551214~HL*3*2*22*1~NM1*IL*1*SMITH*ROBERT*B
***MI*11122333301~REF*1L*599119~N3*29 FREMONT ST*APT# 1~N4*PEACE*NY*10023
~DMG*D8*19430519*M~HL*4*3*23*0~TRN*1*93175-012547*9877281234
*RADIOLOGY~NM1*03*1*SMITH*MARYLOU~REF*SY*003221234~N3*29 FREMONT ST*APT# 1~N4*PEACE*
NY*10023~DMG*D8*19781014*F~DTP*472*D8*19990501~EQ*81**FAM~SE*26*1234~GE*1*1~IEA*1*000000905~]]></output>
</documents>| iWay Software |