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$: C:EDIdEvExamplesHIPAA5010cSharpcSharp Gen834X220A1 ...€¦ · C:\EDIdEv\Examples\HIPAA\5010\cSharp\cSharp_Gen834X220A1_SqlClient\frmGen834.cs 2 { //CREATES THE ISA SEGMENT$
1C:\EDIdEv\Examples\HIPAA\5010\cSharp\cSharp_Gen834X220A1_SqlClient\frmGen834.cs

using System;using System.Configuration;using System.Collections.Generic;using System.ComponentModel;using System.Data;using System.Data.SqlClient;using System.Drawing;using System.Text;using System.Windows.Forms;using Edidev.FrameworkEDIx64;

namespace cSharp_Gen834X220A1{ public partial class frmGen834 : Form { public frmGen834() { InitializeComponent(); }

private string sConnection = ConfigurationManager.ConnectionStrings["Development"].ConnectionString;

private void btnGenerate_Click(object sender, EventArgs e) { SqlConnection oConnection = new SqlConnection(sConnection);

ediDocument oEdiDoc = null; ediSchema oSchema = null; ediSchemas oSchemas = null; ediInterchange oInterchange = null; ediGroup oGroup = null; ediTransactionSet oTransactionSet = null; ediDataSegment oSegment = null;

string sSql = ""; string sPath = AppDomain.CurrentDomain.BaseDirectory; string sEdiFile = "834_5010X220A1.X12"; string sSefFile = "834_005010X220A1.SemRef.EVAL0.SEF"; //EVALUATION SEF FILE

//CREATES OEDIDOC OBJECT ediDocument.Set(ref oEdiDoc, new ediDocument());

//THIS MAKES CERTAIN THAT FREDI ONLY USES THE SEF FILE PROVIDED, AND THAT IT DOES //NOT USE ITS BUILT‐IN STANDARD REFERENCE TABLE TO GENERATE THE EDI FILE. ediSchemas.Set(ref oSchemas, (ediSchemas)oEdiDoc.GetSchemas()); oSchemas.EnableStandardReference = false;

//ENABLES FORWARD WRITE, AND INCREASES BUFFER I/O TO IMPROVE PERFORMANCE oEdiDoc.CursorType = DocumentCursorTypeConstants.Cursor_ForwardWrite; oEdiDoc.set_Property(DocumentPropertyIDConstants.Property_DocumentBufferIO, 2000);

//SET TERMINATORS oEdiDoc.SegmentTerminator = "~"; oEdiDoc.ElementTerminator = "*"; oEdiDoc.CompositeTerminator = ":";

//LOADS THE SEF FILE ediSchema.Set(ref oSchema, (ediSchema)oEdiDoc.LoadSchema(sPath + sSefFile , 0));

sSql = "select * from [Interchange]"; SqlDataAdapter oInterchangeAdapter = new SqlDataAdapter(sSql, oConnection); DataSet oInterchangeDs = new DataSet("dsInterchange"); oInterchangeAdapter.Fill(oInterchangeDs, "dsInterchange");

foreach (DataRow oInterchangeRow in oInterchangeDs.Tables["dsInterchange"].Rows)


{ //CREATES THE ISA SEGMENT oInterchange = (ediInterchange)oEdiDoc.CreateInterchange("X", "005010"); oSegment = (ediDataSegment)oInterchange.GetDataSegmentHeader(); oSegment.set_DataElementValue(1, 0, oInterchangeRow["ISA01_AuthorizationInfoQlfr"].ToString

()); //Authorization Information Qualifier oSegment.set_DataElementValue(2, 0, oInterchangeRow["ISA02_AuthorizationInfo"].ToString());

//Authorization Information oSegment.set_DataElementValue(3, 0, oInterchangeRow["ISA03_SecurityInfoQlfr"].ToString());

//Security Information Qualifier oSegment.set_DataElementValue(4, 0, oInterchangeRow["ISA04_SecurityInfo"].ToString());

//Security Information oSegment.set_DataElementValue(5, 0, oInterchangeRow["ISA05_SenderIdQlfr"].ToString());

//Interchange ID Qualifier oSegment.set_DataElementValue(6, 0, oInterchangeRow["ISA06_SenderId"].ToString()); //

Interchange Sender ID oSegment.set_DataElementValue(7, 0, oInterchangeRow["ISA07_ReceiverIdQlfr"].ToString());

//Interchange ID Qualifier oSegment.set_DataElementValue(8, 0, oInterchangeRow["ISA08_ReceiverId"].ToString()); //

Interchange Receiver ID oSegment.set_DataElementValue(9, 0, oInterchangeRow["ISA09_Date"].ToString()); //

Interchange Date oSegment.set_DataElementValue(10, 0, oInterchangeRow["ISA10_Time"].ToString()); //

Interchange Time oSegment.set_DataElementValue(11, 0, oInterchangeRow["ISA11_RepetitionSeparator"].ToString

()); //Repetition Separator oSegment.set_DataElementValue(12, 0, oInterchangeRow["ISA12_ControlVersionNumber"].ToString

()); //Interchange Control Version Number oSegment.set_DataElementValue(13, 0, oInterchangeRow["ISA13_ControlNumber"].ToString());

//Interchange Control Number oSegment.set_DataElementValue(14, 0, oInterchangeRow["ISA14_AcknowledgmentRequested"].

ToString()); //Acknowledgment Requested oSegment.set_DataElementValue(15, 0, oInterchangeRow["ISA15_UsageIndicator"].ToString());

//Usage Indicator oSegment.set_DataElementValue(16, 0, oInterchangeRow["ISA16_ComponentElementSeparator"].

ToString()); //Component Element Separator

sSql = "select * from [FuncGroup] where Interkey = " + oInterchangeRow["Interkey"].ToString();

SqlDataAdapter oGroupAdapter = new SqlDataAdapter(sSql, oConnection); DataSet oGroupDs = new DataSet("dsGroup"); oGroupAdapter.Fill(oGroupDs, "dsGroup");

foreach (DataRow oGroupRow in oGroupDs.Tables["dsGroup"].Rows) { //CREATES THE GS SEGMENT oGroup = (ediGroup)oInterchange.CreateGroup("005010X223A2"); ediDataSegment.Set(ref oSegment, oGroup.GetDataSegmentHeader()); oSegment.set_DataElementValue(1, 0, oGroupRow["GS01_FunctionalIdfrCode"].ToString());

//Functional Identifier Code oSegment.set_DataElementValue(2, 0, oGroupRow["GS02_SendersCode"].ToString()); //

Application Sender//s Code oSegment.set_DataElementValue(3, 0, oGroupRow["GS03_ReceiversCode"].ToString()); //

Application Receiver//s Code oSegment.set_DataElementValue(4, 0, oGroupRow["GS04_Date"].ToString()); //Date oSegment.set_DataElementValue(5, 0, oGroupRow["GS05_Time"].ToString()); //Time oSegment.set_DataElementValue(6, 0, oGroupRow["GS06_GroupControlNumber"].ToString());

//Group Control Number oSegment.set_DataElementValue(7, 0, oGroupRow["GS07_ResponsibleAgencyCode"].ToString())

; //Responsible Agency Code oSegment.set_DataElementValue(8, 0, oGroupRow["GS08_VersionReleaseCode"].ToString());

//Version / Release / Industry Identifier Code

sSql = "select * from [834X220_Header] where Groupkey = " + oGroupRow["Groupkey"].ToString();

SqlDataAdapter oDaHeader = new SqlDataAdapter(sSql, oConnection);


DataSet oHeaderDs = new DataSet("dsHeader"); oDaHeader.Fill(oHeaderDs, "dsHeader");

foreach (DataRow oHeaderRow in oHeaderDs.Tables["dsHeader"].Rows) { //CREATES THE ST SEGMENT ediTransactionSet.Set(ref oTransactionSet, (ediTransactionSet)oGroup.

CreateTransactionSet("834")); ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionSet.

GetDataSegmentHeader()); oSegment.set_DataElementValue(1, 0, oHeaderRow["ST01_TransactionSetIdentifierCode"]

.ToString()); //Transaction Set Identifier Code oSegment.set_DataElementValue(2, 0, oHeaderRow["ST02_TransactionSetControlNumber"].

ToString()); //Transaction Set Control Number oSegment.set_DataElementValue(3, 0, oHeaderRow[

"ST03_ImplementationConventionReference"].ToString()); //Implementation Convention Reference

//BGN ‐ BEGINNING SEGMENT ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionSet.CreateDataSegment

("BGN")); oSegment.set_DataElementValue(1, 0, oHeaderRow["BGN01_TransactionSetPurposeCode"].

ToString()); //Transaction Set Purpose Code oSegment.set_DataElementValue(2, 0, oHeaderRow["BGN02_TransactionSetReferenceNumber

"].ToString()); //Reference Identification oSegment.set_DataElementValue(3, 0, oHeaderRow["BGN03_TransactionSetCreationDate"].

ToString()); //Date oSegment.set_DataElementValue(4, 0, oHeaderRow["BGN04_TransactionSetCreationTime"].

ToString()); //Time oSegment.set_DataElementValue(5, 0, oHeaderRow["BGN05_TimeZoneCode"].ToString());

// Time Code (623) oSegment.set_DataElementValue(6, 0, oHeaderRow[

"BGN06_OriginalTransactionSetReferenceNo"].ToString()); // Reference Identification (127) oSegment.set_DataElementValue(8, 0, oHeaderRow["BGN08_ActionCode"].ToString());

//Action Code

// Transaction Set Policy Number (REF) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment("REF")); oSegment.set_DataElementValue(1, 0,"38"); // Reference Identification

Qualifier (128) oSegment.set_DataElementValue(2, 0, oHeaderRow["REF02_MasterPolicyNumber"].ToString

()); // Reference Identification (127)

// File Effective Dates sSql = "select * from [834X220_FileEffectiveDates] where Headerkey = " + oHeaderRow

["Headerkey"].ToString(); SqlDataAdapter oDaFileEffectiveDates = new SqlDataAdapter(sSql, oConnection); DataSet oFileEffectiveDatesDs = new DataSet("dsFileEffectiveDates"); oDaFileEffectiveDates.Fill(oFileEffectiveDatesDs, "dsFileEffectiveDates");

foreach (DataRow oFileEffectiveDatesRow in oFileEffectiveDatesDs.Tables["dsFileEffectiveDates"].Rows)

{ // File Effective Date (DTP) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment("DTP")); oSegment.set_DataElementValue(1, 0, oFileEffectiveDatesRow["DTP01_DateTimeQlfr"

].ToString()); // Date/Time Qualifier (374) oSegment.set_DataElementValue(2, 0, "D8"); // Date Time Period Format

Qualifier (1250) oSegment.set_DataElementValue(3, 0, oFileEffectiveDatesRow["DTP03_DateTime"].

ToString()); // Date Time Period (1251)

}// foreach oFileEffectiveDatesRow

// Dependent Total (QTY) if (oHeaderRow["QTY02_TransactionSetDependentTotal"].ToString().Trim() != "") {


ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment("QTY")); oSegment.set_DataElementValue(1, 0, "DT"); // Quantity Qualifier (673) oSegment.set_DataElementValue(2, 0, oHeaderRow[

"QTY02_TransactionSetDependentTotal"].ToString()); // Quantity (380)

}

// Employee Total (QTY) if (oHeaderRow["QTY02_TransactionSetEmployeeTotal"].ToString().Trim() != "") { ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment("QTY")); oSegment.set_DataElementValue(1, 0, "ET"); // Quantity Qualifier (673) oSegment.set_DataElementValue(2, 0, oHeaderRow[

"QTY02_TransactionSetEmployeeTotal"].ToString()); // Quantity (380)

}

// Employee Total (QTY) if (oHeaderRow["QTY02_TransactionSetTotal"].ToString().Trim() != "") { ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment("QTY")); oSegment.set_DataElementValue(1, 0, "TO"); // Quantity Qualifier (673) oSegment.set_DataElementValue(2, 0, oHeaderRow["QTY02_TransactionSetTotal"].

ToString()); // Quantity (380)

} //1000A SPONSOR NAME ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionSet.CreateDataSegment

(@"N1\N1")); oSegment.set_DataElementValue(1, 0, "P5"); // Entity Identifier Code (98) oSegment.set_DataElementValue(2, 0, oHeaderRow["N102_PlanSponsorName"].ToString());

/// Name (93) oSegment.set_DataElementValue(3, 0, oHeaderRow["N103_PlanSponsorIdCodeQlfr"].

ToString()); // Identification Code Qualifier (66) oSegment.set_DataElementValue(4, 0, oHeaderRow["N104_PlanSponsorIdCode"].ToString

()); //Identification Code

//1000B PAYER ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionSet.CreateDataSegment

(@"N1\N1")); oSegment.set_DataElementValue(1, 0, "IN"); // Entity Identifier Code (98) oSegment.set_DataElementValue(2, 0, oHeaderRow["N102_PayerInsurerName"].ToString())

; /// Name (93) oSegment.set_DataElementValue(3, 0, oHeaderRow["N103_PayerInsurerIdCodeQlfr"].

ToString()); // Identification Code Qualifier (66) oSegment.set_DataElementValue(4, 0, oHeaderRow["N104_PayerInsurerIdCode"].ToString

()); //Identification Code

//1000C BROKER NAME if (oHeaderRow["N102_BrokerSalesName"].ToString().Trim() != "") { ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionSet.

CreateDataSegment(@"N1\N1")); oSegment.set_DataElementValue(1, 0, "BO"); // Entity Identifier Code (98) oSegment.set_DataElementValue(2, 0, oHeaderRow["N102_BrokerSalesName"].ToString

()); /// Name (93) oSegment.set_DataElementValue(3, 0, oHeaderRow["N103_BrokerSalesIdCodeQlfr"].

ToString()); // Identification Code Qualifier (66) oSegment.set_DataElementValue(4, 0, oHeaderRow["N104_BrokerSalesIdCode"].

ToString()); //Identification Code

//1100C BROKER ACCOUNT INFORMATION ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionSet.

CreateDataSegment("N1\\ACT\\ACT")); oSegment.set_DataElementValue(1, 0, oHeaderRow["ACT01_BrokerSalesAccountNumber"


].ToString()); // Account Number (508) oSegment.set_DataElementValue(6, 0, oHeaderRow["ACT06_BrokerSalesAccountNumber2

"].ToString()); // Account Number (508)

}

//1000C THIRD PARTY ADMIINISTRATOR (TPA) NAME if (oHeaderRow["N102_BrokerSalesName"].ToString().Trim() != "") { ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionSet.

CreateDataSegment(@"N1\N1")); oSegment.set_DataElementValue(1, 0, "TV"); // Entity Identifier Code (98) oSegment.set_DataElementValue(2, 0, oHeaderRow["N102_TPA_Name"].ToString());

/// Name (93) oSegment.set_DataElementValue(3, 0, oHeaderRow["N103_TPA_IdCodeQlfr"].ToString

()); // Identification Code Qualifier (66) oSegment.set_DataElementValue(4, 0, oHeaderRow["N104_TPA_IdCode"].ToString());

//Identification Code

//1100C TPA ACCOUNT INFORMATION ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionSet.

CreateDataSegment("N1\\ACT\\ACT")); oSegment.set_DataElementValue(1, 0, oHeaderRow["ACT01_TPA_AccountNumber"].

ToString()); // Account Number (508) oSegment.set_DataElementValue(6, 0, oHeaderRow["ACT06_TPA_AccountNumber2"].

ToString()); // Account Number (508)

}

//2000 MEMBER LEVEL DETAIL sSql = "select * from [834X220_MemberDetail] where Headerkey = " + oHeaderRow[

"Headerkey"].ToString(); SqlDataAdapter oDaMemberDetail = new SqlDataAdapter(sSql, oConnection); DataSet oDaMemberDetailDs = new DataSet("dsDaMemberDetail"); oDaMemberDetail.Fill(oDaMemberDetailDs, "dsDaMemberDetail");

foreach (DataRow oMemberDetailRow in oDaMemberDetailDs.Tables["dsDaMemberDetail"].Rows)

{ //INS ‐ INSURED BENEFIT ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionSet.

CreateDataSegment(@"INS\INS")); oSegment.set_DataElementValue(1, 0, oMemberDetailRow["INS01_MemberIndicator"].

ToString()); //Yes/No Condition or Response Code oSegment.set_DataElementValue(2, 0, oMemberDetailRow[

"INS02_IndividualRelationshipCode"].ToString()); //Individual Relationship Code oSegment.set_DataElementValue(3, 0, oMemberDetailRow["INS03_MaintenanceTypeCode

"].ToString()); //Maintenance Type Code oSegment.set_DataElementValue(4, 0, oMemberDetailRow[

"INS04_MaintenanceReasonCode"].ToString()); //Maintenance Reason Code oSegment.set_DataElementValue(5, 0, oMemberDetailRow["INS05_BenefitStatusCode"]

.ToString()); //Benefit Status Code oSegment.set_DataElementValue(6, 1, oMemberDetailRow["INS06_01_MedicarePlanCode

"].ToString()); // Medicare Plan Code (1218) oSegment.set_DataElementValue(6, 2, oMemberDetailRow[

"INS06_02_MedicareEligibilityReasonCode"].ToString()); // Eligibility Reason Code (1701) oSegment.set_DataElementValue(7, 0, oMemberDetailRow["INS07_COBRA_Qualify"].

ToString()); // Consolidated Omnibus Budget Reconciliation Act (COBRA) Qualify (1219) oSegment.set_DataElementValue(8, 0, oMemberDetailRow[

"INS08_EmploymentStatusCode"].ToString()); //Employment Status Code oSegment.set_DataElementValue(9, 0, oMemberDetailRow["INS09_StudentStatusCode"]

.ToString()); // Student Status Code (1220) oSegment.set_DataElementValue(10, 0, oMemberDetailRow["INS10_HandicapIndicator"

].ToString()); // Yes/No Condition or Response Code (1073)


if (oMemberDetailRow["INS12_MemberIndividualDeathDate"].ToString().Trim() != "")

{ oSegment.set_DataElementValue(11, 0, "D8"); // Date Time Period

Format Qualifier (1250) oSegment.set_DataElementValue(12, 0, oMemberDetailRow[

"INS12_MemberIndividualDeathDate"].ToString()); // Date Time Period (1251) } oSegment.set_DataElementValue(13, 0, oMemberDetailRow[

"INS13_ConfidentialityCode"].ToString()); // Confidentiality Code (1165) oSegment.set_DataElementValue(17, 0, oMemberDetailRow[

"INS17_BirthSequenceNumber"].ToString()); // Number (1470)

// Subscriber Identifier (REF) ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionSet.

CreateDataSegment(@"INS\REF")); oSegment.set_DataElementValue(1, 0, "0F"); //Reference Identification

Qualifier oSegment.set_DataElementValue(2, 0, oMemberDetailRow["REF02_SubscriberNumber"].

ToString()); //Reference Identification

// Member Group Policy Number (REF) if (oMemberDetailRow["REF02_GroupPolicyNumber"].ToString().Trim() != "") { ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionSet.

CreateDataSegment(@"INS\REF")); oSegment.set_DataElementValue(1, 0, "1L"); //Reference Identification

Qualifier oSegment.set_DataElementValue(2, 0, oMemberDetailRow[

"REF02_GroupPolicyNumber"].ToString()); //Reference Identification

}

// MEMBER SUPPLEMENT ID sSql = "select * from [834X220_MemberSupplementId] where Detailkey = " +

oMemberDetailRow["Detailkey"].ToString(); SqlDataAdapter oDaMemberSupplementId = new SqlDataAdapter(sSql, oConnection); DataSet oMemberSupplementIdDs = new DataSet("dsMemberSupplementId"); oDaMemberSupplementId.Fill(oMemberSupplementIdDs, "dsMemberSupplementId");

foreach (DataRow oMemberSupplementIdRow in oMemberSupplementIdDs.Tables["dsMemberSupplementId"].Rows)

{ //REF ‐ Member Supplemental Identifier ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionSet.

CreateDataSegment(@"INS\REF")); oSegment.set_DataElementValue(1, 0, oMemberSupplementIdRow[

"REF01_ReferenceIdQlfr"].ToString()); //Reference Identification Qualifier oSegment.set_DataElementValue(2, 0, oMemberSupplementIdRow[

"REF02_ReferenceId"].ToString()); //Reference Identification

} //foreach oMemberSupplementIdRow

// MEMBER LEVEL DATES sSql = "select * from [834X220_MemberLevelDates] where Detailkey = " +

oMemberDetailRow["Detailkey"].ToString(); SqlDataAdapter oDaMemberLevelDates = new SqlDataAdapter(sSql, oConnection); DataSet oMemberLevelDatesDs = new DataSet("dsMemberLevelDates"); oDaMemberLevelDates.Fill(oMemberLevelDatesDs, "dsMemberLevelDates");

foreach (DataRow oMemberLevelDatesRow in oMemberLevelDatesDs.Tables["dsMemberLevelDates"].Rows)

{ // Member Level Dates (DTP) ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionSet.


CreateDataSegment(@"INS\DTP")); oSegment.set_DataElementValue(1, 0, oMemberLevelDatesRow[

"DTP01_DateTimeQlfr"].ToString()); //Date/Time Qualifier oSegment.set_DataElementValue(2, 0, "D8"); //Date Time Period Format

Qualifier oSegment.set_DataElementValue(3, 0, oMemberLevelDatesRow["DTP03_DateTime"].

ToString()); //Date Time Period

}// foreach oMemberLevelDatesRow //'2100A MEMBER NAME if (true) { ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionSet.

CreateDataSegment(@"INS\NM1\NM1")); oSegment.set_DataElementValue(1, 0, oMemberDetailRow[

"NM101_MemberEntityIdCode"].ToString()); //Entity Identifier Code oSegment.set_DataElementValue(2, 0, "1"); //Entity Type Qualifier oSegment.set_DataElementValue(3, 0, oMemberDetailRow["NM103_MemberLastName"

].ToString()); //Name Last or Organization Name oSegment.set_DataElementValue(4, 0, oMemberDetailRow["NM104_MemberFirstName

"].ToString()); //Name First oSegment.set_DataElementValue(5, 0, oMemberDetailRow[

"NM105_MemberMiddleName"].ToString()); //Name Middle oSegment.set_DataElementValue(6, 0, oMemberDetailRow[

"NM106_MemberPrefixName"].ToString()); // Name Prefix (1038) oSegment.set_DataElementValue(7, 0, oMemberDetailRow[

"NM107_MemberSuffixtName"].ToString()); // Name Suffix (1039) oSegment.set_DataElementValue(8, 0, oMemberDetailRow[

"NM108_MemberIdCodeQlfr"].ToString()); //Identification Code Qualifier oSegment.set_DataElementValue(9, 0, oMemberDetailRow["NM109_MemberIdCode"].

ToString()); //Identification Code

//PER ‐ Member Communications Numbers ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionSet.

CreateDataSegment(@"INS\NM1\PER")); oSegment.set_DataElementValue(1, 0, "IP"); //Contact Function Code oSegment.set_DataElementValue(3, 0, oMemberDetailRow[

"PER03_MemberInsuredNumberQlfr"].ToString()); //Communication Number Qualifier oSegment.set_DataElementValue(4, 0, oMemberDetailRow[

"PER04_MemberInsuredNumber"].ToString()); //Communication Number oSegment.set_DataElementValue(5, 0, oMemberDetailRow[

"PER05_MemberInsuredNumberQlfr2"].ToString()); //Communication Number Qualifier oSegment.set_DataElementValue(6, 0, oMemberDetailRow[

"PER06_MemberInsuredNumber2"].ToString()); //Communication Number oSegment.set_DataElementValue(5, 0, oMemberDetailRow[

"PER07_MemberInsuredNumberQlfr3"].ToString()); //Communication Number Qualifier oSegment.set_DataElementValue(6, 0, oMemberDetailRow[

"PER08_MemberInsuredNumber3"].ToString()); //Communication Number

//N3 ‐ Member Residence Street Address ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionSet.

CreateDataSegment(@"INS\NM1\N3")); oSegment.set_DataElementValue(1, 0, oMemberDetailRow["N301_MemberAddress"].

ToString()); //Address Information oSegment.set_DataElementValue(2, 0, oMemberDetailRow["N302_MemberAddress2"]

.ToString()); //Address Information

//N4 ‐ Member City, State, ZIP Code ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionSet.

CreateDataSegment(@"INS\NM1\N4")); oSegment.set_DataElementValue(1, 0, oMemberDetailRow["N401_MemberCity"].

ToString()); //City Name oSegment.set_DataElementValue(2, 0, oMemberDetailRow["N402_MemberState"].

ToString()); //State or Province Code


oSegment.set_DataElementValue(3, 0, oMemberDetailRow["N403_MemberZip"].ToString()); //Postal Code

oSegment.set_DataElementValue(4, 0, oMemberDetailRow["N404_MemberCountryCode"].ToString()); // Country Code (26)

oSegment.set_DataElementValue(5, 0, oMemberDetailRow["N405_MemberLocationQlfr"].ToString()); //Location Qualifier

oSegment.set_DataElementValue(6, 0, oMemberDetailRow["N406_MemberLocationId"].ToString()); //Location Identifier

oSegment.set_DataElementValue(7, 0, oMemberDetailRow["N407_MemberCountrySubdivisionCode"].ToString()); // Country Subdivision Code (1715)

//DMG ‐ Member Demographics ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionSet.

CreateDataSegment(@"INS\NM1\DMG")); oSegment.set_DataElementValue(1, 0, "D8"); //Date Time Period Format

Qualifier oSegment.set_DataElementValue(2, 0, oMemberDetailRow["DMG02_MemberBirthDate

"].ToString()); //Date Time Period oSegment.set_DataElementValue(3, 0, oMemberDetailRow[

"DMG03_MemberGenderCode"].ToString()); //Gender Code oSegment.set_DataElementValue(4, 0, oMemberDetailRow[

"DMG04_MemberMaritalStatusCode"].ToString()); // Marital Status Code (1067) oSegment.set_DataElementValue(5, 1, oMemberDetailRow[

"DMG05_01_MemberRaceEthnicityCode"].ToString()); // Race or Ethnicity Code (1109) oSegment.set_DataElementValue(5, 2, "RET"); // Code List Qualifier

Code (1270) oSegment.set_DataElementValue(5, 3, oMemberDetailRow[

"DMG05_03_MemberRaceEthnicityIndustryCode"].ToString()); // Industry Code (1271) oSegment.set_DataElementValue(6, 0, oMemberDetailRow[

"DMG06_MemberCitizenshipStatusCode"].ToString()); // Citizenship Status Code (1066) oSegment.set_DataElementValue(10, 0, "REC"); // Code List Qualifier

Code (1270) oSegment.set_DataElementValue(11, 0, oMemberDetailRow[

"DMG11_MemberRaceEthnicityCollectionCode"].ToString()); // Industry Code (1271)

// Employment Class (EC) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@"INS\

NM1\EC")); oSegment.set_DataElementValue(1, 0, oMemberDetailRow[

"EC01_EmploymentClassCode"].ToString()); // Employment Class Code (1176) oSegment.set_DataElementValue(2, 0, oMemberDetailRow[

"EC02_EmploymentClassCode2"].ToString()); // Employment Class Code (1176) oSegment.set_DataElementValue(3, 0, oMemberDetailRow[

"EC03_EmploymentClassCode3"].ToString()); // Employment Class Code (1176) // Member Income (ICM) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@"INS\

NM1\ICM")); oSegment.set_DataElementValue(1, 0, oMemberDetailRow[

"ICM01_MemberFrequencyCode"].ToString()); // Frequency Code (594) oSegment.set_DataElementValue(2, 0, oMemberDetailRow[

"ICM02_MemberWageAmount"].ToString()); // Monetary Amount (782) oSegment.set_DataElementValue(3, 0, oMemberDetailRow[

"ICM03_MemberWorkHoursCount"].ToString()); // Quantity (380) oSegment.set_DataElementValue(4, 0, oMemberDetailRow[

"ICM04_MemberLocationIdCode"].ToString()); // Location Identifier (310) oSegment.set_DataElementValue(5, 0, oMemberDetailRow[

"ICM05_MemberSalaryGrade"].ToString()); // Salary Grade (1214) // Member Policy Amounts (AMT) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@"INS\

NM1\AMT")); oSegment.set_DataElementValue(1, 0, oMemberDetailRow[

"AMT01_MemberPolicyQlfr"].ToString()); // Amount Qualifier Code (522) oSegment.set_DataElementValue(2, 0, oMemberDetailRow[


"AMT02_MemberPolicyContractAmount"].ToString()); // Monetary Amount (782) // Member Health Information (HLH) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@"INS\

NM1\HLH")); oSegment.set_DataElementValue(1, 0, oMemberDetailRow[

"HLH01_MemberHealthRelatedCode"].ToString()); // Health‐Related Code (1212) oSegment.set_DataElementValue(2, 0, oMemberDetailRow["HLH02_MemberHeight"].

ToString()); // Height (65) oSegment.set_DataElementValue(3, 0, oMemberDetailRow["HLH03_MemberWeight"].

ToString()); // Weight (81) // Member Language (LUI) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@"INS\

NM1\LUI")); oSegment.set_DataElementValue(1, 0, oMemberDetailRow[

"LUI01_MemberLanguageQlfr"].ToString()); // Identification Code Qualifier (66) oSegment.set_DataElementValue(2, 0, oMemberDetailRow[

"LUI02_MemberLanguageCode"].ToString()); // Identification Code (67) oSegment.set_DataElementValue(3, 0, oMemberDetailRow[

"LUI03_MemberLanguageDescription"].ToString()); // Description (352) oSegment.set_DataElementValue(4, 0, oMemberDetailRow[

"LUI04_MemberUseLanguageIndicator"].ToString()); // Use of Language Indicator (1303) }// if Member Name

//2100B INCORRECT MEMBER NAME if (true) { // Incorrect Member Name (NM1) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@"INS\

NM1\NM1")); oSegment.set_DataElementValue(1, 0, "70"); // Entity Identifier Code

(98) oSegment.set_DataElementValue(2, 0, "1"); // Entity Type Qualifier

(1065) oSegment.set_DataElementValue(3, 0, oMemberDetailRow[

"NM103_IncorrectMemberLastName"].ToString()); // Name Last or Organization Name (1035) oSegment.set_DataElementValue(4, 0, oMemberDetailRow[

"NM104_IncorrectMemberFirstName"].ToString()); // Name First (1036) oSegment.set_DataElementValue(5, 0, oMemberDetailRow[

"NM105_IncorrectMemberMiddleName"].ToString()); // Name Middle (1037) oSegment.set_DataElementValue(6, 0, oMemberDetailRow[

"NM106_IncorrectMemberPrefixName"].ToString()); // Name Prefix (1038) oSegment.set_DataElementValue(7, 0, oMemberDetailRow[

"NM107_IncorrectMemberSuffixtName"].ToString()); // Name Suffix (1039) oSegment.set_DataElementValue(8, 0, oMemberDetailRow[

"NM108_IncorrectMemberIdCodeQlfr"].ToString()); // Identification Code Qualifier (66) oSegment.set_DataElementValue(9, 0, oMemberDetailRow[

"NM109_IncorrectMemberIdCode"].ToString()); // Identification Code (67)

// Incorrect Member Demographics (DMG) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@"INS\

NM1\DMG")); oSegment.set_DataElementValue(1, 0, "D8"); // Date Time Period Format

Qualifier (1250) oSegment.set_DataElementValue(2, 0, oMemberDetailRow[

"DMG02_IncorrectMemberBirthDate"].ToString()); // Date Time Period (1251) oSegment.set_DataElementValue(3, 0, oMemberDetailRow[

"DMG03_IncorrectMemberGenderCode"].ToString()); // Gender Code (1068) oSegment.set_DataElementValue(4, 0, oMemberDetailRow[

"DMG04_IncorrectMemberMaritalStatusCode"].ToString()); // Marital Status Code (1067) oSegment.set_DataElementValue(5, 1, oMemberDetailRow[

"DMG05_01_IncorrectMemberRaceEthnicityCode"].ToString()); // Race or Ethnicity Code (1109)


oSegment.set_DataElementValue(5, 2, "RET"); // Code List Qualifier Code (1270)

oSegment.set_DataElementValue(5, 3, oMemberDetailRow["DMG05_03_IncorrectMemberRaceEthnicityIndustryCode"].ToString()); // Industry Code (1271)

oSegment.set_DataElementValue(6, 0, oMemberDetailRow["DMG06_IncorrectMemberCitizenshipStatusCode"].ToString()); // Citizenship Status Code (1066)

oSegment.set_DataElementValue(10, 0, "REC"); // Code List Qualifier Code (1270)

oSegment.set_DataElementValue(11, 0, oMemberDetailRow["DMG11_IncorrectMemberRaceEthnicityCollectionCode"].ToString()); // Industry Code (1271)

}// if Incorrect Member Name

// 2100C MEMBER MAILING ADDRESS if (true) { // Member Mailing Address (NM1) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@"INS\

NM1\NM1")); oSegment.set_DataElementValue(1, 0, "31"); // Entity Identifier Code


(1065) // Member Mail Street Address (N3) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@"INS\

NM1\N3")); oSegment.set_DataElementValue(1, 0, oMemberDetailRow[

"N301_MemberMailAddress"].ToString()); // Address Information (166) oSegment.set_DataElementValue(2, 0, oMemberDetailRow[

"N302_MemberMailAddress2"].ToString()); // Address Information (166)

// Member Mail City, State, ZIP Code (N4) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@"INS\

NM1\N4")); oSegment.set_DataElementValue(1, 0, oMemberDetailRow["N401_MemberMailCity"]

.ToString()); // City Name (19) oSegment.set_DataElementValue(2, 0, oMemberDetailRow["N402_MemberMailState"

].ToString()); // State or Province Code (156) oSegment.set_DataElementValue(3, 0, oMemberDetailRow["N403_MemberMailZip"].

ToString()); // Postal Code (116) oSegment.set_DataElementValue(4, 0, oMemberDetailRow[

"N404_MemberMailCountryCode"].ToString()); // Country Code (26) oSegment.set_DataElementValue(7, 0, oMemberDetailRow[

"N407_MemberMailCountrySubdivisionCode"].ToString()); // Country Subdivision Code (1715)

}// if Mailing Address

// 2100D MEMBER EMPLOYER sSql = "select * from [834X220_MemberEmployerSchool] where

NM101_EntityIdentifierCode = '36' and Detailkey = " + oMemberDetailRow["Detailkey"].ToString(); SqlDataAdapter oDaMemberEmployer = new SqlDataAdapter(sSql, oConnection); DataSet oMemberEmployerDs = new DataSet("dsMemberEmployer"); oDaMemberEmployer.Fill(oMemberEmployerDs, "dsMemberEmployer");

foreach (DataRow oMemberEmployerRow in oMemberEmployerDs.Tables["dsMemberEmployer"].Rows)

{ ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@"INS\

NM1\NM1")); oSegment.set_DataElementValue(1, 0, oMemberEmployerRow[

"NM101_EntityIdentifierCode"].ToString()); // Entity Identifier Code (98) oSegment.set_DataElementValue(2, 0, oMemberEmployerRow[

"NM102_EntityType_Qualifier"].ToString()); // Entity Type Qualifier (1065)


oSegment.set_DataElementValue(3, 0, oMemberEmployerRow["NM103_NameLastOrganizationName"].ToString()); // Name Last or Organization Name (1035)

oSegment.set_DataElementValue(4, 0, oMemberEmployerRow["NM104_NameFirst"].ToString()); // Name First (1036)

oSegment.set_DataElementValue(5, 0, oMemberEmployerRow["NM105_NameMiddle"].ToString()); // Name Middle (1037)

oSegment.set_DataElementValue(6, 0, oMemberEmployerRow["NM106_NamePrefix"].ToString()); // Name Prefix (1038)

oSegment.set_DataElementValue(7, 0, oMemberEmployerRow["NM107_NameSuffix"].ToString()); // Name Suffix (1039)

oSegment.set_DataElementValue(8, 0, oMemberEmployerRow["NM108_IdentificationCodeQlfr"].ToString()); // Identification Code Qualifier (66)

oSegment.set_DataElementValue(9, 0, oMemberEmployerRow["NM109_IdentificationCode"].ToString()); // Identification Code (67)

//Member Employer Communications Numbers (PER) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment("INS\\

NM1\\PER")); oSegment.set_DataElementValue(1, 0, oMemberEmployerRow[

"PER01_Contact_Function_Code"].ToString()); // Contact Function Code (366) oSegment.set_DataElementValue(2, 0, oMemberEmployerRow["PER02_Name"].

ToString()); // Name (93) oSegment.set_DataElementValue(3, 0, oMemberEmployerRow[

"PER03_CommunicationNumberQlfr"].ToString()); // Communication Number Qualifier (365) oSegment.set_DataElementValue(4, 0, oMemberEmployerRow[

"PER04_CommunicationNumber"].ToString()); // Communication Number (364) oSegment.set_DataElementValue(5, 0, oMemberEmployerRow[

"PER05_CommunicationNumberQlfr2"].ToString()); // Communication Number Qualifier (365) oSegment.set_DataElementValue(6, 0, oMemberEmployerRow[

"PER06_CommunicationNumber2"].ToString()); // Communication Number (364) oSegment.set_DataElementValue(7, 0, oMemberEmployerRow[

"PER07_CommunicationNumberQlfr3"].ToString()); // Communication Number Qualifier (365) oSegment.set_DataElementValue(8, 0, oMemberEmployerRow[

"PER08_CommunicationNumber3"].ToString()); // Communication Number (364)

//Member Employer Street Address (N3) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment("INS\\

NM1\\N3")); oSegment.set_DataElementValue(1, 0, oMemberEmployerRow["N301_Address1"].

ToString()); // Address Information (166) oSegment.set_DataElementValue(2, 0, oMemberEmployerRow["N302_Address2"].

ToString()); // Address Information (166)

//Member Employer City, State, ZIP Code ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment("INS\\

NM1\\N4")); oSegment.set_DataElementValue(1, 0, oMemberEmployerRow["N401_City"].

ToString()); // City Name (19) oSegment.set_DataElementValue(2, 0, oMemberEmployerRow["N402_State"].

ToString()); // State or Province Code (156) oSegment.set_DataElementValue(3, 0, oMemberEmployerRow["N403_Zip"].ToString

()); // Postal Code (116) oSegment.set_DataElementValue(4, 0, oMemberEmployerRow["N404_CountryCode"].

ToString()); // Country Code (26) oSegment.set_DataElementValue(7, 0, oMemberEmployerRow[

"N407_CountrySubdivisionCode"].ToString()); // Country Subdivision Code (1715)

}// foreach oMemberEmployerSchoolRow

// 2100E MEMBER SCHOOL sSql = "select * from [834X220_MemberEmployerSchool] where

NM101_EntityIdentifierCode = '36' and Detailkey = " + oMemberDetailRow["Detailkey"].ToString(); SqlDataAdapter oDaMemberSchool = new SqlDataAdapter(sSql, oConnection); DataSet oMemberSchoolDs = new DataSet("dsMemberSchool"); oDaMemberSchool.Fill(oMemberSchoolDs, "dsMemberSchool");


foreach (DataRow oMemberSchoolRow in oMemberSchoolDs.Tables["dsMemberSchool"].Rows)

{ ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@"INS\

NM1\NM1")); oSegment.set_DataElementValue(1, 0, oMemberSchoolRow[

"NM101_EntityIdentifierCode"].ToString()); // Entity Identifier Code (98) oSegment.set_DataElementValue(2, 0, oMemberSchoolRow[

"NM102_EntityType_Qualifier"].ToString()); // Entity Type Qualifier (1065) oSegment.set_DataElementValue(3, 0, oMemberSchoolRow[

"NM103_NameLastOrganizationName"].ToString()); // Name Last or Organization Name (1035) oSegment.set_DataElementValue(4, 0, oMemberSchoolRow["NM104_NameFirst"].

ToString()); // Name First (1036) oSegment.set_DataElementValue(5, 0, oMemberSchoolRow["NM105_NameMiddle"].

ToString()); // Name Middle (1037) oSegment.set_DataElementValue(6, 0, oMemberSchoolRow["NM106_NamePrefix"].

ToString()); // Name Prefix (1038) oSegment.set_DataElementValue(7, 0, oMemberSchoolRow["NM107_NameSuffix"].

ToString()); // Name Suffix (1039) oSegment.set_DataElementValue(8, 0, oMemberSchoolRow[

"NM108_IdentificationCodeQlfr"].ToString()); // Identification Code Qualifier (66) oSegment.set_DataElementValue(9, 0, oMemberSchoolRow[

"NM109_IdentificationCode"].ToString()); // Identification Code (67)

//Member Employer Communications Numbers (PER) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment("INS\\

NM1\\PER")); oSegment.set_DataElementValue(1, 0, oMemberSchoolRow[

"PER01_Contact_Function_Code"].ToString()); // Contact Function Code (366) oSegment.set_DataElementValue(2, 0, oMemberSchoolRow["PER02_Name"].ToString

()); // Name (93) oSegment.set_DataElementValue(3, 0, oMemberSchoolRow[

"PER03_CommunicationNumberQlfr"].ToString()); // Communication Number Qualifier (365) oSegment.set_DataElementValue(4, 0, oMemberSchoolRow[

"PER04_CommunicationNumber"].ToString()); // Communication Number (364) oSegment.set_DataElementValue(5, 0, oMemberSchoolRow[

"PER05_CommunicationNumberQlfr2"].ToString()); // Communication Number Qualifier (365) oSegment.set_DataElementValue(6, 0, oMemberSchoolRow[

"PER06_CommunicationNumber2"].ToString()); // Communication Number (364) oSegment.set_DataElementValue(7, 0, oMemberSchoolRow[

"PER07_CommunicationNumberQlfr3"].ToString()); // Communication Number Qualifier (365) oSegment.set_DataElementValue(8, 0, oMemberSchoolRow[


//Member Employer Street Address (N3) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment("INS\\

NM1\\N3")); oSegment.set_DataElementValue(1, 0, oMemberSchoolRow["N301_Address1"].

ToString()); // Address Information (166) oSegment.set_DataElementValue(2, 0, oMemberSchoolRow["N302_Address2"].

ToString()); // Address Information (166)

//Member Employer City, State, ZIP Code ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment("INS\\

NM1\\N4")); oSegment.set_DataElementValue(1, 0, oMemberSchoolRow["N401_City"].ToString

()); // City Name (19) oSegment.set_DataElementValue(2, 0, oMemberSchoolRow["N402_State"].ToString

()); // State or Province Code (156) oSegment.set_DataElementValue(3, 0, oMemberSchoolRow["N403_Zip"].ToString

()); // Postal Code (116) oSegment.set_DataElementValue(4, 0, oMemberSchoolRow["N404_CountryCode"].

ToString()); // Country Code (26) oSegment.set_DataElementValue(7, 0, oMemberSchoolRow[



}

// 2100F CUSTODIAL PARENT / 2100G RESPONSIBLE PERSON sSql = "select * from [834X220_MemberCustodialResponsiblePerson] where

NM101_EntityIdentifierCode = 'S3' AND Detailkey = " + oMemberDetailRow["Detailkey"].ToString(); SqlDataAdapter oDaMemberCustodialParent = new SqlDataAdapter(sSql, oConnection)

; DataSet oMemberCustodialParentDs = new DataSet("dsMemberCustodialParent"); oDaMemberCustodialParent.Fill(oMemberCustodialParentDs,

"dsMemberCustodialParent");

foreach (DataRow oMemberCustodialParentRow in oMemberCustodialParentDs.Tables["dsMemberCustodialParent"].Rows)

{ // Custodial Parent (NM1) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@"INS\

NM1\NM1")); oSegment.set_DataElementValue(1, 0, oMemberCustodialParentRow[

"NM101_EntityIdentifierCode"].ToString()); // Entity Identifier Code (98) oSegment.set_DataElementValue(2, 0, oMemberCustodialParentRow[

"NM102_EntityType_Qualifier"].ToString()); // Entity Type Qualifier (1065) oSegment.set_DataElementValue(3, 0, oMemberCustodialParentRow[

"NM103_NameLastOrganizationName"].ToString()); // Name Last or Organization Name (1035) oSegment.set_DataElementValue(4, 0, oMemberCustodialParentRow[

"NM104_NameFirst"].ToString()); // Name First (1036) oSegment.set_DataElementValue(5, 0, oMemberCustodialParentRow[

"NM105_NameMiddle"].ToString()); // Name Middle (1037) oSegment.set_DataElementValue(6, 0, oMemberCustodialParentRow[

"NM106_NamePrefix"].ToString()); // Name Prefix (1038) oSegment.set_DataElementValue(7, 0, oMemberCustodialParentRow[

"NM107_NameSuffix"].ToString()); // Name Suffix (1039) oSegment.set_DataElementValue(8, 0, oMemberCustodialParentRow[

"NM108_IdentificationCodeQlfr"].ToString()); // Identification Code Qualifier (66) oSegment.set_DataElementValue(9, 0, oMemberCustodialParentRow[

"NM109_IdentificationCode"].ToString()); // Identification Code (67) // Custodial Parent Communications Numbers (PER) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@"INS\

NM1\PER")); oSegment.set_DataElementValue(1, 0, oMemberCustodialParentRow[

"PER01_Contact_Function_Code"].ToString()); // Contact Function Code (366) oSegment.set_DataElementValue(2, 0, oMemberCustodialParentRow["PER02_Name"]

.ToString()); // Name (93) oSegment.set_DataElementValue(3, 0, oMemberCustodialParentRow[

"PER03_CommunicationNumberQlfr"].ToString()); // Communication Number Qualifier (365) oSegment.set_DataElementValue(4, 0, oMemberCustodialParentRow[

"PER04_CommunicationNumber"].ToString()); // Communication Number (364) oSegment.set_DataElementValue(5, 0, oMemberCustodialParentRow[

"PER05_CommunicationNumberQlfr2"].ToString()); // Communication Number Qualifier (365) oSegment.set_DataElementValue(6, 0, oMemberCustodialParentRow[

"PER06_CommunicationNumber2"].ToString()); // Communication Number (364) oSegment.set_DataElementValue(7, 0, oMemberCustodialParentRow[

"PER07_CommunicationNumberQlfr3"].ToString()); // Communication Number Qualifier (365) oSegment.set_DataElementValue(8, 0, oMemberCustodialParentRow[

"PER08_CommunicationNumber3"].ToString()); // Communication Number (364) // Custodial Parent Street Address (N3) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@"INS\

NM1\N3")); oSegment.set_DataElementValue(1, 0, oMemberCustodialParentRow[

"N301_Address1"].ToString()); // Address Information (166) oSegment.set_DataElementValue(2, 0, oMemberCustodialParentRow[

"N302_Address2"].ToString()); // Address Information (166)


// Custodial Parent City, State, ZIP Code (N4) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@"INS\

NM1\N4")); oSegment.set_DataElementValue(1, 0, oMemberCustodialParentRow["N401_City"].

ToString()); // City Name (19) oSegment.set_DataElementValue(2, 0, oMemberCustodialParentRow["N402_State"]

.ToString()); // State or Province Code (156) oSegment.set_DataElementValue(3, 0, oMemberCustodialParentRow["N403_Zip"].

ToString()); // Postal Code (116) oSegment.set_DataElementValue(4, 0, oMemberCustodialParentRow[

"N404_CountryCode"].ToString()); // Country Code (26) oSegment.set_DataElementValue(7, 0, oMemberCustodialParentRow[


}

// 2100G RESPONSIBLE PERSON sSql = "select * from [834X220_MemberCustodialResponsiblePerson] where

NM101_EntityIdentifierCode <> 'S3' AND Detailkey = " + oMemberDetailRow["Detailkey"].ToString(); SqlDataAdapter oDaMemberResponsiblePerson = new SqlDataAdapter(sSql,

oConnection); DataSet oMemberResponsiblePersonDs = new DataSet("dsMemberResponsiblePerson"); oDaMemberResponsiblePerson.Fill(oMemberResponsiblePersonDs,

"dsMemberResponsiblePerson");

foreach (DataRow oMemberResponsiblePersonRow in oMemberResponsiblePersonDs.Tables["dsMemberResponsiblePerson"].Rows)

{ // Custodial Parent (NM1) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@"INS\

NM1\NM1")); oSegment.set_DataElementValue(1, 0, oMemberResponsiblePersonRow[

"NM101_EntityIdentifierCode"].ToString()); // Entity Identifier Code (98) oSegment.set_DataElementValue(2, 0, oMemberResponsiblePersonRow[

"NM102_EntityType_Qualifier"].ToString()); // Entity Type Qualifier (1065) oSegment.set_DataElementValue(3, 0, oMemberResponsiblePersonRow[

"NM103_NameLastOrganizationName"].ToString()); // Name Last or Organization Name (1035) oSegment.set_DataElementValue(4, 0, oMemberResponsiblePersonRow[

"NM104_NameFirst"].ToString()); // Name First (1036) oSegment.set_DataElementValue(5, 0, oMemberResponsiblePersonRow[

"NM105_NameMiddle"].ToString()); // Name Middle (1037) oSegment.set_DataElementValue(6, 0, oMemberResponsiblePersonRow[

"NM106_NamePrefix"].ToString()); // Name Prefix (1038) oSegment.set_DataElementValue(7, 0, oMemberResponsiblePersonRow[

"NM107_NameSuffix"].ToString()); // Name Suffix (1039) oSegment.set_DataElementValue(8, 0, oMemberResponsiblePersonRow[

"NM108_IdentificationCodeQlfr"].ToString()); // Identification Code Qualifier (66) oSegment.set_DataElementValue(9, 0, oMemberResponsiblePersonRow[

"NM109_IdentificationCode"].ToString()); // Identification Code (67) // Custodial Parent Communications Numbers (PER) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@"INS\

NM1\PER")); oSegment.set_DataElementValue(1, 0, oMemberResponsiblePersonRow[

"PER01_Contact_Function_Code"].ToString()); // Contact Function Code (366) oSegment.set_DataElementValue(2, 0, oMemberResponsiblePersonRow["PER02_Name

"].ToString()); // Name (93) oSegment.set_DataElementValue(3, 0, oMemberResponsiblePersonRow[

"PER03_CommunicationNumberQlfr"].ToString()); // Communication Number Qualifier (365) oSegment.set_DataElementValue(4, 0, oMemberResponsiblePersonRow[

"PER04_CommunicationNumber"].ToString()); // Communication Number (364) oSegment.set_DataElementValue(5, 0, oMemberResponsiblePersonRow[

"PER05_CommunicationNumberQlfr2"].ToString()); // Communication Number Qualifier (365) oSegment.set_DataElementValue(6, 0, oMemberResponsiblePersonRow[



oSegment.set_DataElementValue(7, 0, oMemberResponsiblePersonRow["PER07_CommunicationNumberQlfr3"].ToString()); // Communication Number Qualifier (365)

oSegment.set_DataElementValue(8, 0, oMemberResponsiblePersonRow["PER08_CommunicationNumber3"].ToString()); // Communication Number (364)

// Custodial Parent Street Address (N3) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@"INS\

NM1\N3")); oSegment.set_DataElementValue(1, 0, oMemberResponsiblePersonRow[

"N301_Address1"].ToString()); // Address Information (166) oSegment.set_DataElementValue(2, 0, oMemberResponsiblePersonRow[

"N302_Address2"].ToString()); // Address Information (166)

// Custodial Parent City, State, ZIP Code (N4) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@"INS\

NM1\N4")); oSegment.set_DataElementValue(1, 0, oMemberResponsiblePersonRow["N401_City"

].ToString()); // City Name (19) oSegment.set_DataElementValue(2, 0, oMemberResponsiblePersonRow["N402_State

"].ToString()); // State or Province Code (156) oSegment.set_DataElementValue(3, 0, oMemberResponsiblePersonRow["N403_Zip"]

.ToString()); // Postal Code (116) oSegment.set_DataElementValue(4, 0, oMemberResponsiblePersonRow[

"N404_CountryCode"].ToString()); // Country Code (26) oSegment.set_DataElementValue(7, 0, oMemberResponsiblePersonRow[


}

// 2100H DROP OFF LOCATION if (true) { // Drop Off Location (NM1) oSegment = oTransactionSet.CreateDataSegment(@"INS\NM1\NM1"); oSegment.set_DataElementValue(1, 0, "45"); // Entity Identifier Code


(1065) oSegment.set_DataElementValue(3, 0, oMemberDetailRow[

"NM103_MemberDropOffLocationLastName"].ToString()); // Name Last or Organization Name (1035) oSegment.set_DataElementValue(4, 0, oMemberDetailRow[

"NM104_MemberDropOffLocationFirstName"].ToString()); // Name First (1036) oSegment.set_DataElementValue(5, 0, oMemberDetailRow[

"NM105_MemberDropOffLocationMiddleName"].ToString()); // Name Middle (1037) oSegment.set_DataElementValue(6, 0, oMemberDetailRow[

"NM106_MemberDropOffLocationPrefixName"].ToString()); // Name Prefix (1038) oSegment.set_DataElementValue(7, 0, oMemberDetailRow[

"NM107_MemberDropOffLocationSuffixtName"].ToString()); // Name Suffix (1039) // Drop Off Location Street Address (N3) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@"INS\


"N301_MemberDropOffLocationAddress"].ToString()); // Address Information (166) oSegment.set_DataElementValue(2, 0, oMemberDetailRow[

"N302_MemberDropOffLocationAddress2"].ToString()); // Address Information (166)

// Drop Off Location City, State, ZIP Code (N4) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@"INS\


"N401_MemberDropOffLocationCity"].ToString()); // City Name (19) oSegment.set_DataElementValue(2, 0, oMemberDetailRow[

"N402_MemberDropOffLocationState"].ToString()); // State or Province Code (156) oSegment.set_DataElementValue(3, 0, oMemberDetailRow[


"N403_MemberDropOffLocationZip"].ToString()); // Postal Code (116) oSegment.set_DataElementValue(4, 0, oMemberDetailRow[

"N404_MemberDropOffLocationCountryCode"].ToString()); // Country Code (26) oSegment.set_DataElementValue(7, 0, oMemberDetailRow[

"N407_MemberDropOffLocationCountrySubdivisionCode"].ToString()); // Country Subdivision Code (1715)

}

// 2200 DISABILITY INFORMATION sSql = "select * from [834X220_DisabilityInfo] where Detailkey = " +

oMemberDetailRow["Detailkey"].ToString(); SqlDataAdapter oDaDisabilityInfo = new SqlDataAdapter(sSql, oConnection); DataSet oDisabilityInfoDs = new DataSet("dsDisabilityInfo"); oDaDisabilityInfo.Fill(oDisabilityInfoDs, "dsDisabilityInfo");

foreach (DataRow oDisabilityInfoRow in oDisabilityInfoDs.Tables["dsDisabilityInfo"].Rows)

{ // Disability Information (DSB) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@"INS\

DSB\DSB")); oSegment.set_DataElementValue(1, 0, oDisabilityInfoRow[

"DSB01_DisabilityTypeCode"].ToString()); // Disability Type Code (1146) oSegment.set_DataElementValue(7, 0, oDisabilityInfoRow[

"DSB07_ProductServiceIdQlfr"].ToString()); // Product/Service ID Qualifier (235) oSegment.set_DataElementValue(8, 0, oDisabilityInfoRow[

"DSB08_MedicalCodeValue"].ToString()); // Medical Code Value (1137)

// Initial Disability Period Start if (oDisabilityInfoRow["DTP03_InitialDisabilityStartDate"].ToString().Trim

() != "") { ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@

"INS\DSB\DTP")); oSegment.set_DataElementValue(1, 0, "360"); // Date/Time

Qualifier (374) oSegment.set_DataElementValue(2, 0, "D8"); // Date Time Period

Format Qualifier (1250) oSegment.set_DataElementValue(3, 0, oDisabilityInfoRow[

"DTP03_InitialDisabilityStartDate"].ToString()); // Date Time Period (1251) } // Initial Disability Period End if (oDisabilityInfoRow["DTP03_InitialDisabilityEndDate"].ToString().Trim()

!= "") { ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@

"INS\DSB\DTP")); oSegment.set_DataElementValue(1, 0, "361"); // Date/Time


Format Qualifier (1250) oSegment.set_DataElementValue(3, 0, oDisabilityInfoRow[

"DTP03_InitialDisabilityEndDate"].ToString()); // Date Time Period (1251) } }// foreach oDisabilityInfoRow

// 2300 HEALTH COVERAGE sSql = "select * from [834X220_HealthCoverage] where Detailkey = " +

oMemberDetailRow["Detailkey"].ToString(); SqlDataAdapter oDaHealthCoverage = new SqlDataAdapter(sSql, oConnection); DataSet oHealthCoverageDs = new DataSet("dsHealthCoverage"); oDaHealthCoverage.Fill(oHealthCoverageDs, "dsHealthCoverage");


foreach (DataRow oHealthCoverageRow in oHealthCoverageDs.Tables["dsHealthCoverage"].Rows)

{ // Health Coverage (HD) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@"INS\HD

\HD")); oSegment.set_DataElementValue(1, 0, oHealthCoverageRow[

"HD01_MaintenanceTypeCode"].ToString()); // Maintenance Type Code (875) oSegment.set_DataElementValue(3, 0, oHealthCoverageRow[

"HD03_InsuranceLineCode"].ToString()); // Insurance Line Code (1205) oSegment.set_DataElementValue(4, 0, oHealthCoverageRow[

"HD04_Plan_Coverage_Description"].ToString()); // Plan Coverage Description (1204) oSegment.set_DataElementValue(5, 0, oHealthCoverageRow[

"HD05_CoverageLevelCode"].ToString()); // Coverage Level Code (1207) oSegment.set_DataElementValue(9, 0, oHealthCoverageRow[

"HD09_LateEnrollmentIndicator"].ToString()); // Yes/No Condition or Response Code (1073) // Health Coverage Dates (DTP) // Benefit Begin if (oHealthCoverageRow["DTP03_BenefitBeginDate"].ToString().Trim() != "") { ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@

"INS\HD\DTP")); oSegment.set_DataElementValue(1, 0, "348"); // Date/Time


Format Qualifier (1250) oSegment.set_DataElementValue(3, 0, oHealthCoverageRow[

"DTP03_BenefitBeginDate"].ToString()); // Date Time Period (1251) }

// Benefit End if (oHealthCoverageRow["DTP03_BenefitEndDate"].ToString().Trim() != "") { ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@




"DTP03_BenefitEndDate"].ToString()); // Date Time Period (1251) }

// Enrollment Signature Date if (oHealthCoverageRow["DTP03_EnrollmentSignDate"].ToString().Trim() != "") { ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@




"DTP03_EnrollmentSignDate"].ToString()); // Date Time Period (1251) }

// Last Premium Paid Date if (oHealthCoverageRow["DTP03_LastPremiumPaidDate"].ToString().Trim() !=

"") { ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@


Qualifier (374)


oSegment.set_DataElementValue(2, 0, "D8"); // Date Time Period Format Qualifier (1250)

oSegment.set_DataElementValue(3, 0, oHealthCoverageRow["DTP03_LastPremiumPaidDate"].ToString()); // Date Time Period (1251)

}

// Health Coverage Policy (AMT) // Co‐insurance ‐ Actual if (oHealthCoverageRow["AMT02_CoInsuranceAmount"].ToString().Trim() != "") { ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@

"INS\HD\AMT")); oSegment.set_DataElementValue(1, 0, "B9"); // Amount Qualifier

Code (522) oSegment.set_DataElementValue(2, 0, oHealthCoverageRow[

"AMT02_CoInsuranceAmount"].ToString()); // Monetary Amount (782) }

// Co‐Payment Amount if (oHealthCoverageRow["AMT02_CoPaymentAmount"].ToString().Trim() != "") { ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@

"INS\HD\AMT")); oSegment.set_DataElementValue(1, 0, "C1"); // Amount Qualifier


"AMT02_CoPaymentAmount"].ToString()); // Monetary Amount (782) }

// Deductible Amount if (oHealthCoverageRow["AMT02_DeductibleAmount"].ToString().Trim() != "") { ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@

"INS\HD\AMT")); oSegment.set_DataElementValue(1, 0, "D2"); // Amount Qualifier


"AMT02_DeductibleAmount"].ToString()); // Monetary Amount (782) }

// Premium Amount if (oHealthCoverageRow["AMT02_PremiumAmount"].ToString().Trim() != "") { ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@

"INS\HD\AMT")); oSegment.set_DataElementValue(1, 0, "P3"); // Amount Qualifier


"AMT02_PremiumAmount"].ToString()); // Monetary Amount (782) }

// Spend Down if (oHealthCoverageRow["AMT02_SpenDownAmount"].ToString().Trim() != "") { ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@

"INS\HD\AMT")); oSegment.set_DataElementValue(1, 0, "R"); // Amount Qualifier


"AMT02_SpenDownAmount"].ToString()); // Monetary Amount (782) }

// Health Coverage Policy Number (REF) // Group or Policy Number


if (oHealthCoverageRow["REF02_GroupPolicyNumber"].ToString().Trim() != "") { ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@

"INS\HD\REF")); oSegment.set_DataElementValue(1, 0, "1L"); // Reference

Identification Qualifier (128) oSegment.set_DataElementValue(2, 0, oHealthCoverageRow[

"REF02_GroupPolicyNumber"].ToString()); // Reference Identification (127) }

// Internal Control Number if (oHealthCoverageRow["REF02_InternalControlNumber"].ToString().Trim() !=

"") { ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@

"INS\HD\REF")); oSegment.set_DataElementValue(1, 0, "X9"); // Reference


"REF02_InternalControlNumber"].ToString()); // Reference Identification (127) }

// Issuer Number if (oHealthCoverageRow["REF02_IssuerNumber"].ToString().Trim() != "") { ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@

"INS\HD\REF")); oSegment.set_DataElementValue(1, 0, "XM"); // Reference


"REF02_IssuerNumber"].ToString()); // Reference Identification (127) }

// Prior Coverage Months (REF) // Issuer Number if (oHealthCoverageRow["REF02_PriorCoverageMonthCount"].ToString().Trim() !

= "") { ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@

"INS\HD\REF")); oSegment.set_DataElementValue(1, 0, "QQ"); // Reference


"REF02_PriorCoverageMonthCount"].ToString()); // Reference Identification (127) }

// Identification Card sSql = "select * from [834X220_IdCard] where HealthCoverageKey = " +

oHealthCoverageRow["HealthCoverageKey"].ToString(); SqlDataAdapter oDaIdCard = new SqlDataAdapter(sSql, oConnection); DataSet oIdCardDs = new DataSet("dsIdCard"); oDaIdCard.Fill(oIdCardDs, "dsIdCard");

foreach (DataRow oIdCardRow in oIdCardDs.Tables["dsIdCard"].Rows) { // Identification Card (IDC) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@

"INS\HD\IDC")); oSegment.set_DataElementValue(1, 0, oIdCardRow[

"IDC01_PlanCoverageDescription"].ToString()); // Plan Coverage Description (1204) oSegment.set_DataElementValue(2, 0, oIdCardRow[

"IDC02_IdentificationCardTypeCode"].ToString()); // Identification Card Type Code (1215) oSegment.set_DataElementValue(3, 0, oIdCardRow["IDC03_IdCardCount"].

ToString()); // Quantity (380) oSegment.set_DataElementValue(4, 0, oIdCardRow["IDC04_ActionCode"].


ToString()); // Action Code (306)

}// foreach oIdCardRow

// 2310 PROVIDER INFORMATION sSql = "select * from [834X220_ProviderInfo] where HealthCoverageKey = " +

oHealthCoverageRow["HealthCoverageKey"].ToString(); SqlDataAdapter oDaProviderInfo = new SqlDataAdapter(sSql, oConnection); DataSet oProviderInfoDs = new DataSet("dsProviderInfo"); oDaProviderInfo.Fill(oProviderInfoDs, "dsProviderInfo");

foreach (DataRow oProviderInfoRow in oProviderInfoDs.Tables["dsProviderInfo"].Rows)

{ // Provider Information (LX) oSegment = oTransactionSet.CreateDataSegment(@"INS\HD\LX\LX"); oSegment.set_DataElementValue(1, 0, oProviderInfoRow[

"LX01_Assigned_Number"].ToString()); // Assigned Number (554)

// Provider Name (NM1) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@

"INS\HD\LX\NM1")); oSegment.set_DataElementValue(1, 0, oProviderInfoRow[

"NM101_EntityIdentifierCode"].ToString()); // Entity Identifier Code (98) oSegment.set_DataElementValue(2, 0, oProviderInfoRow[

"NM102_EntityTyp_Qualifier"].ToString()); // Entity Type Qualifier (1065) oSegment.set_DataElementValue(3, 0, oProviderInfoRow[

"NM103_ProvideNameLastOrganization"].ToString()); // Name Last or Organization Name (1035) oSegment.set_DataElementValue(4, 0, oProviderInfoRow[

"NM104_ProvideNameFirst"].ToString()); // Name First (1036) oSegment.set_DataElementValue(5, 0, oProviderInfoRow[

"NM105_ProvideNameMiddle"].ToString()); // Name Middle (1037) oSegment.set_DataElementValue(6, 0, oProviderInfoRow[

"NM106_ProvideNamePrefix"].ToString()); // Name Prefix (1038) oSegment.set_DataElementValue(7, 0, oProviderInfoRow[

"NM107_ProvideNameSuffix"].ToString()); // Name Suffix (1039) oSegment.set_DataElementValue(8, 0, oProviderInfoRow[

"NM108_ProvideIdQlfr"].ToString()); // Identification Code Qualifier (66) oSegment.set_DataElementValue(9, 0, oProviderInfoRow["NM109_ProvideId"]

.ToString()); // Identification Code (67) oSegment.set_DataElementValue(10, 0, oProviderInfoRow[

"NM110_EntityRelationshipCode"].ToString()); // Entity Relationship Code (706) // Provider Address (N3) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@

"INS\HD\LX\N3")); oSegment.set_DataElementValue(1, 0, oProviderInfoRow[

"N301_ProvideAddress"].ToString()); // Address Information (166) oSegment.set_DataElementValue(2, 0, oProviderInfoRow[

"N302_ProvideAddress2"].ToString()); // Address Information (166)

// Provider City, State, ZIP Code (N4) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@

"INS\HD\LX\N4")); oSegment.set_DataElementValue(1, 0, oProviderInfoRow["N401_ProvideCity"

].ToString()); // City Name (19) oSegment.set_DataElementValue(2, 0, oProviderInfoRow["N402_ProvideState

"].ToString()); // State or Province Code (156) oSegment.set_DataElementValue(3, 0, oProviderInfoRow["N403_ProvideZip"]

.ToString()); // Postal Code (116) oSegment.set_DataElementValue(4, 0, oProviderInfoRow[

"N404_ProvideCountryCode"].ToString()); // Country Code (26) oSegment.set_DataElementValue(7, 0, oProviderInfoRow[

"N407_ProvideCountrySubdivisionCode"].ToString()); // Country Subdivision Code (1715)

// Provider Communications Numbers (PER)


int nElemPos = 4; ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@

"INS\HD\LX\PER")); oSegment.set_DataElementValue(1, 0, "IC"); // Contact Function

Code (366)

// Cellular Phone if (oProviderInfoRow["PER0X_ProviderCellPhoneNumber"].ToString().Trim()

!= "") { oSegment.set_DataElementValue(3, 0, "CP"); // Communication

Number Qualifier (365) oSegment.set_DataElementValue(4, 0, oProviderInfoRow[

"PER0X_ProviderCellPhoneNumber"].ToString()); // Communication Number (364) nElemPos = nElemPos + 2; }

// Home Phone Number if (oProviderInfoRow["PER0X_ProviderHomeNumber"].ToString().Trim() !=

"") { oSegment.set_DataElementValue(3, 0, "HP"); // Communication


"PER0X_ProviderHomeNumber"].ToString()); // Communication Number (364) nElemPos = nElemPos + 2; }

// Work Phone Number if (oProviderInfoRow["PER0X_ProviderWorkNumber"].ToString().Trim() !=

"") { oSegment.set_DataElementValue(3, 0, "WP"); // Communication


"PER0X_ProviderWorkNumber"].ToString()); // Communication Number (364) nElemPos = nElemPos + 2; }

// Facsimile if (oProviderInfoRow["PER0X_ProviderFaxNumber"].ToString().Trim() !=

"") { oSegment.set_DataElementValue(3, 0, "FX"); // Communication


"PER0X_ProviderFaxNumber"].ToString()); // Communication Number (364) nElemPos = nElemPos + 2; }

// Electronic Mail if (oProviderInfoRow["PER0X_ProviderEmail"].ToString().Trim() != "") { oSegment.set_DataElementValue(3, 0, "EM"); // Communication


"PER0X_ProviderEmail"].ToString()); // Communication Number (364) nElemPos = nElemPos + 2; }

// Provider Change Reason (PLA) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@

"INS\HD\LX\PLA")); oSegment.set_DataElementValue(1, 0, "2"); // Action Code (306) oSegment.set_DataElementValue(2, 0, "1P"); // Entity Identifier


Code (98) oSegment.set_DataElementValue(3, 0, oProviderInfoRow[

"PLA03_ProviderEffectiveChangeDate"].ToString()); // Date (373) oSegment.set_DataElementValue(5, 0, oProviderInfoRow[

"PLA05_MaintenanceReasonCode"].ToString()); // Maintenance Reason Code (1203)

}//foreach oProviderInfoRow

// 2320 COORDINATION OF BENEFITS sSql = "select * from [834X220_CoordinationBenefits] where

HealthCoverageKey = " + oHealthCoverageRow["HealthCoverageKey"].ToString(); SqlDataAdapter oDaCoordinationBenefits = new SqlDataAdapter(sSql,

oConnection); DataSet oCoordinationBenefitsDs = new DataSet("dsCoordinationBenefits"); oDaCoordinationBenefits.Fill(oCoordinationBenefitsDs,

"dsCoordinationBenefits");

foreach (DataRow oCoordinationBenefitsRow in oCoordinationBenefitsDs.Tables["dsCoordinationBenefits"].Rows)

{ // Coordination of Benefits (COB) oSegment = oTransactionSet.CreateDataSegment(@"INS\HD\COB\COB"); oSegment.set_DataElementValue(1, 0, oCoordinationBenefitsRow[

"COB01_PayerResponsibility_SequenceNumberCode"].ToString()); // Payer Responsibility Sequence Number Code (1138)

oSegment.set_DataElementValue(2, 0, oCoordinationBenefitsRow["COB02_MemberGroupPolicyNo"].ToString()); // Reference Identification (127)

oSegment.set_DataElementValue(3, 0, oCoordinationBenefitsRow["COB03_CoordinationOfBenefitsCode"].ToString()); // Coordination of Benefits Code (1143)

oSegment.set_DataElementValue(4, 0, oCoordinationBenefitsRow["COB04_ServiceTypeCode"].ToString()); // Service Type Code (1365)

// Additional Coordination of Benefits Identifiers (REF) // Account Suffix Code if (oCoordinationBenefitsRow["REF02_AccountSuffixCode"].ToString().Trim

() != "") { ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment

(@"INS\HD\COB\REF")); oSegment.set_DataElementValue(1, 0, "60"); // Reference

Identification Qualifier (128) oSegment.set_DataElementValue(2, 0, oCoordinationBenefitsRow[

"REF02_AccountSuffixCode"].ToString()); // Reference Identification (127) }

// Group Number if (oCoordinationBenefitsRow["REF02_GroupNumber"].ToString().Trim() !=

"") { ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment

(@"INS\HD\COB\REF")); oSegment.set_DataElementValue(1, 0, "6P"); // Reference


"REF02_GroupNumber"].ToString()); // Reference Identification (127) }

// Social Security Number if (oCoordinationBenefitsRow["REF02_SocialSecurityNo"].ToString().Trim

() != "") { ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment

(@"INS\HD\COB\REF")); oSegment.set_DataElementValue(1, 0, "SY"); // Reference



"REF02_SocialSecurityNo"].ToString()); // Reference Identification (127) }

// Coordination of Benefits Eligibility Dates (DTP) // Coordination of Benefits Begin if (oCoordinationBenefitsRow["DTP03_COB_BeginDate"].ToString().Trim() !

= "") { ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment

(@"INS\HD\COB\DTP")); oSegment.set_DataElementValue(1, 0, "344"); // Date/Time


Format Qualifier (1250) oSegment.set_DataElementValue(3, 0, oCoordinationBenefitsRow[

"DTP03_COB_BeginDate"].ToString()); // Date Time Period (1251) }

// Coordination of Benefits End if (oCoordinationBenefitsRow["DTP03_COB_EndDate"].ToString().Trim() !=

"") { ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment

(@"INS\HD\COB\DTP")); oSegment.set_DataElementValue(1, 0, "345"); // Date/Time


Format Qualifier (1250) oSegment.set_DataElementValue(3, 0, oCoordinationBenefitsRow[

"DTP03_COB_EndDate"].ToString()); // Date Time Period (1251) }

// 2330 COORDINATION OF BENEFITS RELATED ENTITY sSql = "select * from [834X220_COB_RelatedEntity] where

CoordinationBenefitsKey = " + oCoordinationBenefitsRow["CoordinationBenefitsKey"].ToString(); SqlDataAdapter oDaCOB_RelatedEntity = new SqlDataAdapter(sSql,

oConnection); DataSet oCOB_RelatedEntityDs = new DataSet("dsCOB_RelatedEntity"); oDaCOB_RelatedEntity.Fill(oCOB_RelatedEntityDs, "dsCOB_RelatedEntity");

foreach (DataRow oCOB_RelatedEntityRow in oCOB_RelatedEntityDs.Tables["dsCOB_RelatedEntity"].Rows)

{ // Coordination of Benefits Related Entity (NM1) oSegment = oTransactionSet.CreateDataSegment(@"INS\HD\COB\NM1\NM1")

; oSegment.set_DataElementValue(1, 0, oCOB_RelatedEntityRow[

"NM101_COB_RelatedEntityIdentifierCode"].ToString()); // Entity Identifier Code (98) oSegment.set_DataElementValue(2, 0, "2"); // Entity Type

Qualifier (1065) oSegment.set_DataElementValue(3, 0, oCOB_RelatedEntityRow[

"NM103_COB_RelatedEntityOrganizationName"].ToString()); // Name Last or Organization Name (1035)

oSegment.set_DataElementValue(8, 0, oCOB_RelatedEntityRow["NM108_COB_RelatedEntityIdQlfr"].ToString()); // Identification Code Qualifier (66)

oSegment.set_DataElementValue(9, 0, oCOB_RelatedEntityRow["NM109_COB_RelatedEntityId"].ToString()); // Identification Code (67)

// Coordination of Benefits Related Entity Address (N3) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment

(@"INS\HD\COB\NM1\N3")); oSegment.set_DataElementValue(1, 0, oCOB_RelatedEntityRow[

"N301_COB_RelatedEntityAddress"].ToString()); // Address Information (166) oSegment.set_DataElementValue(2, 0, oCOB_RelatedEntityRow[


"N302_COB_RelatedEntityAddress2"].ToString()); // Address Information (166)

// Coordination of Benefits Other Insurance Company City, State, ZIP Code (N4)

ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@"INS\HD\COB\NM1\N4"));

oSegment.set_DataElementValue(1, 0, oCOB_RelatedEntityRow["N401_COB_RelatedEntityCity"].ToString()); // City Name (19)

oSegment.set_DataElementValue(2, 0, oCOB_RelatedEntityRow["N402_COB_RelatedEntityState"].ToString()); // State or Province Code (156)

oSegment.set_DataElementValue(3, 0, oCOB_RelatedEntityRow["N403_COB_RelatedEntityZip"].ToString()); // Postal Code (116)

oSegment.set_DataElementValue(4, 0, oCOB_RelatedEntityRow["N404_COB_RelatedEntityCountryCode"].ToString()); // Country Code (26)

oSegment.set_DataElementValue(7, 0, oCOB_RelatedEntityRow["N407_COB_RelatedEntityCountrySubdivisionCode"].ToString()); // Country Subdivision Code (1715)

// Administrative Communications Contact (PER) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment

(@"INS\HD\COB\NM1\PER")); oSegment.set_DataElementValue(1, 0, "CN"); // Contact Function

Code (366) oSegment.set_DataElementValue(3, 0, "TE"); // Communication

Number Qualifier (365) oSegment.set_DataElementValue(4, 0, oCOB_RelatedEntityRow[

"PER04_TelephoneNumber"].ToString()); // Communication Number (364) }// foreach oCOB_RelatedEntityRow

}// foreach oCoordinationBenefitsRow

}// foreach oHealthCoverageRow

// 2700 MEMBER REPORTING CATEGORIES sSql = "select * from [834X220_MemberReportingCategories] where Detailkey = " +

oMemberDetailRow["Detailkey"].ToString(); SqlDataAdapter oDaMemberReportingCategories = new SqlDataAdapter(sSql,

oConnection); DataSet oMemberReportingCategoriesDs = new DataSet("dsMemberReportingCategories

"); oDaMemberReportingCategories.Fill(oMemberReportingCategoriesDs,

"dsMemberReportingCategories");

foreach (DataRow oMemberReportingCategoriesRow in oMemberReportingCategoriesDs.Tables["dsMemberReportingCategories"].Rows)

{ // Member Reporting Categories (LX) oSegment = oTransactionSet.CreateDataSegment(@"INS\LX\LX"); oSegment.set_DataElementValue(1, 0, oMemberReportingCategoriesRow[

"LX01_Assigned_Number"].ToString()); // Assigned Number (554)

// Reporting Category (N1) if (oMemberReportingCategoriesRow["N102_ParticipantName"].ToString().Trim()

!= "") { oSegment = oTransactionSet.CreateDataSegment(@"INS\LX\N1\N1"); oSegment.set_DataElementValue(1, 0, "75"); // Entity Identifier

Code (98) oSegment.set_DataElementValue(2, 0, oMemberReportingCategoriesRow[

"N102_ParticipantName"].ToString()); // Name (93)

// Reporting Category Reference (REF) ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment(@

"INS\LX\N1\REF")); oSegment.set_DataElementValue(1, 0, oMemberReportingCategoriesRow[

"REF01_ParticipantIdQlfr"].ToString()); // Reference Identification Qualifier (128)


oSegment.set_DataElementValue(2, 0, oMemberReportingCategoriesRow["REF02_ParticipantId"].ToString()); // Reference Identification (127)

// Reporting Category Date (DTP) if (oMemberReportingCategoriesRow["DTP03_EfectiveDates"].ToString().

Trim() != "") { ediDataSegment.Set(ref oSegment, oTransactionSet.CreateDataSegment

(@"INS\LX\N1\DTP")); oSegment.set_DataElementValue(1, 0, "007"); // Date/Time

Qualifier (374) oSegment.set_DataElementValue(2, 0, oMemberReportingCategoriesRow[

"DTP02_EfectiveDateFormatQlfr"].ToString()); // Date Time Period Format Qualifier (1250) oSegment.set_DataElementValue(3, 0, oMemberReportingCategoriesRow[

"DTP03_EfectiveDates"].ToString()); // Date Time Period (1251) } } }// foreach oMemberReportingCategoriesRow

}// foreach oMemberDetailRow

}// foreach oHeaderRow

}// foreach oGroupRow

}// foreach oInterchangeRow

//TRAILING SEGMENTS ARE AUTOMATICALLY CREATED WHEN FREDI COMMITS THE EDIDOC OBJECT INTO AN EDI FILE.

MessageBox.Show(oEdiDoc.GetEdiString());

oEdiDoc.Save(sPath + sEdiFile );

//DESTROYS OBJECTS if (oSegment != null) oSegment.Dispose();

if (oTransactionSet != null) oTransactionSet.Dispose();

if (oGroup != null) oGroup.Dispose();

if (oInterchange != null) oInterchange.Dispose();

if (oSchema != null) oSchema.Dispose();

if (oSchemas != null) oSchemas.Dispose();

if (oEdiDoc != null) oEdiDoc.Dispose();

}

private void btnAddDelRec_Click(object sender, EventArgs e) { frmAddRec oAddRec;

oAddRec = new frmAddRec();


oAddRec.Show(); }

private void btnViewTables_Click(object sender, EventArgs e) { frmViewTables ofrmViewTables = new frmViewTables();

ofrmViewTables.Show(); } }}

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