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Version: v0.1.11

Quickstart

This page gives you a first useful result: read an 835 remittance advice (the electronic EOB) and pull out the money (the payment header, each claim's charge/paid/patient-responsibility split, and the CARC adjustment reasons) in a few lines. The 835 is the document an integration is most often handed first, so it is the quickest way to see what the library does.

The reader is lenient (vendor quirks become stable-coded warnings, never silent failures) and money is decimal-exact throughout (X12Decimal, BigInt-backed; never parseFloat an EDI amount).

Every interchange below is synthetic: fabricated names, invented ids, made-up control numbers. X12 healthcare data is PHI; a fixture must never hold a real one.

Parse an 835 and read the money​

parseX12 decodes the interchange; get835(delimiters, tx) walks an 835 transaction set into a typed X12Remittance (or returns undefined if the transaction set is not an 835).

import { parseX12, get835 } from "@cosyte/x12";

const raw = `ISA*00*          *00*          *ZZ*MEDICARE       *ZZ*SUBMITTER      *260601*1200*^*00501*000000001*0*P*:~
GS*HP*MEDICARE*SUBMITTER*20260601*1200*1*X*005010X221A1~
ST*835*0001~
BPR*I*450.00*C*ACH*CCP*01*123456789*DA*987654321*1512345678**01*111111111*DA*222222222*20260601~
TRN*1*0012345*1512345678~
DTM*405*20260601~
N1*PR*MEDICARE PART A~
N3*123 PAYER WAY~
N4*BALTIMORE*MD*21244~
PER*BL*JANE COORDINATOR*TE*5551234567~
N1*PE*SAMPLE CLINIC INC~
N3*456 PROVIDER LN~
N4*CLEVELAND*OH*44113~
REF*TJ*123456789~
LX*1~
CLP*PT-ACCT-001*1*500.00*450.00*50.00*MC*PAYER-CLAIM-001*11*1~
NM1*QC*1*PATIENT*TEST*A***MI*MEMBER001~
NM1*82*2*RENDERING PROVIDER INC*****XX*1234567890~
DTM*232*20260501~
DTM*233*20260501~
SVC*HC:99213*500.00*450.00**1~
DTM*472*20260501~
CAS*PR*1*50.00~
REF*6R*LINE-CTRL-001~
SE*23*0001~
GE*1*1~
IEA*1*000000001~`;

const ix = parseX12(raw);
const tx = ix.groups[0]?.transactions.find((t) => t.st.elements[1] === "835");
const remit = tx ? get835(ix.delimiters, tx) : undefined;
if (remit === undefined) throw new Error("not an 835");

// Payment header: the money-movement primitive.
remit.payment.totalActualPayment?.toString(); // => "450.00"
remit.payment.creditDebitFlag; // => "C"
remit.payment.method; // => "ACH"
remit.traces[0]?.referenceId; // => "0012345"

// Per claim: your account number echoed back, and the charge/paid/responsibility split.
const claim = remit.claims[0];
claim?.patientControlNumber; // => "PT-ACCT-001"
claim?.totalChargeAmount?.toString(); // => "500.00"
claim?.totalPaymentAmount?.toString(); // => "450.00"
claim?.patientResponsibilityAmount?.toString(); // => "50.00"

// Per service line: the CARC adjustment. Group code is the safety-critical field.
const line = claim?.serviceLines[0];
line?.productServiceId; // => "99213"
const adj = line?.adjustments[0];
adj?.groupCode; // => "PR"
adj?.reasonCode; // => "1"
adj?.amount?.toString(); // => "50.00"

The groupCode (PR = patient responsibility, CO = contractual obligation, …) is what tells you who owes the money. Never infer it, read it. The reasonDescription on each adjustment is prefilled from the bundled CARC snapshot when the code is recognized; an unrecognized code is preserved verbatim and raises X12_UNKNOWN_CARC (the value is never dropped).

Respect the balance warning​

The reader runs the 835 implementation guide's balance equations (005010X221A1, section 1.10.2) and emits X12_835_REMIT_BALANCE_MISMATCH on a mismatch. It never silently rebalances. Gate on two codes, not one: where a term of an equation is undefined the equation cannot be run at all and you get X12_835_BALANCE_NOT_EVALUABLE instead, which is a document you must not post automatically either. Through 0.0.12 that case collapsed to zero and raised the mismatch, so a gate written against the mismatch alone stops firing on it when you upgrade.

import { parseX12, get835, WARNING_CODES } from "@cosyte/x12";

const raw =
  "ISA*00*          *00*          *ZZ*MEDPAY         *ZZ*CLINIC001      " +
  "*260601*1200*^*00501*000000001*0*P*:~" +
  "GS*HP*MEDPAY*CLINIC001*20260601*1200*1*X*005010X221A1~" +
  "ST*835*0001~" +
  "BPR*I*450.00*C*ACH*CCP*01*021000021*DA*1234567*1512345678**01*021000021*DA*98765*20260601~" +
  "TRN*1*0012345*1512345678~" +
  "N1*PR*MEDICARE PART A~" +
  "N1*PE*SAMPLE CLINIC INC*XX*1234567890~" +
  "LX*1~" +
  "CLP*PT-ACCT-001*1*500.00*450.00*50.00*MB*CLAIMREF001*11~" +
  "NM1*QC*1*PATIENT*TEST****MI*MEMBER001~" +
  "SVC*HC:99213*500.00*450.00~" +
  "CAS*PR*1*50.00~" +
  "SE*11*0001~GE*1*1~IEA*1*000000001~";

const ix = parseX12(raw);
const tx = ix.groups[0]?.transactions.find((t) => t.st.elements[1] === "835");
const remit = get835(ix.delimiters, tx!)!;

const doNotPost = remit.warnings.some(
  (w) =>
    w.code === WARNING_CODES.X12_835_REMIT_BALANCE_MISMATCH ||
    w.code === WARNING_CODES.X12_835_BALANCE_NOT_EVALUABLE,
);
doNotPost; // => false

if (doNotPost) {
  // Do NOT auto-post. Route to a human: either the payer's numbers don't add
  // up, or an amount one of the equations needs did not decode at all.
}

Unrecoverable input throws: everything else is a warning​

Only four structurally unrecoverable conditions throw a typed X12ParseError (empty input, no ISA header, a truncated ISA, or unrecoverable delimiters). Vendor quirks never throw; they collect on .warnings:

import { parseX12 } from "@cosyte/x12";

// Not an X12 interchange at all: a structural fatal, not a tolerated quirk.
parseX12("this is not an X12 interchange"); // throws X12ParseError (X12_NO_ISA_HEADER)

Next​

Every TypeScript sample on these pages is run by the package's test suite against the built package, and its // => values are checked, so a sample cannot drift from the code.