# EDI 835 Remittance Advice (ERA) Parser, Viewer & Format Guide
> High-speed ANSI 835 ERA parser extracting payer payments, deductible/coinsurance CAS adjustments, CARC/RARC codes, and PLB provider adjustments in sub-3ms.

- **Canonical URL:** https://stanzaapi.com/tools/x12-parser/transaction/835-remittance-advice
- **Governing Standard:** ANSI ASC X12 Standards (005010) (Accredited Standards Committee X12 / HIPAA 5010)
- **Latency:** <3ms Edge
- **Privacy:** In-memory execution only (zero data stored or logged)

## Technical Overview & Governing Rules
The ANSI X12 835 (5010X221A1) is the federal HIPAA standard for Electronic Remittance Advice (ERA), providing payment, denial, and claim adjudication data from commercial payers and Medicare to healthcare providers.

Financial Envelope: Parses BPR financial information including payment method (ACH, Check, Wire), total remittance amount, routing/EFT trace numbers (TRN), and effective transaction date.

Claim Level Adjudication: Extracts Claim Payment Information (CLP) with claim status codes (1=Primary, 2=Secondary, 4=Denial), billed vs paid totals, patient liability, and Claim Adjustment (CAS) segments containing Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC).

Provider Level Adjustments: Resolves PLB segments including capitation withholdings, interest payments, overpayment recoveries, and forward balances.

## Specification Matrix
| Segment | Description | Key Elements Extracted | Usage |
| --- | --- | --- | --- |
| ISA | Interchange Control Header | ISA05-ISA08 (sender/receiver), ISA11 (repetition separator), ISA16 (element separator) | Delimiters & interchange envelope |
| GS | Functional Group Header | GS01 (HP), GS08 (005010X221A1) | Insurance functional group |
| ST | Transaction Set Header | ST01 (835), ST02 (control number) | Transaction start |
| BPR | Financial Information | BPR01 (Trans Code: I), BPR02 (Total Paid), BPR04 (Payment Method: ACH/CHK) | Check/EFT header |
| TRN | Reassociation Trace Number | TRN02 (Check/EFT Trace #), TRN03 (Payer Tax ID) | Bank reconciliation |
| N1 / N3 / N4 | Party Identification & Address | N101 (PR payer, PE payee), N102 (name) | Payer and payee identification |
| REF / DTM | Reference & Date/Time | REF02 (payer ID), DTM02 (production date) | Supplementary identifiers |
| LX | Transaction Set Line Number | Loop 2000 provider grouping | Provider-level grouping |
| CLP | Claim Payment Information | CLP01 (Claim ID), CLP02 (Status: 1=Primary, 2=Secondary, 4=Denial), CLP03 (Billed), CLP04 (Paid) | Loop 2100 claim reconciliation |
| CAS | Claim Adjustment | CAS01 (Group: CO/PR/OA/PI/CR), CAS02 (CARC Code), CAS03 (Adjustment Amount) | Patient liability & write-offs |
| NM1 | Individual or Organizational Name | NM1*QC (patient), NM1*82 (rendering provider) | Claim-level party names |
| SVC | Service Payment Information | SVC01 (procedure code), SVC02 (charge), SVC03 (paid) | Loop 2110 service line detail |
| PLB | Provider Level Adjustment | PLB01 (Provider ID), PLB03-1 (Reason Code: WO/CS/FB), PLB04 (Amount) | Withholding & balance forward |
| SE | Transaction Set Trailer | SE01 (segment count), SE02 (control number) | Transaction close |

## Standard JSON Response Model
```json
{
  "transactionSet": "835",
  "payment": {
    "paymentMethod": "ACH",
    "totalPaidAmount": 1250,
    "checkTraceNumber": "EFT20268899",
    "paymentDate": "20260828"
  },
  "payer": {
    "name": "BLUE CROSS BLUE SHIELD",
    "id": "BCBS01"
  },
  "claims": [
    {
      "patientControlNumber": "CLM2026-001",
      "claimStatusCode": "1",
      "totalClaimChargeAmount": 245,
      "claimPaymentAmount": 180,
      "patientResponsibilityAmount": 20,
      "adjustments": [
        {
          "groupCode": "CO",
          "reasonCode": "45",
          "amount": 45
        },
        {
          "groupCode": "PR",
          "reasonCode": "1",
          "amount": 20
        }
      ]
    }
  ]
}
```

## Frequently Asked Questions & Edge Cases
### Q: What adjustment group codes are parsed?
**A:** All standard HIPAA group codes: CO (Contractual Obligation), PR (Patient Responsibility), OA (Other Adjustments), PI (Payer Initiated), and CR (Correction).

### Q: Does this extract Provider Level Adjustments (PLB)?
**A:** Yes. PLB segments (capitation withholdings, interest payments, overpayment recoveries) are parsed with respective internal reason codes.

### Q: What are the EDI 835 balancing rules?
**A:** At claim level, the billed amount (CLP03) equals the paid amount (CLP04) plus patient responsibility and all CAS adjustment amounts. At service level, the SVC02 charge equals SVC03 paid plus its CAS adjustments. PLB adjustments apply after claim balancing and can make the net payment differ from the BPR02 total.

### Q: What does the CLP02 claim status code mean in an 835?
**A:** CLP02 reports the claim status: 1 = processed as primary, 2 = processed as secondary, 3 = processed as tertiary, 4 = denied, and 22 = reversal of a previous payment.