X12 855 Purchase Order Acknowledgment

X12 Release 4010

Delimiters

• ~ Segment
• | Element
• > Component

ISA Interchange Control Header

Required · Max use 1

ISA-01 · I01 · Authorization Information Qualifier · Required · Identifier (ID)

• 00: No Authorization Information Present (No Meaningful Information in I02)

ISA-02 · I02 · Authorization Information · Required · String (AN) · Min 10 Max 10

ISA-03 · I03 · Security Information Qualifier · Required · Identifier (ID)

• 00: No Security Information Present (No Meaningful Information in I04)

ISA-04 · I04 · Security Information · Required · String (AN) · Min 10 Max 10

ISA-05 · I05 · Interchange ID Qualifier · Required · Identifier (ID) · Min 2 Max 2

Codes

• 01: Duns (Dun & Bradstreet)
• 02: SCAC (Standard Carrier Alpha Code)
• 03: FMC (Federal Maritime Commission)
• 04: IATA (International Air Transport Association)
• 08: UCC EDI Communications ID (Comm ID)
• 09: X.121 (CCITT)
• 10: Department of Defense (DoD) Activity Address Code
• 11: DEA (Drug Enforcement Administration)
• 12: Phone (Telephone Companies)
• 13: UCS Code (The UCS Code is a Code Used for UCS Transmissions; it includes the Area Code and Telephone Number of a Modem; it Does Not Include Punctuation, Blanks or Access Code)
• 14: Duns Plus Suffix
• 15: Petroleum Accountants Society of Canada Company Code
• 16: Duns Number With 4-Character Suffix
• 17: American Bankers Association (ABA) Transit Routing Number (Including Check Digit, 9 Digit)
• 18: Association of American Railroads (AAR) Standard Distribution Code
• 19: EDI Council of Australia (EDICA) Communications ID Number (COMM ID)
• 20: Health Industry Number (HIN)
• 21: Integrated Postsecondary Education Data System, or (IPEDS)
• 22: Federal Interagency Commission on Education, or FICE
• 23: National Center for Education Statistics Common Core of Data 12-Digit Number for Pre-K-Grade 12 Institutes, or NCES
• 24: The College Board's Admission Testing Program 4-Digit Code of Postsecondary Institutes, or ATP
• 25: American College Testing Program 4-Digit Code of Postsecondary Institutions, or ACT
• 26: Statistics of Canada List of Postsecondary Institutions
• 27: Carrier Identification Number as assigned by Health Care Financing Administration (HCFA)
• 28: Fiscal Intermediary Identification Number as assigned by Health Care Financing Administration (HCFA)
• 29: Medicare Provider and Supplier Identification Number as assigned by Health Care Financing Administration (HCFA)
• 30: U.S. Federal Tax Identification Number
• 31: Jurisdiction Identification Number Plus 4 as assigned by the International Association of Industrial Accident Boards and Commissions (IAIABC)
• 32: U.S. Federal Employer Identification Number (FEIN)
• 33: National Association of Insurance Commissioners Company Code (NAIC)
• 34: Medicaid Provider and Supplier Identification Number as assigned by individual State Medicaid Agencies in conjunction with Health Care Financing Administration (HCFA)
• 35: Statistics Canada Canadian College Student Information System Institution Codes
• 36: Statistics Canada University Student Information System Institution Codes
• 37: Society of Property Information Compilers and Analysts
• AM: Association Mexicana del Codigo de Producto (AMECOP) Communication ID
• NR: National Retail Merchants Association (NRMA) - Assigned
• SN: Standard Address Number
• ZZ: Mutually Defined

ISA-06 · I06 · Interchange Sender ID · Required · String (AN) · Min 15 Max 15

ISA-07 · I05 · Interchange ID Qualifier · Required · Identifier (ID) · Min 2 Max 2

Codes

• 01: Duns (Dun & Bradstreet)
• 02: SCAC (Standard Carrier Alpha Code)
• 03: FMC (Federal Maritime Commission)
• 04: IATA (International Air Transport Association)
• 08: UCC EDI Communications ID (Comm ID)
• 09: X.121 (CCITT)
• 10: Department of Defense (DoD) Activity Address Code
• 11: DEA (Drug Enforcement Administration)
• 12: Phone (Telephone Companies)
• 13: UCS Code (The UCS Code is a Code Used for UCS Transmissions; it includes the Area Code and Telephone Number of a Modem; it Does Not Include Punctuation, Blanks or Access Code)
• 14: Duns Plus Suffix
• 15: Petroleum Accountants Society of Canada Company Code
• 16: Duns Number With 4-Character Suffix
• 17: American Bankers Association (ABA) Transit Routing Number (Including Check Digit, 9 Digit)
• 18: Association of American Railroads (AAR) Standard Distribution Code
• 19: EDI Council of Australia (EDICA) Communications ID Number (COMM ID)
• 20: Health Industry Number (HIN)
• 21: Integrated Postsecondary Education Data System, or (IPEDS)
• 22: Federal Interagency Commission on Education, or FICE
• 23: National Center for Education Statistics Common Core of Data 12-Digit Number for Pre-K-Grade 12 Institutes, or NCES
• 24: The College Board's Admission Testing Program 4-Digit Code of Postsecondary Institutes, or ATP
• 25: American College Testing Program 4-Digit Code of Postsecondary Institutions, or ACT
• 26: Statistics of Canada List of Postsecondary Institutions
• 27: Carrier Identification Number as assigned by Health Care Financing Administration (HCFA)
• 28: Fiscal Intermediary Identification Number as assigned by Health Care Financing Administration (HCFA)
• 29: Medicare Provider and Supplier Identification Number as assigned by Health Care Financing Administration (HCFA)
• 30: U.S. Federal Tax Identification Number
• 31: Jurisdiction Identification Number Plus 4 as assigned by the International Association of Industrial Accident Boards and Commissions (IAIABC)
• 32: U.S. Federal Employer Identification Number (FEIN)
• 33: National Association of Insurance Commissioners Company Code (NAIC)
• 34: Medicaid Provider and Supplier Identification Number as assigned by individual State Medicaid Agencies in conjunction with Health Care Financing Administration (HCFA)
• 35: Statistics Canada Canadian College Student Information System Institution Codes
• 36: Statistics Canada University Student Information System Institution Codes
• 37: Society of Property Information Compilers and Analysts
• AM: Association Mexicana del Codigo de Producto (AMECOP) Communication ID
• NR: National Retail Merchants Association (NRMA) - Assigned
• SN: Standard Address Number
• ZZ: Mutually Defined

ISA-08 · I07 · Interchange Receiver ID · Required · String (AN) · Min 15 Max 15

ISA-09 · I08 · Interchange Date · Required · Date (DT) · YYMMDD format

ISA-10 · I09 · Interchange Time · Required · Time (TM) · HHMM format

ISA-11 · I10 · Interchange Control Standards Identifier · Required · Identifier (ID)

• U: U.S. EDI Community of ASC X12, TDCC, and UCS

ISA-12 · I11 · Interchange Control Version Number · Required · Identifier (ID)

• 00401: Draft Standards for Trial Use Approved for Publication by ASC X12 Procedures Review Board through October 1997

ISA-13 · I12 · Interchange Control Number · Required · Numeric (N0) · Min 9 Max 9

ISA-14 · I13 · Acknowledgment Requested · Required · Identifier (ID) · Min 1 Max 1

• 0: No Acknowledgment Requested
• 1: Interchange Acknowledgment Requested

ISA-15 · I14 · Usage Indicator · Required · Identifier (ID) · Min 1 Max 1

• I: Information
• P: Production Data
• T: Test Data

ISA-16 · I15 · Component Element Separator · Required · String (AN) · Min 1 Max 1

• >: Component Element Separator

GS Functional Group Header

Required · Max use 1

GS-01 · 479 · Functional Identifier Code · Required · Identifier (ID)

• PR: Purchase Order Acknowledgement (855)

GS-02 · 142 · Application Sender's Code · Required · String (AN) · Min 2 Max 15

GS-03 · 124 · Application Receiver's Code · Required · String (AN) · Min 2 Max 15

GS-04 · 373 · Date · Required · Date (DT) · CCYYMMDD format

GS-05 · 337 · Time · Required · Time (TM) · HHMM, HHMMSS, HHMMSSD, or HHMMSSDD format

GS-06 · 28 · Group Control Number · Required · Numeric (N0) · Min 1 Max 9

GS-07 · 455 · Responsible Agency Code · Required · Identifier (ID) · Min 1 Max 2

• T: Transportation Data Coordinating Committee (TDCC)
• X: Accredited Standards Committee X12

GS-08 · 480 · Version / Release / Industry Identifier Code · Required · String (AN)

• 004010: Draft Standards Approved for Publication by ASC X12 Procedures Review Board through October 1997

Heading

010 Heading > ST

ST Transaction Set Header

Required · Max use 1

ST-01 · 143 · Transaction Set Identifier Code · Required · Identifier (ID)

• 855: Purchase Order Acknowledgment

ST-02 · 329 · Transaction Set Control Number · Required · Numeric (N) · Min 4 Max 9

020 Heading > BAK

BAK Beginning Segment for Purchase Order Acknowledgment

Required · Max use 1

BAK-01 · 353 · Transaction Set Purpose Code · Required · Identifier (ID)

• 00: Original

BAK-02 · 587 · Acknowledgment Type · Required · Identifier (ID)

• AC: Acknowledge - With Detail and Change
• AD: Acknowledge - With Detail, No Change
• RD: Reject with Detail

BAK-03 · 324 · Purchase Order Number · Required · String (AN) · Min 1 Max 22

BAK-04 · 373 · Date · Required · Date (DT) · CCYYMMDD format

BAK-09 · 373 · Date · Optional · Date (DT) · CCYYMMDD format

150 Heading > DTM

DTM Date/Time Reference

Optional · Max use 10

DTM-01 · 374 · Date/Time Qualifier · Required · Identifier (ID)

• 067: Current Schedule Delivery

DTM-02 · 373 · Date · Required · Date (DT) · CCYYMMDD format

N1 Loop Optional Max 200

300 Heading > N1 Loop > N1

N1 Name

Required · Max use 1

At least one of Name (N1-02) or Identification Code Qualifier (N1-03) is required

If either Identification Code Qualifier (N1-03) or Identification Code (N1-04) is present, then the other is required

N1-01 · 98 · Entity Identifier Code · Required · Identifier (ID) · Min 2 Max 3

N1-02 · 93 · Name · Optional · String (AN) · Min 1 Max 60

N1-03 · 66 · Identification Code Qualifier · Optional · Identifier (ID)

• 1: D-U-N-S Number, Dun & Bradstreet
• 9: D-U-N-S+4, D-U-N-S Number with Four Character Suffix
• 11: Drug Enforcement Administration (DEA)
• 21: Health Industry Number (HIN)
• ZZ: Mutually Defined

N1-04 · 67 · Identification Code · Optional · String (AN) · Min 2 Max 80

Detail

PO1 Loop Optional Max 100000

010 Detail > PO1 Loop > PO1

PO1 Baseline Item Data

Required · Max use 1

If Unit or Basis for Measurement Code (PO1-03) is present, then Quantity Ordered (PO1-02) is required

If either Product/Service ID Qualifier (PO1-06) or Product/Service ID (PO1-07) is present, then the other is required

PO1-01 · 350 · Assigned Identification · Optional · String (AN) · Min 1 Max 20

PO1-02 · 330 · Quantity Ordered · Optional · Decimal number (R) · Min 1 Max 15

PO1-03 · 355 · Unit or Basis for Measurement Code · Optional · Identifier (ID)

• CA: Case
• DE: Deal
• DZ: Dozen
• EA: Each
• PK: Package

PO1-04 · 212 · Unit Price · Optional · Decimal number (R) · Min 1 Max 15

PO1-06 · 235 · Product/Service ID Qualifier · Optional · Identifier (ID)

• ND: National Drug Code (NDC)
• NH: National Health Related Item Code
• UI: U.P.C. Consumer Package Code (1-5-5)
• UN: U.P.C. Case Code Number (1-1-5-5)
• VC: Vendor's (Seller's) Catalog Number

PO1-07 · 234 · Product/Service ID · Optional · String (AN) · Min 1 Max 48

ACK Loop Optional Max 104

270 Detail > PO1 Loop > ACK Loop > ACK

ACK Line Item Acknowledgment

Required · Max use 1

If either Quantity (ACK-02) or Unit or Basis for Measurement Code (ACK-03) is present, then the other is required

If Date/Time Qualifier (ACK-04) is present, then Date (ACK-05) is required

If either Product/Service ID Qualifier (ACK-07) or Product/Service ID (ACK-08) is present, then the other is required

ACK-01 · 668 · Line Item Status Code · Required · Identifier (ID)

• IA: Item Accepted
• IB: Item Backordered
• IR: Item Rejected

ACK-02 · 380 · Quantity · Optional · Decimal number (R) · Min 1 Max 15

ACK-03 · 355 · Unit or Basis for Measurement Code · Optional · Identifier (ID)

• CA: Case
• DE: Deal
• DZ: Dozen
• EA: Each
• PK: Package

ACK-04 · 374 · Date/Time Qualifier · Optional · Identifier (ID)

• 067: Current Schedule Delivery

ACK-05 · 373 · Date · Optional · Date (DT) · CCYYMMDD format

ACK-07 · 235 · Product/Service ID Qualifier · Optional · Identifier (ID)

• LT: Lot Number
• MF: Manufacturer
• N1: National Drug Code in 4-4-2 Format
• N2: National Drug Code in 5-3-2 Format
• N3: National Drug Code in 5-4-1 Format
• N4: National Drug Code in 5-4-2 Format
• N5: National Health Related Item Code in 5-5 Format
• N6: National Health Related Item Code in 4-6 Format
• ND: National Drug Code (NDC)
• NH: National Health Related Item Code
• UA: U.P.C./EAN Case Code (2-5-5)
• UK: U.P.C./EAN Shipping Container Code (1-2-5-5-1)
• UP: U.P.C. Consumer Package Code (1-5-5-1)
• UX: Universal Product Number
• VC: Vendor's (Seller's) Catalog Number

ACK-08 · 234 · Product/Service ID · Optional · String (AN) · Min 1 Max 48

Summary

CTT Loop Optional Max 1

010 Summary > CTT Loop > CTT

CTT Transaction Totals

Required · Max use 1

CTT-01 · 354 · Number of Line Items · Required · Numeric (N0) · Min 1 Max 6

030 Summary > SE

SE Transaction Set Trailer

Required · Max use 1

SE-01 · 96 · Number of Included Segments · Required · Numeric (N0) · Min 1 Max 10

SE-02 · 329 · Transaction Set Control Number · Required · Numeric (N) · Min 4 Max 9

GE Functional Group Trailer

Required · Max use 1

GE-01 · 97 · Number of Transaction Sets Included · Required · Numeric (N0) · Min 1 Max 6

GE-02 · 28 · Group Control Number · Required · Numeric (N0) · Min 1 Max 9

IEA Interchange Control Trailer

Required · Max use 1

IEA-01 · I16 · Number of Included Functional Groups · Required · Numeric (N0) · Min 1 Max 5

IEA-02 · I12 · Interchange Control Number · Required · Numeric (N0) · Min 9 Max 9

EDI Samples

Sample from AmerisourceBergen

ST|855|1001~
BAK|00|AC|ABC12345|20150901|||||20150901~
DTM|067|20150930~
N1|ST|ABC CHICAGO DIVISION|11|RA0322824~
PO1|1|10|CA|72.95||ND|1234567890~
ACK|IA|10|CA|067|20150930||ND|1234567890~
CTT|1~
SE|08|1001