AT&T
/
Consolidated Service Invoice/Statement
  • Specification
  • EDI Inspector
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X12 811 Consolidated Service Invoice/Statement

X12 Release 4010

This Draft Standard for Trial Use contains the format and establishes the data contents of the Consolidated Service Invoice/Statement Transaction Set (811) for use within the context of an Electronic Data Interchange (EDI) environment.
This transaction set provides for the billing or reporting of complex and structured service invoice/statement detail.

This standard can be used by organizations who are interested in sending or receiving either consolidated or standalone invoices for service arrangements which require processing other than that done for the typical product invoice.

The Consolidated Service Invoice/Statement can be used as a credit/debit memo to differentiate between payable invoice items and information-only memo items.
This transaction set should not be used as a standalone notification of a credit/debit adjustment.

Delimiters
  • ~ Segment
  • * Element
  • > Component
EDI samples
  • None included
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Overview
ISA
-
Interchange Control Header
Max use 1
Required
GS
-
Functional Group Header
Max use 1
Required
heading
ST
010
Transaction Set Header
Max use 1
Required
BIG
020
Beginning Segment for Invoice
Max use 1
Required
REF
050
Reference Identification
Max use 1
Optional
ITD
070
Terms of Sale/Deferred Terms of Sale
Max use 5
Optional
DTM
080
Date/Time Reference
Max use 10
Optional
N1 Loop
detail
HL Loop
HL
010
Hierarchical Level
Max use 1
Required
HL Loop
HL
010
Hierarchical Level
Max use 1
Required
GE
-
Functional Group Trailer
Max use 1
Required
IEA
-
Interchange Control Trailer
Max use 1
Required
ISA

Interchange Control Header

RequiredMax use 1

To start and identify an interchange of zero or more functional groups and interchange-related control segments

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

Code to identify the type of information in the Authorization Information

00
No Authorization Information Present (No Meaningful Information in I02)
ISA-02
I02
Authorization Information
Required
String (AN)
Min 10Max 10

Information used for additional identification or authorization of the interchange sender or the data in the interchange; the type of information is set by the Authorization Information Qualifier (I01)

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

Code to identify the type of information in the Security Information

00
No Security Information Present (No Meaningful Information in I04)
ISA-04
I04
Security Information
Required
String (AN)
Min 10Max 10

This is used for identifying the security information about the interchange sender or the data in the interchange; the type of information is set by the Security Information Qualifier (I03)

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

Qualifier to designate the system/method of code structure used to designate the sender or receiver ID element being qualified

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

Identification code published by the sender for other parties to use as the receiver ID to route data to them; the sender always codes this value in the sender ID element

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

Qualifier to designate the system/method of code structure used to designate the sender or receiver ID element being qualified

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

Identification code published by the receiver of the data; When sending, it is used by the sender as their sending ID, thus other parties sending to them will use this as a receiving ID to route data to them

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

Date of the interchange

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

Time of the interchange

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

Code to identify the agency responsible for the control standard used by the message that is enclosed by the interchange header and trailer

U
U.S. EDI Community of ASC X12, TDCC, and UCS
ISA-12
I11
Interchange Control Version Number
Required
Identifier (ID)

This version number covers the interchange control segments

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 9Max 9

A control number assigned by the interchange sender

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

Code sent by the sender to request an interchange acknowledgment (TA1)

0
No Acknowledgment Requested
1
Interchange Acknowledgment Requested
ISA-15
I14
Usage Indicator
Required
Identifier (ID)
Min 1Max 1

Code to indicate whether data enclosed by this interchange envelope is test, production or information

I
Information
P
Production Data
T
Test Data
ISA-16
I15
Component Element Separator
Required
String (AN)
Min 1Max 1

Type is not applicable; the component element separator is a delimiter and not a data element; this field provides the delimiter used to separate component data elements within a composite data structure; this value must be different than the data element separator and the segment terminator

>
Component Element Separator

Functional Group Header

RequiredMax use 1

To indicate the beginning of a functional group and to provide control information

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

Code identifying a group of application related transaction sets

CI
Consolidated Service Invoice/Statement (811)
GS-02
142
Application Sender's Code
Required
String (AN)
Min 2Max 15

Code identifying party sending transmission; codes agreed to by trading partners

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

Code identifying party receiving transmission. Codes agreed to by trading partners

Required
Date (DT)
CCYYMMDD format

Date expressed as CCYYMMDD

Required
Time (TM)
HHMM, HHMMSS, HHMMSSD, or HHMMSSDD format

Time expressed in 24-hour clock time as follows: HHMM, or HHMMSS, or HHMMSSD, or HHMMSSDD, where H = hours (00-23), M = minutes (00-59), S = integer seconds (00-59) and DD = decimal seconds; decimal seconds are expressed as follows: D = tenths (0-9) and DD = hundredths (00-99)

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

Assigned number originated and maintained by the sender

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

Code used in conjunction with Data Element 480 to identify the issuer of the standard

T
Transportation Data Coordinating Committee (TDCC)
X
Accredited Standards Committee X12
GS-08
480
Version / Release / Industry Identifier Code
Required
String (AN)

Code indicating the version, release, subrelease, and industry identifier of the EDI standard being used, including the GS and GE segments; if code in DE455 in GS segment is X, then in DE 480 positions 1-3 are the version number; positions 4-6 are the release and subrelease, level of the version; and positions 7-12 are the industry or trade association identifiers (optionally assigned by user); if code in DE455 in GS segment is T, then other formats are allowed

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

Heading

ST
010
Heading > ST

Transaction Set Header

RequiredMax use 1

To indicate the start of a transaction set and to assign a control number

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

Code uniquely identifying a Transaction Set

  • The transaction set identifier (ST01) used by the translation routines of the interchange partners to select the appropriate transaction set definition (e.g., 810 selects the Invoice Transaction Set).
811
Consolidated Service Invoice/Statement
ST-02
329
Transaction Set Control Number
Required
Numeric (N)
Min 4Max 9

Identifying control number that must be unique within the transaction set functional group assigned by the originator for a transaction set

BIG
020
Heading > BIG

Beginning Segment for Invoice

RequiredMax use 1

To indicate the beginning of an invoice transaction set and transmit identifying numbers and dates

Example
Required
Date (DT)
CCYYMMDD format

Date expressed as CCYYMMDD

  • BIG01 is the invoice issue date.
BIG-02
76
Invoice Number
Required
String (AN)
Min 1Max 22

Identifying number assigned by issuer

BIG-07
640
Transaction Type Code
Optional
Identifier (ID)
Min 2Max 2

Code specifying the type of transaction

  • BIG07 is used only to further define the type of invoice when needed.
REF
050
Heading > REF

Reference Identification

OptionalMax use >1

To specify identifying information

Example
REF-01
128
Reference Identification Qualifier
Required
Identifier (ID)

Code qualifying the Reference Identification

IK
Invoice Number
IT
Internal Customer Number
REF-02
127
Reference Identification
Required
String (AN)
Min 1Max 30

Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier

ITD
070
Heading > ITD

Terms of Sale/Deferred Terms of Sale

OptionalMax use 5

To specify terms of sale

Example
ITD-06
446
Terms Net Due Date
Required
Date (DT)
CCYYMMDD format

Date when total invoice amount becomes due expressed in format CCYYMMDD

DTM
080
Heading > DTM

Date/Time Reference

OptionalMax use 10

To specify pertinent dates and times

Example
DTM-01
374
Date/Time Qualifier
Required
Identifier (ID)
Min 3Max 3

Code specifying type of date or time, or both date and time

Optional
Date (DT)
CCYYMMDD format

Date expressed as CCYYMMDD

N1 Loop
OptionalMax >1
N1
100
Heading > N1 Loop > N1

Name

RequiredMax use 1

To identify a party by type of organization, name, and code

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

Code identifying an organizational entity, a physical location, property or an individual

Optional
String (AN)
Min 1Max 60

Free-form name

N3
120
Heading > N1 Loop > N3

Address Information

OptionalMax use 2

To specify the location of the named party

Example
N3-01
166
Address Information
Required
String (AN)
Min 1Max 55

Address information

N3-02
166
Address Information
Optional
String (AN)
Min 1Max 55

Address information

N4
130
Heading > N1 Loop > N4

Geographic Location

OptionalMax use 1

To specify the geographic place of the named party

Example
N4-01
19
City Name
Optional
String (AN)
Min 2Max 30

Free-form text for city name

  • A combination of either N401 through N404, or N405 and N406 may be adequate to specify a location.
N4-02
156
State or Province Code
Optional
Identifier (ID)
Min 2Max 2

Code (Standard State/Province) as defined by appropriate government agency

  • N402 is required only if city name (N401) is in the U.S. or Canada.
N4-03
116
Postal Code
Optional
Identifier (ID)
Min 3Max 15

Code defining international postal zone code excluding punctuation and blanks (zip code for United States)

N4-04
26
Country Code
Optional
Identifier (ID)
Min 2Max 3

Code identifying the country

N1 Loop end
Heading end

Detail

HL Loop
OptionalMax >1
HL
010
Detail > HL Loop > HL

Hierarchical Level

RequiredMax use 1

To identify dependencies among and the content of hierarchically related groups of data segments

  • Valid codes for HL03 to define levels for this transaction set are given below:
    1 - Service/Billing Provider (Identifies the Company Providing the Service/Billing)
    2 - Billing Arrangement (Identifies a Specific Billing Arrangement)
    3 - Sub-billing Arrangement (Identifies a More Detailed Billing Arrangement)
    4 - Group (Identifies a Group of Charges on the Bill)
    5 - Category (Identifies the Subdivision of the Group)
    6 - Subcategory (Identifies a Further Breakdown of the Category)
    7 - Type (Identifies a Further Breakdown of the Subcategory)
    8 - Charge Detail (Identifies the Lowest Level of Charges within a Billing Arrangement)
    9 - Line Detail (Identifies the Supporting Detail Associated with the Charge or Group Level)
    They must be used in the (hierarchical) order in which they are listed; however, certain levels are optional and may be omitted. At least one occurrence each of the service/billing provider level and group level is required.
Example
HL-01
628
Hierarchical ID Number
Required
String (AN)
Min 1Max 12

A unique number assigned by the sender to identify a particular data segment in a hierarchical structure

  • HL01 shall contain a unique alphanumeric number for each occurrence of the HL segment in the transaction set. For example, HL01 could be used to indicate the number of occurrences of the HL segment, in which case the value of HL01 would be "1" for the initial HL segment and would be incremented by one in each subsequent HL segment within the transaction.
HL-03
735
Hierarchical Level Code
Required
Identifier (ID)

Code defining the characteristic of a level in a hierarchical structure

  • HL03 indicates the context of the series of segments following the current HL segment up to the next occurrence of an HL segment in the transaction. For example, HL03 is used to indicate that subsequent segments in the HL loop form a logical grouping of data referring to shipment, order, or item-level information.
1
Service/Billing Provider
HL-04
736
Hierarchical Child Code
Optional
Identifier (ID)

Code indicating if there are hierarchical child data segments subordinate to the level being described

  • HL04 indicates whether or not there are subordinate (or child) HL segments related to the current HL segment.
0
No Subordinate HL Segment in This Hierarchical Structure.
1
Additional Subordinate HL Data Segment in This Hierarchical Structure.
LX Loop
OptionalMax >1
LX
020
Detail > HL Loop > LX Loop > LX

Assigned Number

RequiredMax use 1

To reference a line number in a transaction set

Example
LX-01
554
Assigned Number
Required
Numeric (N0)
Min 1Max 6

Number assigned for differentiation within a transaction set

PID
040
Detail > HL Loop > LX Loop > PID

Product/Item Description

OptionalMax use 200

To describe a product or process in coded or free-form format

Example
If Product Description Code (PID-04) is present, then Agency Qualifier Code (PID-03) is required
At least one of Product Description Code (PID-04) or Description (PID-05) is required
PID-01
349
Item Description Type
Required
Identifier (ID)
Min 1Max 1

Code indicating the format of a description

  • If PID01 equals "F", then PID05 is used. If PID01 equals "S", then PID04 is used. If PID01 equals "X", then both PID04 and PID05 are used.
PID-02
750
Product/Process Characteristic Code
Optional
Identifier (ID)
Min 2Max 3

Code identifying the general class of a product or process characteristic

PID-03
559
Agency Qualifier Code
Optional
Identifier (ID)
Min 2Max 2

Code identifying the agency assigning the code values

  • Use PID03 to indicate the organization that publishes the code list being referred to.
PID-04
751
Product Description Code
Optional
String (AN)
Min 1Max 12

A code from an industry code list which provides specific data about a product characteristic

  • PID04 should be used for industry-specific product description codes.
PID-05
352
Description
Optional
String (AN)
Min 1Max 80

A free-form description to clarify the related data elements and their content

REF
050
Detail > HL Loop > LX Loop > REF

Reference Identification

OptionalMax use >1

To specify identifying information

Example
REF-01
128
Reference Identification Qualifier
Required
Identifier (ID)

Code qualifying the Reference Identification

ZZ
Mutually Defined
REF-02
127
Reference Identification
Required
String (AN)
Min 1Max 30

Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier

REF-03
352
Description
Optional
String (AN)
Min 1Max 80

A free-form description to clarify the related data elements and their content

QTY Loop
OptionalMax >1
QTY
090
Detail > HL Loop > LX Loop > QTY Loop > QTY

Quantity

RequiredMax use 1

To specify quantity information

Example
QTY-01
673
Quantity Qualifier
Required
Identifier (ID)
Min 2Max 2

Code specifying the type of quantity

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

Numeric value of quantity

QTY-03
C001
Composite Unit of Measure
OptionalMax use 1
To identify a composite unit of measure (See Figures Appendix for examples of use)
C001-01
355
Unit or Basis for Measurement Code
Required
Identifier (ID)
Min 2Max 2

Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken

QTY Loop end
LX Loop end
HL Loop
OptionalMax >1
HL
010
Detail > HL Loop > HL Loop > HL

Hierarchical Level

RequiredMax use 1

To identify dependencies among and the content of hierarchically related groups of data segments

  • Valid codes for HL03 to define levels for this transaction set are given below:
    1 - Service/Billing Provider (Identifies the Company Providing the Service/Billing)
    2 - Billing Arrangement (Identifies a Specific Billing Arrangement)
    3 - Sub-billing Arrangement (Identifies a More Detailed Billing Arrangement)
    4 - Group (Identifies a Group of Charges on the Bill)
    5 - Category (Identifies the Subdivision of the Group)
    6 - Subcategory (Identifies a Further Breakdown of the Category)
    7 - Type (Identifies a Further Breakdown of the Subcategory)
    8 - Charge Detail (Identifies the Lowest Level of Charges within a Billing Arrangement)
    9 - Line Detail (Identifies the Supporting Detail Associated with the Charge or Group Level)
    They must be used in the (hierarchical) order in which they are listed; however, certain levels are optional and may be omitted. At least one occurrence each of the service/billing provider level and group level is required.
Example
HL-01
628
Hierarchical ID Number
Required
String (AN)
Min 1Max 12

A unique number assigned by the sender to identify a particular data segment in a hierarchical structure

  • HL01 shall contain a unique alphanumeric number for each occurrence of the HL segment in the transaction set. For example, HL01 could be used to indicate the number of occurrences of the HL segment, in which case the value of HL01 would be "1" for the initial HL segment and would be incremented by one in each subsequent HL segment within the transaction.
HL-02
734
Hierarchical Parent ID Number
Required
String (AN)
Min 1Max 12

Identification number of the next higher hierarchical data segment that the data segment being described is subordinate to

  • HL02 identifies the hierarchical ID number of the HL segment to which the current HL segment is subordinate.
HL-03
735
Hierarchical Level Code
Required
Identifier (ID)

Code defining the characteristic of a level in a hierarchical structure

  • HL03 indicates the context of the series of segments following the current HL segment up to the next occurrence of an HL segment in the transaction. For example, HL03 is used to indicate that subsequent segments in the HL loop form a logical grouping of data referring to shipment, order, or item-level information.
2
Billing Arrangement
HL-04
736
Hierarchical Child Code
Optional
Identifier (ID)

Code indicating if there are hierarchical child data segments subordinate to the level being described

  • HL04 indicates whether or not there are subordinate (or child) HL segments related to the current HL segment.
0
No Subordinate HL Segment in This Hierarchical Structure.
1
Additional Subordinate HL Data Segment in This Hierarchical Structure.
LX Loop
OptionalMax >1
LX
020
Detail > HL Loop > HL Loop > LX Loop > LX

Assigned Number

RequiredMax use 1

To reference a line number in a transaction set

Example
LX-01
554
Assigned Number
Required
Numeric (N0)
Min 1Max 6

Number assigned for differentiation within a transaction set

SI
030
Detail > HL Loop > HL Loop > LX Loop > SI

Service Characteristic Identification

OptionalMax use 8

To specify service characteristic data

Example
SI-01
559
Agency Qualifier Code
Required
Identifier (ID)
Min 2Max 2

Code identifying the agency assigning the code values

  • SI01 defines the source for each of the service characteristics qualifiers.
SI-02
1000
Service Characteristics Qualifier
Required
String (AN)
Min 2Max 2

Code from an industry code list qualifying the type of service characteristics

SI-03
234
Product/Service ID
Required
String (AN)
Min 1Max 48

Identifying number for a product or service

PID
040
Detail > HL Loop > HL Loop > LX Loop > PID

Product/Item Description

OptionalMax use 200

To describe a product or process in coded or free-form format

Example
If Product Description Code (PID-04) is present, then Agency Qualifier Code (PID-03) is required
At least one of Product Description Code (PID-04) or Description (PID-05) is required
PID-01
349
Item Description Type
Required
Identifier (ID)
Min 1Max 1

Code indicating the format of a description

  • If PID01 equals "F", then PID05 is used. If PID01 equals "S", then PID04 is used. If PID01 equals "X", then both PID04 and PID05 are used.
PID-03
559
Agency Qualifier Code
Optional
Identifier (ID)
Min 2Max 2

Code identifying the agency assigning the code values

  • Use PID03 to indicate the organization that publishes the code list being referred to.
PID-04
751
Product Description Code
Optional
String (AN)
Min 1Max 12

A code from an industry code list which provides specific data about a product characteristic

  • PID04 should be used for industry-specific product description codes.
PID-05
352
Description
Optional
String (AN)
Min 1Max 80

A free-form description to clarify the related data elements and their content

AMT
060
Detail > HL Loop > HL Loop > LX Loop > AMT

Monetary Amount

OptionalMax use 5

To indicate the total monetary amount

Example
AMT-01
522
Amount Qualifier Code
Required
Identifier (ID)
Min 1Max 3

Code to qualify amount

AMT-02
782
Monetary Amount
Required
Decimal number (R)
Min 1Max 15

Monetary amount

DTM
070
Detail > HL Loop > HL Loop > LX Loop > DTM

Date/Time Reference

OptionalMax use 8

To specify pertinent dates and times

Example
DTM-01
374
Date/Time Qualifier
Required
Identifier (ID)
Min 3Max 3

Code specifying type of date or time, or both date and time

Optional
Date (DT)
CCYYMMDD format

Date expressed as CCYYMMDD

TXI
080
Detail > HL Loop > HL Loop > LX Loop > TXI

Tax Information

OptionalMax use >1

To specify tax information

Example
TXI-01
963
Tax Type Code
Required
Identifier (ID)
Min 2Max 2

Code specifying the type of tax

TXI-02
782
Monetary Amount
Optional
Decimal number (R)
Min 1Max 15

Monetary amount

  • TXI02 is the monetary amount of the tax.
TXI-07
662
Relationship Code
Optional
Identifier (ID)
Min 1Max 1

Code indicating the relationship between entities

  • TXI07 is a code indicating the relationship of the price or amount to the associated segment.
LX Loop end
NM1 Loop
OptionalMax >1
NM1
110
Detail > HL Loop > HL Loop > NM1 Loop > NM1

Individual or Organizational Name

RequiredMax use 1

To supply the full name of an individual or organizational entity

  • When used for telecommunications billing, the service/billing provider level is defined by the NM1 loop.
Example
If either Identification Code Qualifier (NM1-08) or Identification Code (NM1-09) is present, then the other is required
NM1-01
98
Entity Identifier Code
Required
Identifier (ID)
Min 2Max 3

Code identifying an organizational entity, a physical location, property or an individual

NM1-02
1065
Entity Type Qualifier
Required
Identifier (ID)
Min 1Max 1

Code qualifying the type of entity

  • NM102 qualifies NM103.
NM1-03
1035
Name Last or Organization Name
Optional
String (AN)
Min 1Max 35

Individual last name or organizational name

NM1-08
66
Identification Code Qualifier
Optional
Identifier (ID)
Min 1Max 2

Code designating the system/method of code structure used for Identification Code (67)

NM1-09
67
Identification Code
Optional
String (AN)
Min 2Max 80

Code identifying a party or other code

REF
150
Detail > HL Loop > HL Loop > NM1 Loop > REF

Reference Identification

OptionalMax use >1

To specify identifying information

Example
REF-01
128
Reference Identification Qualifier
Required
Identifier (ID)
Min 2Max 3

Code qualifying the Reference Identification

REF-02
127
Reference Identification
Optional
String (AN)
Min 1Max 30

Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier

NM1 Loop end
ITA Loop
OptionalMax >1
ITA
180
Detail > HL Loop > HL Loop > ITA Loop > ITA

Allowance, Charge or Service

RequiredMax use 1

To specify allowances, charges, or services

Example
If either Quantity (ITA-10) or Unit or Basis for Measurement Code (ITA-11) is present, then the other is required
ITA-01
248
Allowance or Charge Indicator
Required
Identifier (ID)
Min 1Max 1

Code which indicates an allowance or charge for the service specified

  • If ITA01 equals "A" - allowance or "C" - charge, then at least one of ITA06, ITA07, or ITA08 must be present.
ITA-02
559
Agency Qualifier Code
Optional
Identifier (ID)
Min 2Max 2

Code identifying the agency assigning the code values

  • ITA02 identifies the source of the code value in ITA03 or ITA15.
ITA-04
331
Allowance or Charge Method of Handling Code
Required
Identifier (ID)
Min 2Max 2

Code indicating method of handling for an allowance or charge

ITA-07
360
Allowance or Charge Total Amount
Optional
Numeric (N2)
Min 1Max 15

Total dollar amount for the allowance or charge

  • If ITA07 is present with either ITA06 or ITA08, then ITA07 takes precedence.
ITA-08
378
Allowance/Charge Percent Qualifier
Optional
Identifier (ID)
Min 1Max 1

Code indicating on what basis allowance or charge percent is calculated

ITA-10
380
Quantity
Optional
Decimal number (R)
Min 1Max 15

Numeric value of quantity

  • ITA10 is the quantity basis when the allowance or charge quantity is different from the purchase order or invoice quantity.
ITA-11
355
Unit or Basis for Measurement Code
Optional
Identifier (ID)
Min 2Max 2

Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken

ITA-13
352
Description
Optional
String (AN)
Min 1Max 80

A free-form description to clarify the related data elements and their content

  • ITA13 is used to clarify the allowance, charge, or service.
ITA-14
150
Special Charge or Allowance Code
Optional
Identifier (ID)
Min 3Max 3

Code identifying type of special charge or allowance

ITA-16
662
Relationship Code
Optional
Identifier (ID)
Min 1Max 1

Code indicating the relationship between entities

  • ITA16 describes the relationship of ITA06, ITA07 or ITA09 to an associated segment.
ITA Loop end
HL Loop Group
OptionalMax >1
Variants (all may be used)
HL Loop Sub Billing Arrangement
HL
010
Detail > HL Loop > HL Loop > HL Loop Group > HL

Hierarchical Level

RequiredMax use 1

To identify dependencies among and the content of hierarchically related groups of data segments

  • Valid codes for HL03 to define levels for this transaction set are given below:
    1 - Service/Billing Provider (Identifies the Company Providing the Service/Billing)
    2 - Billing Arrangement (Identifies a Specific Billing Arrangement)
    3 - Sub-billing Arrangement (Identifies a More Detailed Billing Arrangement)
    4 - Group (Identifies a Group of Charges on the Bill)
    5 - Category (Identifies the Subdivision of the Group)
    6 - Subcategory (Identifies a Further Breakdown of the Category)
    7 - Type (Identifies a Further Breakdown of the Subcategory)
    8 - Charge Detail (Identifies the Lowest Level of Charges within a Billing Arrangement)
    9 - Line Detail (Identifies the Supporting Detail Associated with the Charge or Group Level)
    They must be used in the (hierarchical) order in which they are listed; however, certain levels are optional and may be omitted. At least one occurrence each of the service/billing provider level and group level is required.
Example
HL-01
628
Hierarchical ID Number
Required
String (AN)
Min 1Max 12

A unique number assigned by the sender to identify a particular data segment in a hierarchical structure

  • HL01 shall contain a unique alphanumeric number for each occurrence of the HL segment in the transaction set. For example, HL01 could be used to indicate the number of occurrences of the HL segment, in which case the value of HL01 would be "1" for the initial HL segment and would be incremented by one in each subsequent HL segment within the transaction.
HL-02
734
Hierarchical Parent ID Number
Required
String (AN)
Min 1Max 12

Identification number of the next higher hierarchical data segment that the data segment being described is subordinate to

  • HL02 identifies the hierarchical ID number of the HL segment to which the current HL segment is subordinate.
HL-03
735
Hierarchical Level Code
Required
Identifier (ID)

Code defining the characteristic of a level in a hierarchical structure

  • HL03 indicates the context of the series of segments following the current HL segment up to the next occurrence of an HL segment in the transaction. For example, HL03 is used to indicate that subsequent segments in the HL loop form a logical grouping of data referring to shipment, order, or item-level information.
4
Group
HL-04
736
Hierarchical Child Code
Optional
Identifier (ID)

Code indicating if there are hierarchical child data segments subordinate to the level being described

  • HL04 indicates whether or not there are subordinate (or child) HL segments related to the current HL segment.
0
No Subordinate HL Segment in This Hierarchical Structure.
1
Additional Subordinate HL Data Segment in This Hierarchical Structure.
IT1 Loop
OptionalMax >1
IT1
210
Detail > HL Loop > HL Loop > HL Loop Group > IT1 Loop > IT1

Baseline Item Data (Invoice)

RequiredMax use 1

To specify the basic and most frequently used line item data for the invoice and related transactions

  • The group level is defined by at least one occurrence of the IT1 loop which may only appear at the group level.
Example
If either Quantity Invoiced (IT1-02), Unit or Basis for Measurement Code (IT1-03) or Unit Price (IT1-04) are present, then the others are required
If either Product/Service ID Qualifier (IT1-06) or Product/Service ID (IT1-07) is present, then the other is required
If either Product/Service ID Qualifier (IT1-08) or Product/Service ID (IT1-09) is present, then the other is required
IT1-01
350
Assigned Identification
Optional
String (AN)
Min 1Max 20

Alphanumeric characters assigned for differentiation within a transaction set

  • IT101 is the purchase order line item identification.
IT1-02
358
Quantity Invoiced
Optional
Decimal number (R)
Min 1Max 10

Number of units invoiced (supplier units)

IT1-03
355
Unit or Basis for Measurement Code
Optional
Identifier (ID)
Min 2Max 2

Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken

IT1-04
212
Unit Price
Optional
Decimal number (R)
Min 1Max 15

Price per unit of product, service, commodity, etc.

IT1-06
235
Product/Service ID Qualifier
Optional
Identifier (ID)
Min 2Max 2

Code identifying the type/source of the descriptive number used in Product/Service ID (234)

  • IT106 through IT125 provide for ten different product/service IDs for each item. For example: Case, Color, Drawing No., U.P.C. No., ISBN No., Model No., or SKU.
IT1-07
234
Product/Service ID
Optional
String (AN)
Min 1Max 48

Identifying number for a product or service

IT1-08
235
Product/Service ID Qualifier
Optional
Identifier (ID)
Min 2Max 2

Code identifying the type/source of the descriptive number used in Product/Service ID (234)

IT1-09
234
Product/Service ID
Optional
String (AN)
Min 1Max 48

Identifying number for a product or service

PID
230
Detail > HL Loop > HL Loop > HL Loop Group > IT1 Loop > PID

Product/Item Description

OptionalMax use 200

To describe a product or process in coded or free-form format

Example
If Product Description Code (PID-04) is present, then Agency Qualifier Code (PID-03) is required
At least one of Product Description Code (PID-04) or Description (PID-05) is required
PID-01
349
Item Description Type
Required
Identifier (ID)
Min 1Max 1

Code indicating the format of a description

  • If PID01 equals "F", then PID05 is used. If PID01 equals "S", then PID04 is used. If PID01 equals "X", then both PID04 and PID05 are used.
PID-03
559
Agency Qualifier Code
Optional
Identifier (ID)
Min 2Max 2

Code identifying the agency assigning the code values

  • Use PID03 to indicate the organization that publishes the code list being referred to.
PID-04
751
Product Description Code
Optional
String (AN)
Min 1Max 12

A code from an industry code list which provides specific data about a product characteristic

  • PID04 should be used for industry-specific product description codes.
PID-05
352
Description
Optional
String (AN)
Min 1Max 80

A free-form description to clarify the related data elements and their content

QTY Loop
OptionalMax >1
QTY
290
Detail > HL Loop > HL Loop > HL Loop Group > IT1 Loop > QTY Loop > QTY

Quantity

RequiredMax use 1

To specify quantity information

Example
QTY-01
673
Quantity Qualifier
Required
Identifier (ID)
Min 2Max 2

Code specifying the type of quantity

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

Numeric value of quantity

QTY-03
C001
Composite Unit of Measure
OptionalMax use 1
To identify a composite unit of measure (See Figures Appendix for examples of use)
C001-01
355
Unit or Basis for Measurement Code
Required
Identifier (ID)
Min 2Max 2

Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken

QTY Loop end
IT1 Loop end
HL Loop
OptionalMax >1
HL
010
Detail > HL Loop > HL Loop > HL Loop Group > HL Loop > HL

Hierarchical Level

RequiredMax use 1

To identify dependencies among and the content of hierarchically related groups of data segments

  • Valid codes for HL03 to define levels for this transaction set are given below:
    1 - Service/Billing Provider (Identifies the Company Providing the Service/Billing)
    2 - Billing Arrangement (Identifies a Specific Billing Arrangement)
    3 - Sub-billing Arrangement (Identifies a More Detailed Billing Arrangement)
    4 - Group (Identifies a Group of Charges on the Bill)
    5 - Category (Identifies the Subdivision of the Group)
    6 - Subcategory (Identifies a Further Breakdown of the Category)
    7 - Type (Identifies a Further Breakdown of the Subcategory)
    8 - Charge Detail (Identifies the Lowest Level of Charges within a Billing Arrangement)
    9 - Line Detail (Identifies the Supporting Detail Associated with the Charge or Group Level)
    They must be used in the (hierarchical) order in which they are listed; however, certain levels are optional and may be omitted. At least one occurrence each of the service/billing provider level and group level is required.
Example
HL-01
628
Hierarchical ID Number
Required
String (AN)
Min 1Max 12

A unique number assigned by the sender to identify a particular data segment in a hierarchical structure

  • HL01 shall contain a unique alphanumeric number for each occurrence of the HL segment in the transaction set. For example, HL01 could be used to indicate the number of occurrences of the HL segment, in which case the value of HL01 would be "1" for the initial HL segment and would be incremented by one in each subsequent HL segment within the transaction.
HL-02
734
Hierarchical Parent ID Number
Required
String (AN)
Min 1Max 12

Identification number of the next higher hierarchical data segment that the data segment being described is subordinate to

  • HL02 identifies the hierarchical ID number of the HL segment to which the current HL segment is subordinate.
HL-03
735
Hierarchical Level Code
Required
Identifier (ID)

Code defining the characteristic of a level in a hierarchical structure

  • HL03 indicates the context of the series of segments following the current HL segment up to the next occurrence of an HL segment in the transaction. For example, HL03 is used to indicate that subsequent segments in the HL loop form a logical grouping of data referring to shipment, order, or item-level information.
8
Charge Detail
HL-04
736
Hierarchical Child Code
Optional
Identifier (ID)

Code indicating if there are hierarchical child data segments subordinate to the level being described

  • HL04 indicates whether or not there are subordinate (or child) HL segments related to the current HL segment.
0
No Subordinate HL Segment in This Hierarchical Structure.
1
Additional Subordinate HL Data Segment in This Hierarchical Structure.
SLN Loop
OptionalMax >1
SLN
390
Detail > HL Loop > HL Loop > HL Loop Group > HL Loop > SLN Loop > SLN

Subline Item Detail

RequiredMax use 1

To specify product subline detail item data

  • The SLN loop may only appear at the charge detail level.
Example
If Relationship Code (SLN-08) is present, then Unit Price (SLN-06) is required
If either Product/Service ID Qualifier (SLN-09) or Product/Service ID (SLN-10) is present, then the other is required
SLN-01
350
Assigned Identification
Required
String (AN)
Min 1Max 20

Alphanumeric characters assigned for differentiation within a transaction set

  • SLN01 is the identifying number for the subline item.
  • SLN01 is related to (but not necessarily equivalent to) the baseline item number. Example: 1.1 or 1A might be used as a subline number to relate to baseline number 1.
SLN-03
662
Relationship Code
Required
Identifier (ID)
Min 1Max 1

Code indicating the relationship between entities

  • SLN03 is the configuration code indicating the relationship of the subline item to the baseline item.
SLN-04
380
Quantity
Optional
Decimal number (R)
Min 1Max 15

Numeric value of quantity

SLN-05
C001
Composite Unit of Measure
OptionalMax use 1
To identify a composite unit of measure (See Figures Appendix for examples of use)
C001-01
355
Unit or Basis for Measurement Code
Required
Identifier (ID)
Min 2Max 2

Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken

SLN-06
212
Unit Price
Optional
Decimal number (R)
Min 1Max 15

Price per unit of product, service, commodity, etc.

SLN-08
662
Relationship Code
Optional
Identifier (ID)
Min 1Max 1

Code indicating the relationship between entities

  • SLN08 is a code indicating the relationship of the price or amount to the associated segment.
SLN-09
235
Product/Service ID Qualifier
Optional
Identifier (ID)
Min 2Max 2

Code identifying the type/source of the descriptive number used in Product/Service ID (234)

  • SLN09 through SLN28 provide for ten different product/service IDs for each item. For example: Case, Color, Drawing No., U.P.C. No., ISBN No., Model No., or SKU.
SLN-10
234
Product/Service ID
Optional
String (AN)
Min 1Max 48

Identifying number for a product or service

SI
400
Detail > HL Loop > HL Loop > HL Loop Group > HL Loop > SLN Loop > SI

Service Characteristic Identification

OptionalMax use 2

To specify service characteristic data

Example
SI-01
559
Agency Qualifier Code
Required
Identifier (ID)
Min 2Max 2

Code identifying the agency assigning the code values

  • SI01 defines the source for each of the service characteristics qualifiers.
SI-02
1000
Service Characteristics Qualifier
Required
String (AN)
Min 2Max 2

Code from an industry code list qualifying the type of service characteristics

SI-03
234
Product/Service ID
Required
String (AN)
Min 1Max 48

Identifying number for a product or service

PID
410
Detail > HL Loop > HL Loop > HL Loop Group > HL Loop > SLN Loop > PID

Product/Item Description

OptionalMax use 200

To describe a product or process in coded or free-form format

Example
If Product Description Code (PID-04) is present, then Agency Qualifier Code (PID-03) is required
At least one of Product Description Code (PID-04) or Description (PID-05) is required
PID-01
349
Item Description Type
Required
Identifier (ID)
Min 1Max 1

Code indicating the format of a description

  • If PID01 equals "F", then PID05 is used. If PID01 equals "S", then PID04 is used. If PID01 equals "X", then both PID04 and PID05 are used.
PID-03
559
Agency Qualifier Code
Optional
Identifier (ID)
Min 2Max 2

Code identifying the agency assigning the code values

  • Use PID03 to indicate the organization that publishes the code list being referred to.
PID-04
751
Product Description Code
Optional
String (AN)
Min 1Max 12

A code from an industry code list which provides specific data about a product characteristic

  • PID04 should be used for industry-specific product description codes.
PID-05
352
Description
Optional
String (AN)
Min 1Max 80

A free-form description to clarify the related data elements and their content

MEA
415
Detail > HL Loop > HL Loop > HL Loop Group > HL Loop > SLN Loop > MEA

Measurements

OptionalMax use 20

To specify physical measurements or counts, including dimensions, tolerances, variances, and weights

(See Figures Appendix for example of use of C001)

Example
MEA-02
738
Measurement Qualifier
Optional
Identifier (ID)
Min 1Max 3

Code identifying a specific product or process characteristic to which a measurement applies

MEA-03
739
Measurement Value
Optional
Decimal number (R)
Min 1Max 15

The value of the measurement

DTM
480
Detail > HL Loop > HL Loop > HL Loop Group > HL Loop > SLN Loop > DTM

Date/Time Reference

OptionalMax use 10

To specify pertinent dates and times

Example
DTM-01
374
Date/Time Qualifier
Required
Identifier (ID)
Min 3Max 3

Code specifying type of date or time, or both date and time

Optional
Date (DT)
CCYYMMDD format

Date expressed as CCYYMMDD

AMT
490
Detail > HL Loop > HL Loop > HL Loop Group > HL Loop > SLN Loop > AMT

Monetary Amount

OptionalMax use 15

To indicate the total monetary amount

Example
AMT-01
522
Amount Qualifier Code
Required
Identifier (ID)
Min 1Max 3

Code to qualify amount

AMT-02
782
Monetary Amount
Required
Decimal number (R)
Min 1Max 15

Monetary amount

MSG
500
Detail > HL Loop > HL Loop > HL Loop Group > HL Loop > SLN Loop > MSG

Message Text

OptionalMax use >1

To provide a free-form format that allows the transmission of text information

Example
MSG-01
933
Free-Form Message Text
Required
String (AN)
Min 1Max 264

Free-form message text

QTY Loop
OptionalMax >1
QTY
510
Detail > HL Loop > HL Loop > HL Loop Group > HL Loop > SLN Loop > QTY Loop > QTY

Quantity

RequiredMax use 1

To specify quantity information

Example
QTY-01
673
Quantity Qualifier
Required
Identifier (ID)
Min 2Max 2

Code specifying the type of quantity

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

Numeric value of quantity

QTY-03
C001
Composite Unit of Measure
OptionalMax use 1
To identify a composite unit of measure (See Figures Appendix for examples of use)
C001-01
355
Unit or Basis for Measurement Code
Required
Identifier (ID)
Min 2Max 2

Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken

QTY Loop end
SLN Loop end
HL Loop
OptionalMax >1
HL
010
Detail > HL Loop > HL Loop > HL Loop Group > HL Loop > HL Loop > HL

Hierarchical Level

RequiredMax use 1

To identify dependencies among and the content of hierarchically related groups of data segments

  • Valid codes for HL03 to define levels for this transaction set are given below:
    1 - Service/Billing Provider (Identifies the Company Providing the Service/Billing)
    2 - Billing Arrangement (Identifies a Specific Billing Arrangement)
    3 - Sub-billing Arrangement (Identifies a More Detailed Billing Arrangement)
    4 - Group (Identifies a Group of Charges on the Bill)
    5 - Category (Identifies the Subdivision of the Group)
    6 - Subcategory (Identifies a Further Breakdown of the Category)
    7 - Type (Identifies a Further Breakdown of the Subcategory)
    8 - Charge Detail (Identifies the Lowest Level of Charges within a Billing Arrangement)
    9 - Line Detail (Identifies the Supporting Detail Associated with the Charge or Group Level)
    They must be used in the (hierarchical) order in which they are listed; however, certain levels are optional and may be omitted. At least one occurrence each of the service/billing provider level and group level is required.
Example
HL-01
628
Hierarchical ID Number
Required
String (AN)
Min 1Max 12

A unique number assigned by the sender to identify a particular data segment in a hierarchical structure

  • HL01 shall contain a unique alphanumeric number for each occurrence of the HL segment in the transaction set. For example, HL01 could be used to indicate the number of occurrences of the HL segment, in which case the value of HL01 would be "1" for the initial HL segment and would be incremented by one in each subsequent HL segment within the transaction.
HL-02
734
Hierarchical Parent ID Number
Required
String (AN)
Min 1Max 12

Identification number of the next higher hierarchical data segment that the data segment being described is subordinate to

  • HL02 identifies the hierarchical ID number of the HL segment to which the current HL segment is subordinate.
HL-03
735
Hierarchical Level Code
Required
Identifier (ID)

Code defining the characteristic of a level in a hierarchical structure

  • HL03 indicates the context of the series of segments following the current HL segment up to the next occurrence of an HL segment in the transaction. For example, HL03 is used to indicate that subsequent segments in the HL loop form a logical grouping of data referring to shipment, order, or item-level information.
9
Line Detail
HL-04
736
Hierarchical Child Code
Optional
Identifier (ID)

Code indicating if there are hierarchical child data segments subordinate to the level being described

  • HL04 indicates whether or not there are subordinate (or child) HL segments related to the current HL segment.
0
No Subordinate HL Segment in This Hierarchical Structure.
IT1 Loop
OptionalMax >1
IT1
210
Detail > HL Loop > HL Loop > HL Loop Group > HL Loop > HL Loop > IT1 Loop > IT1

Baseline Item Data (Invoice)

RequiredMax use 1

To specify the basic and most frequently used line item data for the invoice and related transactions

  • The group level is defined by at least one occurrence of the IT1 loop which may only appear at the group level.
Example
If either Quantity Invoiced (IT1-02), Unit or Basis for Measurement Code (IT1-03) or Unit Price (IT1-04) are present, then the others are required
If either Product/Service ID Qualifier (IT1-06) or Product/Service ID (IT1-07) is present, then the other is required
If either Product/Service ID Qualifier (IT1-08) or Product/Service ID (IT1-09) is present, then the other is required
IT1-01
350
Assigned Identification
Optional
String (AN)
Min 1Max 20

Alphanumeric characters assigned for differentiation within a transaction set

  • IT101 is the purchase order line item identification.
IT1-02
358
Quantity Invoiced
Optional
Decimal number (R)
Min 1Max 10

Number of units invoiced (supplier units)

IT1-03
355
Unit or Basis for Measurement Code
Optional
Identifier (ID)
Min 2Max 2

Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken

IT1-04
212
Unit Price
Optional
Decimal number (R)
Min 1Max 15

Price per unit of product, service, commodity, etc.

IT1-06
235
Product/Service ID Qualifier
Optional
Identifier (ID)
Min 2Max 2

Code identifying the type/source of the descriptive number used in Product/Service ID (234)

  • IT106 through IT125 provide for ten different product/service IDs for each item. For example: Case, Color, Drawing No., U.P.C. No., ISBN No., Model No., or SKU.
IT1-07
234
Product/Service ID
Optional
String (AN)
Min 1Max 48

Identifying number for a product or service

IT1-08
235
Product/Service ID Qualifier
Optional
Identifier (ID)
Min 2Max 2

Code identifying the type/source of the descriptive number used in Product/Service ID (234)

IT1-09
234
Product/Service ID
Optional
String (AN)
Min 1Max 48

Identifying number for a product or service

PID
230
Detail > HL Loop > HL Loop > HL Loop Group > HL Loop > HL Loop > IT1 Loop > PID

Product/Item Description

OptionalMax use 200

To describe a product or process in coded or free-form format

Example
If Product Description Code (PID-04) is present, then Agency Qualifier Code (PID-03) is required
At least one of Product Description Code (PID-04) or Description (PID-05) is required
PID-01
349
Item Description Type
Required
Identifier (ID)
Min 1Max 1

Code indicating the format of a description

  • If PID01 equals "F", then PID05 is used. If PID01 equals "S", then PID04 is used. If PID01 equals "X", then both PID04 and PID05 are used.
PID-03
559
Agency Qualifier Code
Optional
Identifier (ID)
Min 2Max 2

Code identifying the agency assigning the code values

  • Use PID03 to indicate the organization that publishes the code list being referred to.
PID-04
751
Product Description Code
Optional
String (AN)
Min 1Max 12

A code from an industry code list which provides specific data about a product characteristic

  • PID04 should be used for industry-specific product description codes.
PID-05
352
Description
Optional
String (AN)
Min 1Max 80

A free-form description to clarify the related data elements and their content

QTY Loop
OptionalMax >1
QTY
290
Detail > HL Loop > HL Loop > HL Loop Group > HL Loop > HL Loop > IT1 Loop > QTY Loop > QTY

Quantity

RequiredMax use 1

To specify quantity information

Example
QTY-01
673
Quantity Qualifier
Required
Identifier (ID)
Min 2Max 2

Code specifying the type of quantity

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

Numeric value of quantity

QTY-03
C001
Composite Unit of Measure
OptionalMax use 1
To identify a composite unit of measure (See Figures Appendix for examples of use)
C001-01
355
Unit or Basis for Measurement Code
Required
Identifier (ID)
Min 2Max 2

Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken

QTY Loop end
IT1 Loop end
TCD Loop
OptionalMax >1
TCD
590
Detail > HL Loop > HL Loop > HL Loop Group > HL Loop > HL Loop > TCD Loop > TCD

Itemized Call Detail

RequiredMax use 1

To specify detail information for itemized calls

  • The TCD loop may only appear at the line detail level.
Example
If either Location Qualifier (TCD-04) or Location Identifier (TCD-05) is present, then the other is required
TCD-01
350
Assigned Identification
Optional
String (AN)
Min 1Max 20

Alphanumeric characters assigned for differentiation within a transaction set

  • TCD01 is the detail information.
Optional
Date (DT)
CCYYMMDD format

Date expressed as CCYYMMDD

  • TCD02 is the date of the call.
Optional
Time (TM)
HHMM, HHMMSS, HHMMSSD, or HHMMSSDD format

Time expressed in 24-hour clock time as follows: HHMM, or HHMMSS, or HHMMSSD, or HHMMSSDD, where H = hours (00-23), M = minutes (00-59), S = integer seconds (00-59) and DD = decimal seconds; decimal seconds are expressed as follows: D = tenths (0-9) and DD = hundredths (00-99)

  • TCD03 is the connect time of the call.
TCD-04
309
Location Qualifier
Optional
Identifier (ID)
Min 1Max 2

Code identifying type of location

  • TCD04, TCD05, and TCD06 are the 'to' location of the call.
TCD-05
310
Location Identifier
Optional
String (AN)
Min 1Max 30

Code which identifies a specific location

TCD-10
739
Measurement Value
Optional
Decimal number (R)
Min 1Max 15

The value of the measurement

  • TCD10 and TCD11 are the total duration of the call. TCD10 is the time measured in minutes or minutes and tenths of minutes. TCD11 is time measured in seconds or seconds and tenths of seconds.
TCD-11
739
Measurement Value
Optional
Decimal number (R)
Min 1Max 15

The value of the measurement

TCD-12
782
Monetary Amount
Optional
Decimal number (R)
Min 1Max 15

Monetary amount

  • TCD12 is an undiscounted amount.
TCD-13
782
Monetary Amount
Optional
Decimal number (R)
Min 1Max 15

Monetary amount

  • TCD13 is a net amount after the discount has been applied to the amount in TCD12.
TCD-14
782
Monetary Amount
Optional
Decimal number (R)
Min 1Max 15

Monetary amount

  • TCD14 is an undiscounted amount.
TCD-15
782
Monetary Amount
Optional
Decimal number (R)
Min 1Max 15

Monetary amount

  • TCD15 is a net amount after the discount has been applied to the amount in TCD14.
TCD-16
662
Relationship Code
Optional
Identifier (ID)
Min 1Max 1

Code indicating the relationship between entities

  • TCD16 is a code indicating the relationship of the price or amount to the associated segment.
SI
600
Detail > HL Loop > HL Loop > HL Loop Group > HL Loop > HL Loop > TCD Loop > SI

Service Characteristic Identification

OptionalMax use 2

To specify service characteristic data

Example
If either Service Characteristics Qualifier (SI-04) or Product/Service ID (SI-05) is present, then the other is required
If either Service Characteristics Qualifier (SI-06) or Product/Service ID (SI-07) is present, then the other is required
If either Service Characteristics Qualifier (SI-08) or Product/Service ID (SI-09) is present, then the other is required
If either Service Characteristics Qualifier (SI-10) or Product/Service ID (SI-11) is present, then the other is required
SI-01
559
Agency Qualifier Code
Required
Identifier (ID)
Min 2Max 2

Code identifying the agency assigning the code values

  • SI01 defines the source for each of the service characteristics qualifiers.
SI-02
1000
Service Characteristics Qualifier
Required
String (AN)
Min 2Max 2

Code from an industry code list qualifying the type of service characteristics

SI-03
234
Product/Service ID
Required
String (AN)
Min 1Max 48

Identifying number for a product or service

SI-04
1000
Service Characteristics Qualifier
Optional
String (AN)
Min 2Max 2

Code from an industry code list qualifying the type of service characteristics

SI-05
234
Product/Service ID
Optional
String (AN)
Min 1Max 48

Identifying number for a product or service

SI-06
1000
Service Characteristics Qualifier
Optional
String (AN)
Min 2Max 2

Code from an industry code list qualifying the type of service characteristics

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

Identifying number for a product or service

SI-08
1000
Service Characteristics Qualifier
Optional
String (AN)
Min 2Max 2

Code from an industry code list qualifying the type of service characteristics

SI-09
234
Product/Service ID
Optional
String (AN)
Min 1Max 48

Identifying number for a product or service

SI-10
1000
Service Characteristics Qualifier
Optional
String (AN)
Min 2Max 2

Code from an industry code list qualifying the type of service characteristics

SI-11
234
Product/Service ID
Optional
String (AN)
Min 1Max 48

Identifying number for a product or service

TCD Loop end
HL Loop end
HL Loop end
HL Loop Group end
HL Loop Sub Billing Arrangement
OptionalMax >1
Variants (all may be used)
HL Loop Group
HL
010
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > HL

Hierarchical Level

RequiredMax use 1

To identify dependencies among and the content of hierarchically related groups of data segments

  • Valid codes for HL03 to define levels for this transaction set are given below:
    1 - Service/Billing Provider (Identifies the Company Providing the Service/Billing)
    2 - Billing Arrangement (Identifies a Specific Billing Arrangement)
    3 - Sub-billing Arrangement (Identifies a More Detailed Billing Arrangement)
    4 - Group (Identifies a Group of Charges on the Bill)
    5 - Category (Identifies the Subdivision of the Group)
    6 - Subcategory (Identifies a Further Breakdown of the Category)
    7 - Type (Identifies a Further Breakdown of the Subcategory)
    8 - Charge Detail (Identifies the Lowest Level of Charges within a Billing Arrangement)
    9 - Line Detail (Identifies the Supporting Detail Associated with the Charge or Group Level)
    They must be used in the (hierarchical) order in which they are listed; however, certain levels are optional and may be omitted. At least one occurrence each of the service/billing provider level and group level is required.
Example
HL-01
628
Hierarchical ID Number
Required
String (AN)
Min 1Max 12

A unique number assigned by the sender to identify a particular data segment in a hierarchical structure

  • HL01 shall contain a unique alphanumeric number for each occurrence of the HL segment in the transaction set. For example, HL01 could be used to indicate the number of occurrences of the HL segment, in which case the value of HL01 would be "1" for the initial HL segment and would be incremented by one in each subsequent HL segment within the transaction.
HL-02
734
Hierarchical Parent ID Number
Required
String (AN)
Min 1Max 12

Identification number of the next higher hierarchical data segment that the data segment being described is subordinate to

  • HL02 identifies the hierarchical ID number of the HL segment to which the current HL segment is subordinate.
HL-03
735
Hierarchical Level Code
Required
Identifier (ID)

Code defining the characteristic of a level in a hierarchical structure

  • HL03 indicates the context of the series of segments following the current HL segment up to the next occurrence of an HL segment in the transaction. For example, HL03 is used to indicate that subsequent segments in the HL loop form a logical grouping of data referring to shipment, order, or item-level information.
3
Sub-Billing Arrangement
HL-04
736
Hierarchical Child Code
Optional
Identifier (ID)

Code indicating if there are hierarchical child data segments subordinate to the level being described

  • HL04 indicates whether or not there are subordinate (or child) HL segments related to the current HL segment.
0
No Subordinate HL Segment in This Hierarchical Structure.
1
Additional Subordinate HL Data Segment in This Hierarchical Structure.
LX Loop
OptionalMax >1
LX
020
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > LX Loop > LX

Assigned Number

RequiredMax use 1

To reference a line number in a transaction set

Example
LX-01
554
Assigned Number
Required
Numeric (N0)
Min 1Max 6

Number assigned for differentiation within a transaction set

SI
030
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > LX Loop > SI

Service Characteristic Identification

OptionalMax use 8

To specify service characteristic data

Example
SI-01
559
Agency Qualifier Code
Required
Identifier (ID)
Min 2Max 2

Code identifying the agency assigning the code values

  • SI01 defines the source for each of the service characteristics qualifiers.
SI-02
1000
Service Characteristics Qualifier
Required
String (AN)
Min 2Max 2

Code from an industry code list qualifying the type of service characteristics

SI-03
234
Product/Service ID
Required
String (AN)
Min 1Max 48

Identifying number for a product or service

PID
040
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > LX Loop > PID

Product/Item Description

OptionalMax use 200

To describe a product or process in coded or free-form format

Example
If Product Description Code (PID-04) is present, then Agency Qualifier Code (PID-03) is required
At least one of Product Description Code (PID-04) or Description (PID-05) is required
PID-01
349
Item Description Type
Required
Identifier (ID)
Min 1Max 1

Code indicating the format of a description

  • If PID01 equals "F", then PID05 is used. If PID01 equals "S", then PID04 is used. If PID01 equals "X", then both PID04 and PID05 are used.
PID-03
559
Agency Qualifier Code
Optional
Identifier (ID)
Min 2Max 2

Code identifying the agency assigning the code values

  • Use PID03 to indicate the organization that publishes the code list being referred to.
PID-04
751
Product Description Code
Optional
String (AN)
Min 1Max 12

A code from an industry code list which provides specific data about a product characteristic

  • PID04 should be used for industry-specific product description codes.
PID-05
352
Description
Optional
String (AN)
Min 1Max 80

A free-form description to clarify the related data elements and their content

REF
050
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > LX Loop > REF

Reference Identification

OptionalMax use >1

To specify identifying information

Example
At least one of Reference Identification (REF-02) or Description (REF-03) is required
REF-01
128
Reference Identification Qualifier
Required
Identifier (ID)
Min 2Max 3

Code qualifying the Reference Identification

REF-02
127
Reference Identification
Optional
String (AN)
Min 1Max 30

Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier

REF-03
352
Description
Optional
String (AN)
Min 1Max 80

A free-form description to clarify the related data elements and their content

REF-04
C040
Reference Identifier
OptionalMax use 1
To identify one or more reference numbers or identification numbers as specified by the Reference Qualifier
C040-01
128
Reference Identification Qualifier
Required
Identifier (ID)
Min 2Max 3

Code qualifying the Reference Identification

C040-02
127
Reference Identification
Required
String (AN)
Min 1Max 30

Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier

AMT
060
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > LX Loop > AMT

Monetary Amount

OptionalMax use 5

To indicate the total monetary amount

Example
AMT-01
522
Amount Qualifier Code
Required
Identifier (ID)
Min 1Max 3

Code to qualify amount

AMT-02
782
Monetary Amount
Required
Decimal number (R)
Min 1Max 15

Monetary amount

DTM
070
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > LX Loop > DTM

Date/Time Reference

OptionalMax use 8

To specify pertinent dates and times

Example
DTM-01
374
Date/Time Qualifier
Required
Identifier (ID)
Min 3Max 3

Code specifying type of date or time, or both date and time

Optional
Date (DT)
CCYYMMDD format

Date expressed as CCYYMMDD

QTY Loop
OptionalMax >1
QTY
090
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > LX Loop > QTY Loop > QTY

Quantity

RequiredMax use 1

To specify quantity information

Example
QTY-01
673
Quantity Qualifier
Required
Identifier (ID)
Min 2Max 2

Code specifying the type of quantity

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

Numeric value of quantity

QTY-03
C001
Composite Unit of Measure
OptionalMax use 1
To identify a composite unit of measure (See Figures Appendix for examples of use)
C001-01
355
Unit or Basis for Measurement Code
Required
Identifier (ID)
Min 2Max 2

Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken

QTY Loop end
LX Loop end
NM1 Loop
OptionalMax >1
NM1
110
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > NM1 Loop > NM1

Individual or Organizational Name

RequiredMax use 1

To supply the full name of an individual or organizational entity

  • When used for telecommunications billing, the service/billing provider level is defined by the NM1 loop.
Example
If either Identification Code Qualifier (NM1-08) or Identification Code (NM1-09) is present, then the other is required
NM1-01
98
Entity Identifier Code
Required
Identifier (ID)
Min 2Max 3

Code identifying an organizational entity, a physical location, property or an individual

NM1-02
1065
Entity Type Qualifier
Required
Identifier (ID)
Min 1Max 1

Code qualifying the type of entity

  • NM102 qualifies NM103.
NM1-03
1035
Name Last or Organization Name
Optional
String (AN)
Min 1Max 35

Individual last name or organizational name

NM1-08
66
Identification Code Qualifier
Optional
Identifier (ID)
Min 1Max 2

Code designating the system/method of code structure used for Identification Code (67)

NM1-09
67
Identification Code
Optional
String (AN)
Min 2Max 80

Code identifying a party or other code

N2
120
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > NM1 Loop > N2

Additional Name Information

OptionalMax use 2

To specify additional names or those longer than 35 characters in length

Example
Required
String (AN)
Min 1Max 60

Free-form name

Optional
String (AN)
Min 1Max 60

Free-form name

TXI
170
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > NM1 Loop > TXI

Tax Information

OptionalMax use >1

To specify tax information

Example
TXI-01
963
Tax Type Code
Required
Identifier (ID)
Min 2Max 2

Code specifying the type of tax

TXI-02
782
Monetary Amount
Optional
Decimal number (R)
Min 1Max 15

Monetary amount

  • TXI02 is the monetary amount of the tax.
TXI-07
662
Relationship Code
Optional
Identifier (ID)
Min 1Max 1

Code indicating the relationship between entities

  • TXI07 is a code indicating the relationship of the price or amount to the associated segment.
NM1 Loop end
ITA Loop
OptionalMax >1
ITA
180
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > ITA Loop > ITA

Allowance, Charge or Service

RequiredMax use 1

To specify allowances, charges, or services

Example
If either Quantity (ITA-10) or Unit or Basis for Measurement Code (ITA-11) is present, then the other is required
ITA-01
248
Allowance or Charge Indicator
Required
Identifier (ID)
Min 1Max 1

Code which indicates an allowance or charge for the service specified

  • If ITA01 equals "A" - allowance or "C" - charge, then at least one of ITA06, ITA07, or ITA08 must be present.
ITA-02
559
Agency Qualifier Code
Optional
Identifier (ID)
Min 2Max 2

Code identifying the agency assigning the code values

  • ITA02 identifies the source of the code value in ITA03 or ITA15.
ITA-04
331
Allowance or Charge Method of Handling Code
Required
Identifier (ID)
Min 2Max 2

Code indicating method of handling for an allowance or charge

ITA-07
360
Allowance or Charge Total Amount
Optional
Numeric (N2)
Min 1Max 15

Total dollar amount for the allowance or charge

  • If ITA07 is present with either ITA06 or ITA08, then ITA07 takes precedence.
ITA-10
380
Quantity
Optional
Decimal number (R)
Min 1Max 15

Numeric value of quantity

  • ITA10 is the quantity basis when the allowance or charge quantity is different from the purchase order or invoice quantity.
ITA-11
355
Unit or Basis for Measurement Code
Optional
Identifier (ID)
Min 2Max 2

Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken

ITA-13
352
Description
Optional
String (AN)
Min 1Max 80

A free-form description to clarify the related data elements and their content

  • ITA13 is used to clarify the allowance, charge, or service.
ITA-14
150
Special Charge or Allowance Code
Optional
Identifier (ID)
Min 3Max 3

Code identifying type of special charge or allowance

ITA-16
662
Relationship Code
Optional
Identifier (ID)
Min 1Max 1

Code indicating the relationship between entities

  • ITA16 describes the relationship of ITA06, ITA07 or ITA09 to an associated segment.
ITA Loop end
HL Loop
OptionalMax >1
HL
010
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > HL Loop > HL

Hierarchical Level

RequiredMax use 1

To identify dependencies among and the content of hierarchically related groups of data segments

  • Valid codes for HL03 to define levels for this transaction set are given below:
    1 - Service/Billing Provider (Identifies the Company Providing the Service/Billing)
    2 - Billing Arrangement (Identifies a Specific Billing Arrangement)
    3 - Sub-billing Arrangement (Identifies a More Detailed Billing Arrangement)
    4 - Group (Identifies a Group of Charges on the Bill)
    5 - Category (Identifies the Subdivision of the Group)
    6 - Subcategory (Identifies a Further Breakdown of the Category)
    7 - Type (Identifies a Further Breakdown of the Subcategory)
    8 - Charge Detail (Identifies the Lowest Level of Charges within a Billing Arrangement)
    9 - Line Detail (Identifies the Supporting Detail Associated with the Charge or Group Level)
    They must be used in the (hierarchical) order in which they are listed; however, certain levels are optional and may be omitted. At least one occurrence each of the service/billing provider level and group level is required.
Example
HL-01
628
Hierarchical ID Number
Required
String (AN)
Min 1Max 12

A unique number assigned by the sender to identify a particular data segment in a hierarchical structure

  • HL01 shall contain a unique alphanumeric number for each occurrence of the HL segment in the transaction set. For example, HL01 could be used to indicate the number of occurrences of the HL segment, in which case the value of HL01 would be "1" for the initial HL segment and would be incremented by one in each subsequent HL segment within the transaction.
HL-02
734
Hierarchical Parent ID Number
Required
String (AN)
Min 1Max 12

Identification number of the next higher hierarchical data segment that the data segment being described is subordinate to

  • HL02 identifies the hierarchical ID number of the HL segment to which the current HL segment is subordinate.
HL-03
735
Hierarchical Level Code
Required
Identifier (ID)

Code defining the characteristic of a level in a hierarchical structure

  • HL03 indicates the context of the series of segments following the current HL segment up to the next occurrence of an HL segment in the transaction. For example, HL03 is used to indicate that subsequent segments in the HL loop form a logical grouping of data referring to shipment, order, or item-level information.
4
Group
HL-04
736
Hierarchical Child Code
Optional
Identifier (ID)

Code indicating if there are hierarchical child data segments subordinate to the level being described

  • HL04 indicates whether or not there are subordinate (or child) HL segments related to the current HL segment.
0
No Subordinate HL Segment in This Hierarchical Structure.
1
Additional Subordinate HL Data Segment in This Hierarchical Structure.
IT1 Loop
OptionalMax >1
IT1
210
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > HL Loop > IT1 Loop > IT1

Baseline Item Data (Invoice)

RequiredMax use 1

To specify the basic and most frequently used line item data for the invoice and related transactions

  • The group level is defined by at least one occurrence of the IT1 loop which may only appear at the group level.
Example
If either Quantity Invoiced (IT1-02), Unit or Basis for Measurement Code (IT1-03) or Unit Price (IT1-04) are present, then the others are required
If either Product/Service ID Qualifier (IT1-06) or Product/Service ID (IT1-07) is present, then the other is required
If either Product/Service ID Qualifier (IT1-08) or Product/Service ID (IT1-09) is present, then the other is required
IT1-01
350
Assigned Identification
Optional
String (AN)
Min 1Max 20

Alphanumeric characters assigned for differentiation within a transaction set

  • IT101 is the purchase order line item identification.
IT1-02
358
Quantity Invoiced
Optional
Decimal number (R)
Min 1Max 10

Number of units invoiced (supplier units)

IT1-03
355
Unit or Basis for Measurement Code
Optional
Identifier (ID)
Min 2Max 2

Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken

IT1-04
212
Unit Price
Optional
Decimal number (R)
Min 1Max 15

Price per unit of product, service, commodity, etc.

IT1-06
235
Product/Service ID Qualifier
Optional
Identifier (ID)
Min 2Max 2

Code identifying the type/source of the descriptive number used in Product/Service ID (234)

  • IT106 through IT125 provide for ten different product/service IDs for each item. For example: Case, Color, Drawing No., U.P.C. No., ISBN No., Model No., or SKU.
IT1-07
234
Product/Service ID
Optional
String (AN)
Min 1Max 48

Identifying number for a product or service

IT1-08
235
Product/Service ID Qualifier
Optional
Identifier (ID)
Min 2Max 2

Code identifying the type/source of the descriptive number used in Product/Service ID (234)

IT1-09
234
Product/Service ID
Optional
String (AN)
Min 1Max 48

Identifying number for a product or service

PID
230
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > HL Loop > IT1 Loop > PID

Product/Item Description

OptionalMax use 200

To describe a product or process in coded or free-form format

Example
If Product Description Code (PID-04) is present, then Agency Qualifier Code (PID-03) is required
At least one of Product Description Code (PID-04) or Description (PID-05) is required
PID-01
349
Item Description Type
Required
Identifier (ID)
Min 1Max 1

Code indicating the format of a description

  • If PID01 equals "F", then PID05 is used. If PID01 equals "S", then PID04 is used. If PID01 equals "X", then both PID04 and PID05 are used.
PID-03
559
Agency Qualifier Code
Optional
Identifier (ID)
Min 2Max 2

Code identifying the agency assigning the code values

  • Use PID03 to indicate the organization that publishes the code list being referred to.
PID-04
751
Product Description Code
Optional
String (AN)
Min 1Max 12

A code from an industry code list which provides specific data about a product characteristic

  • PID04 should be used for industry-specific product description codes.
PID-05
352
Description
Optional
String (AN)
Min 1Max 80

A free-form description to clarify the related data elements and their content

QTY Loop
OptionalMax >1
QTY
290
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > HL Loop > IT1 Loop > QTY Loop > QTY

Quantity

RequiredMax use 1

To specify quantity information

Example
QTY-01
673
Quantity Qualifier
Required
Identifier (ID)
Min 2Max 2

Code specifying the type of quantity

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

Numeric value of quantity

QTY-03
C001
Composite Unit of Measure
OptionalMax use 1
To identify a composite unit of measure (See Figures Appendix for examples of use)
C001-01
355
Unit or Basis for Measurement Code
Required
Identifier (ID)
Min 2Max 2

Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken

QTY Loop end
IT1 Loop end
HL Loop
OptionalMax >1
HL
010
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > HL Loop > HL Loop > HL

Hierarchical Level

RequiredMax use 1

To identify dependencies among and the content of hierarchically related groups of data segments

  • Valid codes for HL03 to define levels for this transaction set are given below:
    1 - Service/Billing Provider (Identifies the Company Providing the Service/Billing)
    2 - Billing Arrangement (Identifies a Specific Billing Arrangement)
    3 - Sub-billing Arrangement (Identifies a More Detailed Billing Arrangement)
    4 - Group (Identifies a Group of Charges on the Bill)
    5 - Category (Identifies the Subdivision of the Group)
    6 - Subcategory (Identifies a Further Breakdown of the Category)
    7 - Type (Identifies a Further Breakdown of the Subcategory)
    8 - Charge Detail (Identifies the Lowest Level of Charges within a Billing Arrangement)
    9 - Line Detail (Identifies the Supporting Detail Associated with the Charge or Group Level)
    They must be used in the (hierarchical) order in which they are listed; however, certain levels are optional and may be omitted. At least one occurrence each of the service/billing provider level and group level is required.
Example
HL-01
628
Hierarchical ID Number
Required
String (AN)
Min 1Max 12

A unique number assigned by the sender to identify a particular data segment in a hierarchical structure

  • HL01 shall contain a unique alphanumeric number for each occurrence of the HL segment in the transaction set. For example, HL01 could be used to indicate the number of occurrences of the HL segment, in which case the value of HL01 would be "1" for the initial HL segment and would be incremented by one in each subsequent HL segment within the transaction.
HL-02
734
Hierarchical Parent ID Number
Required
String (AN)
Min 1Max 12

Identification number of the next higher hierarchical data segment that the data segment being described is subordinate to

  • HL02 identifies the hierarchical ID number of the HL segment to which the current HL segment is subordinate.
HL-03
735
Hierarchical Level Code
Required
Identifier (ID)

Code defining the characteristic of a level in a hierarchical structure

  • HL03 indicates the context of the series of segments following the current HL segment up to the next occurrence of an HL segment in the transaction. For example, HL03 is used to indicate that subsequent segments in the HL loop form a logical grouping of data referring to shipment, order, or item-level information.
8
Charge Detail
HL-04
736
Hierarchical Child Code
Optional
Identifier (ID)

Code indicating if there are hierarchical child data segments subordinate to the level being described

  • HL04 indicates whether or not there are subordinate (or child) HL segments related to the current HL segment.
0
No Subordinate HL Segment in This Hierarchical Structure.
1
Additional Subordinate HL Data Segment in This Hierarchical Structure.
SLN Loop
OptionalMax >1
SLN
390
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > HL Loop > HL Loop > SLN Loop > SLN

Subline Item Detail

RequiredMax use 1

To specify product subline detail item data

  • The SLN loop may only appear at the charge detail level.
Example
If Relationship Code (SLN-08) is present, then Unit Price (SLN-06) is required
If either Product/Service ID Qualifier (SLN-09) or Product/Service ID (SLN-10) is present, then the other is required
SLN-01
350
Assigned Identification
Required
String (AN)
Min 1Max 20

Alphanumeric characters assigned for differentiation within a transaction set

  • SLN01 is the identifying number for the subline item.
  • SLN01 is related to (but not necessarily equivalent to) the baseline item number. Example: 1.1 or 1A might be used as a subline number to relate to baseline number 1.
SLN-03
662
Relationship Code
Required
Identifier (ID)
Min 1Max 1

Code indicating the relationship between entities

  • SLN03 is the configuration code indicating the relationship of the subline item to the baseline item.
SLN-04
380
Quantity
Optional
Decimal number (R)
Min 1Max 15

Numeric value of quantity

SLN-05
C001
Composite Unit of Measure
OptionalMax use 1
To identify a composite unit of measure (See Figures Appendix for examples of use)
C001-01
355
Unit or Basis for Measurement Code
Required
Identifier (ID)
Min 2Max 2

Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken

SLN-06
212
Unit Price
Optional
Decimal number (R)
Min 1Max 15

Price per unit of product, service, commodity, etc.

SLN-08
662
Relationship Code
Optional
Identifier (ID)
Min 1Max 1

Code indicating the relationship between entities

  • SLN08 is a code indicating the relationship of the price or amount to the associated segment.
SLN-09
235
Product/Service ID Qualifier
Optional
Identifier (ID)
Min 2Max 2

Code identifying the type/source of the descriptive number used in Product/Service ID (234)

  • SLN09 through SLN28 provide for ten different product/service IDs for each item. For example: Case, Color, Drawing No., U.P.C. No., ISBN No., Model No., or SKU.
SLN-10
234
Product/Service ID
Optional
String (AN)
Min 1Max 48

Identifying number for a product or service

SI
400
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > HL Loop > HL Loop > SLN Loop > SI

Service Characteristic Identification

OptionalMax use 2

To specify service characteristic data

Example
SI-01
559
Agency Qualifier Code
Required
Identifier (ID)
Min 2Max 2

Code identifying the agency assigning the code values

  • SI01 defines the source for each of the service characteristics qualifiers.
SI-02
1000
Service Characteristics Qualifier
Required
String (AN)
Min 2Max 2

Code from an industry code list qualifying the type of service characteristics

SI-03
234
Product/Service ID
Required
String (AN)
Min 1Max 48

Identifying number for a product or service

PID
410
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > HL Loop > HL Loop > SLN Loop > PID

Product/Item Description

OptionalMax use 200

To describe a product or process in coded or free-form format

Example
If Product Description Code (PID-04) is present, then Agency Qualifier Code (PID-03) is required
At least one of Product Description Code (PID-04) or Description (PID-05) is required
PID-01
349
Item Description Type
Required
Identifier (ID)
Min 1Max 1

Code indicating the format of a description

  • If PID01 equals "F", then PID05 is used. If PID01 equals "S", then PID04 is used. If PID01 equals "X", then both PID04 and PID05 are used.
PID-03
559
Agency Qualifier Code
Optional
Identifier (ID)
Min 2Max 2

Code identifying the agency assigning the code values

  • Use PID03 to indicate the organization that publishes the code list being referred to.
PID-04
751
Product Description Code
Optional
String (AN)
Min 1Max 12

A code from an industry code list which provides specific data about a product characteristic

  • PID04 should be used for industry-specific product description codes.
PID-05
352
Description
Optional
String (AN)
Min 1Max 80

A free-form description to clarify the related data elements and their content

MEA
415
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > HL Loop > HL Loop > SLN Loop > MEA

Measurements

OptionalMax use 20

To specify physical measurements or counts, including dimensions, tolerances, variances, and weights

(See Figures Appendix for example of use of C001)

Example
MEA-02
738
Measurement Qualifier
Optional
Identifier (ID)
Min 1Max 3

Code identifying a specific product or process characteristic to which a measurement applies

MEA-03
739
Measurement Value
Optional
Decimal number (R)
Min 1Max 15

The value of the measurement

DTM
480
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > HL Loop > HL Loop > SLN Loop > DTM

Date/Time Reference

OptionalMax use 10

To specify pertinent dates and times

Example
DTM-01
374
Date/Time Qualifier
Required
Identifier (ID)
Min 3Max 3

Code specifying type of date or time, or both date and time

Optional
Date (DT)
CCYYMMDD format

Date expressed as CCYYMMDD

AMT
490
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > HL Loop > HL Loop > SLN Loop > AMT

Monetary Amount

OptionalMax use 15

To indicate the total monetary amount

Example
AMT-01
522
Amount Qualifier Code
Required
Identifier (ID)
Min 1Max 3

Code to qualify amount

AMT-02
782
Monetary Amount
Required
Decimal number (R)
Min 1Max 15

Monetary amount

MSG
500
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > HL Loop > HL Loop > SLN Loop > MSG

Message Text

OptionalMax use >1

To provide a free-form format that allows the transmission of text information

Example
MSG-01
933
Free-Form Message Text
Required
String (AN)
Min 1Max 264

Free-form message text

QTY Loop
OptionalMax >1
QTY
510
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > HL Loop > HL Loop > SLN Loop > QTY Loop > QTY

Quantity

RequiredMax use 1

To specify quantity information

Example
QTY-01
673
Quantity Qualifier
Required
Identifier (ID)
Min 2Max 2

Code specifying the type of quantity

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

Numeric value of quantity

QTY-03
C001
Composite Unit of Measure
OptionalMax use 1
To identify a composite unit of measure (See Figures Appendix for examples of use)
C001-01
355
Unit or Basis for Measurement Code
Required
Identifier (ID)
Min 2Max 2

Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken

QTY Loop end
SLN Loop end
HL Loop
OptionalMax >1
HL
010
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > HL Loop > HL Loop > HL Loop > HL

Hierarchical Level

RequiredMax use 1

To identify dependencies among and the content of hierarchically related groups of data segments

  • Valid codes for HL03 to define levels for this transaction set are given below:
    1 - Service/Billing Provider (Identifies the Company Providing the Service/Billing)
    2 - Billing Arrangement (Identifies a Specific Billing Arrangement)
    3 - Sub-billing Arrangement (Identifies a More Detailed Billing Arrangement)
    4 - Group (Identifies a Group of Charges on the Bill)
    5 - Category (Identifies the Subdivision of the Group)
    6 - Subcategory (Identifies a Further Breakdown of the Category)
    7 - Type (Identifies a Further Breakdown of the Subcategory)
    8 - Charge Detail (Identifies the Lowest Level of Charges within a Billing Arrangement)
    9 - Line Detail (Identifies the Supporting Detail Associated with the Charge or Group Level)
    They must be used in the (hierarchical) order in which they are listed; however, certain levels are optional and may be omitted. At least one occurrence each of the service/billing provider level and group level is required.
Example
HL-01
628
Hierarchical ID Number
Required
String (AN)
Min 1Max 12

A unique number assigned by the sender to identify a particular data segment in a hierarchical structure

  • HL01 shall contain a unique alphanumeric number for each occurrence of the HL segment in the transaction set. For example, HL01 could be used to indicate the number of occurrences of the HL segment, in which case the value of HL01 would be "1" for the initial HL segment and would be incremented by one in each subsequent HL segment within the transaction.
HL-02
734
Hierarchical Parent ID Number
Required
String (AN)
Min 1Max 12

Identification number of the next higher hierarchical data segment that the data segment being described is subordinate to

  • HL02 identifies the hierarchical ID number of the HL segment to which the current HL segment is subordinate.
HL-03
735
Hierarchical Level Code
Required
Identifier (ID)

Code defining the characteristic of a level in a hierarchical structure

  • HL03 indicates the context of the series of segments following the current HL segment up to the next occurrence of an HL segment in the transaction. For example, HL03 is used to indicate that subsequent segments in the HL loop form a logical grouping of data referring to shipment, order, or item-level information.
9
Line Detail
HL-04
736
Hierarchical Child Code
Optional
Identifier (ID)

Code indicating if there are hierarchical child data segments subordinate to the level being described

  • HL04 indicates whether or not there are subordinate (or child) HL segments related to the current HL segment.
0
No Subordinate HL Segment in This Hierarchical Structure.
IT1 Loop
OptionalMax >1
IT1
210
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > HL Loop > HL Loop > HL Loop > IT1 Loop > IT1

Baseline Item Data (Invoice)

RequiredMax use 1

To specify the basic and most frequently used line item data for the invoice and related transactions

  • The group level is defined by at least one occurrence of the IT1 loop which may only appear at the group level.
Example
If either Quantity Invoiced (IT1-02), Unit or Basis for Measurement Code (IT1-03) or Unit Price (IT1-04) are present, then the others are required
If either Product/Service ID Qualifier (IT1-06) or Product/Service ID (IT1-07) is present, then the other is required
If either Product/Service ID Qualifier (IT1-08) or Product/Service ID (IT1-09) is present, then the other is required
IT1-01
350
Assigned Identification
Optional
String (AN)
Min 1Max 20

Alphanumeric characters assigned for differentiation within a transaction set

  • IT101 is the purchase order line item identification.
IT1-02
358
Quantity Invoiced
Optional
Decimal number (R)
Min 1Max 10

Number of units invoiced (supplier units)

IT1-03
355
Unit or Basis for Measurement Code
Optional
Identifier (ID)
Min 2Max 2

Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken

IT1-04
212
Unit Price
Optional
Decimal number (R)
Min 1Max 15

Price per unit of product, service, commodity, etc.

IT1-06
235
Product/Service ID Qualifier
Optional
Identifier (ID)
Min 2Max 2

Code identifying the type/source of the descriptive number used in Product/Service ID (234)

  • IT106 through IT125 provide for ten different product/service IDs for each item. For example: Case, Color, Drawing No., U.P.C. No., ISBN No., Model No., or SKU.
IT1-07
234
Product/Service ID
Optional
String (AN)
Min 1Max 48

Identifying number for a product or service

IT1-08
235
Product/Service ID Qualifier
Optional
Identifier (ID)
Min 2Max 2

Code identifying the type/source of the descriptive number used in Product/Service ID (234)

IT1-09
234
Product/Service ID
Optional
String (AN)
Min 1Max 48

Identifying number for a product or service

PID
230
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > HL Loop > HL Loop > HL Loop > IT1 Loop > PID

Product/Item Description

OptionalMax use 200

To describe a product or process in coded or free-form format

Example
If Product Description Code (PID-04) is present, then Agency Qualifier Code (PID-03) is required
At least one of Product Description Code (PID-04) or Description (PID-05) is required
PID-01
349
Item Description Type
Required
Identifier (ID)
Min 1Max 1

Code indicating the format of a description

  • If PID01 equals "F", then PID05 is used. If PID01 equals "S", then PID04 is used. If PID01 equals "X", then both PID04 and PID05 are used.
PID-03
559
Agency Qualifier Code
Optional
Identifier (ID)
Min 2Max 2

Code identifying the agency assigning the code values

  • Use PID03 to indicate the organization that publishes the code list being referred to.
PID-04
751
Product Description Code
Optional
String (AN)
Min 1Max 12

A code from an industry code list which provides specific data about a product characteristic

  • PID04 should be used for industry-specific product description codes.
PID-05
352
Description
Optional
String (AN)
Min 1Max 80

A free-form description to clarify the related data elements and their content

QTY Loop
OptionalMax >1
QTY
290
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > HL Loop > HL Loop > HL Loop > IT1 Loop > QTY Loop > QTY

Quantity

RequiredMax use 1

To specify quantity information

Example
QTY-01
673
Quantity Qualifier
Required
Identifier (ID)
Min 2Max 2

Code specifying the type of quantity

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

Numeric value of quantity

QTY-03
C001
Composite Unit of Measure
OptionalMax use 1
To identify a composite unit of measure (See Figures Appendix for examples of use)
C001-01
355
Unit or Basis for Measurement Code
Required
Identifier (ID)
Min 2Max 2

Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken

QTY Loop end
IT1 Loop end
TCD Loop
OptionalMax >1
TCD
590
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > HL Loop > HL Loop > HL Loop > TCD Loop > TCD

Itemized Call Detail

RequiredMax use 1

To specify detail information for itemized calls

  • The TCD loop may only appear at the line detail level.
Example
If either Location Qualifier (TCD-04) or Location Identifier (TCD-05) is present, then the other is required
TCD-01
350
Assigned Identification
Optional
String (AN)
Min 1Max 20

Alphanumeric characters assigned for differentiation within a transaction set

  • TCD01 is the detail information.
Optional
Date (DT)
CCYYMMDD format

Date expressed as CCYYMMDD

  • TCD02 is the date of the call.
Optional
Time (TM)
HHMM, HHMMSS, HHMMSSD, or HHMMSSDD format

Time expressed in 24-hour clock time as follows: HHMM, or HHMMSS, or HHMMSSD, or HHMMSSDD, where H = hours (00-23), M = minutes (00-59), S = integer seconds (00-59) and DD = decimal seconds; decimal seconds are expressed as follows: D = tenths (0-9) and DD = hundredths (00-99)

  • TCD03 is the connect time of the call.
TCD-04
309
Location Qualifier
Optional
Identifier (ID)
Min 1Max 2

Code identifying type of location

  • TCD04, TCD05, and TCD06 are the 'to' location of the call.
TCD-05
310
Location Identifier
Optional
String (AN)
Min 1Max 30

Code which identifies a specific location

TCD-10
739
Measurement Value
Optional
Decimal number (R)
Min 1Max 15

The value of the measurement

  • TCD10 and TCD11 are the total duration of the call. TCD10 is the time measured in minutes or minutes and tenths of minutes. TCD11 is time measured in seconds or seconds and tenths of seconds.
TCD-11
739
Measurement Value
Optional
Decimal number (R)
Min 1Max 15

The value of the measurement

TCD-12
782
Monetary Amount
Optional
Decimal number (R)
Min 1Max 15

Monetary amount

  • TCD12 is an undiscounted amount.
TCD-13
782
Monetary Amount
Optional
Decimal number (R)
Min 1Max 15

Monetary amount

  • TCD13 is a net amount after the discount has been applied to the amount in TCD12.
TCD-14
782
Monetary Amount
Optional
Decimal number (R)
Min 1Max 15

Monetary amount

  • TCD14 is an undiscounted amount.
TCD-15
782
Monetary Amount
Optional
Decimal number (R)
Min 1Max 15

Monetary amount

  • TCD15 is a net amount after the discount has been applied to the amount in TCD14.
TCD-16
662
Relationship Code
Optional
Identifier (ID)
Min 1Max 1

Code indicating the relationship between entities

  • TCD16 is a code indicating the relationship of the price or amount to the associated segment.
SI
600
Detail > HL Loop > HL Loop > HL Loop Sub Billing Arrangement > HL Loop > HL Loop > HL Loop > TCD Loop > SI

Service Characteristic Identification

OptionalMax use 2

To specify service characteristic data

Example
If either Service Characteristics Qualifier (SI-04) or Product/Service ID (SI-05) is present, then the other is required
If either Service Characteristics Qualifier (SI-06) or Product/Service ID (SI-07) is present, then the other is required
If either Service Characteristics Qualifier (SI-08) or Product/Service ID (SI-09) is present, then the other is required
If either Service Characteristics Qualifier (SI-10) or Product/Service ID (SI-11) is present, then the other is required
SI-01
559
Agency Qualifier Code
Required
Identifier (ID)
Min 2Max 2

Code identifying the agency assigning the code values

  • SI01 defines the source for each of the service characteristics qualifiers.
SI-02
1000
Service Characteristics Qualifier
Required
String (AN)
Min 2Max 2

Code from an industry code list qualifying the type of service characteristics

SI-03
234
Product/Service ID
Required
String (AN)
Min 1Max 48

Identifying number for a product or service

SI-04
1000
Service Characteristics Qualifier
Optional
String (AN)
Min 2Max 2

Code from an industry code list qualifying the type of service characteristics

SI-05
234
Product/Service ID
Optional
String (AN)
Min 1Max 48

Identifying number for a product or service

SI-06
1000
Service Characteristics Qualifier
Optional
String (AN)
Min 2Max 2

Code from an industry code list qualifying the type of service characteristics

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

Identifying number for a product or service

SI-08
1000
Service Characteristics Qualifier
Optional
String (AN)
Min 2Max 2

Code from an industry code list qualifying the type of service characteristics

SI-09
234
Product/Service ID
Optional
String (AN)
Min 1Max 48

Identifying number for a product or service

SI-10
1000
Service Characteristics Qualifier
Optional
String (AN)
Min 2Max 2

Code from an industry code list qualifying the type of service characteristics

SI-11
234
Product/Service ID
Optional
String (AN)
Min 1Max 48

Identifying number for a product or service

TCD Loop end
HL Loop end
HL Loop end
HL Loop end
HL Loop Sub Billing Arrangement end
HL Loop end
HL Loop end
Detail end

Summary

TDS
010
Summary > TDS

Total Monetary Value Summary

RequiredMax use 1

To specify the total invoice discounts and amounts

Example
TDS-01
610
Amount
Required
Numeric (N2)
Min 1Max 15

Monetary amount

  • TDS01 is the total amount of invoice (including charges, less allowances) before terms discount (if discount is applicable).
BAL Loop
OptionalMax >1
BAL
040
Summary > BAL Loop > BAL

Balance Detail

RequiredMax use 1

To identify the specific monetary balances associated with a particular account

Example
BAL-01
951
Balance Type Code
Required
Identifier (ID)
Min 1Max 2

Code indicating the type of balance

BAL-02
522
Amount Qualifier Code
Required
Identifier (ID)
Min 1Max 3

Code to qualify amount

BAL-03
782
Monetary Amount
Required
Decimal number (R)
Min 1Max 15

Monetary amount

BAL Loop end
CTT
115
Summary > CTT

Transaction Totals

OptionalMax use 1

To transmit a hash total for a specific element in the transaction set

  • The number of line items (CTT01) is the accumulation of the number of IT1 segments.
Example
CTT-01
354
Number of Line Items
Required
Numeric (N0)
Min 1Max 6

Total number of line items in the transaction set

SE
120
Summary > SE

Transaction Set Trailer

RequiredMax use 1

To indicate the end of the transaction set and provide the count of the transmitted segments (including the beginning (ST) and ending (SE) segments)

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

Total number of segments included in a transaction set including ST and SE segments

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

Identifying control number that must be unique within the transaction set functional group assigned by the originator for a transaction set

Summary end

Functional Group Trailer

RequiredMax use 1

To indicate the end of a functional group and to provide control information

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

Total number of transaction sets included in the functional group or interchange (transmission) group terminated by the trailer containing this data element

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

Assigned number originated and maintained by the sender

Interchange Control Trailer

RequiredMax use 1

To define the end of an interchange of zero or more functional groups and interchange-related control segments

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

A count of the number of functional groups included in an interchange

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

A control number assigned by the interchange sender

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