Stedi maintains this guide based on public documentation from CVS. Contact CVS for official EDI specifications. To report any errors in this guide, please contact us.

X12 855 Purchase Order Acknowledgment

X12 Release 4010

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Delimiters

~ Segment
* Element
> Component

EDI samples

None included

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ISA

Interchange Control Header

RequiredMax use 1

—

Example

ISA-01

I01

Authorization Information Qualifier

Required

Identifier (ID)

—

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

ISA-02

I02

Authorization Information

Required

String (AN)

Min 10Max 10

—

ISA-03

I03

Security Information Qualifier

Required

Identifier (ID)

—

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

ISA-04

I04

Security Information

Required

String (AN)

Min 10Max 10

—

ISA-05

I05

Interchange ID Qualifier

Required

Identifier (ID)

Min 2Max 2

—

Codes

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

ISA-06

I06

Interchange Sender ID

Required

String (AN)

Min 15Max 15

—

ISA-07

I05

Interchange ID Qualifier

Required

Identifier (ID)

Min 2Max 2

—

Codes

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

ISA-08

I07

Interchange Receiver ID

Required

String (AN)

Min 15Max 15

—

ISA-09

I08

Interchange Date

Required

Date (DT)

YYMMDD format

—

ISA-10

I09

Interchange Time

Required

Time (TM)

HHMM format

—

ISA-11

I10

Interchange Control Standards Identifier

Required

Identifier (ID)

—

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

ISA-12

I11

Interchange Control Version Number

Required

Identifier (ID)

—

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

ISA-13

I12

Interchange Control Number

Required

Numeric (N0)

Min 9Max 9

—

ISA-14

I13

Acknowledgment Requested

Required

Identifier (ID)

Min 1Max 1

—

0: No Acknowledgment Requested
1: Interchange Acknowledgment Requested

ISA-15

I14

Usage Indicator

Required

Identifier (ID)

Min 1Max 1

—

I: Information
P: Production Data
T: Test Data

ISA-16

I15

Component Element Separator

Required

String (AN)

Min 1Max 1

—

>: Component Element Separator

Functional Group Header

RequiredMax use 1

—

Example

GS-01

479

Functional Identifier Code

Required

Identifier (ID)

—

PR: Purchase Order Acknowledgement (855)

GS-02

142

Application Sender's Code

Required

String (AN)

Min 2Max 15

—

GS-03

124

Application Receiver's Code

Required

String (AN)

Min 2Max 15

—

GS-04

373

Date

Required

Date (DT)

CCYYMMDD format

—

GS-05

337

Time

Required

Time (TM)

HHMM, HHMMSS, HHMMSSD, or HHMMSSDD format

—

GS-06

Group Control Number

Required

Numeric (N0)

Min 1Max 9

—

GS-07

455

Responsible Agency Code

Required

Identifier (ID)

Min 1Max 2

—

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

GS-08

480

Version / Release / Industry Identifier Code

Required

String (AN)

—

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

Heading

010

Heading > ST

Transaction Set Header

RequiredMax use 1

—

Example

ST-01

143

Transaction Set Identifier Code

Required

Identifier (ID)

—

855: Purchase Order Acknowledgment

ST-02

329

Transaction Set Control Number

Required

Numeric (N)

Min 4Max 9

—

BAK

020

Heading > BAK

Beginning Segment for Purchase Order Acknowledgment

RequiredMax use 1

—

Example

BAK-01

353

Transaction Set Purpose Code

Required

Identifier (ID)

—

00: Original

BAK-02

587

Acknowledgment Type

Required

Identifier (ID)

—

AP: Acknowledge - Product Replenishment

BAK-03

324

Purchase Order Number

Required

String (AN)

Min 1Max 22

—

Usage notes

—

BAK-04

373

Date

Required

Date (DT)

CCYYMMDD format

—

REF

050

Heading > REF

Reference Identification

OptionalMax use >1

—

Example

REF-01

128

Reference Identification Qualifier

Required

Identifier (ID)

—

VR: Vendor ID Number

REF-02

127

Reference Identification

Optional

String (AN)

Min 1Max 30

—

Usage notes

—

DTM

150

Heading > DTM

Date/Time Reference

OptionalMax use 10

—

Example

DTM-01

374

Date/Time Qualifier

Required

Identifier (ID)

—

067: Current Schedule Delivery

DTM-02

373

Date

Optional

Date (DT)

CCYYMMDD format

—

N1 Loop

OptionalMax >1

300

Heading > N1 Loop > N1

Name

RequiredMax use 1

—

Example

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

N1-01

Entity Identifier Code

Required

Identifier (ID)

—

ST: Ship To

N1-03

Identification Code Qualifier

Optional

Identifier (ID)

—

9: D-U-N-S+4, D-U-N-S Number with Four Character Suffix
11: Drug Enforcement Administration (DEA)

N1-04

Identification Code

Optional

String (AN)

Min 2Max 80

—

N1 Loop end

Heading end

Detail

PO1 Loop

OptionalMax >1

PO1

010

Detail > PO1 Loop > PO1

Baseline Item Data

RequiredMax use 1

—

Example

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

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

PO1-02

330

Quantity Ordered

Optional

Decimal number (R)

Min 1Max 15

—

PO1-03

355

Unit or Basis for Measurement Code

Optional

Identifier (ID)

—

EA: Each
—
PC: Piece

PO1-06

235

Product/Service ID Qualifier

Optional

Identifier (ID)

—

ND: National Drug Code (NDC)
PI: Purchaser's Item Code
UD: U.P.C./EAN Consumer Package Code (2-5-5)
UI: U.P.C. Consumer Package Code (1-5-5)

PO1-07

234

Product/Service ID

Optional

String (AN)

Min 1Max 48

—

CTP

040

Detail > PO1 Loop > CTP

Pricing Information

OptionalMax use >1

—

Example

CTP-02

236

Price Identifier Code

Optional

Identifier (ID)

—

UCP: Unit cost price

CTP-03

212

Unit Price

Optional

Decimal number (R)

Min 1Max 15

—

Usage notes

—

PO4

090

Detail > PO1 Loop > PO4

Item Physical Details

OptionalMax use >1

—

Example

PO4-01

356

Pack

Optional

Numeric (N0)

Min 1Max 6

—

Usage notes

—

PO1 Loop end

Detail end

Summary

CTT Loop

OptionalMax >1

CTT

010

Summary > CTT Loop > CTT

Transaction Totals

RequiredMax use 1

—

Example

CTT-01

354

Number of Line Items

Required

Numeric (N0)

Min 1Max 6

—

CTT-02

347

Hash Total

Optional

Decimal number (R)

Min 1Max 10

—

CTT Loop end

030

Summary > SE

Transaction Set Trailer

RequiredMax use 1

—

Example

SE-01

Number of Included Segments

Required

Numeric (N0)

Min 1Max 10

—

SE-02

329

Transaction Set Control Number

Required

Numeric (N)

Min 4Max 9

—

Summary end

Functional Group Trailer

RequiredMax use 1

—

Example

GE-01

Number of Transaction Sets Included

Required

Numeric (N0)

Min 1Max 6

—

GE-02

Group Control Number

Required

Numeric (N0)

Min 1Max 9

—

IEA

Interchange Control Trailer

RequiredMax use 1

—

Example

IEA-01

I16

Number of Included Functional Groups

Required

Numeric (N0)

Min 1Max 5

—

IEA-02

I12

Interchange Control Number

Required

Numeric (N0)

Min 9Max 9

—

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