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X12 820 Payment Order/Remittance Advice

X12 Release 4010

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Delimiters

~ Segment
* Element
> Component

EDI sample

—

Sample 1

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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)

—

RA: Payment Order/Remittance Advice (820)

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)

—

820: Payment Order/Remittance Advice

ST-02

329

Transaction Set Control Number

Required

Numeric (N)

Min 4Max 9

—

BPR

020

Heading > BPR

Beginning Segment for Payment Order/Remittance Advice

RequiredMax use 1

—

Example

BPR-01

305

Transaction Handling Code

Required

Identifier (ID)

—

H: Notification Only

BPR-02

782

Monetary Amount

Required

Decimal number (R)

Min 1Max 15

—

BPR-03

478

Credit/Debit Flag Code

Required

Identifier (ID)

—

C: Credit

BPR-04

591

Payment Method Code

Required

Identifier (ID)

—

ACH: Automated Clearing House (ACH)

TRN

035

Heading > TRN

Trace

RequiredMax use 1

—

Example

TRN-01

481

Trace Type Code

Required

Identifier (ID)

—

1: Current Transaction Trace Numbers

TRN-02

127

Reference Identification

Required

String (AN)

Min 1Max 30

—

DTM

060

Heading > DTM

Date/Time Reference

RequiredMax use >1

—

Example

DTM-01

374

Date/Time Qualifier

Required

Identifier (ID)

—

020: Payment/Check Date

DTM-02

373

Date

Required

Date (DT)

CCYYMMDD format

—

N1 Loop

RequiredMax >1

070

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)

—

PE: Payee
PR: Payer

N1-02

Name

Required

String (AN)

Min 1Max 60

—

N1-03

Identification Code Qualifier

Optional

Identifier (ID)

—

ZZ: Mutually Defined

N1-04

Identification Code

Optional

String (AN)

Min 2Max 80

—

Usage notes

—

090

Heading > N1 Loop > N3

Address Information

RequiredMax use >1

—

Example

N3-01

166

Address Information

Required

String (AN)

Min 1Max 55

—

N3-02

166

Address Information

Optional

String (AN)

Min 1Max 55

—

100

Heading > N1 Loop > N4

Geographic Location

RequiredMax use 1

—

Example

N4-01

City Name

Required

String (AN)

Min 2Max 30

—

N4-02

156

State or Province Code

Required

Identifier (ID)

Min 2Max 2

—

N4-03

116

Postal Code

Required

Identifier (ID)

Min 3Max 15

—

N4-04

Country Code

Required

Identifier (ID)

Min 2Max 3

—

N1 Loop end

Heading end

Detail

ENT Loop

RequiredMax >1

ENT

010

Detail > ENT Loop > ENT

Entity

RequiredMax use 1

—

Example

ENT-01

554

Assigned Number

Required

Numeric (N0)

Min 1Max 6

—

RMR Loop

RequiredMax >1

RMR

150

Detail > ENT Loop > RMR Loop > RMR

Remittance Advice Accounts Receivable Open Item Reference

RequiredMax use 1

—

Example

RMR-01

128

Reference Identification Qualifier

Required

Identifier (ID)

—

IV: Seller's Invoice Number

RMR-02

127

Reference Identification

Required

String (AN)

Min 1Max 30

—

RMR-04

782

Monetary Amount

Required

Decimal number (R)

Min 1Max 15

—

RMR-05

782

Monetary Amount

Required

Decimal number (R)

Min 1Max 15

—

RMR-06

782

Monetary Amount

Required

Decimal number (R)

Min 1Max 15

—

RMR Loop end

ENT Loop end

Detail end

Summary

010

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

—

EDI Samples

Sample 1

ST*820*0001~
BPR*H*3455.12*C*ACH~
TRN*1*151969~
DTM*020*20110223~
N1*PR*MILLS FLEET FARM~
N3*512 LAUREL STREET*PO BOX 5055~
N4*BRAINERD*MN*56401*US~
N1*PE*ACME CORPORATION*ZZ*903672~
N3*1234 MAIN STREET~
N4*ANY TOWN*WI*54313*US~
ENT*1~
RMR*IV*EK6767322**27.34*27.9*0.56~
RMR*IV*EK6765822**102.66*104.76*2.1~
RMR*IV*EK6754122**1043.19*1064.48*21.29~
SE*15*0001~

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