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

ISA Interchange Control Header

Required · Max use 1

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

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 10 Max 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 10 Max 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 2 Max 2

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

Codes

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

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

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 2 Max 2

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

Codes

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

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

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 9 Max 9

A control number assigned by the interchange sender

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

GS Functional Group Header

Required · Max use 1

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

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 2 Max 15

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

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

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

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

Date expressed as CCYYMMDD

GS-05 · 337 · Time · 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 1 Max 9

Assigned number originated and maintained by the sender

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

010 Heading > ST

ST Transaction Set Header

Required · Max use 1

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

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 4 Max 9

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

020 Heading > BIG

BIG Beginning Segment for Invoice

Required · Max use 1

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

BIG-01 · 373 · Date · Required · Date (DT) · CCYYMMDD format

Date expressed as CCYYMMDD

• BIG01 is the invoice issue date.

BIG-02 · 76 · Invoice Number · Required · String (AN) · Min 1 Max 22

Identifying number assigned by issuer

BIG-07 · 640 · Transaction Type Code · Required · Identifier (ID)

Code specifying the type of transaction

• BIG07 is used only to further define the type of invoice when needed.

• CD: Consolidated Debit Invoice
• ME: Memorandum

050 Heading > REF

REF Reference Identification Billing Account

Required · Max use 1

To specify identifying information

Variants (all may be used)

REFReference Identification Master Account Number

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

Code qualifying the Reference Identification

• 12: Billing Account

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

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

050 Heading > REF

REF Reference Identification Master Account Number

Optional · Max use 1

To specify identifying information

Variants (all may be used)

REFReference Identification Billing Account

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

Code qualifying the Reference Identification

• 14: Master Account Number

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

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

080 Heading > DTM

DTM Date/Time Reference Invoice Period End

Optional · Max use 1

To specify pertinent dates and times

Variants (all may be used)

DTMDate/Time Reference Invoice Period Start

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

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

• 187: Invoice Period End

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

Date expressed as CCYYMMDD

080 Heading > DTM

DTM Date/Time Reference Invoice Period Start

Optional · Max use 1

To specify pertinent dates and times

Variants (all may be used)

DTMDate/Time Reference Invoice Period End

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

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

• 186: Invoice Period Start

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

Date expressed as CCYYMMDD

N1 Loop Payee Required Max 1

Variants (all may be used)

N1 Loop Payer

100 Heading > N1 Loop Payee > N1

N1 Name

Required · Max use 1

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

N1-01 · 98 · Entity Identifier Code · Required · Identifier (ID)

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

• PE: Payee

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

Free-form name

120 Heading > N1 Loop Payee > N3

N3 Address Information

Required · Max use 2

To specify the location of the named party

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

Address information

130 Heading > N1 Loop Payee > N4

N4 Geographic Location

Required · Max use 1

To specify the geographic place of the named party

N4-01 · 19 · City Name · Required · String (AN) · Min 2 Max 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 · Required · Identifier (ID) · Min 2 Max 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 · Required · Identifier (ID) · Min 3 Max 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 2 Max 3

Code identifying the country

N1 Loop Payer Required Max 1

Variants (all may be used)

N1 Loop Payee

100 Heading > N1 Loop Payer > N1

N1 Name

Required · Max use 1

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

N1-01 · 98 · Entity Identifier Code · Required · Identifier (ID)

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

• PR: Payer

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

Free-form name

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

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

• 91: Assigned by Seller or Seller's Agent

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

Code identifying a party or other code

• This segment, used alone, provides the most efficient method of providing organizational identification. To obtain this efficiency the "ID Code" (N104) must provide a key to the table maintained by the transaction processing party.

120 Heading > N1 Loop Payer > N3

N3 Address Information

Required · Max use 2

To specify the location of the named party

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

Address information

130 Heading > N1 Loop Payer > N4

N4 Geographic Location

Required · Max use 1

To specify the geographic place of the named party

N4-01 · 19 · City Name · Required · String (AN) · Min 2 Max 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 · Required · Identifier (ID) · Min 2 Max 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 · Required · Identifier (ID) · Min 3 Max 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 2 Max 3

Code identifying the country

Detail

HL Loop Required Max >1

010 Detail > HL Loop > HL

HL Hierarchical Level

Required · Max 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.

HL-01 · 628 · Hierarchical ID Number · Required · String (AN) · Min 1 Max 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 Required Max >1

020 Detail > HL Loop > LX Loop > LX

LX Assigned Number

Required · Max use 1

To reference a line number in a transaction set

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

Number assigned for differentiation within a transaction set

NM1 Loop Required Max >1

110 Detail > HL Loop > NM1 Loop > NM1

NM1 Individual or Organizational Name

Required · Max 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.

NM1-01 · 98 · Entity Identifier Code · Required · Identifier (ID)

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

• SJ: Service Provider

NM1-02 · 1065 · Entity Type Qualifier · Required · Identifier (ID)

Code qualifying the type of entity

• NM102 qualifies NM103.

• 2: Non-Person Entity

NM1-03 · 1035 · Name Last or Organization Name · Required · String (AN) · Min 1 Max 35

Individual last name or organizational name

160 Detail > HL Loop > NM1 Loop > PER

PER Administrative Communications Contact

Required · Max use >1

To identify a person or office to whom administrative communications should be directed

PER-01 · 366 · Contact Function Code · Required · Identifier (ID)

Code identifying the major duty or responsibility of the person or group named

• BI: Bill Inquiry Contact

PER-03 · 365 · Communication Number Qualifier · Required · Identifier (ID)

Code identifying the type of communication number

• TE: Telephone

PER-04 · 364 · Communication Number · Required · String (AN) · Min 1 Max 80

Complete communications number including country or area code when applicable

170 Detail > HL Loop > NM1 Loop > TXI

TXI Tax Information

Optional · Max use >1

To specify tax information

TXI-01 · 963 · Tax Type Code · Required · Identifier (ID)

Code specifying the type of tax

• FD: Federal Tax
• SP: State/Provincial Tax
• TX: All Taxes

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

Monetary amount

• TXI02 is the monetary amount of the tax.

TXI-06 · 441 · Tax Exempt Code · Required · Identifier (ID)

Code identifying exemption status from sales and use tax

• 2: No (Not Tax Exempt)

TXI-07 · 662 · Relationship Code · Required · Identifier (ID)

Code indicating the relationship between entities

• TXI07 is a code indicating the relationship of the price or amount to the associated segment.

• A: Add

TXI-10 · 350 · Assigned Identification · Optional · String (AN) · Min 1 Max 20

Alphanumeric characters assigned for differentiation within a transaction set

ITA Loop Optional Max >1

180 Detail > HL Loop > ITA Loop > ITA

ITA Allowance, Charge or Service

Required · Max use 1

To specify allowances, charges, or services

ITA-01 · 248 · Allowance or Charge Indicator · Required · Identifier (ID)

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.

• A: Allowance
• C: Charge

ITA-02 · 559 · Agency Qualifier Code · Required · Identifier (ID)

Code identifying the agency assigning the code values

• ITA02 identifies the source of the code value in ITA03 or ITA15.

• TI: Telecommunications Industry

ITA-04 · 331 · Allowance or Charge Method of Handling Code · Required · Identifier (ID)

Code indicating method of handling for an allowance or charge

• 06: Charge to be Paid by Customer

ITA-05 · 341 · Allowance or Charge Number · Required · String (AN) · Min 1 Max 16

The number assigned by a vendor referencing an allowance, promotion, deal or charge

ITA-07 · 360 · Allowance or Charge Total Amount · Required · Numeric (N2) · Min 1 Max 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 · Required · Decimal number (R) · Min 1 Max 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 · Required · Identifier (ID)

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

• M4: Monetary Value

ITA-13 · 352 · Description · Optional · String (AN) · Min 1 Max 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 · Required · Identifier (ID)

Code identifying type of special charge or allowance

• AAJ: Adjustments
• LPC: Late payment charge
• PRT: TBD
• SUR: Surcharge

ITA-16 · 662 · Relationship Code · Required · Identifier (ID)

Code indicating the relationship between entities

• ITA16 describes the relationship of ITA06, ITA07 or ITA09 to an associated segment.

• A: Add

HL Loop Billing Arrangement Optional Max >1

Variants (one may be used)

HL Loop Group

010 Detail > HL Loop > HL Loop Billing Arrangement > HL

HL Hierarchical Level

Required · Max 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.

HL-01 · 628 · Hierarchical ID Number · Required · String (AN) · Min 1 Max 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 1 Max 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 Required Max >1

020 Detail > HL Loop > HL Loop Billing Arrangement > LX Loop > LX

LX Assigned Number

Required · Max use 1

To reference a line number in a transaction set

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

Number assigned for differentiation within a transaction set

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

REF Reference Identification

Required · Max use >1

To specify identifying information

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

Code qualifying the Reference Identification

• 11: Account Number
• 14: Master Account Number

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

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

080 Detail > HL Loop > HL Loop Billing Arrangement > LX Loop > TXI

TXI Tax Information

Required · Max use >1

To specify tax information

TXI-01 · 963 · Tax Type Code · Required · Identifier (ID)

Code specifying the type of tax

• TX: All Taxes

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

Monetary amount

• TXI02 is the monetary amount of the tax.

TXI-06 · 441 · Tax Exempt Code · Required · Identifier (ID)

Code identifying exemption status from sales and use tax

• 2: No (Not Tax Exempt)

TXI-07 · 662 · Relationship Code · Required · Identifier (ID)

Code indicating the relationship between entities

• TXI07 is a code indicating the relationship of the price or amount to the associated segment.

• O: Information Only

HL Loop Optional Max >1

010 Detail > HL Loop > HL Loop Billing Arrangement > HL Loop > HL

HL Hierarchical Level

Required · Max 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.

HL-01 · 628 · Hierarchical ID Number · Required · String (AN) · Min 1 Max 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 1 Max 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.

IT1 Loop Required Max >1

210 Detail > HL Loop > HL Loop Billing Arrangement > HL Loop > IT1 Loop > IT1

IT1 Baseline Item Data (Invoice)

Required · Max 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.

IT1-01 · 350 · Assigned Identification · Required · String (AN) · Min 1 Max 20

Alphanumeric characters assigned for differentiation within a transaction set

• IT101 is the purchase order line item identification.

IT1-02 · 358 · Quantity Invoiced · Required · Decimal number (R) · Min 1 Max 10

Number of units invoiced (supplier units)

IT1-03 · 355 · Unit or Basis for Measurement Code · Required · Identifier (ID)

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

• M4: Monetary Value

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

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

IT1-06 · 235 · Product/Service ID Qualifier · Required · Identifier (ID)

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.

• SV: Service Rendered

IT1-07 · 234 · Product/Service ID · Required · String (AN) · Min 1 Max 48

Identifying number for a product or service

IT1-08 · 235 · Product/Service ID Qualifier · Required · Identifier (ID)

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

• ZZ: Mutually Defined

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

Identifying number for a product or service

HL Loop Group Optional Max >1

Variants (one may be used)

HL Loop Billing Arrangement

010 Detail > HL Loop > HL Loop Group > HL

HL Hierarchical Level

Required · Max 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.

HL-01 · 628 · Hierarchical ID Number · Required · String (AN) · Min 1 Max 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 1 Max 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 Required Max >1

210 Detail > HL Loop > HL Loop Group > IT1 Loop > IT1

IT1 Baseline Item Data (Invoice)

Required · Max 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.

IT1-01 · 350 · Assigned Identification · Required · String (AN) · Min 1 Max 20

Alphanumeric characters assigned for differentiation within a transaction set

• IT101 is the purchase order line item identification.

IT1-02 · 358 · Quantity Invoiced · Required · Decimal number (R) · Min 1 Max 10

Number of units invoiced (supplier units)

IT1-03 · 355 · Unit or Basis for Measurement Code · Required · Identifier (ID)

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

• M4: Monetary Value

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

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

IT1-06 · 235 · Product/Service ID Qualifier · Required · Identifier (ID)

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.

• SV: Service Rendered

IT1-07 · 234 · Product/Service ID · Required · String (AN) · Min 1 Max 48

Identifying number for a product or service

IT1-08 · 235 · Product/Service ID Qualifier · Required · Identifier (ID)

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

• ZZ: Mutually Defined

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

Identifying number for a product or service

HL Loop Optional Max >1

010 Detail > HL Loop > HL Loop Group > HL Loop > HL

HL Hierarchical Level

Required · Max 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.

HL-01 · 628 · Hierarchical ID Number · Required · String (AN) · Min 1 Max 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 1 Max 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.

• 5: Category

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 Required Max >1

020 Detail > HL Loop > HL Loop Group > HL Loop > LX Loop > LX

LX Assigned Number

Required · Max use 1

To reference a line number in a transaction set

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

Number assigned for differentiation within a transaction set

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

SI Service Characteristic Identification

Required · Max use 8

To specify service characteristic data

SI-01 · 559 · Agency Qualifier Code · Required · Identifier (ID)

Code identifying the agency assigning the code values

• SI01 defines the source for each of the service characteristics qualifiers.

• TI: Telecommunications Industry

SI-02 · 1000 · Service Characteristics Qualifier · Required · String (AN)

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

• TN: TBD

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

Identifying number for a product or service

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

AMT Monetary Amount

Required · Max use 5

To indicate the total monetary amount

AMT-01 · 522 · Amount Qualifier Code · Required · Identifier (ID)

Code to qualify amount

• 1: Line Item Total

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

Monetary amount

HL Loop Optional Max >1

010 Detail > HL Loop > HL Loop Group > HL Loop > HL Loop > HL

HL Hierarchical Level

Required · Max 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.

HL-01 · 628 · Hierarchical ID Number · Required · String (AN) · Min 1 Max 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 1 Max 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.

SLN Loop Required Max >1

390 Detail > HL Loop > HL Loop Group > HL Loop > HL Loop > SLN Loop > SLN

SLN Subline Item Detail

Required · Max use 1

To specify product subline detail item data

• The SLN loop may only appear at the charge detail level.

SLN-01 · 350 · Assigned Identification · Required · String (AN) · Min 1 Max 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)

Code indicating the relationship between entities

• SLN03 is the configuration code indicating the relationship of the subline item to the baseline item.

• I: Included

SLN-04 · 380 · Quantity · Required · Decimal number (R) · Min 1 Max 15

Numeric value of quantity

SLN-05 · C001 · Composite Unit of Measure · Required Max 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)

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

• M4: Monetary Value

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

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

SLN-08 · 662 · Relationship Code · Required · Identifier (ID)

Code indicating the relationship between entities

• SLN08 is a code indicating the relationship of the price or amount to the associated segment.

• I: Included

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

SI Service Characteristic Identification

Required · Max use 2

To specify service characteristic data

SI-01 · 559 · Agency Qualifier Code · Required · Identifier (ID)

Code identifying the agency assigning the code values

• SI01 defines the source for each of the service characteristics qualifiers.

• TI: Telecommunications Industry

SI-02 · 1000 · Service Characteristics Qualifier · Required · String (AN)

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

• SC: TBD
• SD: TBD

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

Identifying number for a product or service

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

PID Product/Item Description

Required · Max use 200

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

PID-01 · 349 · Item Description Type · Required · Identifier (ID)

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.

• F: Free-form

PID-03 · 559 · Agency Qualifier Code · Required · Identifier (ID)

Code identifying the agency assigning the code values

• Use PID03 to indicate the organization that publishes the code list being referred to.

• AS: Assigned by Seller

PID-04 · 751 · Product Description Code · Required · String (AN) · Min 1 Max 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 · Required · String (AN) · Min 1 Max 80

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

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

AMT Monetary Amount

Optional · Max use 15

To indicate the total monetary amount

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

Code to qualify amount

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

Monetary amount

QTY Loop Optional Max >1

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

QTY Quantity

Required · Max use 1

To specify quantity information

QTY-01 · 673 · Quantity Qualifier · Required · Identifier (ID)

Code specifying the type of quantity

• 99: Quantity Used

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

Numeric value of quantity

QTY-03 · C001 · Composite Unit of Measure · Required Max 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)

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

• C0: Calls
• MJ: Minutes

Summary

010 Summary > TDS

TDS Total Monetary Value Summary

Optional · Max use 1

To specify the total invoice discounts and amounts

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

Monetary amount

• TDS01 is the total amount of invoice (including charges, less allowances) before terms discount (if discount is applicable).

ITA Loop Optional Max >1

020 Summary > ITA Loop > ITA

ITA Allowance, Charge or Service

Required · Max use 1

To specify allowances, charges, or services

ITA-01 · 248 · Allowance or Charge Indicator · Required · Identifier (ID)

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.

• A: Allowance
• C: Charge

ITA-02 · 559 · Agency Qualifier Code · Optional · Identifier (ID)

Code identifying the agency assigning the code values

• ITA02 identifies the source of the code value in ITA03 or ITA15.

• TI: Telecommunications Industry

ITA-04 · 331 · Allowance or Charge Method of Handling Code · Required · Identifier (ID)

Code indicating method of handling for an allowance or charge

• 06: Charge to be Paid by Customer

ITA-05 · 341 · Allowance or Charge Number · Required · String (AN) · Min 1 Max 16

The number assigned by a vendor referencing an allowance, promotion, deal or charge

ITA-07 · 360 · Allowance or Charge Total Amount · Required · Numeric (N2) · Min 1 Max 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 · Required · Decimal number (R) · Min 1 Max 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 · Required · Identifier (ID)

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

• M4: Monetary Value

ITA-13 · 352 · Description · Optional · String (AN) · Min 1 Max 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 · Required · Identifier (ID)

Code identifying type of special charge or allowance

• AAJ: Adjustments
• LPC: Late payment charge

ITA-16 · 662 · Relationship Code · Required · Identifier (ID)

Code indicating the relationship between entities

• ITA16 describes the relationship of ITA06, ITA07 or ITA09 to an associated segment.

• O: Information Only

BAL Loop Optional Max >1

040 Summary > BAL Loop > BAL

BAL Balance Detail

Required · Max use 1

To identify the specific monetary balances associated with a particular account

BAL-01 · 951 · Balance Type Code · Required · Identifier (ID)

Code indicating the type of balance

• A: Adjustment
• M: Current Month
• P: Previous Month

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

Code to qualify amount

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

Monetary amount

N1 Loop Optional Max >1

060 Summary > N1 Loop > N1

N1 Name

Required · Max use 1

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

N1-01 · 98 · Entity Identifier Code · Required · Identifier (ID)

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

• 87: Pay-to Provider
• SJ: Service Provider

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

Free-form name

120 Summary > SE

SE Transaction Set Trailer

Required · Max 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)

SE-01 · 96 · Number of Included Segments · Required · Numeric (N0) · Min 1 Max 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 4 Max 9

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

GE Functional Group Trailer

Required · Max use 1

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

GE-01 · 97 · Number of Transaction Sets Included · Required · Numeric (N0) · Min 1 Max 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 1 Max 9

Assigned number originated and maintained by the sender

IEA Interchange Control Trailer

Required · Max use 1

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

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

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

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

A control number assigned by the interchange sender