X12 867 Product Transfer and Resale Report

X12 Release 4010

This Draft Standard for Trial Use contains the format and establishes the data contents of the Product Transfer and Resale Report Transaction Set (867) for use within the context of an Electronic Data Interchange (EDI) environment. The transaction set can be used to: (1) report information about product that has been transferred from one location to another; (2) report sales of product from one or more locations to an end customer; or (3) report sales of a product from one or more locations to an end customer, and demand beyond actual sales (lost orders). Report may be issued by either buyer or seller.

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

• PT: Product Transfer and Resale Report (867)

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).

• 867: Product Transfer and Resale Report

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 > BPT

BPT Beginning Segment for Product Transfer and Resale

Required · Max use 1

To indicate the beginning of the Product Transfer and Resale Report Transaction Set and transmit identifying data

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

Code identifying purpose of transaction set

• 00: Original

BPT-03 · 373 · Date · Required · Date (DT) · CCYYMMDD format

Date expressed as CCYYMMDD

• BPT03 identifies the transfer/resale date.

BPT-04 · 755 · Report Type Code · Optional · Identifier (ID)

Code indicating the title or contents of a document, report or supporting item

• SS: Seller Sales Report

BPT-10 · 786 · Security Level Code · Optional · Identifier (ID) · Min 2 Max 2

Code indicating the level of confidentiality assigned by the sender to the information following

050 Heading > DTM

DTM Report End

Optional · Max use 10

To specify pertinent dates and times

Usage notes

Example: DTM09120090830

Variants (all may be used)

DTMReport Start

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

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

• 091: Report End

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

Date expressed as CCYYMMDD

050 Heading > DTM

DTM Report Start

Optional · Max use 10

To specify pertinent dates and times

Usage notes

Example: DTM09020090825

Variants (all may be used)

DTMReport End

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

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

• 090: Report Start

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

Date expressed as CCYYMMDD

N1 Distributor Branch Optional Max >1

Variants (all may be used)

Supplier/Manufacturer

080 Heading > Distributor Branch > N1

N1 Name

Required · Max use 1

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

Usage notes

Example: N1DBH-E-B11RH0277067

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

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

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

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

• DB: Distributor Branch

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

Free-form name

Usage notes

Division Name

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

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

• 11: Drug Enforcement Administration (DEA)

N1-04 · 67 · Identification Code · Optional · 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.

Usage notes

DEA Number

N1 Supplier/Manufacturer Optional Max >1

Variants (all may be used)

Distributor Branch

080 Heading > Supplier/Manufacturer > N1

N1 Name

Required · Max use 1

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

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

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

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

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

• SU: Supplier/Manufacturer

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

Free-form name

Usage notes

Supplier Name

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

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

• 11: Drug Enforcement Administration (DEA)

N1-04 · 67 · Identification Code · Optional · 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.

Usage notes

Supplier DEA Number

Detail

PTD Loop Required Max >1

010 Detail > PTD Loop > PTD

PTD Product Transfer and Resale Detail

Required · Max use 1

To indicate the start of detail information relating to the transfer/resale of a product and provide identifying data

Usage notes

Invoice Loop Example: PTDSS*DI5546

If either Reference Identification Qualifier (PTD-04) or Reference Identification (PTD-05) is present, then the other is required

PTD-01 · 521 · Product Transfer Type Code · Required · Identifier (ID)

Code identifying the type of product transfer

• RP: Return of List Price
• SS: Stock Sale

PTD-04 · 128 · Reference Identification Qualifier · Optional · Identifier (ID)

Code qualifying the Reference Identification

• DI: Distributor Invoice Number

PTD-05 · 127 · Reference Identification · Optional · String (AN) · Min 1 Max 30

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

Usage notes

Original Invoice Number

020 Detail > PTD Loop > DTM

DTM Invoice

Optional · Max use 10

To specify pertinent dates and times

Usage notes

Example: DTM00320090823

Variants (all may be used)

DTMOrderDTMShipped

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

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

• 003: Invoice

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

Date expressed as CCYYMMDD

020 Detail > PTD Loop > DTM

DTM Order

Optional · Max use 10

To specify pertinent dates and times

Usage notes

Example: DTM93820090823

Variants (all may be used)

DTMInvoiceDTMShipped

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

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

• 938: Order

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

Date expressed as CCYYMMDD

020 Detail > PTD Loop > DTM

DTM Shipped

Optional · Max use 10

To specify pertinent dates and times

Usage notes

Example: DTM01120090824

Variants (all may be used)

DTMInvoiceDTMOrder

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

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

• 011: Shipped

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

Date expressed as CCYYMMDD

N1 Loop Required Max >1

050 Detail > PTD Loop > N1 Loop > N1

N1 Name

Required · Max use 1

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

Usage notes

Example: N1STSA41 Potranco/160411FH0006418

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

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

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

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

• ST: Ship To

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

Free-form name

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

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

• 11: Drug Enforcement Administration (DEA)

N1-04 · 67 · Identification Code · Optional · 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.

Usage notes

Ship-To DEA Number

070 Detail > PTD Loop > N1 Loop > N3

N3 Address Information

Optional · Max use 2

To specify the location of the named party

Usage notes

Example: N3*10718 POTRANCO

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

Address information

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

Address information

080 Detail > PTD Loop > N1 Loop > N4

N4 Geographic Location

Optional · Max use 1

To specify the geographic place of the named party

Usage notes

Example: N4SAN ANTONIOTX64181USA

N4-01 · 19 · City Name · Optional · 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 · Optional · 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 · Optional · 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

SII Loop Optional Max >1

105 Detail > PTD Loop > N1 Loop > SII Loop > SII

SII Sales Item Information

Required · Max use 1

To specify line item information related to a sale of an item

SII-01 · 235 · Product/Service ID Qualifier · Required · Identifier (ID) · Min 2 Max 2

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

SII-02 · 234 · Product/Service ID · Required · String (AN) · Min 1 Max 48

Identifying number for a product or service

SII-03 · 380 · Quantity · Required · Decimal number (R) · Min 1 Max 15

Numeric value of quantity

• SII03 is the amount of the product identified in SII01 and SII02.

SII-04 · 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) · Min 2 Max 2

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

C001-02 · 1018 · Exponent · Optional · Decimal number (R) · Min 1 Max 15

Power to which a unit is raised

C001-03 · 649 · Multiplier · Optional · Decimal number (R) · Min 1 Max 10

Value to be used as a multiplier to obtain a new value

C001-04 · 355 · Unit or Basis for Measurement Code · Optional · Identifier (ID) · Min 2 Max 2

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

C001-05 · 1018 · Exponent · Optional · Decimal number (R) · Min 1 Max 15

Power to which a unit is raised

C001-06 · 649 · Multiplier · Optional · Decimal number (R) · Min 1 Max 10

Value to be used as a multiplier to obtain a new value

C001-07 · 355 · Unit or Basis for Measurement Code · Optional · Identifier (ID) · Min 2 Max 2

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

C001-08 · 1018 · Exponent · Optional · Decimal number (R) · Min 1 Max 15

Power to which a unit is raised

C001-09 · 649 · Multiplier · Optional · Decimal number (R) · Min 1 Max 10

Value to be used as a multiplier to obtain a new value

C001-10 · 355 · Unit or Basis for Measurement Code · Optional · Identifier (ID) · Min 2 Max 2

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

C001-11 · 1018 · Exponent · Optional · Decimal number (R) · Min 1 Max 15

Power to which a unit is raised

C001-12 · 649 · Multiplier · Optional · Decimal number (R) · Min 1 Max 10

Value to be used as a multiplier to obtain a new value

C001-13 · 355 · Unit or Basis for Measurement Code · Optional · Identifier (ID) · Min 2 Max 2

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

C001-14 · 1018 · Exponent · Optional · Decimal number (R) · Min 1 Max 15

Power to which a unit is raised

C001-15 · 649 · Multiplier · Optional · Decimal number (R) · Min 1 Max 10

Value to be used as a multiplier to obtain a new value

SII-05 · 212 · Unit Price · Optional · Decimal number (R) · Min 1 Max 15

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

• SII05 is the wholesale acquisition price.

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

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

• SII06 is the contract price.

SII-07 · 782 · Monetary Amount · Optional · Decimal number (R) · Min 1 Max 15

Monetary amount

• SII07 is the extended rebate amount.

107 Detail > PTD Loop > N1 Loop > SII Loop > N9

N9 Reference Identification

Optional · Max use 1

To transmit identifying information as specified by the Reference Identification Qualifier

At least one of Reference Identification (N9-02) or Free-form Description (N9-03) is required

If Time Code (N9-06) is present, then Time (N9-05) is required

N9-01 · 128 · Reference Identification Qualifier · Required · Identifier (ID) · Min 2 Max 3

Code qualifying the Reference Identification

N9-02 · 127 · Reference Identification · Optional · String (AN) · Min 1 Max 30

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

N9-03 · 369 · Free-form Description · Optional · String (AN) · Min 1 Max 45

Free-form descriptive text

N9-04 · 373 · Date · Optional · Date (DT) · CCYYMMDD format

Date expressed as CCYYMMDD

N9-05 · 337 · Time · 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)

N9-06 · 623 · Time Code · Optional · Identifier (ID) · Min 2 Max 2

Code identifying the time. In accordance with International Standards Organization standard 8601, time can be specified by a + or - and an indication in hours in relation to Universal Time Coordinate (UTC) time; since + is a restricted character, + and - are substituted by P and M in the codes that follow

• N906 reflects the time zone which the time reflects.

N9-07 · C040 · Reference Identifier · Optional Max use 1 · To identify one or more reference numbers or identification numbers as specified by the Reference Qualifier · If either Reference Identification Qualifier (C040 - 03) or Reference Identification (C040 - 04) is present, then the other is required If either Reference Identification Qualifier (C040 - 05) or Reference Identification (C040 - 06) is present, then the other is required

C040-01 · 128 · Reference Identification Qualifier · Required · Identifier (ID) · Min 2 Max 3

Code qualifying the Reference Identification

C040-02 · 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

C040-03 · 128 · Reference Identification Qualifier · Optional · Identifier (ID) · Min 2 Max 3

Code qualifying the Reference Identification

C040-04 · 127 · Reference Identification · Optional · String (AN) · Min 1 Max 30

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

C040-05 · 128 · Reference Identification Qualifier · Optional · Identifier (ID) · Min 2 Max 3

Code qualifying the Reference Identification

C040-06 · 127 · Reference Identification · Optional · String (AN) · Min 1 Max 30

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

QTY Loop Optional Max >1

110 Detail > PTD Loop > QTY Loop > QTY

QTY Quantity

Required · Max use 1

To specify quantity information

Usage notes

Example: QTY321*EA

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

Code specifying the type of quantity

• 32: Quantity Sold

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

Numeric value of quantity

QTY-03 · C001 · Composite Unit of Measure · Optional 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

• CA: Case
• CT: Carton
• EA: Each

120 Detail > PTD Loop > QTY Loop > LIN

LIN Item Identification

Optional · Max use 1

To specify basic item identification data

Usage notes

Example: LIN*N413310015307PI0089646MG3742954

If either Product/Service ID Qualifier (LIN-04) or Product/Service ID (LIN-05) is present, then the other is required

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

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

Alphanumeric characters assigned for differentiation within a transaction set

• LIN01 is the line item identification

LIN-02 · 235 · Product/Service ID Qualifier · Required · Identifier (ID)

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

• LIN02 through LIN31 provide for fifteen different product/service IDs for each item. For example: Case, Color, Drawing No., U.P.C. No., ISBN No., Model No., or SKU.

• N4: National Drug Code in 5-4-2 Format

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

Identifying number for a product or service

LIN-04 · 235 · Product/Service ID Qualifier · Optional · Identifier (ID)

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

• PI: Purchaser's Item Code

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

Identifying number for a product or service

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

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

• MG: Manufacturer's Part Number

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

Identifying number for a product or service

130 Detail > PTD Loop > QTY Loop > UIT

UIT Unit Detail

Optional · Max use 12

To specify item unit data

Usage notes

Example: UITEA131.049*WH

If Basis of Unit Price Code (UIT-03) is present, then Unit Price (UIT-02) is required

UIT-01 · 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

• CA: Case
• CT: Carton
• EA: Each

UIT-02 · 212 · Unit Price · Optional · Decimal number (R) · Min 1 Max 15

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

UIT-03 · 639 · Basis of Unit Price Code · Optional · Identifier (ID)

Code identifying the type of unit price for an item

• WH: Wholesale

140 Detail > PTD Loop > QTY Loop > AMT

AMT Monetary Amount

Optional · Max use 12

To indicate the total monetary amount

Usage notes

Example: AMTTT131.049

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

Code to qualify amount

• TT: Total Transaction Amount

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

Monetary amount

AMT-03 · 478 · Credit/Debit Flag Code · Optional · Identifier (ID) · Min 1 Max 1

Code indicating whether amount is a credit or debit

150 Detail > PTD Loop > QTY Loop > PID

PID Product/Item Description

Optional · Max use 200

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

Usage notes

Example: PIDF***Asprin

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-05 · 352 · Description · Optional · String (AN) · Min 1 Max 80

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

190 Detail > PTD Loop > QTY Loop > REF

REF Reference Identification

Optional · Max use >1

To specify identifying information

Usage notes

Example: REFDI5546*Asprin

At least one of Reference Identification (REF-02) or Description (REF-03) is required

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

Code qualifying the Reference Identification

• DI: Distributor Invoice Number

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

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

Usage notes

Invoice Number

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

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

Usage notes

Drug Description

210 Detail > PTD Loop > QTY Loop > DTM

DTM Date/Time Reference

Optional · Max use 10

To specify pertinent dates and times

Usage notes

Example: DTM00320090823

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

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

• 003: Invoice

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

Date expressed as CCYYMMDD

Summary

CTT Loop Optional Max >1

010 Summary > CTT Loop > CTT

CTT Transaction Totals

Required · Max 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 LIN segments. If used, hash total (CTT02) is the sum of the value of quantities (QTY02) for each QTY segment.

Usage notes

Example: CTT*125

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

Total number of line items in the transaction set

030 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

EDI Samples

Sample

ISA*00*          *00*          *ZZ*SENDER         *ZZ*RECEIVER       *231106*1427*U*00401*000000001*0*T*>
GS*PT*SENDERGS*RECEIVERGS*20231106*142737*000000001*X*004010
ST*867*540001
BPT*00**20100426*SS
DTM*090*20100420
DTM*091*20100425
N1*DB*H-E-B*11*RH0277067
N1*SU*ABC & CO, INC (EFT)*11*AA2223331
PTD*SS***DI*6158
DTM*938*20100418
DTM*003*20100418
DTM*011*20100419
N1*ST*TRADING PARTNER INFO*11*BH9673941
N3* TRADING PARTNER INFO
N4*AUSTIN*TX*39419*USA
QTY*32*1*EA
LIN**N4*AAAAAAAAAAA*PI*0012028*MG*CCCCCCC
UIT*EA*1537.849*WH
AMT*TT*1537.849
PID*F****ZOSTAVAX VIAL
REF*DI*6158*ZOSTAVAX VIAL
DTM*003*20100418
PTD*SS***DI*1659
DTM*938*20100419
DTM*003*20100419
DTM*011*20100420
N1*ST* TRADING PARTNER INFO *11*BH7514462
N3* TRADING PARTNER INFO
N4*SAN ANTONIO*TX*44621*USA
QTY*32*1*EA
LIN**N4*AAAAAAAAAAA*PI*0012028*MG*CCCCCCC
UIT*EA*1537.849*WH
AMT*TT*1537.849
PID*F****ZOSTAVAX VIAL
REF*DI*1659*ZOSTAVAX VIAL
DTM*003*20100419
PTD*SS***DI*1829
DTM*938*20100419
DTM*003*20100419
DTM*011*20100420
N1*ST* TRADING PARTNER INFO *11*BH7489063
N3*TRADING PARTNER INFO
N4*GATESVILLE*TX*90638*USA
QTY*32*1*EA
LIN**N4*AAAAAAAAAAA*PI*0012028*MG*CCCCCCC
UIT*EA*1537.849*WH
AMT*TT*1537.849
PID*F****ZOSTAVAX VIAL
REF*DI*1829*ZOSTAVAX VIAL
DTM*003*20100419
PTD*SS***DI*7184
DTM*938*20100420
DTM*003*20100420
DTM*011*20100420
N1*ST*TRADING PARTNER INFO*11*BH7866405
N3*TRADING PARTNER INFO
N4*FREDERICKSBURG*TX*64054*USA
QTY*32*1*EA
LIN**N4*AAAAAAAAAAA*PI*0012028*MG*CCCCCCC
UIT*EA*1537.849*WH
AMT*TT*1537.849
PID*F****ZOSTAVAX VIAL
REF*DI*7184*ZOSTAVAX VIAL
DTM*003*20100420
PTD*SS***DI*7267
DTM*938*20100420
DTM*003*20100420
DTM*011*20100421
N1*ST* TRADING PARTNER INFO *11*BH7487780
N3* TRADING PARTNER INFO
N4*SAN ANTONIO*TX*77803*USA
QTY*32*1*EA
LIN**N4*AAAAAAAAAAA*PI*0012028*MG*CCCCCCC
UIT*EA*1537.849*WH
AMT*TT*1537.849
PID*F****ZOSTAVAX VIAL
REF*DI*7267*ZOSTAVAX VIAL
DTM*003*20100420
PTD*SS***DI*8322
DTM*938*20100422
DTM*003*20100422
DTM*011*20100423
N1*ST*TRADING PARTNER INFO*11*BH7488718
N3* TRADING PARTNER INFO
N4*SAN ANTONIO*TX*87187*USA
QTY*32*1*EA
LIN**N4*AAAAAAAAAAA*PI*0012028*MG*CCCCCCC
UIT*EA*1537.849*WH
AMT*TT*1537.849
PID*F****ZOSTAVAX VIAL
REF*DI*8322*ZOSTAVAX VIAL
DTM*003*20100422
CTT*6
SE*92*540001
GE*1*000000001
IEA*1*000000001