X12 820 [Rithum HubEDI] Payment Order/Remittance Advice

X12 Release 4010Revised

Feb 26, 12:46 AM

Delimiters

• ~ Segment
• * Element
• > Component

ISA Interchange Control Header

Required · Max use 1

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

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

ISA-02 · I02 · Authorization Information · Required · String (AN) · Min 10 Max 10

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

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

ISA-04 · I04 · Security Information · Required · String (AN) · Min 10 Max 10

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

Codes

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

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

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

Codes

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

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

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

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

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

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

ISA-12 · I11 · Interchange Control Version Number · Required · Identifier (ID)

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

ISA-13 · I12 · Interchange Control Number · Required · Numeric (N0) · Min 9 Max 9

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

• 0: No Acknowledgment Requested
• 1: Interchange Acknowledgment Requested

ISA-15 · I14 · Usage Indicator · Required · Identifier (ID) · Min 1 Max 1

• I: Information
• P: Production Data
• T: Test Data

ISA-16 · I15 · Component Element Separator · Required · String (AN) · Min 1 Max 1

• >: Component Element Separator

GS Functional Group Header

Required · Max use 1

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

• RA: Payment Order/Remittance Advice (820)

GS-02 · 142 · Application Sender's Code · Required · String (AN) · Min 2 Max 15

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

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

GS-05 · 337 · Time · Required · Time (TM) · HHMM, HHMMSS, HHMMSSD, or HHMMSSDD format

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

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

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

GS-08 · 480 · Version / Release / Industry Identifier Code · Required · String (AN)

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

Heading

010 Heading > ST

ST Transaction Set Header

Required · Max use 1

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

• 820: Payment Order/Remittance Advice

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

020 Heading > BPR

BPR Beginning Segment for Payment Order/Remittance Advice

Required · Max use 1

BPR-01 · 305 · Transaction Handling Code · Required · Identifier (ID)

• I: Remittance Information Only
• P: Prenotification of Future Transfers

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

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

BPR-04 · 591 · Payment Method Code · Required · Identifier (ID)

• ACH: Automated Clearing House (ACH)
• CHK: Check

BPR-05 · 812 · Payment Format Code · Optional · Identifier (ID) · Min 1 Max 10

BPR-16 · 373 · Date · Optional · Date (DT) · CCYYMMDD format

050 Heading > REF

REF Reference Identification

Optional · Max use >1

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

• CK: Check Number
• IA: Internal Vendor Number

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

060 Heading > DTM

DTM Date/Time Reference

Optional · Max use >1

At least one of Date (DTM-02) or Time (DTM-03) is required

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

• 097: Transaction Creation

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

DTM-03 · 337 · Time · Optional · Time (TM) · HHMM, HHMMSS, HHMMSSD, or HHMMSSDD format

Detail

ENT Loop Optional Max >1

010 Detail > ENT Loop > ENT

ENT Entity

Required · Max use 1

ENT-01 · 554 · Assigned Number · Optional · Numeric (N0) · Min 1 Max 6

NM1 Loop Optional Max >1

020 Detail > ENT Loop > NM1 Loop > NM1

NM1 Individual or Organizational Name

Required · Max use 1

If either Identification Code Qualifier (NM1-08) or Identification Code (NM1-09) is present, then the other is required

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

• PO: Party to Receive Invoice for Goods or Services

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

• 2: Non-Person Entity

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

NM1-08 · 66 · Identification Code Qualifier · Optional · Identifier (ID)

• 92: Assigned by Buyer or Buyer's Agent

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

ADX Loop Optional Max >1

080 Detail > ENT Loop > ADX Loop > ADX

ADX Adjustment

Required · Max use 1

ADX-01 · 782 · Monetary Amount · Required · Decimal number (R) · Min 1 Max 15

ADX-02 · 426 · Adjustment Reason Code · Required · Identifier (ID)

• 01: Pricing Error
• 02: Allowance/Charge Error
• 04: Item Not Accepted - Damaged
• 06: Quantity Contested
• 07: Incorrect Product
• 16: Non-Invoice Related Allowance/Charge
• 19: Duplicate Billing
• 24: Incorrect Discount
• 26: Invoice Cancelled
• 49: Processing Charge
• 54: Freight Deducted
• 55: Tax Deducted
• 59: Item not received
• 72: Authorized Return
• 79: Cooperative Advertising
• 93: Field Destroy
• 97: Handling Charge
• L2: Discount
• L3: Penalty
• L4: Administrative Fees
• ZZ: Mutually Defined

REF Loop Optional Max >1

110 Detail > ENT Loop > ADX Loop > REF Loop > REF

REF Reference Identification

Required · Max use 1

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

• DP: Department Number

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

120 Detail > ENT Loop > ADX Loop > REF Loop > DTM

DTM Date/Time Reference

Optional · Max use >1

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

• 097: Transaction Creation

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

RMR Loop Optional Max >1

150 Detail > ENT Loop > RMR Loop > RMR

RMR Remittance Advice Accounts Receivable Open Item Reference

Required · Max use 1

If either Reference Identification Qualifier (RMR-01) or Reference Identification (RMR-02) is present, then the other is required

RMR-01 · 128 · Reference Identification Qualifier · Optional · Identifier (ID)

• IV: Seller's Invoice Number

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

RMR-05 · 782 · Monetary Amount · Optional · Decimal number (R) · Min 1 Max 15

RMR-06 · 782 · Monetary Amount · Optional · Decimal number (R) · Min 1 Max 15

170 Detail > ENT Loop > RMR Loop > REF

REF Reference Identification

Optional · Max use >1

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

• DP: Department Number

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

180 Detail > ENT Loop > RMR Loop > DTM

DTM Date/Time Reference

Optional · Max use >1

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

• 097: Transaction Creation

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

Summary

010 Summary > SE

SE Transaction Set Trailer

Required · Max use 1

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

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

GE Functional Group Trailer

Required · Max use 1

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

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

IEA Interchange Control Trailer

Required · Max use 1

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

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