| ISA | [1…1]
| – | Required. ISA interchange envelope. | – |
| | ISA01 | [1…1]
| 2/2 | Required. Qualifier for authorization control number in ISA02. Valid values: 00 - No authorization info present. 03 - Additional data identification. | 00 |
| | ISA02 | [1…1]
| 10/10 | Required. Information used for additional identification or authorization of the interchange sender or the data in the interchange/ 10 spaces a valid entry. | – |
| | ISA03 | [1…1]
| 2/2 | Required. Qualifier for security information in ISA04. Valid values: 00 - No security information present. 01 - Password. | 00 |
| | ISA04 | [1…1]
| 10/10 | Required. Identifies security information about the interchange sender or data. | – |
| | ISA05 | [1…1]
| 2/2 | Required. Interchange sender partner ID qualifier. Valid values: 01 – Duns (Dun & Bradstreet). 02 – Standard Carrier Alpha Code. 03 – Federal Maritime Commission. 04 – International Air Transport Association. 07 – Global Location Number (GLN). 08 – UCC EDI Communications ID (Comm ID). 09 – X.121 (CCITT). 10 – Department of Defense (DoD) Activity Address Code. 11 – Drug Enforcement Administration identifier. 12 – Telephone Companies. 13 – Used for UCS Transmissions. Includes Area Code and Telephone Number of a Modem. 14 – Duns Plus Suffix. 15 – Petroleum Accountants Society of Canada Company Code. 16 – DINS 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. 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. 24 – The College Board's Admission Testing Program 4-Digit Code of Postsecondary Institutes, or ATP. 25 – 4-Digit Code of Postsecondary Institutions. 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 assigned by Health Care Financing Administration (HCFA). 30 – U.S. Federal Tax Identification Number. 31 – Jurisdiction Identification Number Plus 4 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 (SPICA). 38 – The College Board and ACT, Inc. 6-Digit Code List of Secondary Institutions. AM – Association Mexicana del Codigo de Producto (AMECOP) Communication ID. NR – National Retail Merchants Association (NRMA) - Assigned. SA – User Identification Number as assigned by the Safety and the Fitness Electronic Records (SAFER) System. SN – Standard Address Number. ZZ – Mutually Defined. | 07 |
| | ISA06 | [1…1]
| 15/15 | Required. EDI sender ID. | 7777776067344 |
| | ISA07 | [1…1]
| 2/2 | Required. Interchange receiver partner ID qualifier. Valid values: 01 – Duns (Dun & Bradstreet). 02 – Standard Carrier Alpha Code. 03 – Federal Maritime Commission. 04 – International Air Transport Association. 07 – Global Location Number (GLN). 08 – UCC EDI Communications ID (Comm ID). 09 – X.121 (CCITT). 10 – Department of Defense (DoD) Activity Address Code. 11 – Drug Enforcement Administration identifier. 12 – Telephone Companies. 13 – Used for UCS Transmissions. Includes Area Code and Telephone Number of a Modem. 14 – Duns Plus Suffix. 15 – Petroleum Accountants Society of Canada Company Code. 16 – DINS 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. 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. 24 – The College Board's Admission Testing Program 4-Digit Code of Postsecondary Institutes, or ATP. 25 – 4-Digit Code of Postsecondary Institutions. 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 assigned by Health Care Financing Administration (HCFA). 30 – U.S. Federal Tax Identification Number. 31 – Jurisdiction Identification Number Plus 4 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 (SPICA). 38 – The College Board and ACT, Inc. 6-Digit Code List of Secondary Institutions. AM – Association Mexicana del Codigo de Producto (AMECOP) Communication ID. NR – National Retail Merchants Association (NRMA) - Assigned. SA – User Identification Number as assigned by the Safety and the Fitness Electronic Records (SAFER) System. SN – Standard Address Number. ZZ – Mutually Defined. | 07 |
| | ISA08 | [1…1]
| 15/15 | Required. EDI receiver ID. | 888888404358877 |
| | ISA09 | [1…1]
| 6/6 | Required. Interchange date in 6 char YYMMDD format. | 231020 |
| | ISA10 | [1…1]
| 4/4 | Required. Interchange time in 4 char HHMM format. | 1420 |
| | ISA11 | [1…1]
| 1/1 | Required. Repetition separator. Delimiter that separates repeated occurrences of a data element or composite data structure. Must be different than the data element separator, component separator, and segment terminator | : |
| | ISA12 | [1…1]
| 5/5 | Required. Interchange control version number. Valid value is 00501. | 00501 |
| | ISA13 | [1…1]
| 9/9 | Required. Interchange control number for file control header. | 0000000000619827 |
| | ISA14 | [1…1]
| 1/1 | Required. Interchange level acknowledgment requested. Valid values: 0 - No acknowledgment requested. 1 - Interchange level acknowledgment requested. | 0 |
| | ISA15 | [1…1]
| 1/1 | Required. Indicates whether the interchange is for production, test, or information purposes. Valid values: I - Information. P - Production data. T - Test data. | P |
| | ISA16 | [1…1]
| 1/1 | Required. Component element separator. Delimiter that separates data elements within a composite data structure. Must be different than the data element separator and segment terminator | > |
| GS | [1…1]
| – | Required. GS group functional envelope. Child of ISA. Only one GS group expected per interchange. | – |
| | GS01 | [1…1]
| 2/2 | Required. GS group function code. Valid value is IN - Invoice. | IN |
| | GS02 | [1…1]
| 2/15 | Required. Application sender's code. | 2222224043588 |
| | GS03 | [1…1]
| 2/15 | Required. Application receiver's code. | TRACELINK |
| | GS04 | [1…1]
| 8/8 | Required. Current date stamp in 8 char X12 date format YYYYMMDD. | 231020 |
| | GS05 | [1…1]
| 4/8 | Required. Current time stamp in 6 char X12 time format HHMMSS. | 142000 |
| | GS06 | [1…1]
| 1/9 | Required. Group Control ID Number. | 619827 |
| | GS07 | [1…1]
| 1/2 | Required. Responsible Agency Code. Valid value is X. | X |
| | GS08 | [1…1]
| 1/12 | Required. X12 message version code. Valid value is 004010. | 005010 |
| ST | [1…*]
| – | ST transaction set envelope. Child of GS group. Only one ST transaction expected. | – |
| | ST01 | [1…1]
| 3/3 | Required. Transaction set identifier code. | 810 |
| | ST02 | [1…1]
| 4/9 | Required. Transaction set ID number. Counter for each ST segment beginning with 1. | 1 |
| | BIG | [1…1]
| – | Required. Beginning segment for Invoice. Child of ST transaction set. | – |
| | | BIG01 | [1…1]
| 8/8 | Required. Invoice issue date. | 20231020 |
| | | BIG02 | [1…1]
| 1/22 | Required. Invoice number. | 4506733288 |
| | | BIG03 | [1…1]
| 8/8 | Required. Date assigned by the purchaser to purchase order. | 20230915 |
| | | BIG04 | [0…1]
| 1/22 | Purchase order number. | 1234567890 |
| | | BIG05 | [0…1]
| 1/30 | Release document number. Identifies a release against a Purchase Order. | 789 |
| | | BIG06 | [0…1]
| 1/8 | Change order sequence number. | – |
| | | BIG07 | [0…1]
| 2/2 | Transaction Type Code. Only to further define the type of invoice when needed. Valid values: CR - Credit Memo DR - Debit Memo DO - Drop Ship | – |
| | CUR | [0…1]
| – | Invoice currency | – |
| | | CUR01 | [1…1]
| 2/3 | Required. Entity identifier code identifying an organizational entity, a physical location, property or individual using the identified currency code. | BY |
| | | CUR02 | [1…1]
| 3/3 | Required. ISO currency code for the country whose currency the charges are specified. | USD |
| | REF | 0…1 | – | Reference Information | – |
| | | REF01 | 1…1 | 2/3 | Reference Identification Qualifier | IA |
| | | REF02 | 1…1 | 3/3 | Reference Identification | INTERNAL_VENDOR_NUMBER |
| | N1 | [0…1]
| – | N1: Name segment loop for: - Ship to party.
- Bill to party.
- Ship to party.
- Selling party.
- Remit to party.
- Buyer to party.
- Invoice Payer party.
| – |
| | | N101 | [1…1]
| 2/3 | Required. Entity identifier code for party identifier and address information for: ST – Ship to party. BT – Bill to party. BS – Bill and ship to party. SU – Supplier party. RI or RE – Remit To, Party to receive commercial invoice remittance. BY – Buyer. PR – Payer. | ST |
| | | N102 | [1…1]
| 1/60 | Required. Name. | Wholesale Inc |
| | | N103 | [1…1]
| 1/2 | Required. Identifier code qualifier. Valid values: 01 – DUNS 09 – DUNS+4 11 – Drug Enforcement Agency registration number 21 – Health Industry Number 54 - Warehouse 91 – Company identifier 92 – Company location identifier UL – Global Location Number | 11 |
| | | N104 | [1…1]
| 2/80 | Required. Ship to party identifier, as qualified by N103. | 3333331013655 |
| | | N3 | [0…1]
| – | N3: Address. Child of Ship to N1 Name segment. | – |
| | | | N301 | [1…1]
| 1/55 | Required. Street address 1. | 555 Neelan Road |
| | | | N302 | [0…1]
| 1/55 | Street address 2. | Suite 123 |
| | | N4 | [0…1]
| – | N4: Geographic location. Child of ship to N1 name segment. | – |
| | | | N401 | [0…1]
| 2/30 | City name | Sacramento |
| | | | N402 | [0…1]
| 2/2 | State or province code. Code (Standard state/province) as defined by appropriate government agency | CA |
| | | | N403 | [0…1]
| 3/15 | Postal code. Code defining international postal zone code excluding punctuation and blanks (zip code for United States) | 95833 |
| | | | N404 | [0…1]
| 2/3 | Country code | US |
| | | | N405 | [0…1]
| 1/2 | Placeholder for future use of SGLN. | – |
| | | | N406 | [0…1]
| 1/30 | Placeholder for future use. Origin or Destination Shipping Location ID. SGLN number. NNI will not have sGLNs defined for any of their customers for the 2015 requirement. | – |
| | | PER | [0…1]
| – | Administrative communications contact. | – |
| | | | PER01 | [0…1]
| 2/2 | Contact function code. Valid value is IC = Information contact. | – |
| | | | PER02 | [0…1]
| 1/60 | Name. | ContactName |
| | | | PER03 | [0…1]
| 2/2 | Communication number qualifier. | TE |
| | | | PER04 | [0…1]
| 1/256 | Communication number. | ContactNumber |
| | | | PER05 | [0…1]
| 2/2 | Communication number qualifier. | EM |
| | | | PER06 | [0…1]
| 1/256 | Communication number. | ContactEmail |
| | ITD | [0…*]
| – | Terms of sale or deferred terms of sale. | – |
| | | ITD01 | [0…1]
| 2/2 | Terms of sale type code. Identifies type of payment code. Valid values: 01 – Basic terms of sale 02 – End of month 03 – Fixed date for payment 04 – Deferred or installment 05 – Discount not applicable 06 – Missed terms 07 – Extended terms 09 - Proximo 13 – Seller to advise buyer 14 – Previously agreed terms 15 – Special proximo | 01 |
| | | ITD02 | [0…1]
| 1/2 | Terms of sale basis code. Identifies beginning of the terms of payment code. Valid values: 1 – Ship date 2 – Delivery date 3 – Invoice date 5 – Invoice receipt date 7 – Effective date 09 – Purchase order date | 3 |
| | | ITD03 | [0…1]
| 1/6 | Percentage of discount availablle to the purchaser if an invoice is paid on or before the terms of payment discount due date. | 1.25 |
| | | ITD04 | [0…1]
| 8/8 | Discount due date in X12 date format YYYYMMDD.. | – |
| | | ITD05 | [0…1]
| 1/3 | Number of days payment is due within discount period to qualify for the discount. | – |
| | | ITD06 | [0…1]
| 8/8 | Terms net due date. Date when the invoice total amount is due in X12 date format YYYYMMDD. | 20231125 |
| | | ITD07 | [0…1]
| 1/3 | Number of days total invoice payment is due where no discount is applicable. | 30 |
| | | ITD08 | [0…1]
| 1/10 | Total amount of terms of sale discount. | – |
| | | ITD09 | [0…1]
| 8/8 | Deferred due date for terms of sale. Refers to deferred payment or percent of invoice payable in X12 date format YYYYMMDD. | 20231215 |
| | | ITD10 | [0…1]
| 1/10 | Deferred amount due for payment. | 55.25 |
| | | ITD11 | [0…1]
| 1/5 | Percent of invoice payable. The amount of the invoice payable expressed as a percentage. | 100.00 |
| | | ITD12 | [0…1]
| 0/80 | Description. | description |
| | | ITD13 | [0…1]
| 0/80 | Day of the month, this value can be min 1 and max can be maximum day in a month, expected to get this validated at front end or back end. | 21 |
| | DTM | [0…10]
| – | DTM header level dates. | – |
| | | DTM01 | [1…1]
| 3/3 | Required. Date type. Valid values: 011 – Shipped AAG – Due date | 004 |
| | | DTM02 | [0…1]
| 8/8 | Date value in date format YYYYMMDD. | 20240329 |
| | | DTM03 | [0…1]
| 4/8 | Time in time format HHMMSS. | 092413 |
| | IT1 | [1…*]
| – | Baseline item data (Invoice) - Looping Group. | – |
| | | IT101 | [0…1]
| 1/20 | Invoice line item number. | 000010 |
| | | IT102 | [0…1]
| 1/15 | Quantity invoiced. | 25 |
| | | IT103 | [0…1]
| 2/2 | Unit of measure for quantity. Valid values 02 – Statute Mile 4G – Microliter AM – Ampoule AV – Capsule BD – Bundle BG – Bag BO – Bottle BX – Box C3 – Centiliter CA – Case CC – Cubic Centimeter CF – Cubic Feet CG – Card Blister CH – Container CI – Cubic Inches CL – Cylinder CM – Centimeter CN – Can CP – Crate CQ – Cartridge CR – Cubic Meters CT – Carton DA – Day DI – Dispenser DK – Kilometers DL – Deciliter DM – Decimeter DQ – Cubic decimeters DR – Drum DS – Display DZ – Dozen EA – Each FO – US Fluid Ounce FT – Foot GA – US Gallon GL – Gram/Liter GR – Gram GS – Gross H4 – Hectoliter HF – Hundred Feet HR – Hours IN – Inch K6 – Kiloliters KG – Kilogram KT – Kit LB – US Pound LF – Linear Foot LO – Lot (unit of procurement) LT – Liter LY – Linear Yard MC – Microgram ME – Milligram ML – Milliliter MM – Millimeter MO – Months 01 – Cubic millimeter MR – Meter OZ – Ounce P1 – Percent PC – Piece PF – Pallet PH – Pack PK – Package PR – Pair PT – Pint QT – Quart RL – Roll SC – Square Centimeter SF – Square Foot SH – Sheet SI – Square Inch SM – Square Meter SP – Self Package ST – Set SY – Square Yard SZ – Syringe T3 – Thousand Pieces TB – Tube TH – Thousands TN – Tonne TS – Thousands TY – Tray U2 – Tablet UM – Million UN – Unit US – Dosage Form V2 – Pouch VI – Vial WK – Week YD – Yard YR – Years | EA |
| | | IT104 | [0…1]
| 1/17 | Unit price per saleable unit for ordered quantity. | 25.22 |
| | | IT106 | [0…1]
| 2/2 | Product service ID qualifier mapping from global standards enum list. Valid values: BP – Buyer item code FV – Canada National Drug Identification Number LT – Lot number MF – Manufacturer's product number N1 – US National-Drug-Code-NDC442-with-hyphen-separators N2 – US National-Drug-Code-NDC532-with-hyphen-separators N3 – US National-Drug-Code-NDC541-with-hyphen-separators N4 – US-National-Drug-Code-NDC542-with-hyphen-separators ND – US-National-Drug-Code-NDC542-with-hyphen-separators PI or IN – Customer's (Purchaser's) item code SK – Stock keeping unit UK – GTIN14 identifier UP – EAN/UPC Universal Item Number/GTIN (UCC-12) VC – Vendor catalog material Number. VN – Vendor/Supplier material Number. | VN |
| | | IT107 | [0…1]
| 1/48 | Product or service identifier. Should be the same identifiers that will be used in the invoice. | 08202000230 |
| | | IT108 | [0…1]
| 2/2 | Product service ID qualifier mapping from global standards enum list. Valid values: BP – Buyer item code FV – Canada National Drug Identification Number LT – Lot number MF – Manufacturer's product number N1 – US National-Drug-Code-NDC442-with-hyphen-separators N2 – US National-Drug-Code-NDC532-with-hyphen-separators N3 – US National-Drug-Code-NDC541-with-hyphen-separators N4 – US-National-Drug-Code-NDC542-with-hyphen-separators ND – US-National-Drug-Code-NDC542-with-hyphen-separators PI or IN – Customer's (Purchaser's) item code SK – Stock keeping unit UK – GTIN14 identifier UP – EAN/UPC Universal Item Number/GTIN (UCC-12) VC – Vendor catalog material Number. VN – Vendor/Supplier material Number. | IN |
| | | IT109 | [0…1]
| 1/48 | Product or service identifier. Should be the same identifiers that will be used in the invoice. | 08202000230 |
| | | IT110 | [0…1]
| 2/2 | Instance 2 product service ID qualifier mapping from global standards enum list. Valid values: BP – Buyer item code FV – Canada National Drug Identification Number LT – Lot number MF – Manufacturer's product number N1 – US National-Drug-Code-NDC442-with-hyphen-separators N2 – US National-Drug-Code-NDC532-with-hyphen-separators N3 – US National-Drug-Code-NDC541-with-hyphen-separators N4 – US-National-Drug-Code-NDC542-with-hyphen-separators ND – US-National-Drug-Code-NDC542-with-hyphen-separators PI or IN – Customer's (Purchaser's) item code SK – Stock keeping unit UK – GTIN14 identifier UP – EAN/UPC Universal Item Number/GTIN (UCC-12) VC – Vendor catalog material Number. VN – Vendor/Supplier material Number. | MF |
| | | IT111 | [0…1]
| 1/48 | Product or service identifier. Should be the same identifiers that will be used in the invoice. | 08202000230 |
| | | IT112 | [0…1]
| 2/2 | Product service ID qualifier mapping from global standards enum list. Valid values: BP – Buyer item code FV – Canada National Drug Identification Number LT – Lot number MF – Manufacturer's product number N1 – US National-Drug-Code-NDC442-with-hyphen-separators N2 – US National-Drug-Code-NDC532-with-hyphen-separators N3 – US National-Drug-Code-NDC541-with-hyphen-separators N4 – US-National-Drug-Code-NDC542-with-hyphen-separators ND – US-National-Drug-Code-NDC542-with-hyphen-separators PI or IN – Customer's (Purchaser's) item code SK – Stock keeping unit UK – GTIN14 identifier UP – EAN/UPC Universal Item Number/GTIN (UCC-12) VC – Vendor catalog material Number. VN – Vendor/Supplier material Number. | N4 |
| | | IT113 | [0…1]
| 1/48 | Product or service identifier. Should be the same identifiers that will be used in the invoice. | |
| | | IT114 | [0…1]
| 2/2 | Product service ID qualifier mapping from global standards enum list. Valid values: BP – Buyer item code FV – Canada National Drug Identification Number LT – Lot number MF – Manufacturer's product number N1 – US National-Drug-Code-NDC442-with-hyphen-separators N2 – US National-Drug-Code-NDC532-with-hyphen-separators N3 – US National-Drug-Code-NDC541-with-hyphen-separators N4 – US-National-Drug-Code-NDC542-with-hyphen-separators ND – US-National-Drug-Code-NDC542-with-hyphen-separators PI or IN – Customer's (Purchaser's) item code SK – Stock keeping unit UK – GTIN14 identifier UP – EAN/UPC Universal Item Number/GTIN (UCC-12) VC – Vendor catalog material Number. VN – Vendor/Supplier material Number. | UK |
| | | IT115 | [0…1]
| 1/48 | Product or service identifier. Should be the same identifiers that will be used in the invoice. | – |
| | | IT116 | [0…1]
| 2/2 | Product service ID qualifier mapping from global standards enum list. Valid values: BP – Buyer item code FV – Canada National Drug Identification Number LT – Lot number MF – Manufacturer's product number N1 – US National-Drug-Code-NDC442-with-hyphen-separators N2 – US National-Drug-Code-NDC532-with-hyphen-separators N3 – US National-Drug-Code-NDC541-with-hyphen-separators N4 – US-National-Drug-Code-NDC542-with-hyphen-separators ND – US-National-Drug-Code-NDC542-with-hyphen-separators PI or IN – Customer's (Purchaser's) item code SK – Stock keeping unit UK – GTIN14 identifier UP – EAN/UPC Universal Item Number/GTIN (UCC-12) VC – Vendor catalog material Number. VN – Vendor/Supplier material Number. | UP |
| | | IT117 | [0…1]
| 1/48 | Product or service identifier. Should be the same identifiers that will be used in the invoice. | – |
| | | IT118 | [0…1]
| 2/2 | Product service ID qualifier mapping from global standards enum list. Valid values: BP – Buyer item code FV – Canada National Drug Identification Number LT – Lot number MF – Manufacturer's product number N1 – US National-Drug-Code-NDC442-with-hyphen-separators N2 – US National-Drug-Code-NDC532-with-hyphen-separators N3 – US National-Drug-Code-NDC541-with-hyphen-separators N4 – US-National-Drug-Code-NDC542-with-hyphen-separators ND – US-National-Drug-Code-NDC542-with-hyphen-separators PI or IN – Customer's (Purchaser's) item code SK – Stock keeping unit UK – GTIN14 identifier UP – EAN/UPC Universal Item Number/GTIN (UCC-12) VC – Vendor catalog material Number. VN – Vendor/Supplier material Number. | FV |
| | | IT119 | [0…1]
| 1/48 | Product or service identifier. Should be the same identifiers that will be used in the invoice. | – |
| | | IT120 | [0…1]
| 2/2 | Product service ID qualifier mapping from global standards enum list. Valid values: BP – Buyer item code FV – Canada National Drug Identification Number LT – Lot number MF – Manufacturer's product number N1 – US National-Drug-Code-NDC442-with-hyphen-separators N2 – US National-Drug-Code-NDC532-with-hyphen-separators N3 – US National-Drug-Code-NDC541-with-hyphen-separators N4 – US-National-Drug-Code-NDC542-with-hyphen-separators ND – US-National-Drug-Code-NDC542-with-hyphen-separators PI or IN – Customer's (Purchaser's) item code SK – Stock keeping unit UK – GTIN14 identifier UP – EAN/UPC Universal Item Number/GTIN (UCC-12) VC – Vendor catalog material Number. VN – Vendor/Supplier material Number. | ND |
| | | IT121 | [0…1]
| 1/48 | Product or service identifier. Should be the same identifiers that will be used in the invoice. | – |
| | | IT122 | [0…1]
| 2/2 | Product service ID qualifier mapping from global standards enum list. Valid values: BP – Buyer item code FV – Canada National Drug Identification Number LT – Lot number MF – Manufacturer's product number N1 – US National-Drug-Code-NDC442-with-hyphen-separators N2 – US National-Drug-Code-NDC532-with-hyphen-separators N3 – US National-Drug-Code-NDC541-with-hyphen-separators N4 – US-National-Drug-Code-NDC542-with-hyphen-separators ND – US-National-Drug-Code-NDC542-with-hyphen-separators PI or IN – Customer's (Purchaser's) item code SK – Stock keeping unit UK – GTIN14 identifier UP – EAN/UPC Universal Item Number/GTIN (UCC-12) VC – Vendor catalog material Number. VN – Vendor/Supplier material Number. | SK |
| | | IT123 | [0…1]
| 1/48 | Product or service identifier. Should be the same identifiers that will be used in the invoice. | – |
| | | IT124 | [0…1]
| 2/2 | Product service ID qualifier mapping from global standards enum list. Valid values: BP – Buyer item code FV – Canada National Drug Identification Number LT – Lot number MF – Manufacturer's product number N1 – US National-Drug-Code-NDC442-with-hyphen-separators N2 – US National-Drug-Code-NDC532-with-hyphen-separators N3 – US National-Drug-Code-NDC541-with-hyphen-separators N4 – US-National-Drug-Code-NDC542-with-hyphen-separators ND – US-National-Drug-Code-NDC542-with-hyphen-separators PI or IN – Customer's (Purchaser's) item code SK – Stock keeping unit UK – GTIN14 identifier UP – EAN/UPC Universal Item Number/GTIN (UCC-12) VC – Vendor catalog material Number. VN – Vendor/Supplier material Number. | BP |
| | | IT125 | [0…1]
| 1/48 | Product or service identifier. Should be the same identifiers that will be used in the invoice. | – |
| | IT3 | [0…5]
| – | Additional Item information | – |
| | | IT301 | [0…1]
| 0/10 | No of units shipped | 12 |
| | | IT302 | [0…1]
| 2/2 | Unit or Basis for Measurement Code. Valid values 02 – Statute Mile 4G – Microliter AM – Ampoule AV – Capsule BD – Bundle BG – Bag BO – Bottle BX – Box C3 – Centiliter CA – Case CC – Cubic Centimeter CF – Cubic Feet CG – Card Blister CH – Container CI – Cubic Inches CL – Cylinder CM – Centimeter CN – Can CP – Crate CQ – Cartridge CR – Cubic Meters CT – Carton DA – Day DI – Dispenser DK – Kilometers DL – Deciliter DM – Decimeter DQ – Cubic decimeters DR – Drum DS – Display DZ – Dozen EA – Each FO – US Fluid Ounce FT – Foot GA – US Gallon GL – Gram/Liter GR – Gram GS – Gross H4 – Hectoliter HF – Hundred Feet HR – Hours IN – Inch K6 – Kiloliters KG – Kilogram KT – Kit LB – US Pound LF – Linear Foot LO – Lot (unit of procurement) LT – Liter LY – Linear Yard MC – Microgram ME – Milligram ML – Milliliter MM – Millimeter MO – Months 01 – Cubic millimeter MR – Meter OZ – Ounce P1 – Percent PC – Piece PF – Pallet PH – Pack PK – Package PR – Pair PT – Pint QT – Quart RL – Roll SC – Square Centimeter SF – Square Foot SH – Sheet SI – Square Inch SM – Square Meter SP – Self Package ST – Set SY – Square Yard SZ – Syringe T3 – Thousand Pieces TB – Tube TH – Thousands TN – Tonne TS – Thousands TY – Tray U2 – Tablet UM – Million UN – Unit US – Dosage Form V2 – Pouch VI – Vial WK – Week YD – Yard YR – Years | CA |
| | | IT303 | [0…1]
| 2/2 | Status code for the order or shipment. Valid values: BK – Back Ordered from Previous Order BO – Back ordered BP – Shipment Partial, Back Order to Ship on (Date) CC – Shipment Complete on (Date). For complete shipment of backordered merchandise CM – Shipment Complete with Additional Quantity. To meet minimum order quantity CP – Partial Shipment on (Date), Considered No Backorder HQ – Held Awaiting Qualification. Manufacturer needs more information to process order IC – Item Canceled. Discontinued item. ID – Insufficient Information IS – Item Represents Substitution from Original Order. NN – Not in Process - No Shipping Schedule. Item currently unavailable—please reorder NS – Not In Process, Scheduled to Ship on (Date) PD – Purchase Order Complete PH – Product On Hold PR – Partial Shipment PS – In Process, Scheduled to Ship On (Date). Item currently unavailable—backorder to follow SS – Split Shipment | PS |
| | | IT304 | [0…1]
| 1/9 | Numeric value of variance between ordered and shipped quantities. | 3 |
| | PID | [0…*]
| – | Product or item description. | – |
| | | PID01 | [0…1]
| 1/1 | Item description type. Valid value is F – Free from. | F |
| | | PID05 | [0…1]
| 1/80 | Item description. | Sublocade 100MG/0.5ML CIII |
| | DTM | [0…10]
| – | DTM date segment for expiry date | – |
| | | DTM01 | [1…1]
| 3/3 | Required. Date type qualifier for the date type. Valid value is 208 = Expiry date. | 208 |
| | | DTM02 | [0…1]
| 8/8 | Expiry date in date format YYYYMMDD. | 20240628 |
| | | DTM03 | [0…1]
| 4/8 | Processing time in time format HHMMSS. | 123422 |
| | SAC | [0…25]
| – | Service, promotion, allowance, or charge information. | – |
| | | SAC01 | [1…1]
| 1/1 | Required. Allowance or charge indicator. Identifies an allowance or charge for the invoice. Valid values: A – Allowance. C – Charge. N – No allowance or charge. | C |
| | | SAC02 | [0…1]
| 4/4 | Service, promotion, allowance, or charge code. Valid values: A010 – Absolute minimum charge A150 – Adjustment for maximum charge billing A170 – Adjustments to credits or charges A172 – Administrative credits or charges A210 – Advance fee A250 – Advances on credits or charges A260 – Advertising Allowance A320 – Air transport charge A380 – Advance on allowance A400 – Allowance Non-performance A480 – Assembly credit or charge A520 – Base charge A600 – Bill of lading charge A880 – Cancelation charge A930 – Carrier credit allowance A940 – Carrier debit allowance A960 – Carrier charge A980 – Cartage credit or charge C030 – Delivery surcharge C040 – Delivery credit or charge C110 – Deposit C150 – Destination charge C310 – Discount C340 – Distribution service C350 – Distributor discount/allowance C370 – Diversion charge C400 – Documentation charge C760 – Excess weight charge D040 – Finance charge D070 – Flat rate D200 – Delivery Fee (Freight Charges to Destination) F800 – Promotional Allowance F810 – Promotional Discount H000 – Special Allowance I410 – Unsaleable minimum charge allowance | C030 |
| | | SAC05 | [0…1]
| 1/15 | Amount of allowance or charge. | 60.00 |
| | | SAC06 | [0…1]
| 1/1 | Allowance or charge percentage qualifer. Valid values: 0 – Gross amount. 1 – Item list cost. 2 – Item net cost. 3 – Discount/gross. 4 – Discount/net. 5 – Base price per unit. 6 – Base price amount. 7 – Base price amount less previous discount. 8 – Net monthly on all invoices past due. 9 – Late payment charge base amount. B – Item total amount. C – Item unit price. D – Order total amount. | B |
| | | SAC07 | [0…1]
| 1/6 | Percentage of allowance or charge in decimal format. | 1.0 |
| | | SAC12 | [0…1]
| 2/2 | Allowance or Charge Method of Handling Code. Valid values: 01 – Bill back 02 – Off invoice 04 – Credit customer account | – |
| | | SAC13 | [0…1]
| 0/50 | Reference Identification. | – |
| | | SAC14 | [0…1]
| 0/20 | Option Number. | – |
| | | SAC15 | [0…1]
| 0/80 | Description. | Freight Charge |
| | TDS | [0…1]
| – | Total Monetary Value Summary | – |
| | | TDS01 | [1…1]
| 1/15 | Required. Amount Total Invoice. The amount of invoice before terms discount, if applicable. | 69050 |
| | | TDS02 | [1…1]
| 1/15 | Required. Amount Invoice Amount subject to discount. The amount upon which the terms discount amount is calculated. | 69050 |
| | | TDS03 | [1…1]
| 1/15 | Required. Amount The amount of invoice due if paid by terms discount due date (total invoice amount less cash discount). | 69000 |
| | | TDS04 | [1…1]
| 1/15 | Required. Amount The total amount of terms discount. | 50 |
| | TXI | [0…*]
| – | Tax Information | – |
| | | TXI01 | [1…1]
| 2/2 | Required. Tax Type Code Valid values: AB – SurTax BE – Harmonized Sales Tax CG – Customs Duty Tax (Federal Value Added tax on goods) CS – City Sales Tax CT – County Sales Tax FD – Federal Excise Tax GS – Goods and Services Tax PG – Provincial Sales Tax ST – State Sales Tax TX – All Taxes VA – Value Added Tax | CS |
| | | TXI02 | [0…1]
| 1/18 | Monetary amount. | 5.43 |
| | | TXI03 | [0…1]
| 1/10 | Percentage as decimal. | – |
| | | TXI04 | [0…1]
| 2/2 | Tax jurisdiction code qualifier. Valid values: CD – Customer defined MB – Taxing Authority Code SP – State or Province ST – State Defined VD – Vendor Defined VE – Vertex | – |
| | | TXI05 | [0…1]
| 1/10 | Tax jurisdiction code. | – |
| | | TXI06 | [0…1]
| 1/1 | Tax exempt code. Valid values: 1 – Yes (Tax Exempt) 2 – No (Tax Exempt) | 2 |
| | | TXI07 | [0…1]
| 1/1 | Relationship code. | – |
| | | TXI08 | [0…1]
| 1/9 | Dollar basis for percent. | – |
| | | TXI09 | [0…1]
| 1/20 | Tax identification number. | – |
| | SAC | [0…25]
| – | Service, promotion, allowance, or charge information. | – |
| | | SAC01 | [1…1]
| 1/1 | Required. Allowance or charge indicator. Identifies an allowance or charge for the invoice. Valid values: A – Allowance. C – Charge. N – No allowance or charge. | C |
| | | SAC02 | [0…1]
| 4/4 | Service, promotion, allowance, or charge code. Valid values: A010 – Absolute minimum charge A150 – Adjustment for maximum charge billing A170 – Adjustments to credits or charges A172 – Administrative credits or charges A210 – Advance fee A250 – Advances on credits or charges A260 – Advertising Allowance A320 – Air transport charge A380 – Advance on allowance A400 – Allowance Non-performance A480 – Assembly credit or charge A520 – Base charge A600 – Bill of lading charge A880 – Cancelation charge A930 – Carrier credit allowance A940 – Carrier debit allowance A960 – Carrier charge A980 – Cartage credit or charge C030 – Delivery surcharge C040 – Delivery credit or charge C110 – Deposit C150 – Destination charge C310 – Discount C340 – Distribution service C350 – Distributor discount/allowance C370 – Diversion charge C400 – Documentation charge C760 – Excess weight charge D040 – Finance charge D070 – Flat rate D200 – Delivery Fee (Freight Charges to Destination) F800 – Promotional Allowance F810 – Promotional Discount H000 – Special Allowance I410 – Unsaleable minimum charge allowance | C030 |
| | | SAC05 | [0…1]
| 1/15 | Amount of allowance or charge. | 6000 |
| | | SAC06 | [0…1]
| 1/1 | Allowance or charge percentage qualifier. Valid values: 0 – Gross amount. 1 – Item list cost. 2 – Item net cost. 3 – Discount/gross. 4 – Discount/net. 5 – Base price per unit. 6 – Base price amount. 7 – Base price amount less previous discount. 8 – Net monthly on all invoices past due. 9 – Late payment charge base amount. B – Item total amount. C – Item unit price. D – Order total amount. | B |
| | | SAC07 | [0…1]
| 1/6 | Percentage of allowance or charge in decimal format. | 1.0 |
| | | SAC12 | [0…1]
| 2/2 | Allowance or Charge Method of Handling Code. Valid values: 01 – Bill back 02 – Off invoice 04 – Credit customer account | – |
| | | SAC13 | [0…1]
| 0/50 | Reference identification. | – |
| | | SAC14 | [0…1]
| 0/20 | Option number. | – |
| | | SAC15 | [0…1]
| 0/80 | Description. | Freight Charge |
| | CTT | [0…1]
| – | CTT-Transaction totals. | – |
| | | CTT01 | [1…1]
| 1/6 | Required. Total number of line items in the transaction set. | 15 |
| SE | [1…1]
| – | Required. ST … SE transaction set trailer envelope. Child of GS group. Only one ST transaction expected. | – |
| | SE01 | [1…1]
| 1/10 | Required. Total count of segments in ST … SE transaction set including ST and SE segments. | 10 |
| | SE02 | [1…1]
| 4/9 | Required. Transaction set control number. | 1 |
| GE | [1…1]
| – | Required. GS … GE functional group trailer envelope. Child of ISA interchange. Only one GS group expected. | – |
| | GE01 | [1…1]
| 1/6 | Required. Number of transaction sets in functional group. | 5 |
| | GE02 | [1…1]
| 1/9 | Required. Functional group control number. | 619827 |
| IEA | [1…1]
| – | Required. ISA … IEA interchange control trailer envelope. Only one interchange expected per transmission. | – |
| | IEA01 | [1…1]
| 1/5 | Required. Number of functional groups in interchange. | 1 |
| | IEA02 | [1…1]
| 9/9 | Required. Interchange control number | 0000000000619827 |