EDI Implementation Guide - fsc.va.govTransaction Set (856) for use within the context of an...

EDI Implementation Guide

Transaction Set

856

Version 5010 Inbound Ship Notice/ Manifest

Revised – February 2020

Financial Services Center ANSI X12 V 005010 856 Implementation Guide

OAL-IPPS-5010-GUIDELINES (005010) 2 February 07, 2020

Contact Information

VA FSC Electronic Commerce Division may be contacted through the following methods

Primary production support

Email: [email protected] Phone: Main contact number: 512‐460‐5311

Development and testing

Stephen Bodnarchuk [email protected]

Trading Partner IDs

The VA FSC ECB team uses the following IDs for Procurement

ISA Qualifier: ZZ

ISA ID: VAFSCEDIPROD1

GS ID: VAFSCEDIPROD1

EDI Delimiters

The VA FSC ECB team uses the following delimiters

Segment Terminator: Hex 7E (~ Tilde)

Element Separator: Hex 5E (^ Caret)

Sub Element Separator: Hex 7C (| Pipe)

Repetition Separator: Hex 3A ( : Colon)

All data segments are sent wrapped unless otherwise requested. If an alternative delimiter set is

needed, please let the ECB team know during testing.

Functional Acknowledgements

The VA FSC ECB team will return a functional acknowledgement (997) on all transactions received.



Transaction Purpose

The VA FSC ECB team has implemented this transaction to receive shipping information from our

vendors that received purchase orders for goods purchased by the Department of Veterans Affairs.

Who must provide this transaction?

The VA FSC ECB team requests an Ship Notice/Manifest (856) in response to all purchase orders for

goods sent from the VA electronically.

Delivery Schedule

The VA FSC ECB team requests a Ship Notice/Manifest be provided when products are shipped.

Implementation Notes

The VA FSC ECB team supports the use of data segments in the following hierarchical level

Shipment: Where HL03 = “S”

TD1, TD5, TD3, TD4, REF, DTM, FOB, N1 loop (N1, N2, N3, N4, REF, PER) and YNQ

Order: Where HL03 = “O”

PRF, REF and FOB

Pack: Where HL03 = “P”

REF and MAN

Item: Where HL03 = “I”

LIN, SN1, SLN, PID, REF, and DTM

A ship date and estimated delivery date must be provided within the Shipment level HL loop

A lot expiration date should be provided at the Item level HL loop as appropriate

If you wish to send additional segments, please coordinate with FSC EDI Development team prior to

implementation.

Please use the Hierarchal level structure option provided that best fits the product being shipped. A

minimum of Shipment, Order, and Item levels are required on all Ship notices.



856 Ship Notice/Manifest

Functional Group ID=SH Introduction: This X12 Transaction Set contains the format and establishes the data contents of the Ship Notice/Manifest Transaction Set (856) for use within the context of an Electronic Data Interchange (EDI) environment. The transaction set can be used to list the contents of a shipment of goods as well as additional information relating to the shipment, such as order information, product description, physical characteristics, type of packaging, marking, carrier information, and configuration of goods within the transportation equipment. The transaction set enables the sender to describe the contents and configuration of a shipment in various levels of detail and provides an ordered flexibility to convey information. The sender of this transaction is the organization responsible for detailing and communicating the contents of a shipment, or shipments, to one or more receivers of the transaction set. The receiver of this transaction set can be any organization having an interest in the contents of a shipment or information about the contents of a shipment. Heading: Pos. Seg. Req. Loop Notes and No. ID Name Des. Max.Use Repeat Comments

0050 ISA Interchange Control Header O 1 0075 GS Functional Group Header O 1 M 0100 ST Transaction Set Header M 1 M 0200 BSN Beginning Segment for Ship Notice M 1 0400 DTM Date/Time Reference O 10

Detail: Pos. Seg. Req. Loop Notes and No. ID Name Des. Max.Use Repeat Comments

LOOP ID - HL 200000 M 0100 HL Hierarchical Level M 1 c1 0200 LIN Item Identification O 1 0300 SN1 Item Detail (Shipment) O 1 0400 SLN Subline Item Detail O 1000 0500 PRF Purchase Order Reference O 1 0700 PID Product/Item Description O 200 M 1100 TD1 Carrier Details (Quantity and Weight) M 20 1200 TD5 Carrier Details (Routing Sequence/Transit

Time) O 12

LOOP ID - TD3 12 1300 TD3 Carrier Details (Equipment) O 1

1400 TD4 Carrier Details (Special Handling, or Hazardous Materials, or Both)

O 5

1500 REF Reference Information O >1 1900 MAN Marks and Numbers Information O >1 2000 DTM Date/Time Reference O 10



2100 FOB F.O.B. Related Instructions O 1 LOOP ID - N1 200 2200 N1 Party Identification O 1 2300 N2 Additional Name Information O 2 2400 N3 Party Location O 2 2500 N4 Geographic Location O 1 2600 REF Reference Information O 12 2700 PER Administrative Communications Contact O 3

3350 YNQ Yes/No Question O 10

Summary: Pos. Seg. Req. Loop Notes and No. ID Name Des. Max.Use Repeat Comments

0100 CTT Transaction Totals O 1 n1 M 0200 SE Transaction Set Trailer M 1 0900 GE Functional Group Trailer O 1 1000 IEA Interchange Control Trailer O 1

Transaction Set Notes 1. Number of line items (CTT01) is the accumulation of the number of HL segments. If used, hash total

(CTT02) is the sum of the value of units shipped (SN102) for each SN1 segment. Transaction Set Comments 1. The HL segment is the only mandatory segment within the HL loop, and by itself, the HL segment has no

meaning.



Segment: ISA Interchange Control Header Position: 0050 Loop: Level: Heading Usage: Optional Max Use: 1 Purpose: To start and identify an interchange of zero or more functional groups and interchange-

related control segments Syntax Notes: Semantic Notes: Comments:

Data Element Summary Ref. Data Des. Element Name Attributes M ISA01 I01 Authorization Information Qualifier M 1 ID 2/2 Code identifying the type of information in the Authorization Information Refer to 005010 Data Element Dictionary for acceptable code values. M ISA02 I02 Authorization Information M 1 AN 10/10 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)

M ISA03 I03 Security Information Qualifier M 1 ID 2/2 Code identifying the type of information in the Security Information Refer to 005010 Data Element Dictionary for acceptable code values. M ISA04 I04 Security Information M 1 AN 10/10 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)

M ISA05 I05 Interchange ID Qualifier M 1 ID 2/2 Code indicating the system/method of code structure used to designate the

sender or receiver ID element being qualified Vendor provided ISA ID Qualifier M ISA06 I06 Interchange Sender ID M 1 AN 15/15 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

Vendor provided ISA ID M ISA07 I05 Interchange ID Qualifier M 1 ID 2/2 Code indicating the system/method of code structure used to designate the

sender or receiver ID element being qualified ZZ Mutually Defined M ISA08 I07 Interchange Receiver ID M 1 AN 15/15 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

VAFSCEDIPROD1 M ISA09 I08 Interchange Date M 1 DT 6/6 Date of the interchange M ISA10 I09 Interchange Time M 1 TM 4/4 Time of the interchange



M ISA11 I65 Repetition Separator M 1 AN 1/1 Type is not applicable; the repetition separator is a delimiter and not a data

element; this field provides the delimiter used to separate repeated occurrences of a simple data element or a composite data structure; this value must be different than the data element separator, component element separator, and the segment terminator

A repetition separator is required in ISA11. The repetition separator must be non-alphabetic, non-numeric, and not located within data. The VA FSC use s3A ( : ) - colon as a Repetition Separator on all outbound documents

M ISA12 I11 Interchange Control Version Number M 1 ID 5/5 Code specifying the version number of the interchange control segments Refer to 005010 Data Element Dictionary for acceptable code values. M ISA13 I12 Interchange Control Number M 1 N0 9/9 A control number assigned by the interchange sender M ISA14 I13 Acknowledgment Requested M 1 ID 1/1 Code indicating sender's request for an interchange acknowledgment M ISA15 I14 Interchange Usage Indicator M 1 ID 1/1 Code indicating whether data enclosed by this interchange envelope is test,

production or information P Production Data T Test Data M ISA16 I15 Component Element Separator M 1 AN 1/1 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



Segment: GS Functional Group Header Position: 0075 Loop: Level: Heading Usage: Optional Max Use: 1 Purpose: To indicate the beginning of a functional group and to provide control information Syntax Notes: Semantic Notes: 1 GS04 is the group date. 2 GS05 is the group time. 3 The data interchange control number GS06 in this header must be identical to the

same data element in the associated functional group trailer, GE02. Comments: 1 A functional group of related transaction sets, within the scope of X12 standards,

consists of a collection of similar transaction sets enclosed by a functional group header and a functional group trailer.

Data Element Summary Ref. Data Des. Element Name Attributes M GS01 479 Functional Identifier Code M 1 ID 2/2 Code identifying a group of application related transaction sets Refer to 005010 Data Element Dictionary for acceptable code values. M GS02 142 Application Sender's Code M 1 AN 2/15 Code identifying party sending transmission; codes agreed to by trading

partners Vendor provided GS ID M GS03 124 Application Receiver's Code M 1 AN 2/15 Code identifying party receiving transmission; codes agreed to by trading

partners VAFSCEDIPROD1 M GS04 373 Date M 1 DT 8/8 Date expressed as CCYYMMDD where CC represents the first two digits of

the calendar year M GS05 337 Time M 1 TM 4/8 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)

M GS06 28 Group Control Number M 1 N0 1/9 Assigned number originated and maintained by the sender M GS07 455 Responsible Agency Code M 1 ID 1/2 Code identifying the issuer of the standard; this code is used in conjunction

with Data Element 480 Refer to 005010 Data Element Dictionary for acceptable code values. M GS08 480 Version / Release / Industry Identifier Code M 1 AN 1/12 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

Refer to 005010 Data Element Dictionary for acceptable code values.



Segment: ST Transaction Set Header Position: 0100 Loop: Level: Heading Usage: Mandatory Max Use: 1 Purpose: To indicate the start of a transaction set and to assign a control number Syntax Notes: Semantic Notes: 1 The transaction set identifier (ST01) is used by the translation routines of the

interchange partners to select the appropriate transaction set definition (e.g., 810 selects the Invoice Transaction Set).

2 The implementation convention reference (ST03) is used by the translation routines of the interchange partners to select the appropriate implementation convention to match the transaction set definition. When used, this implementation convention reference takes precedence over the implementation reference specified in the GS08.

Comments: Notes: ST*856*0001~

Data Element Summary

Ref. Data Des. Element Name Attributes M ST01 143 Transaction Set Identifier Code M 1 ID 3/3 Code uniquely identifying a Transaction Set Refer to 005010 Data Element Dictionary for acceptable code values. M ST02 329 Transaction Set Control Number M 1 AN 4/9 Identifying control number that must be unique within the transaction set

functional group assigned by the originator for a transaction set ST03 1705 Implementation Convention Reference O 1 AN 1/35 Reference assigned to identify Implementation Convention



Segment: BSN Beginning Segment for Ship Notice Position: 0200 Loop: Level: Heading Usage: Mandatory Max Use: 1 Purpose: To transmit identifying numbers, dates, and other basic data relating to the transaction set Syntax Notes: 1 If BSN07 is present, then BSN06 is required. Semantic Notes: 1 BSN03 is the date the shipment transaction set is created. 2 BSN04 is the time the shipment transaction set is created. Comments:

Notes: BSN*00*8109930034*20190126*1427*0001~

Data Element Summary Ref. Data Des. Element Name Attributes M BSN01 353 Transaction Set Purpose Code M 1 ID 2/2 Code identifying purpose of transaction set 00 Original 04 Change 05 Replace M BSN02 396 Shipment Identification M 1 AN 2/30 A unique control number assigned by the original shipper to identify a specific

shipment Unique supplier-assigned number that identifies the shipment

For a Cancellation (BSN01 = 01) or Change (BSN01 = 04) the original shipment identification number is required

M BSN03 373 Date M 1 DT 8/8 Date expressed as CCYYMMDD where CC represents the first two digits of

the calendar year Ship Notice creation date M BSN04 337 Time M 1 TM 4/8 Time expressed in 24-hour clock time as follows: HHMM, or HHMMSS, or


Ship Notice creation time BSN05 1005 Hierarchical Structure Code O 1 ID 4/4 Code indicating the hierarchical application structure of a transaction set that

utilizes the HL segment to define the structure of the transaction set 0001 Shipment, Order, Packaging, Item 0002 Shipment, Order, Item, Packaging 0004 Shipment, Order, Item



Segment: DTM Date/Time Reference Position: 0400 Loop: Level: Heading Usage: Optional Max Use: 10 Purpose: To specify pertinent dates and times Syntax Notes: 1 At least one of DTM02 DTM03 or DTM05 is required. Semantic Notes: Comments:

Notes: The Ship Date provided on the Ship Notice should match the Shipped Date provided on the invoice

DTM*011*20190126*1545~

Data Element Summary Ref. Data Des. Element Name Attributes M DTM01 374 Date/Time Qualifier M 1 ID 3/3 Code specifying type of date or time, or both date and time 011 Shipped 017 Estimated Delivery DTM02 373 Date X 1 DT 8/8 Date expressed as CCYYMMDD where CC represents the first two digits of

the calendar year When DTM01 = "011" then DTM02 = Date item shipped

When DTM01 = "017" then DTM02 = Estimated Delivery Date DTM03 337 Time X 1 TM 4/8 Time expressed in 24-hour clock time as follows: HHMM, or HHMMSS, or


When DTM01 = "011" then DTM03 = Time item shipped When DTM01 = "017" then DTM03 = Estimated Delivery Time



Segment: HL Hierarchical Level Position: 0100 Loop: HL Mandatory Level: Detail Usage: Mandatory Max Use: 1 Purpose: To identify dependencies among and the content of hierarchically related groups of data

segments Syntax Notes: Semantic Notes: Comments: 1 The HL segment is used to identify levels of detail information using a hierarchical

structure, such as relating line-item data to shipment data, and packaging data to line-item data.

The HL segment defines a top-down/left-right ordered structure. 2 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.

3 HL02 identifies the hierarchical ID number of the HL segment to which the current HL segment is subordinate.

4 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 HL04 indicates whether or not there are subordinate (or child) HL segments related to the current HL segment.

Notes: HL*1**S*1~

Data Element Summary Ref. Data Des. Element Name Attributes M HL01 628 Hierarchical ID Number M 1 AN 1/12 A unique number assigned by the sender to identify a particular data segment

in a hierarchical structure HL02 734 Hierarchical Parent ID Number O 1 AN 1/12 Identification number of the next higher hierarchical data segment that the data

segment being described is subordinate to M HL03 735 Hierarchical Level Code M 1 ID 1/2 Code defining the characteristic of a level in a hierarchical structure I Item O Order P Pack S Shipment HL04 736 Hierarchical Child Code O 1 ID 1/1 Code indicating if there are hierarchical child data segments subordinate to the

level being described 0 No Subordinate HL Segment in This Hierarchical

Structure. 1 Additional Subordinate HL Data Segment in This

Hierarchical Structure.



Segment: LIN Item Identification Position: 0200 Loop: HL Mandatory Level: Detail Usage: Optional Max Use: 1 Purpose: To specify basic item identification data Syntax Notes: 1 If either LIN04 or LIN05 is present, then the other is required. 2 If either LIN06 or LIN07 is present, then the other is required. 3 If either LIN08 or LIN09 is present, then the other is required. 4 If either LIN10 or LIN11 is present, then the other is required. 5 If either LIN12 or LIN13 is present, then the other is required. 6 If either LIN14 or LIN15 is present, then the other is required. 7 If either LIN16 or LIN17 is present, then the other is required. 8 If either LIN18 or LIN19 is present, then the other is required. 9 If either LIN20 or LIN21 is present, then the other is required. Semantic Notes: 1 LIN01 is the line item identification Comments: 1 See the Data Dictionary for a complete list of IDs. 2 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. Notes: This segment appears at the Item hierarchical level, where HL03 = "I"

LIN*1*VC*VCN004619*CR*CNTRKNBR4619*UK*GTIN0000004619~

Data Element Summary Ref. Data Des. Element Name Attributes LIN01 350 Assigned Identification O 1 AN 1/20 Alphanumeric characters assigned for differentiation within a transaction set LIN02 235 Product/Service ID Qualifier X 1 ID 2/2 Code identifying the type/source of the descriptive number used in

Product/Service ID (234) A8 Exhibit Line Item Number The line item of a document referenced in and appended

to a procurement instrument which establishes a delivery requirement

LIN03 234 Product/Service ID X 1 AN 1/48 Identifying number for a product or service Contract Line Item Number (CLIN) LIN04 235 Product/Service ID Qualifier X 1 ID 2/2 Code identifying the type/source of the descriptive number used in

Product/Service ID (234) A7 Subline Item Number A further subdivision of a contract or exhibit line item

that identifies a specific part of that contract or exhibit line item

LIN05 234 Product/Service ID X 1 AN 1/48 Identifying number for a product or service SBI Contract Line Item Number (CLIN) LIN06 235 Product/Service ID Qualifier X 1 ID 2/2 Code identifying the type/source of the descriptive number used in

Product/Service ID (234)



MG Manufacturer's Part Number LIN07 234 Product/Service ID X 1 AN 1/48 Identifying number for a product or service Manufacturers Part Number LIN08 235 Product/Service ID Qualifier X 1 ID 2/2 Code identifying the type/source of the descriptive number used in

Product/Service ID (234) VP Vendor's (Seller's) Part Number LIN09 234 Product/Service ID X 1 AN 1/48 Identifying number for a product or service Vendor (Seller) Part Number LIN10 235 Product/Service ID Qualifier X 1 ID 2/2 Code identifying the type/source of the descriptive number used in

Product/Service ID (234) VC Vendor's (Seller's) Catalog Number LIN11 234 Product/Service ID X 1 AN 1/48 Identifying number for a product or service Vendor (Seller) Catalog Number LIN12 235 Product/Service ID Qualifier X 1 ID 2/2 Code identifying the type/source of the descriptive number used in

Product/Service ID (234) CR Contract Number LIN13 234 Product/Service ID X 1 AN 1/48 Identifying number for a product or service Item contract Number LIN14 235 Product/Service ID Qualifier X 1 ID 2/2 Code identifying the type/source of the descriptive number used in

Product/Service ID (234) ND National Drug Code (NDC) LIN15 234 Product/Service ID X 1 AN 1/48 Identifying number for a product or service National Drug Code LIN16 235 Product/Service ID Qualifier X 1 ID 2/2 Code identifying the type/source of the descriptive number used in

Product/Service ID (234) LT Lot Number LIN17 234 Product/Service ID X 1 AN 1/48 Identifying number for a product or service Lot Number LIN18 235 Product/Service ID Qualifier X 1 ID 2/2 Code identifying the type/source of the descriptive number used in

Product/Service ID (234) SN Serial Number LIN19 234 Product/Service ID X 1 AN 1/48 Identifying number for a product or service Serial Number LIN20 235 Product/Service ID Qualifier X 1 ID 2/2 Code identifying the type/source of the descriptive number used in



Product/Service ID (234) UK GTIN 14-digit Data Structure Data structure for the 14 digit EAN.UCC (EAN

International.Uniform Code Council) Global Trade Item Number (GTIN)

LIN21 234 Product/Service ID X 1 AN 1/48 Identifying number for a product or service GTIN



Segment: SN1 Item Detail (Shipment) Position: 0300 Loop: HL Mandatory Level: Detail Usage: Optional Max Use: 1 Purpose: To specify line-item detail relative to shipment Syntax Notes: 1 If either SN105 or SN106 is present, then the other is required. Semantic Notes: 1 SN101 is the ship notice line-item identification. 2 SN105 is quantity ordered. Comments: 1 SN103 defines the unit of measurement for both SN102 and SN104.

Notes: This segment appears at the Item hierarchical level, where HL03 = "I" SN1*1*2*PK*2*2*PK~

Data Element Summary Ref. Data Des. Element Name Attributes SN101 350 Assigned Identification O 1 AN 1/20 Alphanumeric characters assigned for differentiation within a transaction set M SN102 382 Number of Units Shipped M 1 R 1/10 Numeric value of units shipped in manufacturer's shipping units for a line item

or transaction set The VA will accept up to four decimal places.

A decimal point must be present when the quantity is not a whole number M SN103 355 Unit or Basis for Measurement Code M 1 ID 2/2 Code specifying the units in which a value is being expressed, or manner in

which a measurement has been taken The Unit of Measure must match the Unit of Measure provided on the

Purchase Order and the Unit of Measure returned on the Invoice Refer to 005010 Data Element Dictionary for acceptable code values. SN104 646 Quantity Shipped to Date O 1 R 1/15 Number of units shipped to date Total units shipped against this line item

The VA will accept up to four decimal places. A decimal point must be present when the quantity is not a whole number

SN105 380 Quantity X 1 R 1/15 Numeric value of quantity Quantity Ordered

The VA will accept up to four decimal places. A decimal point must be present when the quantity is not a whole number

SN106 355 Unit or Basis for Measurement Code X 1 ID 2/2 Code specifying the units in which a value is being expressed, or manner in

which a measurement has been taken The Unit of Measure must match the Unit of Measure provided on the

Purchase Order and the Unit of Measure returned on the Invoice Refer to 005010 Data Element Dictionary for acceptable code values.



Segment: SLN Subline Item Detail Position: 0400 Loop: HL Mandatory Level: Detail Usage: Optional Max Use: 1000 Purpose: To specify product subline detail item data Syntax Notes: 1 If either SLN04 or SLN05 is present, then the other is required. Semantic Notes: 1 SLN01 is the identifying number for the subline item. 2 SLN02 is the identifying number for the subline level. The subline level is analogous

to the level code used in a bill of materials. 3 SLN03 is the configuration code indicating the relationship of the subline item to the

baseline item. Comments: 1 See the Data Element Dictionary for a complete list of IDs. 2 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.

Notes: This segment appears at the Item hierarchical level, where HL03 = "I" SLN*1*1*I*1*EA~

Data Element Summary Ref. Data Des. Element Name Attributes M SLN01 350 Assigned Identification M 1 AN 1/20 Alphanumeric characters assigned for differentiation within a transaction set SLN02 350 Assigned Identification O 1 AN 1/20 Alphanumeric characters assigned for differentiation within a transaction set M SLN03 662 Relationship Code M 1 ID 1/1 Code indicating the relationship between entities I Included S Substituted SLN04 380 Quantity X 1 R 1/15 Numeric value of quantity SLN05 C001 Composite Unit of Measure X 1 To identify a composite unit of measure (See Figures Appendix for examples

of use) M C00101 355 Unit or Basis for Measurement Code M ID 2/2 Code specifying the units in which a value is being expressed, or manner in

which a measurement has been taken Refer to 005010 Data Element Dictionary for acceptable code values.



Segment: PRF Purchase Order Reference Position: 0500 Loop: HL Mandatory Level: Detail Usage: Optional Max Use: 1 Purpose: To provide reference to a specific purchase order Syntax Notes: Semantic Notes: 1 PRF04 is the date assigned by the purchaser to purchase order. Comments:

Notes: This segment appears at the Order hierarchical level, where HL03 = "O" PRF*PO90123*REL90123**20190126*CNTRK2975518364~

Data Element Summary Ref. Data Des. Element Name Attributes M PRF01 324 Purchase Order Number M 1 AN 1/22 Identifying number for Purchase Order assigned by the orderer/purchaser Department of Veterans Affairs original purchase order number provided in the

BEG03 of the 850 transaction PRF02 328 Release Number O 1 AN 1/30 Number identifying a release against a Purchase Order previously placed by

the parties involved in the transaction PRF03 327 Change Order Sequence Number O 1 AN 1/8 Number assigned by the orderer identifying a specific change or revision to a

previously transmitted transaction set PRF04 373 Date O 1 DT 8/8 Date expressed as CCYYMMDD where CC represents the first two digits of

the calendar year The Purchase Order Date provided in the BEG05 of the 850 transaction PRF06 367 Contract Number O 1 AN 1/30 Contract number Department of Veterans Affairs Contract Number provided in the BEG05 of

the 850 transaction



Segment: PID Product/Item Description Position: 0700 Loop: HL Mandatory Level: Detail Usage: Optional Max Use: 200 Purpose: To describe a product or process in coded or free-form format Syntax Notes: 1 If PID04 is present, then PID03 is required. 2 At least one of PID04 or PID05 is required. Semantic Notes: Comments: 1 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. Notes: This segment appears at the Item hierarchical level, where HL03 = "I"

PID*F****4PAC Package Of Four~

Data Element Summary Ref. Data Des. Element Name Attributes M PID01 349 Item Description Type M 1 ID 1/1 Code indicating the format of a description F Free-form PID05 352 Description X 1 AN 1/80 A free-form description to clarify the related data elements and their content Product Description



Segment: TD1 Carrier Details (Quantity and Weight) Position: 1100 Loop: HL Mandatory Level: Detail Usage: Mandatory Max Use: 20 Purpose: To specify the transportation details relative to commodity, weight, and quantity Syntax Notes: 1 If TD101 is present, then TD102 is required. 2 If TD103 is present, then TD104 is required. 3 If TD106 is present, then TD107 is required. 4 If either TD107 or TD108 is present, then the other is required. 5 If either TD109 or TD110 is present, then the other is required. Semantic Notes: Comments:

Notes: This segment appears at the Shipment hierarchical level, where HL03 = "S" TD1*CAS*6****G*7.50*LB~

Data Element Summary Ref. Data Des. Element Name Attributes TD101 103 Packaging Code O 1 AN 3/5 Code identifying the type of packaging; Part 1: Packaging Form, Part 2:

Packaging Material; if the Data Element is used, then Part 1 is always required BAG Bag BOX Box CAS Case CTN Carton PLT Pallet TBN Tote Bin TD102 80 Lading Quantity X 1 N0 1/7 Number of units (pieces) of the lading commodity Number of Units defined in TD101 TD106 187 Weight Qualifier O 1 ID 1/2 Code defining the type of weight G Gross Weight TD107 81 Weight X 1 R 1/10 Numeric value of weight Gross Weight in Pounds TD108 355 Unit or Basis for Measurement Code X 1 ID 2/2 Code specifying the units in which a value is being expressed, or manner in

which a measurement has been taken LB Pound TD109 183 Volume X 1 R 1/8 Value of volumetric measure TD110 355 Unit or Basis for Measurement Code X 1 ID 2/2 Code specifying the units in which a value is being expressed, or manner in

which a measurement has been taken CF Cubic Feet



Segment: TD5 Carrier Details (Routing Sequence/Transit Time) Position: 1200 Loop: HL Mandatory Level: Detail Usage: Optional Max Use: 12 Purpose: To specify the carrier and sequence of routing and provide transit time information Syntax Notes: 1 At least one of TD502 TD504 TD505 TD506 or TD512 is required. 2 If TD502 is present, then TD503 is required. Semantic Notes: Comments: 1 When specifying a routing sequence to be used for the shipment movement in lieu of

specifying each carrier within the movement, use TD502 to identify the party responsible for defining the routing sequence, and use TD503 to identify the actual routing sequence, specified by the party identified in TD502.

Notes: This segment appears at the Shipment hierarchical level, where HL03 = "S" TD5*A*2*FEDG*E*FedEx Ground Service~

Data Element Summary Ref. Data Des. Element Name Attributes TD501 133 Routing Sequence Code O 1 ID 1/2 Code describing the relationship of a carrier to a specific shipment movement Refer to 005010 Data Element Dictionary for acceptable code values. TD502 66 Identification Code Qualifier X 1 ID 1/2 Code designating the system/method of code structure used for Identification

Code (67) 2 Standard Carrier Alpha Code (SCAC) TD503 67 Identification Code X 1 AN 2/80 Code identifying a party or other code Carrier SCAC TD504 91 Transportation Method/Type Code X 1 ID 1/2 Code specifying the method or type of transportation for the shipment 7 Mail Type of transportation provided by the U.S. Postal

Service A Air D Parcel Post E Expedited Truck M Motor (Common Carrier) MP Motor (Package Carrier) T Best Way (Shippers Option) U Private Parcel Service TD505 387 Routing X 1 AN 1/35 Free-form description of the routing or requested routing for shipment, or the

originating carrier's identity Carrier Name is required TD506 368 Shipment/Order Status Code X 1 ID 2/2 Code indicating the status of an order or shipment or the disposition of any

difference between the quantity ordered and the quantity shipped for a line item or transaction



Refer to 005010 Data Element Dictionary for acceptable code values.



Segment: TD3 Carrier Details (Equipment) Position: 1300 Loop: TD3 Optional Level: Detail Usage: Optional Max Use: 1 Purpose: To specify transportation details relating to the equipment used by the carrier Syntax Notes: 1 Only one of TD301 or TD310 may be present. 2 If TD302 is present, then TD303 is required. Semantic Notes: Comments:

Notes: This segment appears at the Shipment hierarchical level, where HL03 = "S" TD3*TV*2D*FEDG024369~

Data Element Summary Ref. Data Des. Element Name Attributes TD301 40 Equipment Description Code X 1 ID 2/2 Code identifying type of equipment used for shipment Refer to 005010 Data Element Dictionary for acceptable code values. TD302 206 Equipment Initial O 1 AN 1/4 Prefix or alphabetic part of an equipment unit's identifying number TD303 207 Equipment Number X 1 AN 1/15 Sequencing or serial part of an equipment unit's identifying number (pure

numeric form for equipment number is preferred)



Segment: TD4 Carrier Details (Special Handling, or Hazardous Materials, or Both) Position: 1400 Loop: HL Mandatory Level: Detail Usage: Optional Max Use: 5 Purpose: To specify transportation special handling requirements, or hazardous materials

information, or both Syntax Notes: 1 At least one of TD401 TD402 or TD404 is required. 2 If TD402 is present, then TD403 is required. Semantic Notes: Comments:

Notes: This segment appears at the Shipment hierarchical level, where HL03 = "S" TD4*HM***FAB 2 Anti-Rat IgG~

Data Element Summary Ref. Data Des. Element Name Attributes TD401 152 Special Handling Code X 1 ID 2/3 Code specifying special transportation handling instructions HM Endorsed as Hazardous Material TD404 352 Description X 1 AN 1/80 A free-form description to clarify the related data elements and their content Material Safety Data Sheet (MSDS) required



Segment: REF Reference Information Position: 1500 Loop: HL Mandatory Level: Detail Usage: Optional Max Use: >1 Purpose: To specify identifying information Syntax Notes: 1 At least one of REF02 or REF03 is required. Semantic Notes: Comments:

Notes: This segment appears at the Shipment hierarchical level, where HL03 = "S" This segment appears at the Order hierarchical level, where HL03 = "O" This segment appears at the Pack hierarchical level, where HL03 = "P"

REF*BM*BOL1234~

Data Element Summary Ref. Data Des. Element Name Attributes M REF01 128 Reference Identification Qualifier M 1 ID 2/3 Code qualifying the Reference Identification BM Bill of Lading Number C7 Contract Line Item Number CN Carrier's Reference Number (PRO/Invoice) FR Freight Bill Number FW State License Identification Number A unique number assigned to each provider of service;

this number is assigned by state governments and is the provider's legal identification number in the state that is assigned

IA Internal Vendor Number IV Seller's Invoice Number LT Lot Number PK Packing List Number VN Vendor Order Number REF02 127 Reference Identification X 1 AN 1/50 Reference information as defined for a particular Transaction Set or as

specified by the Reference Identification Qualifier



Segment: MAN Marks and Numbers Information Position: 1900 Loop: HL Mandatory Level: Detail Usage: Optional Max Use: >1 Purpose: To indicate identifying marks and numbers for shipping containers Syntax Notes: 1 If either MAN04 or MAN05 is present, then the other is required. Semantic Notes: 1 MAN01/MAN02 and MAN04/MAN05 may be used to identify two different marks

and numbers assigned to the same physical container. 2 When both MAN02 and MAN03 are used, MAN02 is the starting number of a

sequential range and MAN03 is the ending number of that range. Comments: 1 When MAN01 contains code "UC" (U.P.C. Shipping Container Code) and

MAN05/MAN06 contain a range of ID numbers, MAN03 is not used. The reason for this is that the U.P.C. Shipping Container code is the same on every carton that is represented in the range in MAN05/MAN06.

Notes: This segment appears at the Pack hierarchical level, where HL03 = "P" MAN*SM*SZ3QQ*MKNBR1062763601~

Data Element Summary Ref. Data Des. Element Name Attributes M MAN01 88 Marks and Numbers Qualifier M 1 ID 1/2 Code specifying the application or source of Marks and Numbers (87) SM Shipper Assigned M MAN02 87 Marks and Numbers M 1 AN 1/48 Marks and numbers used to identify a shipment or parts of a shipment Shipper assigned barcode label on the box MAN03 87 Marks and Numbers O 1 AN 1/48 Marks and numbers used to identify a shipment or parts of a shipment



Segment: DTM Date/Time Reference Position: 2000 Loop: HL Mandatory Level: Detail Usage: Optional Max Use: 10 Purpose: To specify pertinent dates and times Syntax Notes: 1 At least one of DTM02 DTM03 or DTM05 is required. Semantic Notes: Comments:

Notes: This segment appears at the Shipment hierarchical level, where HL03 = "S" This segment appears at the Item hierarchical level, where HL03 = "I" A Ship Date and Estimated Delivery Date must be provided within the Shipment level HL loop A Lot Expiration Date should be provided at the Item level HL loop as appropriate The Expiration Date is Mandatory if applicable to a product

DTM*011*20190127~

Data Element Summary Ref. Data Des. Element Name Attributes M DTM01 374 Date/Time Qualifier M 1 ID 3/3 Code specifying type of date or time, or both date and time 011 Shipped 017 Estimated Delivery 036 Expiration Date coverage expires 208 Lot Number Expiration DTM02 373 Date X 1 DT 8/8 Date expressed as CCYYMMDD where CC represents the first two digits of

the calendar year DTM03 337 Time X 1 TM 4/8 Time expressed in 24-hour clock time as follows: HHMM, or HHMMSS, or




Segment: FOB F.O.B. Related Instructions Position: 2100 Loop: HL Mandatory Level: Detail Usage: Optional Max Use: 1 Purpose: To specify transportation instructions relating to shipment Syntax Notes: Semantic Notes: 1 FOB01 indicates which party will pay the carrier. 2 FOB02 is the code specifying transportation responsibility location. Comments:

Notes: This segment appears at the Shipment hierarchical level, where HL03 = "S" This segment appears at the Pack hierarchical level, where HL03 = "P"

FOB*PP~

Data Element Summary Ref. Data Des. Element Name Attributes M FOB01 146 Shipment Method of Payment M 1 ID 2/2 Code identifying payment terms for transportation charges BP Paid by Buyer The buyer agrees to the transportation payment term

requiring the buyer to pay transportation charges to a specified location (origin or destination location)

PP Prepaid (by Seller)



Segment: N1 Party Identification Position: 2200 Loop: N1 Optional Level: Detail Usage: Optional Max Use: 1 Purpose: To identify a party by type of organization, name, and code Syntax Notes: 1 At least one of N102 or N103 is required. 2 If either N103 or N104 is present, then the other is required. Semantic Notes: Comments: 1 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.

2 N105 and N106 further define the type of entity in N101. Notes: This segment appears at the Shipment hierarchical level, where HL03 = "S"

N1*SF*Earth City, MO Distribution Center*91*DSS~

Data Element Summary Ref. Data Des. Element Name Attributes M N101 98 Entity Identifier Code M 1 ID 2/3 Code identifying an organizational entity, a physical location, property or an

individual SF Ship From SH Shipper ST Ship To N102 93 Name X 1 AN 1/60 Free-form name N103 66 Identification Code Qualifier X 1 ID 1/2 Code designating the system/method of code structure used for Identification

Code (67) 91 Assigned by Seller or Seller's Agent 92 Assigned by Buyer or Buyer's Agent N104 67 Identification Code X 1 AN 2/80 Code identifying a party or other code



Segment: N2 Additional Name Information Position: 2300 Loop: N1 Optional Level: Detail Usage: Optional Max Use: 2 Purpose: To specify additional names Syntax Notes: Semantic Notes: Comments:

Notes: This segment appears at the Shipment hierarchical level, where HL03 = "S" This segment appears at the Order hierarchical level, where HL03 = "O" This segment appears at the Item hierarchical level, where HL03 = "I"

N2*MSPV WAREHOUSE BLDG 14~

Data Element Summary Ref. Data Des. Element Name Attributes M N201 93 Name M 1 AN 1/60 Free-form name N202 93 Name O 1 AN 1/60 Free-form name



Segment: N3 Party Location Position: 2400 Loop: N1 Optional Level: Detail Usage: Optional Max Use: 2 Purpose: To specify the location of the named party Syntax Notes: Semantic Notes: Comments:


N3*13636 Lakefront Drive~

Data Element Summary Ref. Data Des. Element Name Attributes M N301 166 Address Information M 1 AN 1/55 Address information N302 166 Address Information O 1 AN 1/55 Address information



Segment: N4 Geographic Location Position: 2500 Loop: N1 Optional Level: Detail Usage: Optional Max Use: 1 Purpose: To specify the geographic place of the named party Syntax Notes: 1 Only one of N402 or N407 may be present. Semantic Notes: Comments: 1 A combination of either N401 through N404, or N405 and N406 may be adequate to

specify a location. 2 N402 is required only if city name (N401) is in the U.S. or Canada.


N4*Earth City*MO*63045*US~

Data Element Summary Ref. Data Des. Element Name Attributes N401 19 City Name O 1 AN 2/30 Free-form text for city name N402 156 State or Province Code X 1 ID 2/2 Code (Standard State/Province) as defined by appropriate government agency N403 116 Postal Code O 1 ID 3/15 Code defining international postal zone code excluding punctuation and blanks

(zip code for United States) N404 26 Country Code X 1 ID 2/3 Code identifying the country



Segment: REF Reference Information Position: 2600 Loop: N1 Optional Level: Detail Usage: Optional Max Use: 12 Purpose: To specify identifying information Syntax Notes: 1 At least one of REF02 or REF03 is required. Semantic Notes: 1 REF04 contains data relating to the value cited in REF02. Comments:


REF*BM*BOL1234~

Data Element Summary Ref. Data Des. Element Name Attributes M REF01 128 Reference Identification Qualifier M 1 ID 2/3 Code qualifying the Reference Identification Refer to 005010 Data Element Dictionary for acceptable code values. REF02 127 Reference Identification X 1 AN 1/50 Reference information as defined for a particular Transaction Set or as

specified by the Reference Identification Qualifier



Segment: PER Administrative Communications Contact Position: 2700 Loop: N1 Optional Level: Detail Usage: Optional Max Use: 3 Purpose: To identify a person or office to whom administrative communications should be directed Syntax Notes: 1 If either PER03 or PER04 is present, then the other is required. 2 If either PER05 or PER06 is present, then the other is required. 3 If either PER07 or PER08 is present, then the other is required. Semantic Notes: Comments:


PER*IC*KerryJ*EA*[email protected]~

Data Element Summary Ref. Data Des. Element Name Attributes M PER01 366 Contact Function Code M 1 ID 2/2 Code identifying the major duty or responsibility of the person or group named Person to contact for information from the associated N1 loop (shipper, seller,

buyer, ship from location) IC Information Contact PER02 93 Name O 1 AN 1/60 Free-form name Contact Name or group Name PER03 365 Communication Number Qualifier X 1 ID 2/2 Code identifying the type of communication number TE Telephone PER04 364 Communication Number X 1 AN 1/256 Complete communications number including country or area code when

applicable Individual Contact or Group Telephone Number PER05 365 Communication Number Qualifier X 1 ID 2/2 Code identifying the type of communication number EA Internet Email Address Internet based electronic mail address with a structure of

"ADDRESSEE @ DOMAIN NAME . DOMAIN NAME EXTENSION"

PER06 364 Communication Number X 1 AN 1/256 Complete communications number including country or area code when

applicable Individual Contract or Group Email Address PER07 365 Communication Number Qualifier X 1 ID 2/2 Code identifying the type of communication number FX Facsimile PER08 364 Communication Number X 1 AN 1/256 Complete communications number including country or area code when



applicable Individual Contract or Group Fax Number



Segment: YNQ Yes/No Question Position: 3350 Loop: HL Mandatory Level: Detail Usage: Optional Max Use: 10 Purpose: To identify and answer yes and no questions, including the date, time, and comments

further qualifying the condition Syntax Notes: 1 Only one of YNQ01 YNQ09 or YNQ10 may be present. Semantic Notes: 1 YNQ02 confirms or denies the statement made in YNQ01, YNQ09 or YNQ10. A

"Y" indicates the statement is confirmed; an "N" indicates the statement is denied. Comments:

Notes: Separate YNQ segments must be used to represent the Transaction Statement (TS), the direct purchase statement (DPS) and the Transaction Statement (TS)to comply with the Drug Supply Chain Security Act (DSCSA) as applicable This segment may appear at the Shipment hierarchical level, where HL03 = "S" and the Order hierarchical level, where HL 03 = "O"

YNQ*3S*Y*D8*20190126*Approved~

Data Element Summary Ref. Data Des. Element Name Attributes YNQ01 1321 Condition Indicator X 1 ID 2/3 Code indicating a condition Refer to 005010 Data Element Dictionary for acceptable code values. M YNQ02 1073 Yes/No Condition or Response Code M 1 ID 1/1 Code indicating a Yes or No condition or response N No Y Yes YNQ05 933 Free-form Message Text O 1 AN 1/264 Free-form message text



Segment: CTT Transaction Totals Position: 0100 Loop: Level: Summary Usage: Optional Max Use: 1 Purpose: To transmit a hash total for a specific element in the transaction set Syntax Notes: Semantic Notes: Comments: 1 This segment is intended to provide hash totals to validate transaction completeness

and correctness. Notes: CTT*1*64~

Data Element Summary

Ref. Data Des. Element Name Attributes M CTT01 354 Number of Line Items M 1 N0 1/6 Total number of line items in the transaction set CTT02 347 Hash Total O 1 R 1/10 Sum of values of the specified data element. All values in the data element will

be summed without regard to decimal points (explicit or implicit) or signs. Truncation will occur on the left most digits if the sum is greater than the maximum size of the hash total of the data element. Example: -.0018 First occurrence of value being hashed. .18 Second occurrence of value being hashed. 1.8 Third occurrence of value being hashed. 18.01 Fourth occurrence of value being hashed. 18E2 Fifth occurrence of value being hashed. -------- 1873 Hash Total



Segment: SE Transaction Set Trailer Position: 0200 Loop: Level: Summary Usage: Mandatory Max Use: 1 Purpose: To indicate the end of the transaction set and provide the count of the transmitted

segments (including the beginning (ST) and ending (SE) segments) Syntax Notes: Semantic Notes: Comments: 1 SE is the last segment of each transaction set.

Notes: SE*43*0001~

Data Element Summary Ref. Data Des. Element Name Attributes M SE01 96 Number of Included Segments M 1 N0 1/10 Total number of segments included in a transaction set including ST and SE

segments M SE02 329 Transaction Set Control Number M 1 AN 4/9 Identifying control number that must be unique within the transaction set

functional group assigned by the originator for a transaction set



Segment: GE Functional Group Trailer Position: 0900 Loop: Level: Summary Usage: Optional Max Use: 1 Purpose: To indicate the end of a functional group and to provide control information Syntax Notes: Semantic Notes: 1 The data interchange control number GE02 in this trailer must be identical to the

same data element in the associated functional group header, GS06. Comments: 1 The use of identical data interchange control numbers in the associated functional

group header and trailer is designed to maximize functional group integrity. The control number is the same as that used in the corresponding header.

Notes: GE*1*81600087~

Data Element Summary Ref. Data Des. Element Name Attributes M GE01 97 Number of Transaction Sets Included M 1 N0 1/6 Total number of transaction sets included in the functional group or

interchange (transmission) group terminated by the trailer containing this data element

M GE02 28 Group Control Number M 1 N0 1/9 Assigned number originated and maintained by the sender



Segment: IEA Interchange Control Trailer Position: 1000 Loop: Level: Summary Usage: Optional Max Use: 1 Purpose: To define the end of an interchange of zero or more functional groups and interchange-

related control segments Syntax Notes: Semantic Notes: Comments:

Notes: IEA*1*112600307~

Data Element Summary Ref. Data Des. Element Name Attributes M IEA01 I16 Number of Included Functional Groups M 1 N0 1/5 A count of the number of functional groups included in an interchange M IEA02 I12 Interchange Control Number M 1 N0 9/9 A control number assigned by the interchange sender



Appendix A

Supported Unit or Basis for Measurement Codes

The following codes are currently used as Unit or Basis for Measurement codes by the Department of

Veterans Affairs, Financial Service Center, Electronic Commerce Branch on all ANSI X.12 transactions.

The Unit of Measure provided on the Purchase Order (850) must be returned as provided on the

Purchase Order Acknowledgement (855) and on the Invoice (810).

New codes are added to this list as requested by vendors or based on business needs. If you would like

to add a valid ANSI X.12 Unit or Basis for Measurement codes to this list, please notify the ECD team

during testing.

X.12 Code DESCRIPTION

10 GROUP

11 OUTFIT

12 PACKET

13 RATION

14 SHOT

15 STICK

AA BALL

AM AMPOULE

AS ASSORTMENT

AY ASSEMBLY

BA BALE

BD BUNDLE

BF BOARD FOOT

BG BAG

BI BAR

BK BOOK



BM BOLT

BO BOTTLE

BR BARREL

BX BOX

CA CASE

CB CARBOY

CF CUBIC FOOT

CH CONTAINER

CJ CONE

CL CYLINDER

CN CAN

CQ CARTRIDGE

CR CUBIC METER

CT CARTON

CX COIL

CY CUBIC YARD

DA DAY

DI DISPENSER

DR DRUM

DZ DOZEN

EA DOSE

EA EACH

EA FEE

EA SERVICE

FT FOOT

GA GALLON

GM GRAM



GS GROSS

HA HANK

HR HOUR

HU HUNDRED

IN INCH

JA JOB

JR JAR

KA CAKE

KG KILOGRAM

KT KIT

LB POUND

LF LINEAR FOOT

LN LENGTH

LO LOT

LT LITER

MO MONTH

OZ OUNCE

PA PAIL

PC PIECE

PD PAD

PH PACK

PK PACKAGE

PP PLATE

PR PAIR

PT PINT

Q1 QUARTER (TIME)

Q3 MEAL



QT QUART

RE REEL

RL ROLL

RM REAM

SF SQUARE FOOT

SH SHEET

SJ SACK

SO SPOOL

SP SHELF PACK

ST SET

SV SKID

SW SKEIN

SY SQUARE YARD

TB TUBE

TH THOUSAND

TN TON

TO TROY OUNCE

TU TUBE

TY TRAY

TY TRAY

TZ THOUSAND CUBIC FEET

UN UNIT

US DOSAGE FORM

V1 FLAT

VI VIAL

WK WEEK



YD YARD

YR YEAR

Any additional Unit or Basis for Measurement codes sent will not be captured for processing

unless the ECD team is notified in advance and they are added to the list.



Appendix B

Sample X12 Data

The following Department of Veterans Affairs, Financial Service Center, Electronic Commerce Branch

ANSI X.12 sample transactions are provided for your reference.

ISA*00* *00* *ZZ*RSAMPLE *ZZ*VAFSCEDIPROD1 *191209*1427*U*00501*112600307*0*P*|~ GS*SH*RSAMPLE*VAFSCEDIPROD1*2019109*1427*81600087*X*005010~ ST*856*0001~ BSN*00*8109930034*20190126*1427*0001~ DTM*011*20190126*1545~ DTM*017*20190127~ HL*1**S*1~ TD1*CAS*6****G*7.50*LB~ TD5*A*2*FEDG*E*FedEx Ground Service~ TD3*TV*2D*FEDG024369~ TD4*HM***FAB 2 Anti-Rat IgG~ REF*BM*BOL1234~ DTM*011**20190126~ FOB*PP~ N1*SF*Earth City, MO Distribution Center*91*DSS~ N2*MSPV WAREHOUSE BLDG 14~ N3*13636 Lakefront Drive~ N4*Earth City*MO*63045*US~ REF*BM*BOL1234~ PER*IC*KerryJ*EA*[email protected]~ N1*BY*Kansas City VAMC #130~ N2*M1-130~ N3*4800 Main Street*Suite 107~ N4*Kansas City*MO*64112*US~ REF*CO*PO90123~ PER*IC*Jane Doe*EA*[email protected]~ YNQ*3S*Y*D8*20190126*Approved~ HL*2*1*O*1~ PRF*PO90123*REL90123**20190126*CNTRK2975518364~ REF*VN*PO90123~ HL*3*2*P*1~ REF*PK*PKNBR1062763601~ MAN*SM*SZ3QQ*MKNBR1062763601~ HL*4*3*I~ LIN*1*VC*VCN004619*CR*CNTRKNBR4619*UK*GTIN0000004619~ SN1*1*2*PK*2*2*PK~ SLN*1*1*I*1*EA~ SLN*1*2*I*1*EA~ SLN*1*3*I*1*EA~ SLN*1*4*I*1*EA~ PID*F****4PAC Package Of Four~ REF*BM*35976405~ DTM*011*20190127~ CTT*1*64~ SE*43*0001~ GE*1*81600087~ IEA*1*112600307~

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