X12 Release 4010
Delimiters: ~ Segment * Element > Component
Certified December 3, 2024
Walgreens
X12 820 Payment Order/Remittance Advice
This Draft Standard for Trial Use contains the format and establishes the data contents of the Payment Order/Remittance Advice Transaction Set (820) for use within the context of an Electronic Data Interchange (EDI) environment.
X12 820 Payment Order/Remittance Advice
Heading
ISA
Interchange Control Header
Required
Max Use 1
To start and identify an interchange of zero or more functional groups and interchange-related control segments
ISA01
I01
Authorization Information Qualifier
Required
ID
Min 2 Max 2
Code to identify the type of information in the Authorization Information
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
ISA02
I02
Authorization Information
Required
alphanumeric (AN)
Min 10 Max 10
Information used for additional identification or authorization of the interchange sender or the data in the interchange; the type of information is set by the Authorization Information Qualifier (I01)
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
ISA03
I03
Security Information Qualifier
Required
ID
Min 2 Max 2
Code to identify the type of information in the Security Information
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
ISA04
I04
Security Information
Required
alphanumeric (AN)
Min 10 Max 10
This is used for identifying the security information about the interchange sender or the data in the interchange; the type of information is set by the Security Information Qualifier (I03)
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
ISA05
I05
Interchange ID Qualifier
Required
ID
Min 2 Max 2
Qualifier to designate the system/method of code structure used to designate the sender or receiver ID element being qualified
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
ISA06
I06
Interchange Sender ID
Required
alphanumeric (AN)
Min 15 Max 15
Identification code published by the sender for other parties to use as the receiver ID to route data to them; the sender always codes this value in the sender ID element
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
ISA07
I05
Interchange ID Qualifier
Required
ID
Min 2 Max 2
Qualifier to designate the system/method of code structure used to designate the sender or receiver ID element being qualified
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
ISA08
I07
Interchange Receiver ID
Required
alphanumeric (AN)
Min 15 Max 15
Identification code published by the receiver of the data; When sending, it is used by the sender as their sending ID, thus other parties sending to them will use this as a receiving ID to route data to them
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
ISA09
I08
Interchange Date
Required
date (DT)
Min 6 Max 6
Date of the interchange
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
ISA10
I09
Interchange Time
Required
time (TM)
Min 4 Max 4
Time of the interchange
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
ISA11
I10
Interchange Control Standards Identifier
Required
ID
Min 1 Max 1
Code to identify the agency responsible for the control standard used by the message that is enclosed by the interchange header and trailer
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
ISA12
I11
Interchange Control Version Number
Required
ID
Min 5 Max 5
This version number covers the interchange control segments
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
ISA13
I12
Interchange Control Number
Required
numeric (N0)
Min 9 Max 9
A control number assigned by the interchange sender
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
ISA14
I13
Acknowledgment Requested
Required
ID
Min 1 Max 1
Code sent by the sender to request an interchange acknowledgment (TA1)
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
ISA15
I14
Usage Indicator
Required
ID
Min 1 Max 1
Code to indicate whether data enclosed by this interchange envelope is test, production or information
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
ISA16
I15
Component Element Separator
Required
undefined ()
Min 1 Max 1
Type is not applicable; the component element separator is a delimiter and not a data element; this field provides the delimiter used to separate component data elements within a composite data structure; this value must be different than the data element separator and the segment terminator
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
GS
Functional Group Header
Required
Max Use 1
To indicate the beginning of a functional group and to provide control information
GS01
479
Functional Identifier Code
Required
ID
Min 2 Max 2
Code identifying a group of application related transaction sets
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
GS02
142
Application Sender's Code
Required
alphanumeric (AN)
Min 2 Max 15
Code identifying party sending transmission; codes agreed to by trading partners
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
GS03
124
Application Receiver's Code
Required
alphanumeric (AN)
Min 2 Max 15
Code identifying party receiving transmission. Codes agreed to by trading partners
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
GS04
373
Date
Required
longDate (DT)
Min 8 Max 8
Date expressed as CCYYMMDD
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
GS05
337
Time
Required
time (TM)
Min 4 Max 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)
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
GS06
28
Group Control Number
Required
numeric (N0)
Min 1 Max 9
Assigned number originated and maintained by the sender
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
GS07
455
Responsible Agency Code
Required
ID
Min 1 Max 2
Code used in conjunction with Data Element 480 to identify the issuer of the standard
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
GS08
480
Version / Release / Industry Identifier Code
Required
alphanumeric (AN)
Min 1 Max 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
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
ST
Transaction Set Header
Required
Max Use 1
To indicate the start of a transaction set and to assign a control number
ST01
143
Transaction Set Identifier Code
Required
ID
Min 3 Max 3
Code uniquely identifying a Transaction Set
820
Payment Order/Remittance Advice
ST02
329
Transaction Set Control Number
Required
alphanumeric (AN)
Min 4 Max 9
Identifying control number that must be unique within the transaction set functional group assigned by the originator for a transaction set
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
BPR
Beginning Segment for Payment Order/Remittance Advice
Required
Max Use 1
To indicate the beginning of a Payment Order/Remittance Advice Transaction Set and total payment amount, or to enable related transfer of funds and/or information from payer to payee to occur
Syntax Notes
If any of BPR06 or BPR07 are present, then all are required.
If BPR08 is present, then and BPR09 is required.
If any of BPR12 or BPR13 are present, then all are required.
If BPR14 is present, then and BPR15 is required.
If any of BPR18 or BPR19 are present, then all are required.
If BPR20 is present, then and BPR21 is required.
BPR01
305
Transaction Handling Code
Required
ID
Min 1 Max 2
Code designating the action to be taken by all parties
P
Prenotification of Future Transfers
X
Handling Party's Option to Split Payment and Remittance
BPR02
782
Monetary Amount
Required
decimal (R)
Min 1 Max 18
Monetary amount
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
BPR03
478
Credit/Debit Flag Code
Required
ID
Min 1 Max 1
Code indicating whether amount is a credit or debit
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
BPR04
591
Payment Method Code
Required
ID
Min 3 Max 3
Code identifying the method for the movement of payment instructions
ACH
Automated Clearing House (ACH)
BPR05
812
Payment Format Code
Required
ID
Min 1 Max 10
Code identifying the payment format to be used
CCP
Cash Concentration/Disbursement plus Addenda (CCD+) (ACH)
CTX
Corporate Trade Exchange (CTX) (ACH)
BPR06
506
(DFI) ID Number Qualifier
Required
ID
Min 2 Max 2
Code identifying the type of identification number of Depository Financial Institution (DFI)
01
ABA Transit Routing Number Including Check Digits (9 digits)
BPR07
507
(DFI) Identification Number
Required
alphanumeric (AN)
Min 3 Max 12
Depository Financial Institution (DFI) identification number
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
BPR08
569
Account Number Qualifier
Required
ID
Min 1 Max 3
Code indicating the type of account
DA
Demand Deposit
BPR09
508
Account Number
Required
alphanumeric (AN)
Min 1 Max 35
Account number assigned
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
BPR10
509
Originating Company Identifier
Required
alphanumeric (AN)
Min 10 Max 10
A unique identifier designating the company initiating the funds transfer instructions. The first character is one-digit ANSI identification code designation (ICD) followed by the nine-digit identification number which may be an IRS employer identification number (EIN), data universal numbering system (DUNS), or a user assigned number; the ICD for an EIN is 1, DUNS is 3, user assigned number is 9
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
BPR12
506
(DFI) ID Number Qualifier
Required
ID
Min 2 Max 2
Code identifying the type of identification number of Depository Financial Institution (DFI)
01
ABA Transit Routing Number Including Check Digits (9 digits)
BPR13
507
(DFI) Identification Number
Required
alphanumeric (AN)
Min 3 Max 12
Depository Financial Institution (DFI) identification number
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
BPR14
569
Account Number Qualifier
Required
ID
Min 1 Max 3
Code indicating the type of account
DA
Demand Deposit
BPR15
508
Account Number
Required
alphanumeric (AN)
Min 1 Max 35
Account number assigned
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
BPR16
373
Date
Required
longDate (DT)
Min 8 Max 8
Date expressed as CCYYMMDD
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
TRN
Trace
Required
Max Use 1
To uniquely identify a transaction to an application
TRN01
481
Trace Type Code
Required
ID
Min 1 Max 2
Code identifying which transaction is being referenced
1
Current Transaction Trace Numbers
TRN02
127
Reference Identification
Required
alphanumeric (AN)
Min 1 Max 30
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
DTM
Date/Time Reference
Required
To specify pertinent dates and times
Syntax Notes
At least one of DTM02, DTM03 or DTM05 is required.
If DTM04 is present, then and DTM03 is required.
If any of DTM05 or DTM06 are present, then all are required.
DTM01
374
Date/Time Qualifier
Required
ID
Min 3 Max 3
Code specifying type of date or time, or both date and time
097
Transaction Creation
DTM02
373
Date
Required
longDate (DT)
Min 8 Max 8
Date expressed as CCYYMMDD
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
DTM03
337
Time
Required
time (TM)
Min 4 Max 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)
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
N1 loop
Required
Min Items
Max Loop undefined
N1
Name
Required
Max Use 1
To identify a party by type of organization, name, and code
Syntax Notes
At least one of N102 or N103 is required.
If any of N103 or N104 are present, then all are required.
N101
98
Entity Identifier Code
Required
ID
Min 2 Max 3
Code identifying an organizational entity, a physical location, property or an individual
PR
Payer
N102
93
Name
Required
alphanumeric (AN)
Min 1 Max 60
Free-form name
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
N103
66
Identification Code Qualifier
Required
ID
Min 1 Max 2
Code designating the system/method of code structure used for Identification Code (67)
92
Assigned by Buyer or Buyer's Agent
N104
67
Identification Code
Required
alphanumeric (AN)
Min 6 Max 10
Code identifying a party or other code
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
N1
Name
Required
Max Use 1
To identify a party by type of organization, name, and code
Syntax Notes
At least one of N102 or N103 is required.
If any of N103 or N104 are present, then all are required.
N101
98
Entity Identifier Code
Required
ID
Min 2 Max 3
Code identifying an organizational entity, a physical location, property or an individual
PE
Payee
N102
93
Name
Required
alphanumeric (AN)
Min 1 Max 60
Free-form name
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
N103
66
Identification Code Qualifier
Optional
Min 1 Max 1
Code designating the system/method of code structure used for Identification Code (67)
N104
67
Identification Code
Optional
Min 1 Max 1
Code identifying a party or other code
N2
Additional Name Information
Required
To specify additional names or those longer than 35 characters in length
N201
93
Name
Required
alphanumeric (AN)
Min 1 Max 60
Free-form name
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
N3
Address Information
Required
To specify the location of the named party
N301
166
Address Information
Required
alphanumeric (AN)
Min 1 Max 55
Address information
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
N302
166
Address Information
Optional
alphanumeric (AN)
Min 1 Max 55
Address information
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
N3
Address Information
Required
To specify the location of the named party
N301
166
Address Information
Required
alphanumeric (AN)
Min 1 Max 55
Address information
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
N302
166
Address Information
Optional
Min 1 Max 1
Address information
N4
Geographic Location
Required
Max Use 1
To specify the geographic place of the named party
Syntax Notes
If N406 is present, then and N405 is required.
N401
19
City Name
Required
alphanumeric (AN)
Min 2 Max 30
Free-form text for city name
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
N402
156
State or Province Code
Required
ID
Min 2 Max 2
Code (Standard State/Province) as defined by appropriate government agency
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
N403
116
Postal Code
Required
ID
Min 3 Max 15
Code defining international postal zone code excluding punctuation and blanks (zip code for United States)
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
N404
26
Country Code
Required
ID
Min 2 Max 3
Code identifying the country
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
N4
Geographic Location
Required
Max Use 1
To specify the geographic place of the named party
Syntax Notes
If N406 is present, then and N405 is required.
N401
19
City Name
Required
alphanumeric (AN)
Min 2 Max 30
Free-form text for city name
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
N402
156
State or Province Code
Required
ID
Min 2 Max 2
Code (Standard State/Province) as defined by appropriate government agency
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
N403
116
Postal Code
Required
ID
Min 3 Max 15
Code defining international postal zone code excluding punctuation and blanks (zip code for United States)
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
N404
26
Country Code
Required
ID
Min 2 Max 3
Code identifying the country
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
ENT loop
Required
Min Items
Max Loop undefined
ENT
Entity
Required
Max Use 1
To designate the entities which are parties to a transaction and specify a reference meaningful to those entities
Syntax Notes
If any of ENT02, ENT03 or ENT04 are present, then all are required.
If any of ENT05, ENT06 or ENT07 are present, then all are required.
If any of ENT08 or ENT09 are present, then all are required.
ENT01
554
Assigned Number
Required
numeric (N0)
Min 1 Max 6
Number assigned for differentiation within a transaction set
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
RMR loop
Required
RMR
98
Remittance Advice Accounts Receivable Open Item Reference
Required
Min 1 Max 1
Max Use 1
To specify the accounts receivable open item(s) to be included in the cash application and to convey the appropriate detail
Syntax Notes
If any of RMR01 or RMR02 are present, then all are required.
If any of RMR07 or RMR08 are present, then all are required.
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
RMR01
128
Reference Identification Qualifier
Required
ID
Min 2 Max 3
Code qualifying the Reference Identification
IK
Invoice Number
RMR02
127
Reference Identification
Required
alphanumeric (AN)
Min 1 Max 30
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
RMR03
482
Payment Action Code
Required
ID
Min 2 Max 2
Code specifying the accounts receivable open item(s), if any, to be included in the cash application.
FL
Final
RMR04
782
Monetary Amount
Required
decimal (R)
Min 1 Max 18
Monetary amount
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
RMR05
782
Monetary Amount
Required
decimal (R)
Min 1 Max 18
Monetary amount
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
RMR06
782
Monetary Amount
Required
decimal (R)
Min 1 Max 18
Monetary amount
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
REF
98
Reference Identification
Optional
Min 1 Max 1
To specify identifying information
Syntax Notes
At least one of REF02 or REF03 is required.
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
REF01
128
Reference Identification Qualifier
Optional
ID
Min 2 Max 3
Code qualifying the Reference Identification
12
Billing Account
REF02
127
Reference Identification
Optional
alphanumeric (AN)
Min 1 Max 30
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
DTM
98
Date/Time Reference
Required
Min 1 Max 1
To specify pertinent dates and times
Syntax Notes
At least one of DTM02, DTM03 or DTM05 is required.
If DTM04 is present, then and DTM03 is required.
If any of DTM05 or DTM06 are present, then all are required.
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
DTM01
374
Date/Time Qualifier
Required
ID
Min 3 Max 3
Code specifying type of date or time, or both date and time
003
Invoice
DTM02
373
Date
Required
longDate (DT)
Min 8 Max 8
Date expressed as CCYYMMDD
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
DTM03
337
Time
Required
time (TM)
Min 4 Max 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)
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
SE
Transaction Set Trailer
Required
Max Use 1
To indicate the end of the transaction set and provide the count of the transmitted segments (including the beginning (ST) and ending (SE) segments)
SE01
96
Number of Included Segments
Required
numeric (N0)
Min 1 Max 10
Total number of segments included in a transaction set including ST and SE segments
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here
SE02
329
Transaction Set Control Number
Required
alphanumeric (AN)
Min 4 Max 9
Identifying control number that must be unique within the transaction set functional group assigned by the originator for a transaction set
123
Description Goes Here
123
Description Goes Here
123
Description Goes Here