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Product Transfer Account Adjustment
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X12 844 Product Transfer Account Adjustment

X12 Release 4010

This Draft Standard for Trial Use contains the format and establishes the data contents of the Product Transfer Account Adjustment Transaction Set (844) for use within the context of an Electronic Data Interchange (EDI) environment. The transaction set can be used to transmit specific data in the form of a debit, credit, or request for credit relating to pre-authorized product transfer actions.

Delimiters
  • ~ Segment
  • | Element
  • > Component
EDI sample
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    Overview
    ISA
    -
    Interchange Control Header
    Max use 1
    Required
    GS
    -
    Functional Group Header
    Max use 1
    Required
    heading
    ST
    010
    Transaction Set Header
    Max use 1
    Required
    BAA
    020
    Beginning Segment for Product Transfer Account Adjustment
    Max use 1
    Required
    N1 Loop
    detail
    CON Loop
    GE
    -
    Functional Group Trailer
    Max use 1
    Required
    IEA
    -
    Interchange Control Trailer
    Max use 1
    Required
    ISA

    Interchange Control Header

    RequiredMax use 1

    To start and identify an interchange of zero or more functional groups and interchange-related control segments

    Example
    ISA-01
    I01
    Authorization Information Qualifier
    Required

    Code to identify the type of information in the Authorization Information

    00
    No Authorization Information Present (No Meaningful Information in I02)
    ISA-02
    I02
    Authorization Information
    Required
    Min 10Max 10

    Information used for additional identification or authorization of the interchange sender or the data in the interchange; the type of information is set by the Authorization Information Qualifier (I01)

    ISA-03
    I03
    Security Information Qualifier
    Required

    Code to identify the type of information in the Security Information

    00
    No Security Information Present (No Meaningful Information in I04)
    ISA-04
    I04
    Security Information
    Required
    Min 10Max 10

    This is used for identifying the security information about the interchange sender or the data in the interchange; the type of information is set by the Security Information Qualifier (I03)

    ISA-05
    I05
    Interchange ID Qualifier
    Required
    Min 2Max 2

    Qualifier to designate the system/method of code structure used to designate the sender or receiver ID element being qualified

    Codes
    ISA-06
    I06
    Interchange Sender ID
    Required
    Min 15Max 15

    Identification code published by the sender for other parties to use as the receiver ID to route data to them; the sender always codes this value in the sender ID element

    ISA-07
    I05
    Interchange ID Qualifier
    Required
    Min 2Max 2

    Qualifier to designate the system/method of code structure used to designate the sender or receiver ID element being qualified

    Codes
    ISA-08
    I07
    Interchange Receiver ID
    Required
    Min 15Max 15

    Identification code published by the receiver of the data; When sending, it is used by the sender as their sending ID, thus other parties sending to them will use this as a receiving ID to route data to them

    ISA-09
    I08
    Interchange Date
    Required
    YYMMDD format

    Date of the interchange

    ISA-10
    I09
    Interchange Time
    Required
    HHMM format

    Time of the interchange

    ISA-11
    I10
    Interchange Control Standards Identifier
    Required

    Code to identify the agency responsible for the control standard used by the message that is enclosed by the interchange header and trailer

    U
    U.S. EDI Community of ASC X12, TDCC, and UCS
    ISA-12
    I11
    Interchange Control Version Number
    Required

    This version number covers the interchange control segments

    00401
    Draft Standards for Trial Use Approved for Publication by ASC X12 Procedures Review Board through October 1997
    ISA-13
    I12
    Interchange Control Number
    Required
    Min 9Max 9

    A control number assigned by the interchange sender

    ISA-14
    I13
    Acknowledgment Requested
    Required
    Min 1Max 1

    Code sent by the sender to request an interchange acknowledgment (TA1)

    0
    No Acknowledgment Requested
    1
    Interchange Acknowledgment Requested
    ISA-15
    I14
    Usage Indicator
    Required
    Min 1Max 1

    Code to indicate whether data enclosed by this interchange envelope is test, production or information

    I
    Information
    P
    Production Data
    T
    Test Data
    ISA-16
    I15
    Component Element Separator
    Required
    Min 1Max 1

    Type is not applicable; the component element separator is a delimiter and not a data element; this field provides the delimiter used to separate component data elements within a composite data structure; this value must be different than the data element separator and the segment terminator

    >
    Component Element Separator

    Functional Group Header

    RequiredMax use 1

    To indicate the beginning of a functional group and to provide control information

    Example
    GS-01
    479
    Functional Identifier Code
    Required

    Code identifying a group of application related transaction sets

    CF
    Corporate Financial Adjustment Information (844 and 849)
    GS-02
    142
    Application Sender's Code
    Required
    Min 2Max 15

    Code identifying party sending transmission; codes agreed to by trading partners

    GS-03
    124
    Application Receiver's Code
    Required
    Min 2Max 15

    Code identifying party receiving transmission. Codes agreed to by trading partners

    GS-04
    373
    Date
    Required
    CCYYMMDD format

    Date expressed as CCYYMMDD

    GS-05
    337
    Time
    Required
    HHMM, HHMMSS, HHMMSSD, or HHMMSSDD format

    Time expressed in 24-hour clock time as follows: HHMM, or HHMMSS, or HHMMSSD, or HHMMSSDD, where H = hours (00-23), M = minutes (00-59), S = integer seconds (00-59) and DD = decimal seconds; decimal seconds are expressed as follows: D = tenths (0-9) and DD = hundredths (00-99)

    GS-06
    28
    Group Control Number
    Required
    Min 1Max 9

    Assigned number originated and maintained by the sender

    GS-07
    455
    Responsible Agency Code
    Required
    Min 1Max 2

    Code used in conjunction with Data Element 480 to identify the issuer of the standard

    T
    Transportation Data Coordinating Committee (TDCC)
    X
    Accredited Standards Committee X12
    GS-08
    480
    Version / Release / Industry Identifier Code
    Required

    Code indicating the version, release, subrelease, and industry identifier of the EDI standard being used, including the GS and GE segments; if code in DE455 in GS segment is X, then in DE 480 positions 1-3 are the version number; positions 4-6 are the release and subrelease, level of the version; and positions 7-12 are the industry or trade association identifiers (optionally assigned by user); if code in DE455 in GS segment is T, then other formats are allowed

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

    Heading

    ST
    010

    Transaction Set Header

    RequiredMax use 1

    To indicate the start of a transaction set and to assign a control number

    Example
    ST-01
    143
    Transaction Set Identifier Code
    Required

    Code uniquely identifying a Transaction Set

    • The transaction set identifier (ST01) used by the translation routines of the interchange partners to select the appropriate transaction set definition (e.g., 810 selects the Invoice Transaction Set).
    844
    Product Transfer Account Adjustment
    ST-02
    329
    Transaction Set Control Number
    Required
    Min 4Max 9

    Identifying control number that must be unique within the transaction set functional group assigned by the originator for a transaction set

    BAA
    020

    Beginning Segment for Product Transfer Account Adjustment

    RequiredMax use 1

    To identify the beginning of a Product Transfer Account Adjustment Transaction Set and further define the type of product account adjustment transaction set and its reference number and date

    Example
    If either Reference Identification Qualifier (BAA-04) or Reference Identification (BAA-05) is present, then the other is required
    BAA-01
    353
    Transaction Set Purpose Code
    Required

    Code identifying purpose of transaction set

    00
    Original
    BAA-02
    640
    Transaction Type Code
    Required

    Code specifying the type of transaction

    RA
    Request for Credit
    BAA-03
    373
    Date
    Required
    CCYYMMDD format

    Date expressed as CCYYMMDD

    • BAA03 is the account adjustment date.
    Usage notes

    This is the date the chargeback was generated by the computer.

    BAA-04
    128
    Reference Identification Qualifier
    Optional

    Code qualifying the Reference Identification

    AM
    Adjustment Memo (Charge Back)
    BAA-05
    127
    Reference Identification
    Optional
    Min 1Max 30

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

    Usage notes

    ABC Debit Memo Numbers are 11 Digits.
    The leading two digits are the Company Code ( 61 for Mainland, and 33 for Puerto Rico), followed by a 2 digit fiscal year (2011 = 11) then the seven digit document number.
    Example Mainland: 61 + 11 + 1234567
    Example Puerto Rico: 33 + 11 + 1234567

    N1 Loop
    OptionalMax 50
    Variants (all may be used)
    N1N1 Loop
    N1
    070

    Name

    RequiredMax use 1

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

    Example
    At least one of Name (N1-02) or Identification Code Qualifier (N1-03) is required
    N1-01
    98
    Entity Identifier Code
    Required

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

    DB
    Distributor Branch
    N1-02
    93
    Name
    Optional
    Min 1Max 60

    Free-form name

    N1-03
    66
    Identification Code Qualifier
    Required

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

    11
    Drug Enforcement Administration (DEA)
    N1-04
    67
    Identification Code
    Required
    Min 2Max 80

    Code identifying a party or other code

    • This segment, used alone, provides the most efficient method of providing organizational identification. To obtain this efficiency the "ID Code" (N104) must provide a key to the table maintained by the transaction processing party.
    N1 Loop
    OptionalMax 50
    Variants (all may be used)
    N1N1 Loop
    N1
    070

    Name

    RequiredMax use 1

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

    Example
    N1-01
    98
    Entity Identifier Code
    Required

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

    SU
    Supplier/Manufacturer
    N1-03
    66
    Identification Code Qualifier
    Required

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

    11
    Drug Enforcement Administration (DEA)
    N1-04
    67
    Identification Code
    Required
    Min 2Max 80

    Code identifying a party or other code

    • This segment, used alone, provides the most efficient method of providing organizational identification. To obtain this efficiency the "ID Code" (N104) must provide a key to the table maintained by the transaction processing party.

    Detail

    CON Loop
    RequiredMax 10000
    CON
    010

    Contract Number Detail

    RequiredMax use 1

    To specify contract or reference number and status

    Example
    CON-01
    128
    Reference Identification Qualifier
    Required

    Code qualifying the Reference Identification

    VC
    Vendor Contract Number
    CON-02
    127
    Reference Identification
    Required
    Min 1Max 30

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

    CON-03
    846
    Contract Status Code
    Required

    Code designating the current status of the contract

    VA
    Valid Open Contract
    N1 Loop
    OptionalMax 50
    N1
    050

    Name

    RequiredMax use 1

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

    Example
    At least one of Name (N1-02) or Identification Code Qualifier (N1-03) is required
    If either Identification Code Qualifier (N1-03) or Identification Code (N1-04) is present, then the other is required
    N1-01
    98
    Entity Identifier Code
    Required

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

    ST
    Ship To
    N1-02
    93
    Name
    Optional
    Min 1Max 60

    Free-form name

    N1-03
    66
    Identification Code Qualifier
    Optional

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

    11
    Drug Enforcement Administration (DEA)
    UL
    UCC/EAN Location Code

    GLN (Global Location Number)

    N1-04
    67
    Identification Code
    Optional
    Min 2Max 80

    Code identifying a party or other code

    • This segment, used alone, provides the most efficient method of providing organizational identification. To obtain this efficiency the "ID Code" (N104) must provide a key to the table maintained by the transaction processing party.
    Usage notes

    DEA or GLN Number.

    N3
    070

    Address Information

    OptionalMax use 2

    To specify the location of the named party

    Example
    N3-01
    166
    Address Information
    Required
    Min 1Max 55

    Address information

    N4
    080

    Geographic Location

    OptionalMax use 1

    To specify the geographic place of the named party

    Example
    N4-01
    19
    City Name
    Optional
    Min 2Max 30

    Free-form text for city name

    • A combination of either N401 through N404, or N405 and N406 may be adequate to specify a location.
    N4-02
    156
    State or Province Code
    Optional
    Min 2Max 2

    Code (Standard State/Province) as defined by appropriate government agency

    • N402 is required only if city name (N401) is in the U.S. or Canada.
    N4-03
    116
    Postal Code
    Optional
    Min 3Max 15

    Code defining international postal zone code excluding punctuation and blanks (zip code for United States)

    REF
    090

    Reference Identification

    OptionalMax use 12

    To specify identifying information

    Example
    Variants (all may be used)
    REFReference Identification
    REF-01
    128
    Reference Identification Qualifier
    Required

    Code qualifying the Reference Identification

    2U
    Payer Identification Number
    REF-02
    127
    Reference Identification
    Required
    Min 1Max 30

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

    REF
    090

    Reference Identification

    OptionalMax use 1

    To specify identifying information

    Example
    Variants (all may be used)
    REFReference Identification
    REF-01
    128
    Reference Identification Qualifier
    Required

    Code qualifying the Reference Identification

    HI
    Health Industry Number (HIN)
    REF-02
    127
    Reference Identification
    Required
    Min 1Max 30

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

    SII Loop
    OptionalMax >1
    SII
    105

    Sales Item Information

    RequiredMax use 1

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

    Example
    SII-01
    235
    Product/Service ID Qualifier
    Required

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

    ND
    National Drug Code (NDC)
    NH
    National Health Related Item Code
    UP
    U.P.C. Consumer Package Code (1-5-5-1)
    SII-02
    234
    Product/Service ID
    Required
    Min 1Max 48

    Identifying number for a product or service

    Usage notes

    NDC or UPC Number or the National Health Related Item Code

    SII-03
    380
    Quantity
    Required
    Min 1Max 15

    Numeric value of quantity

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

    A positive value represents the quantity sold. In previous versions, quantity sold was indicated by a code 32 in the QTY01.
    A negative value represents returns. In previous versions, returns were indicated by a code 76 in the QTY01.

    SII-04
    C001
    Composite Unit of Measure
    To identify a composite unit of measure (See Figures Appendix for examples of use)
    C001-01
    355
    Unit or Basis for Measurement Code
    Required

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

    EA
    Each
    SII-05
    212
    Unit Price
    Required
    Min 1Max 15

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

    • SII05 is the wholesale acquisition price.
    SII-06
    212
    Unit Price
    Required
    Min 1Max 15

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

    • SII06 is the contract price.
    SII-07
    782
    Monetary Amount
    Required
    Min 1Max 15

    Monetary amount

    • SII07 is the extended rebate amount.
    Usage notes

    Extended Chargeback
    (SII05 - SII06) x SII03 = SII07

    N9
    107

    Reference Identification

    OptionalMax use 1

    To transmit identifying information as specified by the Reference Identification Qualifier

    Example
    N9-01
    128
    Reference Identification Qualifier
    Required

    Code qualifying the Reference Identification

    DI
    Distributor Invoice Number
    N9-02
    127
    Reference Identification
    Optional
    Min 1Max 30

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

    N9-04
    373
    Date
    Optional
    CCYYMMDD format

    Date expressed as CCYYMMDD

    N9-06
    623
    Time Code
    Optional

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

    • N906 reflects the time zone which the time reflects.
    L1
    Unique Line Item Identifier
    N9-07
    C040
    Reference Identifier
    To identify one or more reference numbers or identification numbers as specified by the Reference Qualifier
    If either Reference Identification Qualifier (C040-03) or Reference Identification (C040-04) is present, then the other is required
    C040-01
    128
    Reference Identification Qualifier
    Required
    Min 2Max 3

    Code qualifying the Reference Identification

    C040-02
    127
    Reference Identification
    Required
    Min 1Max 30

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

    C040-03
    128
    Reference Identification Qualifier
    Optional

    Code qualifying the Reference Identification

    8X
    Transaction Category or Type
    C040-04
    127
    Reference Identification
    Optional

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

    00
    for original
    18
    for credit/rebill with original
    41
    for credit/rebill with no original

    Summary

    CTT
    010

    Transaction Totals

    RequiredMax use 1

    To transmit a hash total for a specific element in the transaction set

    • Number of line items (CTT01) is the accumulation of the number of CON segments.
      If used, hash total (CTT02) is the sum of adjustment quantities (QTY02) for each QTY segment.
    Example
    CTT-01
    354
    Number of Line Items
    Required
    Min 1Max 6

    Total number of line items in the transaction set

    Usage notes

    Total number of CON segments

    AMT
    020

    Monetary Amount

    OptionalMax use 5

    To indicate the total monetary amount

    Example
    AMT-01
    522
    Amount Qualifier Code
    Required
    Min 1Max 3

    Code to qualify amount

    AMT-02
    782
    Monetary Amount
    Required
    Min 1Max 15

    Monetary amount

    Usage notes

    Total Chargeback Amount
    Sum of SII07

    SE
    030

    Transaction Set Trailer

    RequiredMax 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)

    Example
    SE-01
    96
    Number of Included Segments
    Required
    Min 1Max 10

    Total number of segments included in a transaction set including ST and SE segments

    SE-02
    329
    Transaction Set Control Number
    Required
    Min 4Max 9

    Identifying control number that must be unique within the transaction set functional group assigned by the originator for a transaction set

    Functional Group Trailer

    RequiredMax use 1

    To indicate the end of a functional group and to provide control information

    Example
    GE-01
    97
    Number of Transaction Sets Included
    Required
    Min 1Max 6

    Total number of transaction sets included in the functional group or interchange (transmission) group terminated by the trailer containing this data element

    GE-02
    28
    Group Control Number
    Required
    Min 1Max 9

    Assigned number originated and maintained by the sender

    Interchange Control Trailer

    RequiredMax use 1

    To define the end of an interchange of zero or more functional groups and interchange-related control segments

    Example
    IEA-01
    I16
    Number of Included Functional Groups
    Required
    Min 1Max 5

    A count of the number of functional groups included in an interchange

    IEA-02
    I12
    Interchange Control Number
    Required
    Min 9Max 9

    A control number assigned by the interchange sender

    EDI Samples

    Sample from AmerisourceBergen

    ST|844|100001757~
    BAA|00|RA|20210220|AM|6192955447~
    N1|DB|ABC DC SACRAMENTO|11|RA0310603~
    N1|SU||11|043569607~
    CON|VC|V797D70168|VA~
    N1|ST|CSDC TRAVIS-TRAVIS AFB CA ROOM 136|11|RC0351849~
    N3|106 BODIN CIRCLE, BUILDING 791~
    N4|TRAVIS AFB|CA|94535~
    SII|ND|54738054803|1|EA|6.53|5.94|.59~
    N9|DI|0987543262||20210216|||L1>4187818169000020~
    CON|VC|V797D70168|VA~
    N1|ST|MISAWA AB MARK FOR MEDICAL MATERIEL|11|PM0059661~
    N3|UNIT 5024, BLDG. 99~
    N4|APO|AP|96319~
    SII|ND|54738054803|11|EA|6.53|5.94|6.49~
    N9|DI|0987637270||20210217|||L1>4188602230000160~
    CON|VC|V797D70168|VA~
    N1|ST|US NAVAL HOSP OKINAWA - HT0720 ATTN SUPPLY OFFICER N68470|11|PM0059661~
    N3|PSC 482 BLDG 966 TARAWA RD CAMP FOS~
    N4|FPO|AP|96362~
    SII|ND|54738054803|4|EA|6.53|5.94|2.36~
    N9|DI|0987637769||20210217|||L1>4188603101000380~
    CTT|3~
    AMT|CC|9.44~
    SE|25|100001757~

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