Sequence
Element
Name
Type
Requirement
Min
Max
Repeat
01
Quantity
Decimal number (R)
Mandatory
1
15
1
Numeric value of quantity
02
Assigned Identification
String (AN)
Optional
1
20
1
Alphanumeric characters assigned for differentiation within a transaction set
03
Change or Response Type Code
Identifier (ID)
Optional
2
2
1
Code specifying the type of change to the line item
04
Product/Service ID
String (AN)
Optional
1
80
1
Identifying number for a product or service
LS104 indicates the manufacturer's part number.
05
Product/Service ID
String (AN)
Optional
1
80
1
Identifying number for a product or service
LS105 indicates the manufacturer.
06
Product/Service ID
String (AN)
Optional
1
80
1
Identifying number for a product or service
LS106 indicates the type.
07
Product/Service ID
String (AN)
Optional
1
80
1
Identifying number for a product or service
LS107 indicates the model.