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1 820 Payment Order/Remittance Advice Version: 1.0 Author: Land O' Lakes, Inc. V4010 1

2 820 Payment Order/Remittance Advice Functional Group=RA Not Defined: Pos Id Segment Name Req Max Use Repeat Notes ISA Interchange Control Header M 1 GS Functional Group Header M 1 Heading: Pos Id Segment Name Req Max Use Repeat Notes 010 ST Transaction Set Header M BPR Beginning Segment for Payment M 1 Order/Remittance Advice 035 TRN Trace O 1 C1/ REF Reference Identification O >1 060 DTM Date/Time Reference O >1 LOOP ID - N1 >1 C1/070L 070 N1 Name O 1 C1/ N2 Additional Name Information O >1 090 N3 Address Information O >1 100 N4 Geographic Location O REF Reference Identification O >1 Detail: Pos Id Segment Name Req Max Use Repeat Notes LOOP ID - ENT >1 CN2/010L LOOP ID - ADX >1 C2/080L 080 ADX Adjustment O 1 C2/ NTE Note/Special Instruction O >1 105 DTM Date/Time Reference O 1 LOOP ID - RMR >1 C2/150L 150 RMR Remittance Advice Accounts Receivable O 1 C2/150 Open Item Reference 160 NTE Note/Special Instruction O >1 170 REF Reference Identification O >1 180 DTM Date/Time Reference O >1 LOOP ID - ADX >1 C2/210L 210 ADX Adjustment O 1 C2/210 Summary: Pos Id Segment Name Req Max Use Repeat Notes 010 SE Transaction Set Trailer M 1 Not Defined: Pos Id Segment Name Req Max Use Repeat Notes GE Functional Group Trailer M 1 IEA Interchange Control Trailer M 1 V4010 2

3 ISA Interchange Control Header Pos: Max: 1 Not Defined - Mandatory Elements: Loop: N/A 16 ISA01 I01 Authorization Information Qualifier M ID 2/2 ISA02 I02 Authorization Information M AN 10/10 ISA03 I03 Security Information Qualifier M ID 2/2 ISA04 I04 Security Information M AN 10/10 ISA05 I05 Interchange ID Qualifier M ID 2/2 ISA06 I06 Interchange Sender ID M AN 15/15 ISA07 I05 Interchange ID Qualifier M ID 2/2 ISA08 I07 Interchange Receiver ID M AN 15/15 ' T' (DUNS) for MCI test ' ' (DUNS) for MCI Live '925323LLAKT' (Comm-ID) for Commerce Test '925323LLAK' (Comm-ID) FOR Commerce Live ISA09 I08 Interchange Date M DT 6/6 ISA10 I09 Interchange Time M TM 4/4 ISA11 I10 Interchange Control Standards Identifier M ID 1/1 ISA12 I11 Interchange Control Version Number M ID 5/5 ISA13 I12 Interchange Control Number M N0 9/9 ISA14 I13 Acknowledgment Requested M ID 1/1 ISA15 I14 Usage Indicator M ID 1/1 ISA16 I15 Component Element Separator M 1/1 V4010 3

4 GS Functional Group Header Pos: Max: 1 Not Defined - Mandatory Loop: N/A Elements: 8 GS Functional Identifier Code M ID 2/2 GS Application Sender's Code M AN 2/15 GS Application Receiver's Code M AN 2/15 ' T' for Test ' ' for Live GS Date M DT 8/8 GS Time M TM 4/8 GS06 28 Group Control Number M N0 1/9 GS Responsible Agency Code M ID 1/2 GS Version / Release / Industry Identifier Code M AN 1/12 V4010 4

5 ST Transaction Set Header Pos: 010 Max: 1 Heading - Mandatory Loop: N/A Elements: 2 ST Transaction Set Identifier Code M ID 3/3 ST Transaction Set Control Number M AN 4/9 V4010 5

6 BPR Beginning Segment for Payment Order/Remittance Advice Pos: 020 Max: 1 Heading - Mandatory Loop: N/A Elements: 5 BPR Transaction Handling Code M ID 1/2 BPR Monetary Amount M R 1/18 BPR (DFI) Identification Number X AN 3/12 BPR Account Number X AN 1/35 BPR Date O DT 8/8 V4010 6

7 TRN Trace Pos: 035 Max: 1 Heading - Optional Loop: N/A Elements: 2 TRN Trace Type Code M ID 1/2 TRN Reference Identification M AN 1/30 V4010 7

8 REF Reference Identification Pos: 050 Max: >1 Heading - Optional Loop: N/A Elements: 2 REF Reference Identification Qualifier M ID 2/3 REF Reference Identification X AN 1/30 V4010 8

9 DTM Date/Time Reference Pos: 060 Max: >1 Heading - Optional Loop: N/A Elements: 3 DTM Date/Time Qualifier M ID 3/3 DTM Date X DT 8/8 DTM Time X TM 4/8 V4010 9

10 Loop N1 Pos: 070 Repeat: >1 Optional Elements: Loop: N1 N/A Loop Summary: Pos Id Segment Name Req Max Use Repeat 070 N1 Name O N2 Additional Name Information O >1 090 N3 Address Information O >1 100 N4 Geographic Location O REF Reference Identification O >1 V

11 N1 Name Pos: 070 Max: 1 Heading - Optional Loop: N1 Elements: 4 N Entity Identifier Code M ID 2/3 N Name X AN 1/60 N Identification Code Qualifier X ID 1/2 N Identification Code DUNS number for Originator X AN 2/80 V

12 N2 Additional Name Information Pos: 080 Max: >1 Heading - Optional Loop: N1 Elements: 1 N Name M AN 1/60 V

13 N3 Address Information Pos: 090 Max: >1 Heading - Optional Loop: N1 Elements: 2 N Address Information M AN 1/55 N Address Information O AN 1/55 V

14 N4 Geographic Location Pos: 100 Max: 1 Heading - Optional Loop: N1 Elements: 3 N City Name O AN 2/30 N State or Province Code O ID 2/2 N Postal Code O ID 3/15 V

15 REF Reference Identification Pos: 110 Max: >1 Heading - Optional Loop: N1 Elements: 2 REF Reference Identification Qualifier M ID 2/3 REF Reference Identification X AN 1/30 V

16 Loop ENT Pos: 010 Repeat: >1 Optional Elements: Loop: ENT N/A Loop Summary: Pos Id Segment Name Req Max Use Repeat 080 Loop ADX O >1 150 Loop RMR O >1 V

17 Loop ADX Pos: 080 Repeat: >1 Optional Elements: Loop: ADX N/A Loop Summary: Pos Id Segment Name Req Max Use Repeat 080 ADX Adjustment O NTE Note/Special Instruction O >1 105 DTM Date/Time Reference O 1 V

18 ADX Adjustment Pos: 080 Max: 1 Detail - Optional Loop: ADX Elements: 4 ADX Monetary Amount M R 1/18 ADX Adjustment Reason Code M ID 2/2 ADX Reference Identification Qualifier X ID 2/3 ADX Reference Identification Invoice Adjustment Number if this is the same number as RMR-02. Otherwise this is the Purchase Order. X AN 1/30 V

19 NTE Note/Special Instruction Pos: 090 Max: >1 Detail - Optional Loop: ADX Elements: 1 NTE Description M AN 1/80 V

20 DTM Date/Time Reference Pos: 105 Max: 1 Detail - Optional Loop: ADX Elements: 2 DTM Date/Time Qualifier M ID 3/3 DTM Date X DT 8/8 V

21 Loop RMR Pos: 150 Repeat: >1 Optional Elements: Loop: RMR N/A Loop Summary: Pos Id Segment Name Req Max Use Repeat 150 RMR Remittance Advice Accounts Receivable Open Item O 1 Reference 160 NTE Note/Special Instruction O >1 170 REF Reference Identification O >1 180 DTM Date/Time Reference O >1 210 Loop ADX O >1 V

22 RMR Remittance Advice Accounts Receivable Open Item Reference Pos: 150 Max: 1 Detail - Optional Loop: RMR Elements: 5 RMR Reference Identification Qualifier X ID 2/3 RMR Reference Identification X AN 1/30 RMR Monetary Amount O R 1/18 RMR Monetary Amount O R 1/18 RMR Monetary Amount O R 1/18 V

23 NTE Note/Special Instruction Pos: 160 Max: >1 Detail - Optional Loop: RMR Elements: 1 NTE Description M AN 1/80 V

24 REF Reference Identification Pos: 170 Max: >1 Detail - Optional Loop: RMR Elements: 2 REF Reference Identification Qualifier M ID 2/3 REF Reference Identification X AN 1/30 V

25 DTM Date/Time Reference Pos: 180 Max: >1 Detail - Optional Loop: RMR Elements: 2 DTM Date/Time Qualifier M ID 3/3 DTM Date X DT 8/8 V

26 Loop ADX Pos: 210 Repeat: >1 Optional Elements: Loop: ADX N/A Loop Summary: Pos Id Segment Name Req Max Use Repeat 210 ADX Adjustment O 1 V

27 ADX Adjustment Pos: 210 Max: 1 Detail - Optional Loop: ADX Elements: 4 ADX Monetary Amount M R 1/18 ADX Adjustment Reason Code M ID 2/2 ADX Reference Identification Qualifier X ID 2/3 ADX Reference Identification X AN 1/30 V

28 SE Transaction Set Trailer Pos: 010 Max: 1 Summary - Mandatory Loop: N/A Elements: 2 SE01 96 Number of Included Segments M N0 1/10 SE Transaction Set Control Number M AN 4/9 V

29 GE Functional Group Trailer Pos: Max: 1 Not Defined - Mandatory Loop: N/A Elements: 2 GE01 97 Number of Transaction Sets Included M N0 1/6 GE02 28 Group Control Number M N0 1/9 V

30 IEA Interchange Control Trailer Pos: Max: 1 Not Defined - Mandatory Loop: N/A Elements: 2 IEA01 I16 Number of Included Functional Groups M N0 1/5 IEA02 I12 Interchange Control Number M N0 9/9 V

IMPLEMENTATION GUIDELINES FOR ANSI ASC X12 EDI CONVENTIONS MAJOR DAMAGE TRACKING PAYMENT ORDER/REMITTANCE ADVICE (820) TRANSACTION SET

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