EDI 142 Product Service Claim

EDI 142 Format

ISA*01*0000000000*01*0000000000*ZZ*ABCDEFGHIJKLMNO*ZZ*123456789012345*101127*1719*U*00400*000003438*0*P*>GS*WA*1234567890 *999999999 *20120126*1211*1*T*004010ST*142*0001BGN*00*Reference Identification*20120227*1251*01*Reference Identification*01*1*00N9*01*Reference Identification*Free-form Description*20120227*1251*01*01Reference Identification1Reference Identification1Reference IdentificationN1*01*Name*1*Identification Code*01*01N2*Name*NameN3*Address Information*Address InformationN4*City Name*ST*POSTAL CODE*COU*A*Location IdentifierREF*01*Reference Identification*Description*01Reference Identification1Reference Identification1Reference IdentificationPER*1A*Name*AA*Communication Number*AA*Communication Number*AA*Communication Number*Contact Inquiry RefeLX*27N9*01*Reference Identification*Free-form Description*20120227*125111*01*01Reference Identification1Reference Identification1Reference IdentificationMSG*Free-Form Message Text*AA*2LIN*Assigned Identificat*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service IDPID*F*01*10*Product Desc*Description*1S*Source Subquali*N*LANLOC*01*Reference Identification*Description*Reference Identification*Catego*01*Reference Identification*Description*Reference Identification*1835216312231861206*011133514194673011262208711139221075230123155047126564315686284971878621289195991964812823925483258661*3989143*01418020489859945619117332292230813003931636724111104354312518221104203072831291*3*0180422409615523761191506739354144259125674510711292660373311544253215832073061*128193037529189226*012265516722321130971416041281129739188123659631812939124907272844*8540320215199*01490855153760222117837888321559580724714220511406329172252131800723711262271813189652*87551*01226901891079629319954107532516167112350127652791842212483129380870858318552967517543025353*01*Reference Identification*DescriptionQTY*01*179038665*011288412981183884112392212125481117592963531342445DTM*001*20120227*12511100*01*CC*Date Time PeriodREF*01*Reference Identification*Description*01Reference Identification1Reference Identification1Reference IdentificationPER*1A*Name*AA*Communication Number*AA*Communication Number*AA*Communication Number*Contact Inquiry RefePSC*AC*AF*AF*Reference Identification*01*Contract Number*0119301324901713669188313527416389110515409111759949412112141430632*5*001*20120227*20120227*01128452555371413991852856524441112225117222761112411198136491110872*2387272727521172*111*6954129601857794612*1*239*10*Source Subquali*01*AC*Description*1646291*N*ESSS*A*10*AC*Service Marks and Numbers*713229905*5942237*Description*26*Source SubqualiLM*10*Source SubqualiLQ*0*Industry CodeN1*01*Name*1*Identification Code*01*01N2*Name*NameN3*Address Information*Address InformationN4*City Name*ST*POSTAL CODE*COU*A*Location IdentifierN9*01*Reference Identification*Free-form Description*20120227*12511100*01*01Reference Identification1Reference Identification1Reference IdentificationPER*1A*Name*AA*Communication Number*AA*Communication Number*AA*Communication Number*Contact Inquiry RefePRR*Assigned Identificat*10*Source Subquali*BRK*Description*10*Source Subquali*A*10*Source Subquali*1LIN*Assigned Identificat*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service IDLOC*01*Reference Identification*Description*Reference Identification*Catego*01*Reference Identification*Description*Reference Identification*192662773610362237*014680108891400219618260512511146399841203343082489307511291399659611479303606*41778137276851797011*0117926644224301311530603266311024323291774819740104162186103868117926*421913348326552804*011581073493128096185263096726531402415187182178314912844111000171943719404112140281551852174011*25203121*01314396274131302343132381162411541421943281246531172752401171072222*1*0116690139325451082265812761621295638654282711942418912415719117691472356115317*1247219396228768465*0110228883258114313035616625743417357202151955413091166071913130611760930805171416546472*01*Reference Identification*DescriptionQTY*01*13312645516*01434331241212175956811631154110812088120198412628225763193DTM*001*20120227*125111*01*CC*Date Time PeriodMSG*Free-Form Message Text*AA*222RC*A1*Product/Service ID*Name*10*Source Subquali*Cas*Description*Free-Form Message Text*NPER*1A*Name*AA*Communication Number*AA*Communication Number*AA*Communication Number*Contact Inquiry RefePSC*AC*AF*AF*Reference Identification*01*Contract Number*0114761264182675312509124119636985222160412282925444111135771*64*001*20120227*20120227*012297891051286332191138762707112345534248222361541425218188*153551*163411021696248965*15*1*32128234*10*Source Subquali*01*AC*Description*1313428453*N*ESSS*A*10*AC*Service Marks and Numbers*46786794258777*3221*Description*91792339722067*Source SubqualiCID*1*01*10*Product Desc*Description*Source Subquali*NTMD*01*10*Product Desc*01*01*Description*20120227*Reference Identification*Source SubqualiMEA*9L*1*2601139731*013084223744187522107457112473111893074221541111153900191121833299282728451279113*5738321*25152859*01**1S*BMDTM*001*20120227*12511100*01*CC*Date Time PeriodLIN*Assigned Identificat*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service IDREP*Assigned Identificat*A1*Product/Service ID*A1*Product/Service ID*10*Source Subquali*AL*Description*10*Source Subquali*DAP*A1*Product/Service ID*AL*Description*10*Source Subquali*Reference Identification*AuthREF*01*Reference Identification*Description*01Reference Identification1Reference Identification1Reference IdentificationN1*01*Name*1*Identification Code*01*01PER*1A*Name*AA*Communication Number*AA*Communication Number*AA*Communication Number*Contact Inquiry RefeRC*A1*Product/Service ID*Name*10*Source Subquali*Cas*Description*Free-Form Message Text*NDTM*001*20120227*1251110*01*CC*Date Time PeriodLIN*Assigned Identificat*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service IDITA*A*10*AC*01*Allowance or Cha*189*843328*1*1*14050337031368*01*22451*Description*002*Source Subquali*A*01MSG*Free-Form Message Text*AA*212023699PRT*EXC*10*Source Subquali*NLM*10*Source SubqualiLQ*0*Industry CodeMEA*9L*1*17560174*01239922802235412185801213193128148704631186722197172178328852*24*26456*01**1S*BMDTM*001*20120227*125112*01*CC*Date Time PeriodLIN*Assigned Identificat*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service IDIT1*Assigned Identificat*17*01*15330229*AA*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service IDLIN*Assigned Identificat*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service IDN1*01*Name*1*Identification Code*01*01N9*01*Reference Identification*Free-form Description*20120227*1251*01*01Reference Identification1Reference Identification1Reference IdentificationPRT*EXC*10*Source Subquali*NDTM*001*20120227*12511200*01*CC*Date Time PeriodITA*A*10*AC*01*Allowance or Cha*177793*159294425*1*35*306842*01*2056626*Description*002*Source Subquali*A*01CUR*01*CUR*295729412*01*CUR*IMF*001*20120227*1251120*001*20120227*125112*001*20120227*12511200*001*20120227*12511200*001*20120227*125112AMT*1*2539*CTXI*AA*3223*3133314*CD*Tax Jurisd*0*A*370719*Tax Identification N*Assigned IdentificatCUR*01*CUR*15605*01*CUR*IMF*001*20120227*1251120*001*20120227*1251120*001*20120227*125112*001*20120227*1251120*001*20120227*12511200TDS*103*1050562*430652*2012678TXI*AA*5766104*1015*CD*Tax Jurisd*0*A*108*Tax Identification N*Assigned IdentificatCUR*01*CUR*2794*01*CUR*IMF*001*20120227*1251*001*20120227*125112*001*20120227*1251*001*20120227*1251*001*20120227*1251SE*74*0001GE*1*1IEA*1*000000475

EDI 142 Specification

This X12 Transaction Set contains the format and establishes the data contents of the Product Service Claim Transaction Set (142) for use within the context of an Electronic Data Interchange (EDI) environment. The transaction set can be used to transmit the servicing organization, claimant, manufacturer, seller, and purchaser of the product.It can specify the product's current usage, date the product was sold, delivered, and placed in service as well as identify product model and serial numbers and serial numbers of any subassemblies. It can specify a malfunction or recall condition, service performed, labor, parts, and any other associated costs. It can show the costs of the repair and the date service was requested and when it was available to be placed back in service.

Sources

Accredited Standards Committee X12. ASC X12 Standard [Table Data]. Data Interchange Standards Association, Inc., Falls Church, VA. http://www.x12.org