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*004010 ST*142*0001 BGN*00*Reference Identification*20120227*1251*01*Reference Identification*01*1*00 N9*01*Reference Identification*Free-form Description*20120227*1251*01*01Reference Identification1Reference Identification1Reference Identification N1*01*Name*1*Identification Code*01*01 N2*Name*Name N3*Address Information*Address Information N4*City Name*ST*POSTAL CODE*COU*A*Location Identifier REF*01*Reference Identification*Description*01Reference Identification1Reference Identification1Reference Identification PER*1A*Name*AA*Communication Number*AA*Communication Number*AA*Communication Number*Contact Inquiry Refe LX*27 N9*01*Reference Identification*Free-form Description*20120227*125111*01*01Reference Identification1Reference Identification1Reference Identification MSG*Free-Form Message Text*AA*2 LIN*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 ID PID*F*01*10*Product Desc*Description*1S*Source Subquali*N*LAN LOC*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*Description QTY*01*179038665*011288412981183884112392212125481117592963531342445 DTM*001*20120227*12511100*01*CC*Date Time Period REF*01*Reference Identification*Description*01Reference Identification1Reference Identification1Reference Identification PER*1A*Name*AA*Communication Number*AA*Communication Number*AA*Communication Number*Contact Inquiry Refe PSC*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*E SSS*A*10*AC*Service Marks and Numbers*713229905*5942237*Description*26*Source Subquali LM*10*Source Subquali LQ*0*Industry Code N1*01*Name*1*Identification Code*01*01 N2*Name*Name N3*Address Information*Address Information N4*City Name*ST*POSTAL CODE*COU*A*Location Identifier N9*01*Reference Identification*Free-form Description*20120227*12511100*01*01Reference Identification1Reference Identification1Reference Identification PER*1A*Name*AA*Communication Number*AA*Communication Number*AA*Communication Number*Contact Inquiry Refe PRR*Assigned Identificat*10*Source Subquali*BRK*Description*10*Source Subquali*A*10*Source Subquali*1 LIN*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 ID LOC*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*Description QTY*01*13312645516*01434331241212175956811631154110812088120198412628225763193 DTM*001*20120227*125111*01*CC*Date Time Period MSG*Free-Form Message Text*AA*222 RC*A1*Product/Service ID*Name*10*Source Subquali*Cas*Description*Free-Form Message Text*N PER*1A*Name*AA*Communication Number*AA*Communication Number*AA*Communication Number*Contact Inquiry Refe PSC*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*E SSS*A*10*AC*Service Marks and Numbers*46786794258777*3221*Description*91792339722067*Source Subquali CID*1*01*10*Product Desc*Description*Source Subquali*N TMD*01*10*Product Desc*01*01*Description*20120227*Reference Identification*Source Subquali MEA*9L*1*2601139731*013084223744187522107457112473111893074221541111153900191121833299282728451279113*5738321*25152859*01**1S*BM DTM*001*20120227*12511100*01*CC*Date Time Period LIN*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 ID REP*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*Auth REF*01*Reference Identification*Description*01Reference Identification1Reference Identification1Reference Identification N1*01*Name*1*Identification Code*01*01 PER*1A*Name*AA*Communication Number*AA*Communication Number*AA*Communication Number*Contact Inquiry Refe RC*A1*Product/Service ID*Name*10*Source Subquali*Cas*Description*Free-Form Message Text*N DTM*001*20120227*1251110*01*CC*Date Time Period LIN*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 ID ITA*A*10*AC*01*Allowance or Cha*189*843328*1*1*14050337031368*01*22451*Description*002*Source Subquali*A*01 MSG*Free-Form Message Text*AA*212023699 PRT*EXC*10*Source Subquali*N LM*10*Source Subquali LQ*0*Industry Code MEA*9L*1*17560174*01239922802235412185801213193128148704631186722197172178328852*24*26456*01**1S*BM DTM*001*20120227*125112*01*CC*Date Time Period LIN*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 ID IT1*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 ID LIN*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 ID N1*01*Name*1*Identification Code*01*01 N9*01*Reference Identification*Free-form Description*20120227*1251*01*01Reference Identification1Reference Identification1Reference Identification PRT*EXC*10*Source Subquali*N DTM*001*20120227*12511200*01*CC*Date Time Period ITA*A*10*AC*01*Allowance or Cha*177793*159294425*1*35*306842*01*2056626*Description*002*Source Subquali*A*01 CUR*01*CUR*295729412*01*CUR*IMF*001*20120227*1251120*001*20120227*125112*001*20120227*12511200*001*20120227*12511200*001*20120227*125112 AMT*1*2539*C TXI*AA*3223*3133314*CD*Tax Jurisd*0*A*370719*Tax Identification N*Assigned Identificat CUR*01*CUR*15605*01*CUR*IMF*001*20120227*1251120*001*20120227*1251120*001*20120227*125112*001*20120227*1251120*001*20120227*12511200 TDS*103*1050562*430652*2012678 TXI*AA*5766104*1015*CD*Tax Jurisd*0*A*108*Tax Identification N*Assigned Identificat CUR*01*CUR*2794*01*CUR*IMF*001*20120227*1251*001*20120227*125112*001*20120227*1251*001*20120227*1251*001*20120227*1251 SE*74*0001 GE*1*1 IEA*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