Segment
X12 EDI Release 00504
To specify allowances, charges, or services
Elements
  • ITA01248Allowance or Charge Indicator
    ID
    M必须(Mandatory)

    Code which indicates an allowance or charge for the service specified

    Codes (7)
  • ITA02559Agency Qualifier Code
    ID
    O可选(Optional)

    Code identifying the agency assigning the code values

    Codes (195)
  • ITA03560Special Services Code
    ID
    O可选(Optional)

    Code identifying the special service

    Codes (172)
  • ITA04331Allowance or Charge Method of Handling Code
    ID
    M必须(Mandatory)

    Code indicating method of handling for an allowance or charge

    Codes (22)
  • ITA05341Allowance or Charge Number
    AN
    O可选(Optional)
    Min 1 / Max 16

    The number assigned by a vendor referencing an allowance, promotion, deal or charge

  • ITA06359Allowance or Charge Rate
    R
    O可选(Optional)
    Min 1 / Max 15

    Allowance or Charge Rate per Unit

  • ITA07360Allowance or Charge Total Amount
    N
    O可选(Optional)
    Min 1 / Max 15

    Total dollar amount for the allowance or charge

  • ITA08378Allowance/Charge Percent Qualifier
    ID
    O可选(Optional)

    Code indicating on what basis allowance or charge percent is calculated

    Codes (16)
  • ITA09332Percent, Decimal Format
    R
    O可选(Optional)
    Min 1 / Max 6

    Percent given in decimal format (e.g., 0.0 through 100.0 represents 0% through 100%)

  • ITA10380Quantity
    R
    O可选(Optional)
    Min 1 / Max 15

    Numeric value of quantity

  • ITA11355Unit or Basis for Measurement Code
    ID
    O可选(Optional)

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

    Codes (884)
  • ITA12380Quantity
    R
    O可选(Optional)
    Min 1 / Max 15

    Numeric value of quantity

  • ITA13352Description
    AN
    O可选(Optional)
    Min 1 / Max 80

    A free-form description to clarify the related data elements and their content

  • ITA14150Special Charge or Allowance Code
    ID
    O可选(Optional)

    Code identifying type of special charge or allowance

    Codes (1116)
  • ITA15822Source Subqualifier
    AN
    O可选(Optional)
    Min 1 / Max 15

    A reference that indicates the table or text maintained by the Source Qualifier

  • ITA16662Relationship Code
    ID
    O可选(Optional)

    Code indicating the relationship between entities

    Codes (5)
  • ITA17355Unit or Basis for Measurement Code
    ID
    O可选(Optional)

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

    Codes (884)