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x12 124 Vehicle Damage

124 Example

ISA*00* *00* *01*1234567890 *01*999999999 *120126*1211*U*00401*000000016*0*P~
GS*NL*1234567890 *999999999 *20120126*1211*1*T*004010~
ST*124*0001~
BGN*00*Reference Identification*20120130*16584800*01*Reference Identification*01*1*00~
DTM*001*20120130*1658*01*CC*Date Time Period~
C3*CUR*2067*CUR*CUR~
SUP*BLC*01*Free Form Message*CN~
MSG*Free-Form Message Text*AA*2601528~
NM1*01*1*Name Last or Organization Name*Name First*Name Middle*Name Prefi*Name Suffi*1*Identification Code*01*01~
N2*Name*Name~
N3*Address Information*Address Information~
N4*City Name*ST*POSTAL CODE*COU*A*Location Identifier~
PER*1A*Name*AA*Communication Number*AA*Communication Number~
LX*31857~
TXI*AA*31*12306*CD*Tax Jurisd*0*A*724963671*Tax Identification N*Assigned Identificat~
YNQ*01*N*CC*Date Time Period*Free-Form Message Text*Free-Form Message Text*Free-Form Message Text*0~
AP1*01*ST*ACT*481*84*POSTAL CODE*POSTAL CODE*CN*666424*557720207649125*Free-Form Message*Product/Service ID*Description~
SUP*BLC*01*Free Form Message*CN~
MSG*Free-Form Message Text*AA*1059~
LM*10~
LQ*0*Industry Code~
CTP*AA*ACT*65850787*2288001*01\2\9397145\01\11091863\704\01\15034\108\01\1\6152002\01\15145\172997*CSD*1092*279856*AA*ConditionX*1~
TXI*AA*143881520751521*257677*CD*Tax Jurisd*0*A*2282731~
SAC*A*A010*10*Agency Ser*229161*2*1331*01*14*1749330116*01*02*Option Number*Description*LAN~
VEH*32*Vehicle Identification Nu*3495*10*Product Desc*Product Desc*Product Desc*139~
PID*F*01*10*Product Desc*Description*1S*Source Subquali*N*LAN~
REF*01*Reference Identification*Description*01\Reference Identification\01\Reference Identification\01\Reference Identification~
BCI*Industry Code*D*Reference Identification*ST*CC*Date Time Period*01*CUR~
AMT*1*1286522328273616*C~
LID*CC*Date Time Period*Industry Code*Industry Code*Description*N*N*Description~
LQ*0*Industry Code~
DAM*NW*DA*2949593*CUR*NW*DA*968116*NW*DA*1463130*NW*DA*1632322*NW*DA*159803~
CRC*01*N*01*01*01*01*01~
DVI*ACT*1267*CUR*CC*Date Time Period*Name*30335164*Reference Identification*ST*CC*Date Time Period*AM*N~
VAT*Industry Code*1*107951954*CUR*01*10*Source Subquali*Industry Code*Description*1*01~
NM1*01*1*Name Last or Organization Name*Name First*Name Middle*Name Prefi*Name Suffi*1*Identification Code*01*01~
N2*Name*Name~
N3*Address Information*Address Information~
N4*City Name*ST*POSTAL CODE*COU*A*Location Identifier~
PER*1A*Name*AA*Communication Number*AA*Communication Number~
III*0*Industry Code*01*Free-Form Message Text*8381504*01\126\20121\01\2312\24663131\01\285\2915\01\1207\328588\01\258862\11*1S*1S*1S~
DTP*001*CC*Date Time Period~
LS*3310~
NM1*01*1*Name Last or Organization Name*Name First*Name Middle*Name Prefi*Name Suffi*1*Identification Code*01*01~
N2*Name*Name~
N3*Address Information*Address Information~
N4*City Name*ST*POSTAL CODE*COU*A*Location Identifier~
PER*1A*Name*AA*Communication Number*AA*Communication Number~
REF*01*Reference Identification*Description*01\Reference Identification\01\Reference Identification\01\Reference Identification~
F13*Check Number*20120130*9656574*MICR Number MICR*20120130*CUR~
AMT*1*13017189791784309*C~
LE*3310~
LM*10*Source~
LQ*0*Industry Code~
AMT*1*1043610093217*C~
QTY*01*23790272581881*01\93\2\01\213232245\107\01\184334\94\01\275752334\381\01\14\196623~
TXI*AA*14121261*393822447*CD*Tax Jurisd*0*A*12~
N9*01*Reference Identification*Free-form Description*20120130*1658*01~
LQ*0*Industry Code~
REF*01*Reference Identification*Description*01\Reference Identification\01\Reference Identification\01\Reference Identification~
ID*DA*DA*D~
DP*1*Product/Service ID*1*14290258*N*01*N*N*N*N*12599857142*Product/Service ID*Free-form Description*51*88*N~
DL*1*23*264*N*47*11*24*N*N*N*N~
MSG*Free-Form Message Text*AA*31~
SE*63*0001~
GE*1*1~
IEA*1*000000016~