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Segment
in
X12 Release 003030

F12 Basic Claim Information - Automotive

To provide information for automotive claims
Sequence
Element
Name
Type
Requirement
Min
Max
Repeat
01
127
Reference Number
String (AN)
Mandatory
1
30
-
Reference number or identification number as defined for a particular Transaction Set, or as specified by the Reference Number Qualifier.
F1201 is used for Dealer's Repair Order Number.
02
Reference Number
String (AN)
Mandatory
1
30
-
Reference number or identification number as defined for a particular Transaction Set, or as specified by the Reference Number Qualifier.
F1202 is used for Dealer's Document Number.
03
Date
Date (DT)
Mandatory
6
6
-
Date (YYMMDD).
F1203 is used for Repair Order Date.
04
Credit/Debit Adjustment Number
String (AN)
Mandatory
1
16
-
Number assigned by issuer of a credit or debit memo.
F1204 and F1205 will be used if sublet services are reported.
05
Date
Date (DT)
Mandatory
6
6
-
Date (YYMMDD).
F1205 will contain the Debit/Credit memo date.
06
Labor Rate
N2
Mandatory
3
4
-
The labor/time guide rate used by the division to reimburse the dealer for repair work.
F1206 is used for Body Repair Rate.
07
Labor Rate
N2
Mandatory
3
4
-
The labor/time guide rate used by the division to reimburse the dealer for repair work.
F1207 is used for Chassis Repair Rate.
08
Damage Code Qualifier
Identifier (ID)
Optional
1
1
-
Code identifying the party maintaining damage area, damage type and damage severity code lists.
Codes (2)
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Stedi is a registered trademark of Stedi, Inc. Stedi's EDI Reference and Mapping Guides are provided for marketing purposes and are free of charge. All names, logos, and brands of third parties listed on our site are trademarks of their respective owners (including “X12”, which is a trademark of X12 Incorporated). Stedi, Inc. and its products and services are not endorsed by, sponsored by, or affiliated with these third parties. Our use of these names, logos, and brands is for identification purposes only, and does not imply any such endorsement, sponsorship, or affiliation.