To specify coupon reporting requirements
| Position | Element | Name | Type | Min/Max | Repeat | |
|---|---|---|---|---|---|---|
| 1 | 1178 | Level | Mandatory | Alphanumeric | 1/3 | 1 |
| 2 | 729 | Category | Mandatory | Alphanumeric | 1/6 | 1 |
| 3 | 729 | Category | Opt | Alphanumeric | 1/6 | 1 |
| 4 | 729 | Category | Opt | Alphanumeric | 1/6 | 1 |
| 5 | 729 | Category | Opt | Alphanumeric | 1/6 | 1 |
| 6 | 729 | Category | Opt | Alphanumeric | 1/6 | 1 |
| 7 | 128 | Reference Identification Qualifier | Rel | ID | 2/3 | 1 |
| 8 | 127 | Reference Identification | Rel | Alphanumeric | 1/50 | 1 |
| 9 | 1073 | Yes/No Condition or Response Code | Opt | ID | 1/1 | 1 |
| 10 | 369 | Free-form Description | Opt | Alphanumeric | 1/45 | 1 |