To respond to a specific government reporting requirement
| Position | Element | Name | Type | Min/Max | Repeat | |
|---|---|---|---|---|---|---|
| 1 | 1260 | Reported Data ID Code | Mandatory | Alphanumeric | 1/6 | AtMax 1 |
| 2 | 1261 | Reported Data Response | Rel | Alphanumeric | 1/10 | AtMax 1 |
| 3 | 673 | Quantity Qualifier | Opt | ID | 2/2 | AtMax 1 |
| 4 | 380 | Quantity | Rel | Decimal | 1/15 | AtMax 1 |
| 5 | 522 | Amount Qualifier Code | Opt | ID | 1/3 | AtMax 1 |
| 6 | 782 | Monetary Amount | Rel | Decimal | 1/18 | AtMax 1 |
| 7 | 1004 | Percent Qualifier | Opt | ID | 1/2 | AtMax 1 |
| 8 | 488 | Percent, Integer Format | Rel | Number | 1/3 | AtMax 1 |
| 9 | 374 | Date/Time Qualifier | Opt | ID | 3/3 | AtMax 1 |
| 10 | 373 | Date | Rel | Date | 8/8 | AtMax 1 |
| 11 | 352 | Description | Opt | Alphanumeric | 1/80 | AtMax 1 |