Form 4572 - Electronic Filing Trading Partner Agreement (Tpa) Page 11
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16Type ‘7’ Record
Field
Data Element
Field Req.
Type
Length
Value
Name
M=Mandatory
O= Optional
R= Required
1
Record Type
M
Numeric
1
‘7’
Code
2
Addenda Type
M
Numeric
2
‘05’
Code
3
Payment
O
Alphanumeric
80
See Addenda Record Layout
Related Info.
4
Addenda
M
Numeric
4
‘0001’
Sequence
Number
5
Entry Detail
M
Numeric
7
‘0000001’
Sequence
Number
End of Type ‘7’ Record.
11
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Parent category: Financial