IDC Identification Card

To provide notification to produce replacement identification card(s)

Position

Element

Name

Type

Requirement

Min

Max

Repeat

IDC01

Plan Coverage Description

String (AN)

Mandatory

A description or number that identifies the plan or coverage

IDC02

Identification Card Type Code

Identifier (ID)

Mandatory

Code identifying the type of identification card

IDC03

Quantity

Decimal number (R)

Optional

Numeric value of quantity

IDC03 is the number of cards being requested.

IDC04

Action Code

Identifier (ID)

Optional

Code indicating type of action

IDC04 is the reason for the card being requested, i.e., add or a change.