IDC Identification Card

To provide notification to produce replacement identification card(s)

Position
Element
Name
Type
Requirement
Min
Max
Repeat
IDC-01
Plan Coverage Description
String (AN)
Mandatory
1
50
-
A description or number that identifies the plan or coverage
IDC-02
Identification Card Type Code
Identifier (ID)
Mandatory
1
1
-
Code identifying the type of identification card
IDC-03
Quantity
Decimal number (R)
Optional
1
15
-
Numeric value of quantity
IDC03 is the number of cards being requested.
IDC-04
Action Code
Identifier (ID)
Optional
1
2
-
Code indicating type of action
IDC04 is the reason for the card being requested, i.e., add or a change.

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