Segment
X12 EDI Release 00403
To provide notification to produce replacement identification card(s)
Elements
  • IDC011204Plan Coverage Description
    AN
    M必须(Mandatory)
    Min 1 / Max 50

    A description or number that identifies the plan or coverage

  • IDC021215Identification Card Type Code
    ID
    M必须(Mandatory)

    Code identifying the type of identification card

    Codes (5)
  • IDC03380Quantity
    R
    O可选(Optional)
    Min 1 / Max 15

    Numeric value of quantity

  • IDC04306Action Code
    ID
    O可选(Optional)

    Code indicating type of action

    Codes (311)