DC 8 All Report the Planassigned contract number. Plan Do not include values in this element that Specific Contract will distinguish one member of the family DC 9 6/24/10 Text ID Contract varchar[30] All 70% Contract Number from another. This should be the contract Number or certificate number for the subscriber and all of the dependents. Member Suffix or Contract Report the unique number / identifier of the DC 10 6/24/10 Text ID Sequence varchar[20] All 98% Sequence member / patient within the contract Number Number DC 11 Patient to Individual Lookup Report the that defines the Patient's Subscriber DC 12 6/24/10 Table varchar[2] relationship to the Subscriber. EXAMPLE: All 98% B Relationship Code Numeric 20 = Self / Employee Code Value Description 1 Spouse 4 Grandfather or Grandmother 5 Grandson or Granddaughter 7 Nephew or 10 Foster 15 Ward 17 Stepson or Stepdaughter 19 Child 20 Self/Employee 21 Unknown
DC 8 All DC 9 Plan Specific Contract Number 6/24/10 Text ID Contract varchar[30] Contract Number Report the Planassigned contract number. Do not include values in this element that will distinguish one member of the family from another. This should be the contract or certificate number for the subscriber and all of the dependents. All 70% DC 10 Member Suffix or Number 6/24/10 Text ID Sequence varchar[20] Contract Sequence Number Report the unique number / identifier of the member / patient within the contract All 98% DC 11 DC 12 Individual Code 6/24/10 Lookup Table Numeric varchar[2] Patient to Subscriber Relationship Code Report the that defines the Patient's relationship to the Subscriber. EXAMPLE: 20 = Self / Employee All 98% B Value Description 1 Spouse 4 Grandfather or Grandmother 5 Grandson or Granddaughter 7 Nephew or 10 Foster 15 Ward 17 Stepson or Stepdaughter 19 Child 20 Self/Employee 21 Unknown
v6-apcd-dental-claim-file-submission-guide-Redline-.docx