To specify the condition under which insurance coverage is offered
| Position | Element | Name | Type | Min/Max | Repeat | |
|---|---|---|---|---|---|---|
| 1 | 1123 | Offer Basis Code | Mandatory | ID | 2/3 | AtMax 1 |
| 2 | 352 | Description | Opt | Alphanumeric | 1/80 | AtMax 1 |
| 3 | 673 | Quantity Qualifier | Rel | ID | 2/2 | AtMax 1 |
| 4 | 380 | Quantity | Rel | Decimal | 1/15 | AtMax 1 |
| 5 | 355 | Unit or Basis for Measurement Code | Opt | ID | 2/2 | AtMax 1 |
| 6 | 610 | Amount | Opt | Number | 1/15 | AtMax 1 |
| 7 | 954 | Percent | Opt | Decimal | 1/10 | AtMax 1 |