Definition: This data type specifies a practitioner_s license number, or other ID number such as UPIN, Medicare and Medicaid number, and associated detail.
Maximum Length: 101
1OptionalityO → R
1DescriptionID number (ST) → ID Number
1Max Length→ 20
2OptionalityO → R
2Descriptiontype of ID number (IS) → Type of ID Number
2Table Ref→ 338
2Max Length→ 8
3Descriptionstate/other qualifying info → State/other Qualifying Information
3Max Length→ 62
4Descriptionexpiration date → Expiration Date
4Max Length→ 8
4
| Comp# | FHIR | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| 1 | 242 | 20 | - | R | - | PLN.1 | ID Number | ||
| 2 | 243 | 8 | - | R | PLN.2 | Type of ID Number | |||
| 3 | 244 | 62 | - | O | - | PLN.3 | State/other Qualifying Information | - | |
| 4 | 245 | 8 | - | O | - | PLN.4 | Expiration Date |
3