4
| Comp# | FHIR | ||||||
|---|---|---|---|---|---|---|---|
| 1 | 255 | R | - | PLN.1 | ID Number | ||
| 2 | 256 | R | PLN.2 | Type of ID Number | |||
| 3 | 257 | O | - | PLN.3 | State/other Qualifying Information | - | |
| 4 | 258 | O | - | PLN.4 | Expiration Date |
3
| Comp# | FHIR | ||||||
|---|---|---|---|---|---|---|---|
| 1 | 255 | R | - | PLN.1 | ID Number | ||
| 2 | 256 | R | PLN.2 | Type of ID Number | |||
| 3 | 257 | O | - | PLN.3 | State/other Qualifying Information | - | |
| 4 | 258 | O | - | PLN.4 | Expiration Date |