4
| Comp# | FHIR | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| 1 | 721 | - | 20= | R | - | PLN.1 | ID Number | ||
| 2 | 722 | - | - | R | PLN.2 | Type of ID Number | |||
| 3 | 723 | - | 62# | O | - | PLN.3 | State/other Qualifying Information | - | |
| 4 | 724 | - | 8= | O | - | PLN.4 | Expiration Date |
3
| Comp# | FHIR | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| 1 | 721 | - | 20= | R | - | PLN.1 | ID Number | ||
| 2 | 722 | - | - | R | PLN.2 | Type of ID Number | |||
| 3 | 723 | - | 62# | O | - | PLN.3 | State/other Qualifying Information | - | |
| 4 | 724 | - | 8= | O | - | PLN.4 | Expiration Date |