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payerdomain
concept_nameconcept_codedomain_idvocabulary_idconcept_class_idstandard_concept
Bronze Plan with 60% Actuarial Plan ValueOMOP generatedPayerPayerPlanS
Silver Plan with 70% Actuarial Plan ValueOMOP generatedPayerPayerPlanS
Gold Plan with 80% Actuarial Plan ValueOMOP generatedPayerPayerPlanS
Platinum Plan with 80% Actuarial Plan ValueOMOP generatedPayerPayerPlanS
Catastrophic Plan with <60% Actuarial Plan ValueOMOP generatedPayerPayerPlanS
Self-Insured Health Insurance PlanOMOP generatedPayerPayerSponsorS
Fully Insured Health Insurance PlanOMOP generatedPayerPayerSponsorS
Individual Health Insurance PlanOMOP generatedPayerPayerSponsorS
Small Group Health Insurance PlanOMOP generatedPayerPayerSponsorS
Large Group Health Insurance PlanOMOP generatedPayerPayerSponsorS
MEDICARE1PayerPHDSCPayerS
Medicare (Managed Care)11PayerPHDSCPayerS
Medicare HMO111PayerPHDSCPayerS
Medicare PPO112PayerPHDSCPayerS
Medicare POS113PayerPHDSCPayerS
Medicare Managed Care Other119PayerPHDSCPayerS
Medicare (Non-managed Care)12PayerPHDSCPayerS
Medicare FFS121PayerPHDSCPayerS
Medicare Drug Benefit122PayerPHDSCPayerS
Medicare Medical Savings Account (MSA)123PayerPHDSCPayerS
Medicare Non-managed Care Other129PayerPHDSCPayerS
Medicare Hospice13PayerPHDSCPayerS
Dual Eligibility Medicare/Medicaid Organization14PayerPHDSCPayerS
Medicare Other19PayerPHDSCPayerS
Medicare Pharmacy Benefit Manager191PayerPHDSCPayerS
MEDICAID2PayerPHDSCPayerS
Medicaid (Managed Care)21PayerPHDSCPayerS
Medicaid HMO211PayerPHDSCPayerS
Medicaid PPO212PayerPHDSCPayerS
Medicaid PCCM (Primary Care Case Management)213PayerPHDSCPayerS
Medicaid Managed Care Other219PayerPHDSCPayerS
Medicaid (Non-managed Care Plan)22PayerPHDSCPayerS
Medicaid/SCHIP23PayerPHDSCPayerS
Medicaid Applicant24PayerPHDSCPayerS
Medicaid - Out of State25PayerPHDSCPayerS
Medicaid - Long Term Care26PayerPHDSCPayerS
Medicaid Other29PayerPHDSCPayerS
Medicaid Pharmacy Benefit Manager291PayerPHDSCPayerS
Medicaid - Dental299PayerPHDSCPayerS
OTHER GOVERNMENT (Federal/State/Local)(excluding Department of Corrections)3PayerPHDSCPayerS
Department of Defense31PayerPHDSCPayerS
DoD TRICARE (CHAMPUS)311PayerPHDSCPayerS
DoD TRICARE Prime - HMO3111PayerPHDSCPayerS
DoD TRICARE Extra - PPO3112PayerPHDSCPayerS
DoD TRICARE Standard - Fee For Service3113PayerPHDSCPayerS
DoD TRICARE For Life - Medicare Supplement3114PayerPHDSCPayerS
DoD TRICARE Reserve Select3115PayerPHDSCPayerS
DoD Uniformed Services Family Health Plan (USFHP) - HMO3116PayerPHDSCPayerS
DoD Department of Defense - (other)3119PayerPHDSCPayerS
Military Treatment Facility312PayerPHDSCPayerS
Military Treatment Facility - Enrolled Prime - HMO3121PayerPHDSCPayerS
Military Treatment Facility - Non-enrolled Space Available3122PayerPHDSCPayerS
Military Treatment Facility - TRICARE For Life (TFL)3123PayerPHDSCPayerS
DoD Dental - Stand Alone313PayerPHDSCPayerS
Department of Veterans Affairs32PayerPHDSCPayerS
Veteran care - Care provided to Veterans321PayerPHDSCPayerS
VA Direct Care - Care provided in VA facilities3211PayerPHDSCPayerS
VA Indirect Care - Care provided outside VA facilities3212PayerPHDSCPayerS
VA Outside VA facilities - Fee Basis32121PayerPHDSCPayerS
VA Outside VA facilities - Foreign Fee/Foreign Medical Program (FMP)32122PayerPHDSCPayerS
VA Outside VA facilities - Contract Nursing Home/Community Nursing Home32123PayerPHDSCPayerS
VA Outside VA facilities - State Veterans Home32124PayerPHDSCPayerS
VA Outside VA facilities - Sharing Agreements32125PayerPHDSCPayerS
VA Outside VA facilities - Other Federal Agency32126PayerPHDSCPayerS
VA Outside VA facilities - Dental Care32127PayerPHDSCPayerS
VA Outside VA facilities - Vision Care32128PayerPHDSCPayerS
VA Non-veteran care322PayerPHDSCPayerS
VA Civilian Health and Medical Program for the VA (CHAMPVA)3221PayerPHDSCPayerS
VA Spina Bifida Health Care Program (SB)3222PayerPHDSCPayerS
VA Children of Women Vietnam Veterans (CWVV)3223PayerPHDSCPayerS
VA Other non-veteran care3229PayerPHDSCPayerS
Indian Health Service or Tribe33PayerPHDSCPayerS
Indian Health Service - Regular331PayerPHDSCPayerS
Indian Health Service - Contract332PayerPHDSCPayerS
Indian Health Service - Managed Care333PayerPHDSCPayerS
Indian Tribe - Sponsored Coverage334PayerPHDSCPayerS
HRSA Program34PayerPHDSCPayerS
HRSA Title V (MCH Block Grant)341PayerPHDSCPayerS
HRSA Migrant Health Program342PayerPHDSCPayerS
HRSA Ryan White Act343PayerPHDSCPayerS
HSRA Other349PayerPHDSCPayerS
Black Lung35PayerPHDSCPayerS
State Government36PayerPHDSCPayerS
State SCHIP program (codes for individual states)361PayerPHDSCPayerS
Specific state programs (list/ local code)362PayerPHDSCPayerS
State, not otherwise specified (other state)369PayerPHDSCPayerS
Local Government37PayerPHDSCPayerS
Local - Managed care371PayerPHDSCPayerS
Local HMO3711PayerPHDSCPayerS
Local PPO3712PayerPHDSCPayerS
Local POS3713PayerPHDSCPayerS
FFS/Indemnity372PayerPHDSCPayerS
FFS/Indemnity Local, not otherwise specified (other local, county)379PayerPHDSCPayerS
Other Government (Federal, State, Local not specified)38PayerPHDSCPayerS
Federal, State, Local not specified managed care381PayerPHDSCPayerS
Federal, State, Local not specified - HMO3811PayerPHDSCPayerS
Federal, State, Local not specified - PPO3812PayerPHDSCPayerS
Federal, State, Local not specified - POS3813PayerPHDSCPayerS
Federal, State, Local not specified - not specified managed care3819PayerPHDSCPayerS
Federal, State, Local not specified - FFS382PayerPHDSCPayerS
Federal, State, Local not specified - Other389PayerPHDSCPayerS
Other Federal39PayerPHDSCPayerS
Federal Employee Health Plan - Use when known.391PayerPHDSCPayerS
DEPARTMENTS OF CORRECTIONS4PayerPHDSCPayerS
Corrections Federal41PayerPHDSCPayerS
Corrections State42PayerPHDSCPayerS
Corrections Local43PayerPHDSCPayerS
Corrections Unknown Level44PayerPHDSCPayerS
PRIVATE HEALTH INSURANCE5PayerPHDSCPayerS
Managed Care (Private)51PayerPHDSCPayerS
Commercial Managed Care - HMO511PayerPHDSCPayerS
Commercial Managed Care - PPO512PayerPHDSCPayerS
Commercial Managed Care - POS513PayerPHDSCPayerS
Exclusive Provider Organization514PayerPHDSCPayerS
Gatekeeper PPO (GPPO)515PayerPHDSCPayerS
Commercial Managed Care - Pharmacy Benefit Manager516PayerPHDSCPayerS
Commercial Managed Care - Dental517PayerPHDSCPayerS
Managed Care, Other (non HMO)519PayerPHDSCPayerS
Private Health Insurance - Indemnity52PayerPHDSCPayerS
Commercial Indemnity521PayerPHDSCPayerS
Self-insured (ERISA) Administrative Services Only (ASO) plan522PayerPHDSCPayerS
Medicare supplemental policy (as second payer)523PayerPHDSCPayerS
Indemnity Insurance - Dental524PayerPHDSCPayerS
Private health insurance - other commercial Indemnity529PayerPHDSCPayerS
Managed Care (private) or private health insurance (indemnity), not otherwise specified53PayerPHDSCPayerS
Organized Delivery System54PayerPHDSCPayerS
Small Employer Purchasing Group55PayerPHDSCPayerS
Specialized Stand Alone Plan56PayerPHDSCPayerS
Dental561PayerPHDSCPayerS
Vision Other Private Insurance562PayerPHDSCPayerS
BLUE CROSS/BLUE SHIELD6PayerPHDSCPayerS
BC Managed Care61PayerPHDSCPayerS
BC Managed Care - HMO611PayerPHDSCPayerS
BC Managed Care - PPO612PayerPHDSCPayerS
BC Managed Care - POS613PayerPHDSCPayerS
BC Managed Care - Dental614PayerPHDSCPayerS
BC Managed Care - Other619PayerPHDSCPayerS
BC Insurance Indemnity62PayerPHDSCPayerS
BC Indemnity621PayerPHDSCPayerS
BC Self-insured (ERISA) Administrative Services Only (ASO)Plan622PayerPHDSCPayerS
BC Medicare Supplemental Plan623PayerPHDSCPayerS
BC Indemnity - Dental629PayerPHDSCPayerS
MANAGED CARE, UNSPECIFIED (to be used only if one can't distinguish public from private)7PayerPHDSCPayerS
Managed Care HMO71PayerPHDSCPayerS
Managed Care PPO72PayerPHDSCPayerS
Managed Care POS73PayerPHDSCPayerS
Other Managed Care79PayerPHDSCPayerS
NO PAYMENT from an Organization/Agency/Program/Private Payer Listed8PayerPHDSCPayerS
Self-pay81PayerPHDSCPayerS
No Charge82PayerPHDSCPayerS
Charity821PayerPHDSCPayerS
Professional Courtesy822PayerPHDSCPayerS
Research/Clinical Trial823PayerPHDSCPayerS
Refusal to Pay/Bad Debt83PayerPHDSCPayerS
Hill Burton Free Care84PayerPHDSCPayerS
Research/Donor85PayerPHDSCPayerS
No Payment, Other89PayerPHDSCPayerS
MISCELLANEOUS/OTHER9PayerPHDSCPayerS
Foreign National91PayerPHDSCPayerS
Other (Non-government)92PayerPHDSCPayerS
Disability Insurance93PayerPHDSCPayerS
Long-term Care Insurance94PayerPHDSCPayerS
Worker's Compensation95PayerPHDSCPayerS
Worker's Comp HMO951PayerPHDSCPayerS
Worker's Comp Fee-for-Service953PayerPHDSCPayerS
Worker’s Comp Other Managed Care954PayerPHDSCPayerS
Worker's Comp, Other unspecified959PayerPHDSCPayerS
Auto Insurance (includes no fault)96PayerPHDSCPayerS
Legal Liability / Liability Insurance97PayerPHDSCPayerS
Other specified but not otherwise classifiable (includes Hospice - Unspecified plan)98PayerPHDSCPayer
No Typology Code available for payment source99PayerPHDSCPayer
Unavailable / Unknown/ No Payer Specified / Blank9999PayerPHDSCPayer
payerdomain.txt · Last modified: 2018/06/13 19:24 by cgreich