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payerdomain [2018/06/13 19:24] (current)
cgreich created
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 +^concept_name^concept_code^domain_id^vocabulary_id^concept_class_id^standard_concept^
 +|Bronze Plan with 60% Actuarial Plan Value|OMOP generated|Payer|Payer|Plan|S|
 +|Silver Plan with 70% Actuarial Plan Value|OMOP generated|Payer|Payer|Plan|S|
 +|Gold Plan with 80% Actuarial Plan Value|OMOP generated|Payer|Payer|Plan|S|
 +|Platinum Plan with 80% Actuarial Plan Value|OMOP generated|Payer|Payer|Plan|S|
 +|Catastrophic Plan with <60% Actuarial Plan Value|OMOP generated|Payer|Payer|Plan|S|
 +|Self-Insured Health Insurance Plan|OMOP generated|Payer|Payer|Sponsor|S|
 +|Fully Insured Health Insurance Plan|OMOP generated|Payer|Payer|Sponsor|S|
 +|Individual Health Insurance Plan|OMOP generated|Payer|Payer|Sponsor|S|
 +|Small Group Health Insurance Plan|OMOP generated|Payer|Payer|Sponsor|S|
 +|Large Group Health Insurance Plan|OMOP generated|Payer|Payer|Sponsor|S|
 +|MEDICARE|1|Payer|PHDSC|Payer|S|
 +|Medicare (Managed Care)|11|Payer|PHDSC|Payer|S|
 +|Medicare HMO|111|Payer|PHDSC|Payer|S|
 +|Medicare PPO|112|Payer|PHDSC|Payer|S|
 +|Medicare POS|113|Payer|PHDSC|Payer|S|
 +|Medicare Managed Care Other|119|Payer|PHDSC|Payer|S|
 +|Medicare (Non-managed Care)|12|Payer|PHDSC|Payer|S|
 +|Medicare FFS|121|Payer|PHDSC|Payer|S|
 +|Medicare Drug Benefit|122|Payer|PHDSC|Payer|S|
 +|Medicare Medical Savings Account (MSA)|123|Payer|PHDSC|Payer|S|
 +|Medicare Non-managed Care Other|129|Payer|PHDSC|Payer|S|
 +|Medicare Hospice|13|Payer|PHDSC|Payer|S|
 +|Dual Eligibility Medicare/​Medicaid Organization|14|Payer|PHDSC|Payer|S|
 +|Medicare Other|19|Payer|PHDSC|Payer|S|
 +|Medicare Pharmacy Benefit Manager|191|Payer|PHDSC|Payer|S|
 +|MEDICAID|2|Payer|PHDSC|Payer|S|
 +|Medicaid (Managed Care)|21|Payer|PHDSC|Payer|S|
 +|Medicaid HMO|211|Payer|PHDSC|Payer|S|
 +|Medicaid PPO|212|Payer|PHDSC|Payer|S|
 +|Medicaid PCCM (Primary Care Case Management)|213|Payer|PHDSC|Payer|S|
 +|Medicaid Managed Care Other|219|Payer|PHDSC|Payer|S|
 +|Medicaid (Non-managed Care Plan)|22|Payer|PHDSC|Payer|S|
 +|Medicaid/​SCHIP|23|Payer|PHDSC|Payer|S|
 +|Medicaid Applicant|24|Payer|PHDSC|Payer|S|
 +|Medicaid - Out of State|25|Payer|PHDSC|Payer|S|
 +|Medicaid - Long Term Care|26|Payer|PHDSC|Payer|S|
 +|Medicaid Other|29|Payer|PHDSC|Payer|S|
 +|Medicaid Pharmacy Benefit Manager|291|Payer|PHDSC|Payer|S|
 +|Medicaid - Dental|299|Payer|PHDSC|Payer|S|
 +|OTHER GOVERNMENT (Federal/​State/​Local)(excluding Department of Corrections)|3|Payer|PHDSC|Payer|S|
 +|Department of Defense|31|Payer|PHDSC|Payer|S|
 +|DoD TRICARE (CHAMPUS)|311|Payer|PHDSC|Payer|S|
 +|DoD TRICARE Prime - HMO|3111|Payer|PHDSC|Payer|S|
 +|DoD TRICARE Extra - PPO|3112|Payer|PHDSC|Payer|S|
 +|DoD TRICARE Standard - Fee For Service|3113|Payer|PHDSC|Payer|S|
 +|DoD TRICARE For Life - Medicare Supplement|3114|Payer|PHDSC|Payer|S|
 +|DoD TRICARE Reserve Select|3115|Payer|PHDSC|Payer|S|
 +|DoD Uniformed Services Family Health Plan (USFHP) - HMO|3116|Payer|PHDSC|Payer|S|
 +|DoD Department of Defense - (other)|3119|Payer|PHDSC|Payer|S|
 +|Military Treatment Facility|312|Payer|PHDSC|Payer|S|
 +|Military Treatment Facility - Enrolled Prime - HMO|3121|Payer|PHDSC|Payer|S|
 +|Military Treatment Facility - Non-enrolled Space Available|3122|Payer|PHDSC|Payer|S|
 +|Military Treatment Facility - TRICARE For Life (TFL)|3123|Payer|PHDSC|Payer|S|
 +|DoD Dental - Stand Alone|313|Payer|PHDSC|Payer|S|
 +|Department of Veterans Affairs|32|Payer|PHDSC|Payer|S|
 +|Veteran care - Care provided to Veterans|321|Payer|PHDSC|Payer|S|
 +|VA Direct Care - Care provided in VA facilities|3211|Payer|PHDSC|Payer|S|
 +|VA Indirect Care - Care provided outside VA facilities|3212|Payer|PHDSC|Payer|S|
 +|VA Outside VA facilities - Fee Basis|32121|Payer|PHDSC|Payer|S|
 +|VA Outside VA facilities - Foreign Fee/Foreign Medical Program (FMP)|32122|Payer|PHDSC|Payer|S|
 +|VA Outside VA facilities - Contract Nursing Home/​Community Nursing Home|32123|Payer|PHDSC|Payer|S|
 +|VA Outside VA facilities - State Veterans Home|32124|Payer|PHDSC|Payer|S|
 +|VA Outside VA facilities - Sharing Agreements|32125|Payer|PHDSC|Payer|S|
 +|VA Outside VA facilities - Other Federal Agency|32126|Payer|PHDSC|Payer|S|
 +|VA Outside VA facilities - Dental Care|32127|Payer|PHDSC|Payer|S|
 +|VA Outside VA facilities - Vision Care|32128|Payer|PHDSC|Payer|S|
 +|VA Non-veteran care|322|Payer|PHDSC|Payer|S|
 +|VA Civilian Health and Medical Program for the VA (CHAMPVA)|3221|Payer|PHDSC|Payer|S|
 +|VA Spina Bifida Health Care Program (SB)|3222|Payer|PHDSC|Payer|S|
 +|VA Children of Women Vietnam Veterans (CWVV)|3223|Payer|PHDSC|Payer|S|
 +|VA Other non-veteran care|3229|Payer|PHDSC|Payer|S|
 +|Indian Health Service or Tribe|33|Payer|PHDSC|Payer|S|
 +|Indian Health Service - Regular|331|Payer|PHDSC|Payer|S|
 +|Indian Health Service - Contract|332|Payer|PHDSC|Payer|S|
 +|Indian Health Service - Managed Care|333|Payer|PHDSC|Payer|S|
 +|Indian Tribe - Sponsored Coverage|334|Payer|PHDSC|Payer|S|
 +|HRSA Program|34|Payer|PHDSC|Payer|S|
 +|HRSA Title V (MCH Block Grant)|341|Payer|PHDSC|Payer|S|
 +|HRSA Migrant Health Program|342|Payer|PHDSC|Payer|S|
 +|HRSA Ryan White Act|343|Payer|PHDSC|Payer|S|
 +|HSRA Other|349|Payer|PHDSC|Payer|S|
 +|Black Lung|35|Payer|PHDSC|Payer|S|
 +|State Government|36|Payer|PHDSC|Payer|S|
 +|State SCHIP program (codes for individual states)|361|Payer|PHDSC|Payer|S|
 +|Specific state programs (list/ local code)|362|Payer|PHDSC|Payer|S|
 +|State, not otherwise specified (other state)|369|Payer|PHDSC|Payer|S|
 +|Local Government|37|Payer|PHDSC|Payer|S|
 +|Local - Managed care|371|Payer|PHDSC|Payer|S|
 +|Local HMO|3711|Payer|PHDSC|Payer|S|
 +|Local PPO|3712|Payer|PHDSC|Payer|S|
 +|Local POS|3713|Payer|PHDSC|Payer|S|
 +|FFS/​Indemnity|372|Payer|PHDSC|Payer|S|
 +|FFS/​Indemnity Local, not otherwise specified (other local, county)|379|Payer|PHDSC|Payer|S|
 +|Other Government (Federal, State, Local not specified)|38|Payer|PHDSC|Payer|S|
 +|Federal, State, Local not specified managed care|381|Payer|PHDSC|Payer|S|
 +|Federal, State, Local not specified - HMO|3811|Payer|PHDSC|Payer|S|
 +|Federal, State, Local not specified - PPO|3812|Payer|PHDSC|Payer|S|
 +|Federal, State, Local not specified - POS|3813|Payer|PHDSC|Payer|S|
 +|Federal, State, Local not specified - not specified managed care|3819|Payer|PHDSC|Payer|S|
 +|Federal, State, Local not specified - FFS|382|Payer|PHDSC|Payer|S|
 +|Federal, State, Local not specified - Other|389|Payer|PHDSC|Payer|S|
 +|Other Federal|39|Payer|PHDSC|Payer|S|
 +|Federal Employee Health Plan - Use when known.|391|Payer|PHDSC|Payer|S|
 +|DEPARTMENTS OF CORRECTIONS|4|Payer|PHDSC|Payer|S|
 +|Corrections Federal|41|Payer|PHDSC|Payer|S|
 +|Corrections State|42|Payer|PHDSC|Payer|S|
 +|Corrections Local|43|Payer|PHDSC|Payer|S|
 +|Corrections Unknown Level|44|Payer|PHDSC|Payer|S|
 +|PRIVATE HEALTH INSURANCE|5|Payer|PHDSC|Payer|S|
 +|Managed Care (Private)|51|Payer|PHDSC|Payer|S|
 +|Commercial Managed Care - HMO|511|Payer|PHDSC|Payer|S|
 +|Commercial Managed Care - PPO|512|Payer|PHDSC|Payer|S|
 +|Commercial Managed Care - POS|513|Payer|PHDSC|Payer|S|
 +|Exclusive Provider Organization|514|Payer|PHDSC|Payer|S|
 +|Gatekeeper PPO (GPPO)|515|Payer|PHDSC|Payer|S|
 +|Commercial Managed Care - Pharmacy Benefit Manager|516|Payer|PHDSC|Payer|S|
 +|Commercial Managed Care - Dental|517|Payer|PHDSC|Payer|S|
 +|Managed Care, Other (non HMO)|519|Payer|PHDSC|Payer|S|
 +|Private Health Insurance - Indemnity|52|Payer|PHDSC|Payer|S|
 +|Commercial Indemnity|521|Payer|PHDSC|Payer|S|
 +|Self-insured (ERISA) Administrative Services Only (ASO) plan|522|Payer|PHDSC|Payer|S|
 +|Medicare supplemental policy (as second payer)|523|Payer|PHDSC|Payer|S|
 +|Indemnity Insurance - Dental|524|Payer|PHDSC|Payer|S|
 +|Private health insurance - other commercial Indemnity|529|Payer|PHDSC|Payer|S|
 +|Managed Care (private) or private health insurance (indemnity),​ not otherwise specified|53|Payer|PHDSC|Payer|S|
 +|Organized Delivery System|54|Payer|PHDSC|Payer|S|
 +|Small Employer Purchasing Group|55|Payer|PHDSC|Payer|S|
 +|Specialized Stand Alone Plan|56|Payer|PHDSC|Payer|S|
 +|Dental|561|Payer|PHDSC|Payer|S|
 +|Vision Other Private Insurance|562|Payer|PHDSC|Payer|S|
 +|BLUE CROSS/BLUE SHIELD|6|Payer|PHDSC|Payer|S|
 +|BC Managed Care|61|Payer|PHDSC|Payer|S|
 +|BC Managed Care - HMO|611|Payer|PHDSC|Payer|S|
 +|BC Managed Care - PPO|612|Payer|PHDSC|Payer|S|
 +|BC Managed Care - POS|613|Payer|PHDSC|Payer|S|
 +|BC Managed Care - Dental|614|Payer|PHDSC|Payer|S|
 +|BC Managed Care - Other|619|Payer|PHDSC|Payer|S|
 +|BC Insurance Indemnity|62|Payer|PHDSC|Payer|S|
 +|BC Indemnity|621|Payer|PHDSC|Payer|S|
 +|BC Self-insured (ERISA) Administrative Services Only (ASO)Plan|622|Payer|PHDSC|Payer|S|
 +|BC Medicare Supplemental Plan|623|Payer|PHDSC|Payer|S|
 +|BC Indemnity - Dental|629|Payer|PHDSC|Payer|S|
 +|MANAGED CARE, UNSPECIFIED (to be used only if one can't distinguish public from private)|7|Payer|PHDSC|Payer|S|
 +|Managed Care HMO|71|Payer|PHDSC|Payer|S|
 +|Managed Care PPO|72|Payer|PHDSC|Payer|S|
 +|Managed Care POS|73|Payer|PHDSC|Payer|S|
 +|Other Managed Care|79|Payer|PHDSC|Payer|S|
 +|NO PAYMENT from an Organization/​Agency/​Program/​Private Payer Listed|8|Payer|PHDSC|Payer|S|
 +|Self-pay|81|Payer|PHDSC|Payer|S|
 +|No Charge|82|Payer|PHDSC|Payer|S|
 +|Charity|821|Payer|PHDSC|Payer|S|
 +|Professional Courtesy|822|Payer|PHDSC|Payer|S|
 +|Research/​Clinical Trial|823|Payer|PHDSC|Payer|S|
 +|Refusal to Pay/Bad Debt|83|Payer|PHDSC|Payer|S|
 +|Hill Burton Free Care|84|Payer|PHDSC|Payer|S|
 +|Research/​Donor|85|Payer|PHDSC|Payer|S|
 +|No Payment, Other|89|Payer|PHDSC|Payer|S|
 +|MISCELLANEOUS/​OTHER|9|Payer|PHDSC|Payer|S|
 +|Foreign National|91|Payer|PHDSC|Payer|S|
 +|Other (Non-government)|92|Payer|PHDSC|Payer|S|
 +|Disability Insurance|93|Payer|PHDSC|Payer|S|
 +|Long-term Care Insurance|94|Payer|PHDSC|Payer|S|
 +|Worker'​s Compensation|95|Payer|PHDSC|Payer|S|
 +|Worker'​s Comp HMO|951|Payer|PHDSC|Payer|S|
 +|Worker'​s Comp Fee-for-Service|953|Payer|PHDSC|Payer|S|
 +|Worker’s Comp Other Managed Care|954|Payer|PHDSC|Payer|S|
 +|Worker'​s Comp, Other unspecified|959|Payer|PHDSC|Payer|S|
 +|Auto Insurance (includes no fault)|96|Payer|PHDSC|Payer|S|
 +|Legal Liability / Liability Insurance|97|Payer|PHDSC|Payer|S|
 +|Other specified but not otherwise classifiable (includes Hospice - Unspecified plan)|98|Payer|PHDSC|Payer| |
 +|No Typology Code available for payment source|99|Payer|PHDSC|Payer| |
 +|Unavailable / Unknown/ No Payer Specified / Blank|9999|Payer|PHDSC|Payer| |
  
payerdomain.txt · Last modified: 2018/06/13 19:24 by cgreich