This shows you the differences between two versions of the page.
— |
payerdomain [2018/06/13 19:24] (current) cgreich created |
||
---|---|---|---|
Line 1: | Line 1: | ||
+ | ^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| | | ||