Arizona (SID and SEDD)
Arizona
|
(Valid beginning 2003 SID, Valid beginning 2005 SEDD)
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
05, 5 |
Medicare |
1 |
Medicare |
11 |
Medicare Risk |
06 |
Arizona Health Care Cost Containment System (AHCCCS) Health Care Group/ Medicaid |
2 |
Medicaid |
08 |
Children's Rehab Services (valid beginning 2013) |
01 |
Commercial (Indemnity) |
3 |
Private Insurance |
02 |
HMO |
03, 3 |
PPO |
04 |
Arizona Health Care Cost Containment System (AHCCCS) Health Care Group (for the self employed, small businesses (under 50 employees), and the uninsured employees of political subdivisions) Discontinued/Reserved beginning 2014 |
00 |
Self pay |
4 |
Self pay |
12 |
Charity |
5 |
No charge |
07 |
TRICARE |
6 |
Other |
08 |
Children's Rehab Services (Valid through 2012) |
09 |
Worker's Compensation |
10 |
Indian Health Services |
13 |
Foreign National |
14 |
Other |
15 |
Tobacco Tax (beginning in 1998)(discontinued 2007) |
|
|
. |
Missing |
Blank |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Arizona
|
(Valid July 2002 through December 2002 SID)
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
F |
Medicare |
1 |
Medicare |
L |
Medicare Risk |
G |
AHCCCS/Medicaid |
2 |
Medicaid |
B |
Commercial (Indemnity) |
3 |
Private Insurance |
C |
HMO |
D |
PPO |
E |
Arizona Health Care Cost Containment System (AHCCCS) Health Care Group (for the self employed, small businesses (under 50 employees), and the uninsured employees of political subdivisions) |
A |
Self pay |
4 |
Self pay |
M |
Charity |
5 |
No charge |
H |
CHAMPUS/MEDEXCEL |
6 |
Other |
I |
Children's Rehab Services |
J |
Worker's Compensation |
K |
Indian Health Services |
N |
Foreign National |
O |
Other |
?, Blank |
Unknown, Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Arizona
|
(Valid 1995 to June 2002 SID)
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
05, 5 |
Medicare |
1 |
Medicare |
11 |
Medicare Risk |
04 |
Arizona Health Care Cost Containment System (AHCCCS) Health Care Group |
2 |
Medicaid |
06 |
AHCCCS/Medicaid |
01 |
Commercial (Indemnity) |
3 |
Private Insurance |
02 |
HMO |
03, 3 |
PPO |
00 |
Self pay |
4 |
Self pay |
12 |
Charity |
5 |
No charge |
07 |
CHAMPUS/MEDEXCEL |
6 |
Other |
08 |
Children's Rehab Services |
09 |
Worker's Compensation |
10 |
Indian Health Services |
13 |
Foreign National |
14 |
Other |
15 |
Tobacco Tax (Beginning in 1998) |
Blank |
Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Arizona
|
(Valid from 1989-1994 SID)
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
3 |
Medicare |
1 |
Medicare |
4 |
AHCCCS/Medicaid |
2 |
Medicaid |
1 |
Commercial |
3 |
Private Insurance |
2 |
HMO/PHP/Blue Cross |
-- |
|
4 |
Self-pay |
-- |
|
5 |
No charge |
5 |
Other (self-pay, unknown, charity, etc.) |
6 |
Other |
Blank |
|
. |
Missing |
Other Values |
|
.A |
Invalid |
California (SEDD)
California
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
16 |
Health Maintenance Organization (HMO) Medicare Risk - Includes Medicare Patients covered under an HMO arrangement only. |
1 |
Medicare |
MA |
Medicare Part A - Defined by Title XVIII of the Social Security Act. Covers inpatient hospital stays, care in a skilled nursing facility, hospice care and some home health care. |
MB |
Medicare Part B - Defined by Title XVIII of the Social Security Act. Covers some outpatient hospital care and some home health services. |
MC |
Medi-Cal or Medi-Cal Managed Care Plan - Defined by Titile XIX of the Social Security Act and Title I of the Federal Medicare Act (PL 89-97). Includes all Medi-Cal including Fee for Service, PPO, POS, EPO, and HMO. |
2 |
Medicaid |
12 |
Preferred Provider Organization (PPO) - Includes Blue Cross/Blue Shield or commercial insurance companies under a PPO arrangement. Does not include Medi-Cal patients under a PPO arrangement. |
3 |
Private insurance* |
13 |
Point of Service (POS) - Includes Blue Cross/Blue Shield or commercial insurance companies under a POS arrangement |
14 |
Exclusive Provider Organization (EPO) - Includes Blue Cross/Blue Shield or commercial insurance companies under an EPO arrangement |
BL |
Blue Cross/Blue Shield - Includes only BC/BS Fee for Service payments |
CI |
Commercial Insurance Company - Includes payments from insurance carriers on a Fee for Services basis; Excludes PPO, POS, and EPO payments |
AM |
Automobile Medical - Includes PPO, POS, EPO, HMO and Fee for Service or any other payment resulting from automobile coverage |
HM |
Health Maintenance Organization - HMO payment payers. Does not include Medicare HMO or Medi-Cal HMO |
09 |
Self Pay - Payment directly by the patient, personal guarantor, relatives, or friends. The greatest share of patient's bill is not expected to be paid by any form of insurance or other health plan |
4 |
Self-pay |
-- |
-- |
5 |
No charge |
11 |
Other Non-federal programs - Include any form of payment from local, county, or state government agencies |
6 |
Other |
CH |
CHAMPUS (TRICARE) - Includes any PPO, POS, EPO, HMO, Fee for Service, or other payment from the Civilian Heath and Medical Program of the Uniformed Services or from TRICARE |
DS |
Disability - Payments resulting from disability coverage |
OF |
Other Federal Program - Federal programs not covered by any other category |
TV |
Title V - Defined by the Federal Medicare Act (PL 89-97) for Maternal and Child Health. Title V of the Social Security Act is administered by the Health Resources and Services Administration, Public Health Service, Department of Health and Human Services. Includes California Children Services and Maternal and Child Health program payments not covered under Medi-Cal |
VA |
Veterans Affairs Plan - Includes any PPO, POS, EPO, HMO, Fee for Service or other payment resulting from Veterans Administration coverage |
WC |
Workers' Compensation Health Claim - Includes payments from Workers' Compensation Health Claim insurance |
00 |
Other |
99, "-" |
Missing |
. |
Missing |
(blank) |
blank |
(other) |
|
.A |
Invalid |
* HMOs are regulated in California under the Knox Keene Health Care Service Plan Act of 1975. |
California (SID)
California
|
(Valid beginning in 1999)
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
010, 01- |
Medicare |
1 |
Medicare |
011 |
Medicare (HMO) |
012 |
Medicare (Managed care - Other) |
013 |
Medicare (fee for service) |
020, 02- |
Medi-Cal |
2 |
Medi-Cal |
021 |
Medi-Cal (HMO) |
022 |
Medi-Cal (Managed care - Other) |
023 |
Medi-Cal (fee for service) |
030, 03- |
Private Coverage |
3 |
Private insurance |
031 |
Private Coverage (HMO) |
032 |
Private Coverage (Managed care - Other) |
033 |
Private Coverage (fee for service) |
08n, where n=0-3 or "-" |
Self-pay |
4 |
Self-pay |
07n, where n=0-3 or "-" |
Other Indigent (includes charity care) (Valid beginning in 2017) |
5 |
No charge |
04n, where n=0-3 or "-" |
Worker's Compensation |
6 |
Other |
05n, where n=0-3 or "-" |
County Indigent Programs |
06n, where n=0-3 or "-" |
Other Government |
07n, where n=0-3 or "-" |
Other Indigent (includes charity care) (Valid 1999-2016) |
09n, where n=0-3 or "-" |
Other |
0, -0, 000 |
Not Reported |
. |
Missing |
(blank), "-", "-", or "-" |
blank, missing |
(other) |
|
.A |
Invalid |
The first two digits of PAY1_X describes the payer category (e.g., Medicare (01), Medi-Cal (02), Private coverage (03), Workers' Compensation (04), County Indigent Programs (05), Other Government (06), Other Indigent (07), Self Pay (08), and Other Payer (09)).
The third digit of PAY1_X describes the type of coverage (e.g., Knox-Keene (HMO)* or Medi-Cal County Organized Health Systems (MCOHS) plan (1), Managed Care Other (PPO, IPO, POS, etc.) (2), traditional coverage (fee for service) (3), and type of coverage not considered applicable to the payer category (0).
* HMOs are regulated in California under the Knox-Keene Health Care Service Plan Act of 1975.
|
California
|
(Valid from 1995-1998)
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
01 |
Medicare (Even if HMO or PPO) |
1 |
Medicare |
02 |
Medi-Cal (even if HMO or PPO) |
2 |
Medicaid |
07 |
HMO |
3 |
Private insurance |
08 |
PPO |
09 |
Private Insurance Company (not HMO, not PPO) |
10 |
Blue Cross/Blue Shield (not HMO, not PPO) |
11 |
Self-pay |
4 |
Self-pay |
12 |
Charity |
5 |
No charge |
13 |
No Charge |
03 |
Worker's Compensation |
6 |
Other |
04 |
County Indigent Programs |
05 |
CHAMPUS/CHAMPVA/VA |
06 |
Other Governmental |
14 |
Other Non-Governmental |
00, Blank |
Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
California
|
(Valid from 1988-1994)
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
01 |
Medicare |
1 |
Medicare |
02 |
Medi-Cal |
2 |
Medicaid |
06 |
Blue Cross/Blue Shield |
3 |
Private insurance |
07 |
Insurance Company |
08 |
HMO/PHP |
09 |
Self-pay |
4 |
Self-pay |
10 |
No-charge (free charity, special research, or teaching) |
5 |
No charge |
04 |
Title V |
6 |
Other |
03 |
Workers' Compensation |
05, 12 |
Other government; Medically indigent services under Section 17000 |
11 |
Other non-government |
Blank |
Valid before 1994 |
. |
Missing |
00 |
Valid in 1994 |
. |
Missing |
Other Values |
|
.A |
Invalid |
Connecticut (SID and SEDD)
Connecticut
|
(Valid beginning in 1998)
|
PAY1_X and PAY2_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
C |
Medicare |
1 |
Medicare |
M |
Medicare managed care |
D |
Medicaid |
2 |
Medicaid |
J |
Medicaid managed care (beginning in 1998) |
F |
Commercial Insurance |
3 |
Private insurance |
G |
Blue Cross (Blue Cross PPOs are coded as PPOs, value "T") |
S |
HMO |
T |
PPO |
A |
Self-pay |
4 |
Self-pay |
R |
No charge |
5 |
No charge |
B |
Worker's Comp |
6 |
Other |
E |
Other Federal Program |
H |
Champus |
I |
Other |
Q |
Title V |
U |
Charter Oak (Beginning in 2009) |
Blank |
Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Connecticut
|
(Valid from 1993-1997)
|
PAY1_X and PAY2_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
C, M (1997 only) |
Medicare |
1 |
Medicare |
D |
Medicaid |
2 |
Medicaid |
G |
Blue Cross |
3 |
Private Insurance |
F, T |
Commercial Insurance: PPO |
S |
HMO |
A |
Self-pay |
4 |
Self-pay |
R |
No charge |
5 |
No charge |
Q |
Title V |
6 |
Other |
B |
Workers' Compensation |
H |
CHAMPUS |
E |
Other federal programs |
I |
Other |
Blank |
|
. |
Missing |
Other Values |
|
.A |
Invalid |
Florida (SID)
Florida
|
(Valid beginning in 2010) |
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
A |
Medicare |
1 |
Medicare |
B |
Medicare Managed Care |
C |
Medicaid |
2 |
Medicaid |
D |
Medicaid Managed Care |
O |
KidCare (Valid beginning 2017) |
E |
Commercial Health Insurance |
3 |
Private Insurance |
Q |
Commercial Liability Coverage |
L |
Self pay |
4 |
Self-pay |
N |
Non-payment |
5 |
No charge |
H |
Worker's Compensation |
6 |
Other |
I |
TriCare or Other Federal Government |
J |
VA |
K |
Other State/Local Government |
M |
Other |
O |
KidCare (Valid prior to 2017) |
Blank |
Missing |
. |
Missing |
Other |
Any undocumented value |
.A |
Invalid |
Florida (SEDD)
Florida
|
(Valid beginning in 2010) |
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
A |
Medicare |
1 |
Medicare |
B |
Medicare Managed Care |
C |
Medicaid |
2 |
Medicaid |
D |
Medicaid Managed Care |
O |
KidCare (Valid beginning 2017) |
E |
Commercial Health Insurance |
3 |
Private Insurance |
Q |
Commercial Liability Coverage |
L |
Self pay |
4 |
Self-pay |
N |
Non-payment |
5 |
No charge |
H |
Worker's Compensation |
6 |
Other |
I |
TriCare or Other Federal Government |
J |
VA |
K |
Other State/Local Government |
M |
Other |
O |
KidCare (Valid prior to 2017) |
P |
Unknown |
. |
Missing |
. |
Missing |
Other |
Any undocumented value |
.A |
Invalid |
Florida (SID and SEDD)
Florida
|
(Valid 1998-2009 SID and SASD, Valid 2005-2009 SEDD) |
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
A |
Medicare |
1 |
Medicare |
B |
Medicare HMO or Medicare PPO |
C |
Medicaid |
2 |
Medicaid |
D |
Medicaid HMO |
E |
Commercial Insurance |
3 |
Private Insurance |
F |
Commercial HMO |
G |
Commercial PPO |
L |
Self pay/Under-insured (No third party coverage or less than 30% estimated insurance coverage) |
4 |
Self-pay |
N |
Charity |
5 |
No charge |
H |
Worker's Compensation |
6 |
Other |
I |
Champus |
J |
VA |
K |
Other State/Local Government |
M |
Other |
O |
KidCare (Healthy Kids, MediKids, and Children's Medical Services - beginning 2003) |
P (SEDD and SASD only) |
Unknown. Reported only if information is not available, and type of service is "2" and patient status is "7" |
. |
Missing |
Blank |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Florida
|
(Valid for 1997 SID and SASD) |
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
A, B |
Medicare, Medicare HMO |
1 |
Medicare |
C, D |
Medicaid, Medicaid HMO |
2 |
Medicaid |
E, G |
Commercial insurance (includes self-insured and Blue Cross/Blue Shield); Commercial PPO |
3 |
Private Insurance |
F |
Commercial HMO |
L |
Self-pay, charity, underinsured |
4 |
Self-pay |
N |
Charity |
5 |
No charge |
H |
Workers' Compensation |
6 |
Other |
I, J |
CHAMPUS; VA |
K |
Other state/local government |
M |
Other |
Blank |
|
. |
Missing |
Other values |
|
.A |
Missing |
Florida
|
(Valid from 1992-1996 SID) |
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
A, B |
Medicare, Medicare HMO |
1 |
Medicare |
C, D |
Medicaid, Medicaid HMO |
2 |
Medicaid |
E, G |
Commercial insurance (includes self-insured and Blue Cross/Blue Shield); Commercial PPO |
3 |
Private Insurance |
F |
Commercial HMO |
L |
Self-pay, charity, underinsured |
4 |
Self-pay |
-- |
|
5 |
No charge |
H |
Workers' Compensation |
6 |
Other |
I, J |
CHAMPUS; VA |
K |
Other state/local government |
M |
Other |
Blank |
|
. |
Missing |
Other values |
|
.A |
Invalid |
Florida
|
(Valid from 1988-1991 SID) |
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
A |
Medicare |
1 |
Medicare |
C |
Medicaid |
2 |
Medicaid |
E |
Commercial insurance (includes self-insured and Blue Cross/Blue Shield) |
3 |
Private Insurance |
-- |
|
4 |
Self-pay |
-- |
|
5 |
No charge |
M |
Other |
6 |
Other |
Blank |
|
. |
Missing |
Other values |
|
.A |
Invalid |
Georgia (SID and SEDD)
Georgia
|
(Valid beginning 1998 SID, Valid beginning 2002 SASD and SEDD)
|
PAY1_X, PAY2_X, PAY3_X
|
PAY1, PAY2, PAY3
|
Value
|
Description
|
Value
|
Description
|
1 |
Medicare |
1 |
Medicare |
11 |
Medicare (Managed Care) |
111 |
Medicare HMO |
1111 |
Aetna Inc. |
1112 |
Coventry Health Care, Inc. |
1113 |
Humana Inc. |
1114 |
Kaiser Foundation Health Plan, Inc. |
1115 |
United HealthCare of Georgia, Inc. |
1116 |
Wellcare of Georgia |
1117 |
WellPoint, Inc. |
1118 |
Other Medicare HMO |
112 |
Medicare PPO |
113 |
Medicare POS |
119 |
Medicare Managed Care (Other) |
12 |
Medicare (Non-managed Care) |
121 |
Medicare FFS |
122 |
Medicare Drug Benefit |
123 |
Medicare Medical Savings Account (MSA) |
124 |
Medicare Drug Benefit (Part D) |
129 |
Medicare Non-managed Care (Other) |
19 |
Medicare (Other) |
2 |
Medicaid |
2 |
Medicaid |
21 |
Medicaid (Managed Care) |
211 |
Medicaid HMO |
2111 |
Amerigroup CMO |
2112 |
PeachState CMO |
2113 |
WellCare CMO |
2114 |
Medicaid Caresource HMO (Starting in 2017) |
212 |
Medicaid PPO |
213 |
Medicaid PCCM (Primary Care Case Management) |
219 |
Medicaid Managed Care (Other) |
22 |
Medicaid (Non-managed Care Plan) |
23 |
Medicaid/SCHIP |
24 |
Medicaid Applicant |
25 |
Medicaid (Out of State) |
29 |
Medicaid (Other) |
361 |
State SCHIP Program (Starting in 2017) |
5 |
Private Health Insurance (other than Blue Cross/Blue Shield) |
3 |
Private Insurance |
51 |
Managed Care (Private) |
511 |
Commercial Managed Care (HMO) |
512 |
Commercial Managed Care (PPO) |
513 |
Commercial Managed Care (POS) |
514 |
Exclusive Provider Organization |
519 |
Managed Care, Other (non-HMO) |
52 |
Private Health Insurance (Indemnity) |
521 |
Indemnity (e.g. high option/low option) |
522 |
ERISA ASO Plan |
523 |
Commercial Indemnity |
524 |
Self-insured (ERISA) ASO Plan |
525 |
Medicare Supplemental Policy (as secondary payor) |
53 |
Commercial (Indemnity or Managed Care, unspecified) |
54 |
Organized Delivery System |
55 |
Small Employer Purchasing Group |
59 |
Other Private Insurance, not BC or Kaiser |
6 |
Blue Cross/Blue Shield |
61 |
BC Managed Care |
611 |
BC Managed Care (HMO) |
612 |
BC Managed Care (PPO) |
613 |
BC Managed Care (POS) |
619 |
BC Managed Care (Other) |
62 |
BC Indemnity |
63 |
BC Indemnity or Managed Care (Out of State) |
64 |
BC Indemnity or Managed Care (Unspecified) |
69 |
BC Indemnity or Managed Care (Other) |
7 |
Managed Care (Unspecified) |
71 |
HMO |
72 |
PPO |
73 |
POS |
79 |
Other Managed Care (Unknown if public or private) |
96 |
Auto Insurance (no fault) (Starting in 2017) |
8 |
NOPAYMENT from an Organization/Agency/Program/Private Payor Listed |
4 |
Self-pay |
81 |
Self-pay |
82 |
No Charge (Prior to 2009) |
821 |
Charity (prior to 2013) |
822 |
Professional Courtesy (prior to 2013) |
823 |
Research/Clinical Trial (prior to 2013) |
83 |
Refusal to Pay/Bad Debt (prior to 2013) |
84 |
Hill Burton Free Care (Prior to 2012) |
85 |
Research/Donor (prior to 2013 SID) |
89 |
No Payment (Other - Prior to 2009) |
82 |
No Charge (Begin 2009) |
5 |
No charge |
821 |
Charity (Begin 2013) |
822 |
Professional Courtesy (begin 2013 SID) |
823 |
Research/Clinical Trial (begin 2013 SID) |
83 |
Refusal to Pay/Bad Debt (begin 2013 SID) |
84 |
Hill Burton Free Care (begin 2012) |
85 |
Research/Donor (begin 2013 SID) |
89 |
No Payment (Other - begin 2009) |
3 |
Other Government (Federal/State/Government) |
6 |
Other |
31 |
Department of Defense |
311 |
CHAMPUS |
3111 |
Indemnity |
3112 |
TriCare |
312 |
CHAMPVA |
319 |
Department of Defense (not CHAMPUS) |
32 |
VA |
321 |
VA (Priority Veteran) |
322 |
VA (Enrolled Veteran with Copay) |
329 |
VA (Other) |
33 |
Indian Health Service or Tribe |
331 |
Indian Health Service (Regular) |
332 |
Indian Health Service (Contract) |
333 |
Indian Health Service (Managed Care) |
334 |
Indian Tribe (Sponsored Coverage) |
34 |
HRSA Program |
341 |
Title V (MCH Block Grant) |
342 |
Migrant Health Program |
343 |
Ryan White Act |
349 |
Other |
35 |
Black Lung |
36 |
State Government |
361 |
State SCHIP Program (Prior to 2017) |
362 |
Specific State Programs |
369 |
State, not otherwise specified (other state) |
37 |
Local Government |
371 |
Local (Managed Care) |
3711 |
Local government HMO |
3712 |
Local government POS |
3713 |
Local government PPO |
372 |
FFS/Indemnity |
379 |
Local, not otherwise specified (other local, county) |
38 |
Other Government (Federal, State, Local not specified) |
381 |
Federal, State, Local not specified (FFS) |
382 |
Federal, State, Local not specified (HMO) |
383 |
Federal, State, Local not specified (PPO) |
384 |
Federal, State, Local not specified (POS) |
389 |
Federal, State, Local not specified (Other) |
39 |
Other Federal |
4 |
Department of Corrections |
41 |
Corrections Federal |
42 |
Corrections State |
43 |
Corrections Local |
44 |
Corrections (Unknown Level) |
9 |
Miscellaneous/Other |
91 |
Foreign National |
92 |
Other (Non-government) |
93 |
Disability Insurance |
94 |
Long-term Care Insurance |
95 |
Worker's Compensation |
951 |
Worker's Comp (Fee-for-Service) |
952 |
Worker's Comp (HMO) |
953 |
Worker's Comp (Other Managed Care) |
96 |
Auto Insurance (no fault) (prior to 2017) |
97 |
Other (not specified) |
98 |
Other specified (includes Hospice - Unspecified plan) |
99 |
Other Unspecified |
blank |
Not reported |
. |
Missing |
- |
Invalid Code Scheme |
ZZZ |
Missing Data |
Any values not documented by the data source |
.A |
Invalid |
Georgia (SID)
Georgia
|
(Valid for 1997 SID)
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
M |
Medicare |
1 |
Medicare |
D |
Medicaid |
2 |
Medicaid |
B |
Blue Cross and Blue Shield |
3 |
Private Insurance |
I, S |
Other Insurance Companies; Self Insured |
H |
HMO-PPO |
P |
Self-pay |
4 |
Self-pay |
Z |
Free |
5 |
No charge |
W |
Workers' Comp |
6 |
Other |
C |
CHAMPUS |
E, N |
Other Government |
L, O |
Other |
3, 5, A, F, G, J, K, Y |
Unknown |
. |
Missing |
Other values |
|
.A |
Invalid |
Hawaii (SID and SEDD)
In 2008, source value 24 (QUEST (Any QUEST Plan except AlohaCare, HMSA Quest, Kaiser Quest)) was mapped to Private Insurance instead of Medicaid; not too many records were affected, but they have now been fixed starting in 2009.
Hawaii
|
(Valid beginning in 2003 SID, Valid beginning 2007 SASD, Valid beginning 2003 SEDD)
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
01 |
Medicare |
1 |
Medicare |
18 |
HMSA 65C+ |
19 |
Kaiser Senior Advantage/Kaiser 65C+ - beginning 2003 |
25 |
Secure Horizons Medicare Advantage - beginning 2008 |
26 |
AlohaCare Advantage/Advantage Plus - beginning 2008 |
28 |
HMSA Akamai Advantage |
31 |
Other Medicare Advantage Plan |
32 |
AARP Medicare Complete |
33 |
Humana (Choice/GoldChoice/GoldPlus) Medicare Advantage Plans |
34 |
United Healthcare Dual Complete Advantage Special Needs Plans (SNPs) |
02 |
Medicaid |
2 |
Medicaid |
13 |
Hawaii QUEST (managed care) Beginning in 2006, the general QUEST category was discontinued and split into plan-specific categories |
15 |
AlohaCare (plan participating in QUEST) beginning in 2003 |
22 |
HMSA QUEST - beginning 2006 |
23 |
Kaiser QUEST - beginning 2006 |
24 |
QUEST (Any QUEST Plan except AlohaCare, HMSA Quest, Kaiser Quest) - beginning 2006 |
29 |
Ohana Health Plan QUEST |
30 |
United Healthcare Community Plan QUEST |
14 |
HMSA's Health Plan Hawaii beginning in 2003 |
3 |
Private Insurance |
16 |
Hawaii Management Alliance Association (HMAA) beginning in 2003 |
17 |
University Health Alliance (UHA) beginning in 2003 |
27 |
Summerlin Insurance |
04 |
HMSA (any other HMSA plan) |
05 |
Kaiser |
06 |
Other Insurance |
08 |
No Fault |
07 |
Self pay/Charity Care |
4 |
Self pay |
-- |
|
5 |
No charge |
09 |
Worker's Compensation |
6 |
Other |
10 |
Tricare/CHAMPUS/VA/Other Government - Discontinued in 2006 |
12 |
Department of Defense |
20 |
Veterans Administration (VA) - Beginning 2006 |
21 |
Tricare/CHAMPUS/Other Government - Beginning 2006 |
11, Blank |
Unknown, Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Hawaii (SID)
Hawaii
|
(Valid 1998-2002)
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
1 |
Medicare |
1 |
Medicare |
2 |
Medicaid |
2 |
Medicaid |
13 |
QUEST |
4 |
HMSA (Blue Cross/Blue Shield affiliate that provides HMO, PPO and Fee for Service plans) |
3 |
Private Insurance |
5 |
Kaiser |
6 |
Other Insurance |
8 |
No Fault |
7 |
Self pay |
4 |
Self pay |
-- |
|
5 |
No charge |
9 |
Worker's Compensation |
6 |
Other |
10 |
CHAMPUS/VA/Other Government |
12 |
Department of Defense |
11, Blank |
Unknown, Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Hawaii
|
(Valid from 1996-1997)
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
"Medicare" |
Medicare |
1 |
Medicare |
"Medicaid", "SHIP", "Quest" |
Medicaid; SHIP; Quest |
2 |
Medicaid |
"Other Insurance", "HMSA", "No Fault" |
Other Insurance, HMSA, No Fault |
3 |
Private Insurance |
"Kaiser" |
Kaiser |
"Self Pay" |
Self-pay |
4 |
Self-pay |
-- |
|
5 |
No charge |
"Workers Comp" |
Worker's Comp |
6 |
Other |
"Champus", "DOD" |
CHAMPUS/VA/Other Government; Department of Defense |
"Unknown", Blank |
Unknown |
. |
Missing |
Other values |
|
.A |
Invalid |
Illinois (SID)
Illinois
|
(Valid beginning in 1998 SID)
|
PAY1_X, PAY2_X, and PAY3_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
A98910 |
Medicare |
1 |
Medicare |
A98945 |
Medicare Managed Care/Advantage Plan (beginning in 2011) |
B98916 |
Illinois Medicaid |
2 |
Medicaid |
B98917 |
Out of State Medicaid (beginning in 2011), Other Medicaid (prior to 2011) |
B98935 |
Medicaid Managed Care (beginning in 2011) |
C40010 |
Blue Cross Blue Shield Commercial (POS, PPO, etc.) (beginning in 2016) |
3 |
Private Insurance |
C40020 |
United Healthcare Commercial (POS, PPO, etc.) (beginning in 2016) |
C40030 |
Aetna (POS, PPO, etc.) (beginning in 2016) |
C40150 |
Humana Commercial (POS, PPO, etc. ) (beginning in 2016) |
C40160 |
Health Alliance Commercial (POS, PPO, etc.) (beginning in 2016) |
C87726 |
United Healthcare Advan |
C98950 |
Commercial Insurance |
Cnnn, where nnn is a 3-digit number |
Blue Cross Insurance |
Cnnnnnnnnn, where nnnnnnnnn is a 9-digit number |
Commercial Insurance (may include TPA and Worker's Compensation coverage) |
C98920 |
Other Commercial Insurance (PPO, POS etc) other than 400 series |
D40015 |
Blue Cross Blue Shield Commercial HMO (beginning in 2016) |
D40025 |
United Healthcare Commercial HMO (beginning in 2016) |
D40035 |
Aetna Commercial HMO (beginning in 2016) |
D40155 |
Humana Commercial HMO (beginning in 2016) |
D40165 |
Health Alliance Commercial HMO (beginning in 2016) |
Dnnnnnnnnn, where nnnnnnnnn is a 9-digit number |
Commercial HMO |
D98925 |
Commercial HMO other than 400 series |
Ennnnnnnnn, where nnnnnnnnn is a 9-digit number |
Self-administered or Self-insured plans |
E98930 |
Other Self-administered or Self-insured plans |
F98918 |
Self-pay |
4 |
Self-pay |
H98912 |
Charity |
5 |
No charge |
H98913 |
Hill Burton Free Care |
H98911 |
Black Lung |
6 |
Other |
H98914 |
CHAMPUS |
H98915 |
CHAMPVA |
H98919 |
Miscellaneous |
H00121 |
Blue Cross Blue Shield, other than Medicare or commercial plan (Starting in 2013) |
H36335 |
HFN Inc, other than Medicare or commercial plan (Starting in 2013) |
H77950 |
Health Alliance Medical |
H87726 |
United Healthcare Advantage, other than Medicare or commercial plan (Starting in 2013) |
H95964 |
COVID HRSA Uninsured Fund |
H00000 |
Other (valid prior to 2018) |
Blank |
Missing |
. |
Missing |
H00000 (discontinued beginning in 2018), H99999 or any values not documented by the data source |
.A |
Invalid |
Primary, secondary, and tertiary expected payer information was provided in two fields: a one character payer category ("A" through "H") and detailed payer identifier of 3, 5, or 9 digits. The 3-digit identifiers refer to Blue Cross plans, but no source documentation was available to link the 3-digit identifier to a Blue Cross plan name. The 9-digit identifiers refer to commercial, HMO, and self-administered plans, but no source documentation was available to link the 9-digit identifier to a plan name. The Illinois Department of Insurance may have a list of the plan names for the 9-digit codes. All 5-digit identifiers were named. This information is included in the above table.
The one-character payer category and the detailed payer identifier were concatenated together to create the HCUP variables PAY1_X, PAY2_X, and PAY3_X.
During HCUP processing, PAY1/PAY2 and HMOPPO1/HMOPPO2 were assigned using the first character of PAY1_X/PAY2_X (e.g., "A", "B", "C", etc.) with the following exception. When PAY1_X/PAY2_X started with "H", PAY1/PAY2 and HMOPPO1/HMOPPO2 were assigned using the 6 character code.
|
Illinois
|
(Valid from 1995-1997)
|
PAY1_X, PAY2_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
A98910 |
Medicare |
1 |
Medicare |
B98916 |
Illinois Medicaid |
2 |
Medicaid |
B98917 |
Other Medicaid |
Cnnn, where nnn is a 3-digit number |
Blue Cross Insurance |
3 |
Private Insurance |
Cnnnnnnnnn, where nnnnnnnnn is a 9-digit number |
Commercial Insurance (may include TPA and Worker's Compensation coverage) |
C98920 |
Other Commercial Insurance |
Dnnnnnnnnn, where nnnnnnnnn is a 9-digit number |
Commercial HMO |
Ennnnnnnnn, where nnnnnnnnn is a 9-digit number |
Self-administered or Self-insured plans |
E98930 |
Other Self-administered or Self-insured plans |
F98918 |
Self-pay |
4 |
Self-pay |
H98912 |
Charity |
5 |
No charge |
H98913 |
Hill Burton Free Care |
H98911 |
Black Lung |
6 |
Other |
H98914 |
CHAMPUS |
H98915 |
CHAMPVA |
H98919 |
Miscellaneous |
Blank |
Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Primary, secondary, and tertiary expected payer information was provided in two fields: a one character payer category ("A" through "H") and detailed payer identifier of 3, 5, or 9 digits. The 3-digit identifiers refer to Blue Cross plans, but no source documentation was available to link the 3-digit identifier to a Blue Cross plan name. The 9-digit identifiers refer to commercial, HMO, and self-administered plans, but no source documentation was available to link the 9-digit identifier to a plan name. The Illinois Department of Insurance may have a list of the plan names for the 9-digit codes. All 5-digit identifiers were named. This information is included in the above table.
The one-character payer category and the detailed payer identifier were concatenated together to create the HCUP variables PAY1_X, PAY2_X, and PAY3_X.
During HCUP processing, PAY1/PAY2 were assigned using the first character of PAY1_X/PAY2_X (e.g., "A", "B", "C", etc.) with the following exception. When PAY1_X/PAY2_X started with "H", PAY1/PAY2 were assigned using the 6 character code.
|
Illinois
|
(Valid from 1993-1994)
|
PAY1_X, PAY2_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
A |
Medicare |
1 |
Medicare |
B |
Medicaid |
2 |
Medicaid |
C, E |
Commercial, PPO; Self-administered |
3 |
Private Insurance |
D |
HMO |
F |
Self-pay |
4 |
Self-pay |
-- |
|
5 |
No charge |
H |
Other |
6 |
Other |
Blank |
|
. |
Missing |
Other Values |
|
.A |
Invalid |
Illinois
|
(Valid from 1988-1992)
|
PAY1_X and PAY2_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
98910 |
Medicare |
1 |
Medicare |
98916 |
Illinois Medicaid |
2 |
Medicaid |
98917 |
Other Medicaid |
3-digit codes |
Blue Cross Insurance |
3 |
Private Insurance |
061055955 |
HMO/PHP |
232312490 |
HMO/PHP |
237137598 |
HMO/PHP |
361236610 |
HMO/PHP |
362171705 |
HMO/PHP |
362302593 |
HMO/PHP |
362748320 |
HMO/PHP |
362835382 |
HMO/PHP |
362858588 |
HMO/PHP |
363050287 |
HMO/PHP |
363156930 |
HMO/PHP |
363208585 |
HMO/PHP |
363232147 |
HMO/PHP |
363242084 |
HMO/PHP |
363251800 |
HMO/PHP |
363257067 |
HMO/PHP |
363261533 |
HMO/PHP |
363280214 |
HMO/PHP |
363290114 |
HMO/PHP |
363293099 |
HMO/PHP |
363300107 |
HMO/PHP |
363303922 |
HMO/PHP |
363303927 |
HMO/PHP |
363333675 |
HMO/PHP |
363334929 |
HMO/PHP |
363346492 |
HMO/PHP |
363357619 |
HMO/PHP |
363359925 |
HMO/PHP |
363363036 |
HMO/PHP |
363379945 |
HMO/PHP |
363385638 |
HMO/PHP |
363387762 |
HMO/PHP |
363410844 |
HMO/PHP |
363426222 |
HMO/PHP |
363447577 |
HMO/PHP |
363464332 |
HMO/PHP |
363513970 |
HMO/PHP |
363576982 |
HMO/PHP |
36361797l |
HMO/PHP |
363617971 |
HMO/PHP |
363784962 |
HMO/PHP |
363807756 |
HMO/PHP |
363837523 |
HMO/PHP |
363864486 |
HMO/PHP |
371076964 |
HMO/PHP |
371105481 |
HMO/PHP |
371139917 |
HMO/PHP |
371153402 |
HMO/PHP |
371190216 |
HMO/PHP |
371192892 |
HMO/PHP |
371216698 |
HMO/PHP |
371221007 |
HMO/PHP |
371241037 |
HMO/PHP |
371260731 |
HMO/PHP |
376000511 |
HMO/PHP |
421172640 |
HMO/PHP |
421282065 |
HMO/PHP |
431131852 |
HMO/PHP |
431141117 |
HMO/PHP |
431361841 |
HMO/PHP |
431372307 |
HMO/PHP |
431386495 |
HMO/PHP |
541252797 |
HMO/PHP |
611013183 |
HMO/PHP |
611056884 |
HMO/PHP |
741844335 |
HMO/PHP |
953762261 |
HMO/PHP |
954053288 |
HMO/PHP |
963762261 |
HMO/PHP |
98920 |
Other commercial insurance |
98930 |
Other self-administered or self-insured plans |
98918 |
Self-pay |
4 |
Self-pay |
98912 |
Charity |
5 |
No charge |
98913 |
Hill Burton Free Care |
020140690 |
Workers' Compensation |
6 |
Other |
020172170 |
Workers' Compensation |
020177030 |
Workers' Compensation |
020304627 |
Workers' Compensation |
020308052 |
Workers' Compensation |
020311919 |
Workers' Compensation |
020342937 |
Workers' Compensation |
020349547 |
Workers' Compensation |
030316876 |
Workers' Compensation |
041027270 |
Workers' Compensation |
041282020 |
Workers' Compensation |
041288420 |
Workers' Compensation |
041543470 |
Workers' Compensation |
041590940 |
Workers' Compensation |
041924000 |
Workers' Compensation |
042177185 |
Workers' Compensation |
042475442 |
Workers' Compensation |
042656602 |
Workers' Compensation |
042680300 |
Workers' Compensation |
042739160 |
Workers' Compensation |
042794993 |
Workers' Compensation |
042974375 |
Workers' Compensation |
043058503 |
Workers' Compensation |
043058504 |
Workers' Compensation |
046017710 |
Workers' Compensation |
050303803 |
Workers' Compensation |
050393243 |
Workers' Compensation |
060237820 |
Workers' Compensation |
060291290 |
Workers' Compensation |
060294398 |
Workers' Compensation |
060303275 |
Workers' Compensation |
060303520 |
Workers' Compensation |
060336212 |
Workers' Compensation |
060383030 |
Workers' Compensation |
060464510 |
Workers' Compensation |
060480695 |
Workers' Compensation |
060529570 |
Workers' Compensation |
060566050 |
Workers' Compensation |
060640218 |
Workers' Compensation |
060732738 |
Workers' Compensation |
060848755 |
Workers' Compensation |
060876835 |
Workers' Compensation |
060907370 |
Workers' Compensation |
060949141 |
Workers' Compensation |
061008026 |
Workers' Compensation |
061008792 |
Workers' Compensation |
061010609 |
Workers' Compensation |
061024360 |
Workers' Compensation |
061053492 |
Workers' Compensation |
061055955 |
Workers' Compensation |
061067463 |
Workers' Compensation |
061092819 |
Workers' Compensation |
061117063 |
Workers' Compensation |
061182357 |
Workers' Compensation |
061206728 |
Workers' Compensation |
061222527 |
Workers' Compensation |
061325038 |
Workers' Compensation |
066032187 |
Workers' Compensation |
066033504 |
Workers' Compensation |
066033509 |
Workers' Compensation |
066105395 |
Workers' Compensation |
131675535 |
Workers' Compensation |
131941868 |
Workers' Compensation |
131941984 |
Workers' Compensation |
131963495 |
Workers' Compensation |
131963496 |
Workers' Compensation |
131988169 |
Workers' Compensation |
132559805 |
Workers' Compensation |
132611663 |
Workers' Compensation |
132653231 |
Workers' Compensation |
132661002 |
Workers' Compensation |
132669000 |
Workers' Compensation |
132673100 |
Workers' Compensation |
132758523 |
Workers' Compensation |
132781282 |
Workers' Compensation |
132791458 |
Workers' Compensation |
132832845 |
Workers' Compensation |
135277930 |
Workers' Compensation |
135283360 |
Workers' Compensation |
135303710 |
Workers' Compensation |
135316370 |
Workers' Compensation |
135339725 |
Workers' Compensation |
135358230 |
Workers' Compensation |
135379820 |
Workers' Compensation |
135459190 |
Workers' Compensation |
135460208 |
Workers' Compensation |
135481330 |
Workers' Compensation |
135539046 |
Workers' Compensation |
135540698 |
Workers' Compensation |
135616275 |
Workers' Compensation |
135617450 |
Workers' Compensation |
135669461 |
Workers' Compensation |
136081895 |
Workers' Compensation |
136104845 |
Workers' Compensation |
136107326 |
Workers' Compensation |
136108722 |
Workers' Compensation |
150476880 |
Workers' Compensation |
156020948 |
Workers' Compensation |
160366830 |
Workers' Compensation |
220731810 |
Workers' Compensation |
221608585 |
Workers' Compensation |
221708002 |
Workers' Compensation |
221721944 |
Workers' Compensation |
221721950 |
Workers' Compensation |
221964135 |
Workers' Compensation |
221964136 |
Workers' Compensation |
222005057 |
Workers' Compensation |
222053189 |
Workers' Compensation |
222227328 |
Workers' Compensation |
222227331 |
Workers' Compensation |
222342710 |
Workers' Compensation |
230342560 |
Workers' Compensation |
230580680 |
Workers' Compensation |
230723970 |
Workers' Compensation |
230959220 |
Workers' Compensation |
230961349 |
Workers' Compensation |
231330959 |
Workers' Compensation |
231471444 |
Workers' Compensation |
231502700 |
Workers' Compensation |
231614367 |
Workers' Compensation |
231620527 |
Workers' Compensation |
231624911 |
Workers' Compensation |
231641984 |
Workers' Compensation |
231642962 |
Workers' Compensation |
231740414 |
Workers' Compensation |
231742051 |
Workers' Compensation |
231892289 |
Workers' Compensation |
231903575 |
Workers' Compensation |
232182777 |
Workers' Compensation |
232640501 |
Workers' Compensation |
232643432 |
Workers' Compensation |
250410420 |
Workers' Compensation |
250687550 |
Workers' Compensation |
251118791 |
Workers' Compensation |
310396250 |
Workers' Compensation |
310501234 |
Workers' Compensation |
310542366 |
Workers' Compensation |
310708754 |
Workers' Compensation |
310826946 |
Workers' Compensation |
310926059 |
Workers' Compensation |
310970750 |
Workers' Compensation |
311160863 |
Workers' Compensation |
311241230 |
Workers' Compensation |
314177100 |
Workers' Compensation |
314177110 |
Workers' Compensation |
314316080 |
Workers' Compensation |
314423946 |
Workers' Compensation |
340368340 |
Workers' Compensation |
340438190 |
Workers' Compensation |
341022544 |
Workers' Compensation |
341172650 |
Workers' Compensation |
341316396 |
Workers' Compensation |
341532771 |
Workers' Compensation |
346513736 |
Workers' Compensation |
346516838 |
Workers' Compensation |
350145400 |
Workers' Compensation |
350198580 |
Workers' Compensation |
350293728 |
Workers' Compensation |
350293730 |
Workers' Compensation |
350410010 |
Workers' Compensation |
350410420 |
Workers' Compensation |
350913391 |
Workers' Compensation |
350988041 |
Workers' Compensation |
351044900 |
Workers' Compensation |
351288885 |
Workers' Compensation |
351372324 |
Workers' Compensation |
351492884 |
Workers' Compensation |
351495207 |
Workers' Compensation |
351495208 |
Workers' Compensation |
351524574 |
Workers' Compensation |
356018566 |
Workers' Compensation |
356021485 |
Workers' Compensation |
360705950 |
Workers' Compensation |
360719665 |
Workers' Compensation |
360727430 |
Workers' Compensation |
360727470 |
Workers' Compensation |
360810360 |
Workers' Compensation |
360901240 |
Workers' Compensation |
361022580 |
Workers' Compensation |
361236610 |
Workers' Compensation |
361404320 |
Workers' Compensation |
361410470 |
Workers' Compensation |
361412255 |
Workers' Compensation |
361475332 |
Workers' Compensation |
361649210 |
Workers' Compensation |
361877247 |
Workers' Compensation |
361999760 |
Workers' Compensation |
362114545 |
Workers' Compensation |
362349119 |
Workers' Compensation |
362403971 |
Workers' Compensation |
362467238 |
Workers' Compensation |
362489372 |
Workers' Compensation |
362490086 |
Workers' Compensation |
362512064 |
Workers' Compensation |
362542404 |
Workers' Compensation |
362545393 |
Workers' Compensation |
362594678 |
Workers' Compensation |
36260579 |
Workers' Compensation |
362661515 |
Workers' Compensation |
362661954 |
Workers' Compensation |
362663083 |
Workers' Compensation |
362667627 |
Workers' Compensation |
362674180 |
Workers' Compensation |
362678778 |
Workers' Compensation |
362690333 |
Workers' Compensation |
362694846 |
Workers' Compensation |
362704643 |
Workers' Compensation |
362704802 |
Workers' Compensation |
362705935 |
Workers' Compensation |
362709121 |
Workers' Compensation |
362711653 |
Workers' Compensation |
362719165 |
Workers' Compensation |
362722478 |
Workers' Compensation |
362738349 |
Workers' Compensation |
362742183 |
Workers' Compensation |
362748320 |
Workers' Compensation |
362748795 |
Workers' Compensation |
362753986 |
Workers' Compensation |
362755546 |
Workers' Compensation |
362756532 |
Workers' Compensation |
362759195 |
Workers' Compensation |
362760101 |
Workers' Compensation |
362763106 |
Workers' Compensation |
362781080 |
Workers' Compensation |
362789296 |
Workers' Compensation |
362797073 |
Workers' Compensation |
362797074 |
Workers' Compensation |
362811124 |
Workers' Compensation |
362857399 |
Workers' Compensation |
362874262 |
Workers' Compensation |
362930605 |
Workers' Compensation |
362944577 |
Workers' Compensation |
362950161 |
Workers' Compensation |
362994662 |
Workers' Compensation |
362999368 |
Workers' Compensation |
362999370 |
Workers' Compensation |
363027848 |
Workers' Compensation |
363028761 |
Workers' Compensation |
363030511 |
Workers' Compensation |
363040078 |
Workers' Compensation |
363051031 |
Workers' Compensation |
363078103 |
Workers' Compensation |
363101262 |
Workers' Compensation |
363105508 |
Workers' Compensation |
363105737 |
Workers' Compensation |
363141762 |
Workers' Compensation |
363155373 |
Workers' Compensation |
363186541 |
Workers' Compensation |
363230348 |
Workers' Compensation |
363312218 |
Workers' Compensation |
363316692 |
Workers' Compensation |
363341779 |
Workers' Compensation |
363423817 |
Workers' Compensation |
363426425 |
Workers' Compensation |
363432551 |
Workers' Compensation |
363441652 |
Workers' Compensation |
363468793 |
Workers' Compensation |
363492700 |
Workers' Compensation |
363510294 |
Workers' Compensation |
363522250 |
Workers' Compensation |
363529298 |
Workers' Compensation |
363530161 |
Workers' Compensation |
363579407 |
Workers' Compensation |
363585968 |
Workers' Compensation |
363586255 |
Workers' Compensation |
363614264 |
Workers' Compensation |
363649555 |
Workers' Compensation |
363672824 |
Workers' Compensation |
363714287 |
Workers' Compensation |
363715387 |
Workers' Compensation |
363765116 |
Workers' Compensation |
363774557 |
Workers' Compensation |
363789786 |
Workers' Compensation |
363789787 |
Workers' Compensation |
363806723 |
Workers' Compensation |
366033855 |
Workers' Compensation |
366033921 |
Workers' Compensation |
366042949 |
Workers' Compensation |
366043106 |
Workers' Compensation |
366049887 |
Workers' Compensation |
366054328 |
Workers' Compensation |
366064756 |
Workers' Compensation |
366067575 |
Workers' Compensation |
366071400 |
Workers' Compensation |
366077839 |
Workers' Compensation |
366084669 |
Workers' Compensation |
366115679 |
Workers' Compensation |
370268670 |
Workers' Compensation |
370277830 |
Workers' Compensation |
370301640 |
Workers' Compensation |
370344310 |
Workers' Compensation |
370396180 |
Workers' Compensation |
370420520 |
Workers' Compensation |
370530080 |
Workers' Compensation |
370533080 |
Workers' Compensation |
370533100 |
Workers' Compensation |
370558630 |
Workers' Compensation |
370637646 |
Workers' Compensation |
370807507 |
Workers' Compensation |
370815476 |
Workers' Compensation |
370855395 |
Workers' Compensation |
370915434 |
Workers' Compensation |
371054042 |
Workers' Compensation |
371111076 |
Workers' Compensation |
371184187 |
Workers' Compensation |
371277771 |
Workers' Compensation |
376028411 |
Workers' Compensation |
380315280 |
Workers' Compensation |
380828980 |
Workers' Compensation |
380829210 |
Workers' Compensation |
380865250 |
Workers' Compensation |
381184490 |
Workers' Compensation |
381630841 |
Workers' Compensation |
381869912 |
Workers' Compensation |
382145898 |
Workers' Compensation |
382312731 |
Workers' Compensation |
382430150 |
Workers' Compensation |
390264050 |
Workers' Compensation |
390273710 |
Workers' Compensation |
390301590 |
Workers' Compensation |
390333950 |
Workers' Compensation |
390475300 |
Workers' Compensation |
390712210 |
Workers' Compensation |
390941450 |
Workers' Compensation |
390972608 |
Workers' Compensation |
391190263 |
Workers' Compensation |
391338397 |
Workers' Compensation |
391341459 |
Workers' Compensation |
391401314 |
Workers' Compensation |
396058596 |
Workers' Compensation |
396062860 |
Workers' Compensation |
410299900 |
Workers' Compensation |
410406690 |
Workers' Compensation |
410417460 |
Workers' Compensation |
410729473 |
Workers' Compensation |
410881659 |
Workers' Compensation |
410963301 |
Workers' Compensation |
410986076 |
Workers' Compensation |
411232071 |
Workers' Compensation |
411353943 |
Workers' Compensation |
520976199 |
Workers' Compensation |
521050076 |
Workers' Compensation |
420111280 |
Workers' Compensation |
420223390 |
Workers' Compensation |
420234980 |
Workers' Compensation |
420245990 |
Workers' Compensation |
420301440 |
Workers' Compensation |
420594770 |
Workers' Compensation |
420618271 |
Workers' Compensation |
420645088 |
Workers' Compensation |
420645088 |
Workers' Compensation |
421015537 |
Workers' Compensation |
421019055 |
Workers' Compensation |
421234898 |
Workers' Compensation |
426054959 |
Workers' Compensation |
430613000 |
Workers' Compensation |
431037123 |
Workers' Compensation |
431139865 |
Workers' Compensation |
431245798 |
Workers' Compensation |
431249228 |
Workers' Compensation |
436028696 |
Workers' Compensation |
440194612 |
Workers' Compensation |
440237557 |
Workers' Compensation |
440307890 |
Workers' Compensation |
440648645 |
Workers' Compensation |
440652707 |
Workers' Compensation |
440666926 |
Workers' Compensation |
460368854 |
Workers' Compensation |
470159155 |
Workers' Compensation |
470355979 |
Workers' Compensation |
470360368 |
Workers' Compensation |
470444314 |
Workers' Compensation |
470490411 |
Workers' Compensation |
470498866 |
Workers' Compensation |
470574325 |
Workers' Compensation |
470698507 |
Workers' Compensation |
476022701 |
Workers' Compensation |
476024508 |
Workers' Compensation |
480470690 |
Workers' Compensation |
480921045 |
Workers' Compensation |
510098159 |
Workers' Compensation |
520266645 |
Workers' Compensation |
520403120 |
Workers' Compensation |
520515280 |
Workers' Compensation |
520616768 |
Workers' Compensation |
521137203 |
Workers' Compensation |
586020487 |
Workers' Compensation |
590733942 |
Workers' Compensation |
591027412 |
Workers' Compensation |
591320184 |
Workers' Compensation |
591847174 |
Workers' Compensation |
610904881 |
Workers' Compensation |
621101490 |
Workers' Compensation |
630598629 |
Workers' Compensation |
741280541 |
Workers' Compensation |
741296673 |
Workers' Compensation |
750620550 |
Workers' Compensation |
751444207 |
Workers' Compensation |
751670124 |
Workers' Compensation |
756013587 |
Workers' Compensation |
756013697 |
Workers' Compensation |
756017952 |
Workers' Compensation |
756020448 |
Workers' Compensation |
760154296 |
Workers' Compensation |
840513811 |
Workers' Compensation |
840583213 |
Workers' Compensation |
840982643 |
Workers' Compensation |
850165753 |
Workers' Compensation |
850277191 |
Workers' Compensation |
850282785 |
Workers' Compensation |
860274508 |
Workers' Compensation |
880119246 |
Workers' Compensation |
910341780 |
Workers' Compensation |
910449750 |
Workers' Compensation |
910895822 |
Workers' Compensation |
911115311 |
Workers' Compensation |
920040526 |
Workers' Compensation |
940781581 |
Workers' Compensation |
941032958 |
Workers' Compensation |
941390273 |
Workers' Compensation |
941517098 |
Workers' Compensation |
941610280 |
Workers' Compensation |
942532388 |
Workers' Compensation |
946078058 |
Workers' Compensation |
951077060 |
Workers' Compensation |
951078160 |
Workers' Compensation |
951429618 |
Workers' Compensation |
951479095 |
Workers' Compensation |
951542353 |
Workers' Compensation |
952371728 |
Workers' Compensation |
952575892 |
Workers' Compensation |
956016640 |
Workers' Compensation |
980032627 |
Workers' Compensation |
980033230 |
Workers' Compensation |
990041610 |
Workers' Compensation |
98914 |
CHAMPUS |
98915 |
CHAMPVA |
98911 |
Black Lung |
98919 |
Miscellaneous |
Blank, "000000000" |
Unknown |
. |
Missing |
Other Values |
|
.A |
Invalid |
Illinois (SEDD)
Illinois
|
(Valid beginning 2009 SASD and SEDD)
|
PAY1_X, PAY2_X, and PAY3_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
A |
Medicare |
1 |
Medicare |
B |
Medicaid |
2 |
Medicaid |
C |
Commercial |
3 |
Private Insurance |
D |
HMO |
E |
Self-Administered |
F |
Self Pay |
4 |
Self Pay |
- |
|
5 |
No charge |
H |
Other |
6 |
Other |
Blank |
Missing |
. |
Missing |
other |
|
.A |
Invalid |
Iowa (SID and SEDD)
In 2011 and 2012, the expected payer (PAYn and PAYn_X) was set to missing for hospitals with incorrectly reported payer data. The incorrect payer coding was identified by the Iowa Hospital Association.
Iowa
|
(Valid beginning in 2003 SID, SASD, SEDD)
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
1, 01 |
Medicare - Non-managed Care (Title 18) |
1 |
Medicare |
11 |
Medicare Managed Care (e.g. HMO, PPO) beginning 2008 |
2, 02 |
Medicaid - Non-managed Care (Title 19) (valid through 3/31/16) |
2 |
Medicaid |
12 |
Medicaid Managed Care (e.g. HMO, PPO, PCCM) (beginning 2008 - valid through 3/31/16) |
20 |
Medicaid - Fee for Service (valid beginning 4/1/16) |
21 |
Amerigroup Iowa, Inc. (valid beginning 4/1/16) |
22 |
AmeriHealth caritas Iowa, Inc. (valid beginning 4/1/16) |
23 |
UnitedHealthcare Plan of the River Valley, Inc. (valid beginning 4/1/16) |
25 |
Medicaid - Out of State (valid beginning 4/1/16) |
26 |
Iowa Total Care (vallid beginning 2019) |
6, 06 |
Blue Cross (e.g. Blue Cross Alliance Select, Blue Cross Unity Choice) |
3 |
Private Insurance |
7, 07 |
Commercial (private or group plans including HMO, PPO, ODS) |
8, 08 |
Self pay (The patient has no insurance, is ineligible for governmental assistance and is not a "no charge" patient.) |
4 |
Self-pay |
10 |
No Charge (The account has "$0.00" total charges and the patient is not billed for the admission, i.e. cancelled procedure, etc.) |
5 |
No charge |
3, 03 |
Iowa State Government (e.g. Mental Health State Papers, Iowa Cares, etc.) (valid through 3/31/16) |
6 |
Other |
4, 04 |
County/Local Government |
5, 05 |
Other Federal Government (e.g. Champus, Veterans, Title V, Railroad, Crippled Children, DOD/Tricare, Veteran's Affairs, Indian health services, Black Lung) |
9, 09 |
Workers Compensation |
Blank |
Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Iowa (SID)
Iowa
|
(Valid 1998-2002 SID)
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
01 |
Medicare (Title 18) |
1 |
Medicare |
11 |
Medicare Managed Care (Presently no predominant plans in Iowa) |
02 |
Medicaid (Title 19) |
2 |
Medicaid |
12 |
Medicaid Managed Care (e.g., Medipass, Heritage National, Care Choices, Principal Health Care) |
06 |
Blue Cross (e.g., Blue Cross Alliance Select should be recorded as PPO; Blue Cross Unity Choice should be recorded as HMO) |
3 |
Private Insurance |
07 |
Commercial (private or group plans other than HMO, PPO, ODS) |
13 |
HMO (e.g., Care Choices, Medical Associates Health Plan, Inc., Principal Health Care of Iowa, Heritage National Healthplan, Inc., John Deere Family Health Plan, Principal Health Care of Nebraska, United Healthcare of the Midlands, Unity Choice) |
14 |
PPO (e.g., Alliance Select, Healthcare Preferred, Plaines Health Network) |
15 |
Organized Delivery Systems (ODS) (e.g., SecureCare of Iowa) |
08 |
Self-pay (the patient has no insurance, is ineligible for governmental assistance and is not a "no charge" patient) |
4 |
Self-pay |
10 |
No charge |
5 |
No charge |
03 |
Other State (including State Papers) |
6 |
Other |
04 |
County |
05 |
CHAMPUS |
09 |
Workers Compensation |
Blank |
Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Iowa
|
(Valid from 1991-1997 SID)
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
01 |
Medicare (Title 18) |
1 |
Medicare |
02 |
Medicaid (Title 19) |
2 |
Medicaid |
06 |
Blue Cross (of Iowa, Western Iowa, or other state Blue Cross plans) |
3 |
Private Insurance |
08 |
Self-pay or relative |
4 |
Self-pay |
-- |
|
5 |
No charge |
09 |
Workers' Compensation |
6 |
Other |
03, 04, 05 |
Other state; county (including state papers); Other federal government (including CHAMPUS, Veterans, Title V, Railroad, Hill-Burton, Crippled Children, etc.) |
Blank |
|
. |
Missing |
Other Values |
|
.A |
Invalid |
Iowa
|
(Valid from 1988-1990 SID)
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
01 |
Medicare (Title 18) |
1 |
Medicare |
02 |
Medicaid (Title 19) |
2 |
Medicaid |
06 |
Blue Cross (of Iowa, Western Iowa, or other state Blue Cross plans) |
3 |
Private Insurance |
07 |
Commercial (private or group) |
08 |
Self-pay or relative |
4 |
Self-pay |
-- |
|
5 |
No charge |
09 |
Workers' Compensation |
6 |
Other |
03, 04, 05 |
Other state government; Other county government; Other federal government |
10 |
Other non-government |
Blank |
|
. |
Missing |
Other Values |
|
.A |
Invalid |
Indiana (SID and SEDD)
Starting in 2016, there may be inconsistent reporting of primary and secondary payer (PAY1 and PAY2) by hospitals.
Indiana
|
(Valid beginning in 2021 SASD, SEDD and 2022 SID)
|
PAY1_X, PAY2_X, PAY3_X
|
PAY1, PAY2, PAY3
|
Value
|
Description
|
Value
|
Description
|
01 |
Medicare |
1 |
Medicare |
02 |
Medicare Advantage |
03 |
Medicaid |
2 |
Medicaid |
04 |
Medicaid Managed Care |
05 |
Medicaid HIP plans |
06 |
Medicaid Out of State |
07 |
Anthem Commercial |
3 |
Private Insurance |
08 |
Other Commercial |
11 |
Self-pay |
4 |
Self-pay |
12 |
No Charge |
5 |
No Charge |
09 |
Workers Compensation |
6 |
Other |
10 |
Other Federal Government |
Blank |
Missing |
. |
Missing |
Other |
|
.A |
Invalid |
Indiana
|
(Valid beginning in 2008-2020 SASD, SEDD and Valid 2008-2021 SID)
|
PAY1_X and PAY2_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
01 |
Medicare |
1 |
Medicare |
02 |
Medicare Advantage |
03 |
Medicaid |
2 |
Medicaid |
04 |
Medicaid Managed Care |
05 |
Medicaid HIP plans |
06 |
Medicaid Out of State |
07 |
Anthem Commercial |
3 |
Private Insurance |
08 |
Other Commercial |
11 |
Self-pay |
4 |
Self-pay |
12 |
No Charge |
5 |
No Charge |
09 |
Workers Compensation |
6 |
Other |
10 |
Other Federal Government |
Blank |
Missing |
. |
Missing |
Other |
|
.A |
Invalid |
Indiana
|
(Valid 2003 - 2007 SID, SASD, SEDD)
|
PAY1_X and PAY2_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
1 |
Medicare |
1 |
Medicare |
2 |
Medicaid |
2 |
Medicaid |
4 |
Commercial Insurance |
3 |
Private Insurance |
5 |
Managed Care |
6 |
Self-pay |
4 |
Self-pay |
-- |
|
5 |
No charge |
3 |
Other/Government |
6 |
Other |
7 |
Other/Unknown |
Blank (PAY1_X only), Blank; 0 (PAY2_X only) |
Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Kansas (SID and SEDD)
Kansas
|
(Valid beginning in 2017 SID, SASD, SEDD)
|
PAY1_X and PAY2_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
001, 1, 01 |
Medicare |
1 |
Medicare |
101 |
Medicare Managed Care |
002, 2, 02 |
Medicaid |
2 |
Medicaid |
102 |
Medicaid Managed Care |
103 |
HealthWave/ Health Connect Managed Care - Kansas' State Children's Health Insurance Program (SCHIP) |
004, 4, 04 |
Blue Cross/Blue Shield |
3 |
Private Insurance |
007, 7, 07 |
Commercial/Private |
104 |
Blue Cross/Blue Shield Managed Care |
107 |
All Commercial Payers Managed Care |
006, 6, 06 |
Self-pay |
4 |
Self-pay |
008, 8 |
Charity/No Charge |
5 |
No charge |
005, 5,05 |
Workers Compensation |
6 |
Other |
009, 9, 09 |
Other Government |
010, 10 |
Champus |
011, 11 |
Other |
105 |
Workers Compensation Managed Care |
109 |
Other Government Managed Care (not Champus) |
110 |
Champus Managed Care |
111 |
Other Managed Care |
Blank, 00, 000 |
Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Kansas
|
(Valid 2003-2016 SID, SASD, SEDD)
|
PAY1_X and PAY2_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
001, 1, 01 |
Medicare |
1 |
Medicare |
101 |
Medicare Managed Care |
002, 2, 02 |
Medicaid |
2 |
Medicaid |
102 |
Medicaid Managed Care |
004, 4, 04 |
Blue Cross/Blue Shield |
3 |
Private Insurance |
007, 7, 07 |
Commercial/Private |
104 |
Blue Cross/Blue Shield Managed Care |
107 |
All Commercial Payers Managed Care |
006, 6, 06 |
Self-pay |
4 |
Self-pay |
008, 8 |
Charity/No Charge |
5 |
No charge |
005, 5,05 |
Workers Compensation |
6 |
Other |
009, 9, 09 |
Other Government |
010, 10 |
Champus |
011, 11 |
Other |
103 |
HealthWave/ Health Connect Managed Care - Kansas' State Children's Health Insurance Program (SCHIP) |
105 |
Workers Compensation Managed Care |
109 |
Other Government Managed Care (not Champus) |
110 |
Champus Managed Care |
111 |
Other Managed Care |
Blank, 00, 000 |
Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Kansas (SID)
Kansas
|
(Valid 1993-2002 SID)
|
PAY1_X and PAY2_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
1 |
Medicare |
1 |
Medicare |
2 |
Medicaid |
2 |
Medicaid |
3 |
Blue Cross |
3 |
Private Insurance |
4 |
Commercial |
5 |
Self-pay |
4 |
Self-pay |
-- |
|
5 |
No charge |
6 |
Other |
6 |
Other |
Blank |
Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Separate information on HMO and PPO providers is not provided.
|
Kentucky (SID and SEDD)
Kentucky
|
(Valid beginning 2015)
|
PAY1_X, PAY2_X, PAY3_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
98910 |
Medicare (excluding Medicare Managed Care) |
1 |
Medicare |
98945 |
Medicare Managed Care |
98916 |
In State Medicaid |
2 |
Medicaid |
98917 |
Out of State Medicaid |
98929 |
Humana Medicaid Managed Care |
98940 |
Passport Medicaid Managed Care |
98943 |
Medicaid MCO Pending (effective 10/1/18) |
98944 |
United Healthcare Medicaid Managed Care (effective 2021) |
98970 |
Coventry Cares of Kentucky Medicaid Managed Care (effective prior to 10/1/18) |
98970 |
Aetna Better Health of KY Medicaid Managed Care (effective 10/1/18) |
98980 |
Wellcare of Kentucky Medicaid Managed Care |
98990 |
Kentucky Spirit Medicaid Managed Care |
98991 |
BCBS Medicaid Managed Care (effective prior to 10/1/18) |
98991 |
Anthem Medicaid Managed Care (effective 10/1/18) |
98901 |
Commercial - Aetna Health HMO Plan (effective 10/1/18) |
3 |
Private insurance |
98902 |
Commercial - Aetna Health PPO Plan (effective 10/1/18) |
98903 |
Commercial - Humana POS Plan (effective 10/1/18) |
98904 |
Commercial - Humana HMO Plan (effective 10/1/18) |
98905 |
Commercial - Humana PPO Plan (effective 10/1/18) |
98906 |
Commercial - Anthem Health Plans of KY POS Plan (effective 10/1/18) |
98907 |
Commercial - Anthem Health Plans of KY FFS Plan (effective 10/1/18) |
98908 |
Commercial - Anthem Health Plans of KY HMO Plan (effective 10/1/18) |
98920 |
Other Commercial Insurance (HMO, PPO, Alliance) (effective 1/1/15) |
98921 |
Commercial - Indemnity |
98922 |
Commercial - HMO |
98923 |
Commercial - PPO |
98924 |
Commercial - Other |
98926 |
Auto Insurance |
98930 |
Other Self Administered Plan |
98931 |
Commercial - United Healthcare POS Plan (effective 10/1/18) |
98932 |
Commercial - United Healthcare FFS Plan (effective 10/1/18) |
98933 |
Commercial - United Healthcare PPO Plan (effective 10/1/18) |
98934 |
Commercial - United Healthcare of KY POS Plan (effective 10/1/18) |
98935 |
Commercial - United Healthcare of KY HMO Plan (effective 10/1/18) |
98936 |
Commercial - United Healthcare of Ohio POS Plan (effective 10/1/18) |
98937 |
Commercial - Cigna Health & Life FFS Plan (effective 10/1/18) |
98938 |
Commercial - Cigna Health & Life PPO Pla (effective 10/1/18) |
98939 |
Commercial - Nippon Life Insurance Company of America (effective 10/1/18) |
98941 |
Commercial - Caresource Kentucky HMO Plan (effective 10/1/18) |
98942 |
Commercial - Wellcare Health Plans of KY HMO Plan (effective 10/1/18) |
98960 |
Blue Cross Blue Shield (effective prior to 10/1/18) |
98960 |
Commercial - Anthem Health Plans of KY PPO Plan (effective 10/1/18) |
98992 |
Wellcare Health Commercial Plan (effective 1/1/15) |
98993 |
Care Source KY Commercial Plan (effective 1/1/15) |
98994 |
Kentucky Health Cooperative Health Plan |
98918 |
Self Pay |
4 |
Self-pay |
98912 |
Charity defined according to the hospital policy at time of discharge |
5 |
No charge |
98913 |
Hill Burton Free Care |
00000 |
Other |
6 |
Other |
98911 |
Black Lung |
98914 |
Tricare (Champus) |
98915 |
ChampVA |
98925 |
VA |
98927 |
Other Facility |
98928 |
Pending Insurance |
98950 |
Workers' Compensation |
Blank |
Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Kentucky
|
(Valid 2011 - 2014)
|
PAY1_X, PAY2_X, PAY3_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
C |
Medicare |
1 |
Medicare |
R |
Medicare Managed Care |
D |
Medicaid |
2 |
Medicaid |
P |
Passport Medicaid Managed Care (beginning with 2003 data) |
Q |
Kentucky Spirit Medicaid Managed Care |
T |
Coventry Cares of KY Medicaid Managed Care |
U |
WellCare of Kentucky Medicaid Managed Care |
X |
BCBS Medicaid Managed Care (starting in 2014) |
Z |
Humana Medicaid Managed Care |
F |
Commercial - Unknown (Prior to 2011) |
3 |
Private insurance |
G |
Commercial - Unknown (Prior to 2011) |
J |
Commercial - Indemnity |
K |
Commercial - Preferred Provider |
L |
Commercial - HMO |
M |
Commercial - Other Managed Care (Prior to 2011) |
N |
Commercial - Mix |
A |
Self Pay |
4 |
Self-pay |
S |
Charity |
5 |
No charge |
B |
Workers' Compensation |
6 |
Other |
E |
Other federal programs |
H |
Champus |
I |
Other |
O |
Other Faciity Direct Bill |
V |
VA |
W |
Auto Insurance |
Y |
Pending Insurance |
Blank |
Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Kentucky
|
(Valid 2009 - SID, SASD, SEDD)
|
PAY1_X, PAY2_X, PAY3_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
98910 |
Medicare (Excluding Medicare Managed Care) |
1 |
Medicare |
98945 |
Medicare Managed Care |
98916 |
In State Medicaid (Excluding Passport) |
2 |
Medicaid |
98917 |
Out of State Medicaid |
98940 |
Passport Medicaid Managed Care |
98921 |
Commercial - Indemnity |
3 |
Private insurance |
98923 |
Commercial - PPO |
98922 |
Commercial - HMO |
98924 |
Commercial - Other |
98930 |
Other Self Administered Plan |
98918 |
Self Pay |
4 |
Self-pay |
98912 |
Charity |
5 |
No charge |
98913 |
Hill Burton Free Care |
98911 |
Black Lung |
6 |
Other |
98950 |
Workers' Compensation |
98914 |
Champus |
98915 |
Champva |
00000 |
Other |
Blank |
Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Kentucky
|
(Valid prior to 2009 - SID, SASD, SEDD)
|
PAY1_X, PAY2_X, PAY3_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
C |
Medicare |
1 |
Medicare |
D |
Medicaid |
2 |
Medicaid |
R |
Medicare Managed Care (incorrectly mapped to Medicaid) |
P |
Passport Medicaid Managed Care (beginning with 2003 data) |
F |
Commercial - Unknown |
3 |
Private insurance |
G |
Commercial - Unknown |
J |
Commercial - Indemnity |
K |
Commercial - Preferred Provider |
L |
Commercial - HMO |
M |
Commercial - Managed Care |
N |
Commercial - Mix |
A |
Self Pay |
4 |
Self-pay |
S |
Charity |
5 |
No charge |
B |
Workers' Compensation |
6 |
Other |
E |
Other Federal programs |
H |
Champus |
I |
Other |
Blank |
Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Maine (SID and SEDD)
Maine
|
(Valid beginning in 1999 - SID, Valid beginning in 2006 - SASD, SEDD)
|
PAY1_X, PAY2_X, PAY3_X
|
PAY1, PAY 2
|
Value
|
Description
|
Value
|
Description
|
01 |
Medicare |
1 |
Medicare |
12 |
MEDICARE ADVANTAGE |
02 |
Medicaid |
2 |
Medicaid |
05 |
Blue Cross (Valid prior to 2015) |
3 |
Private insurance |
06 |
Other commercial carriers |
10 |
HMO/PPO (valid prior to 2011) |
08 |
Self-pay |
4 |
Self-pay |
07 |
Charity |
5 |
No charge |
03 |
U.S. Title V (Valid 2003 and before) |
6 |
Other |
04 |
CHAMPUS/USVA |
09 |
Worker's Compensation |
11 |
Unknown (Valid prior to 2011), Other (Beginning 2015) |
00, 99, blank |
Missing |
. |
Missing |
other |
|
.A |
Invalid |
Maryland (SID and SEDD)
Maryland
|
(Valid beginning with 2021 Q3 SID, SASD, SEDD)
|
PAY1_X, PAY2_X, and PAY3_X
|
PAY1, PAY2, and PAY3
|
Value
|
Description
|
Value
|
Description
|
01 |
Medicare FFS |
1 |
Medicare |
15 |
Medicare Advantage Managed Care (payer specified in PAYER1_X/PAYER2_X) |
02 |
MD Medicaid FFS only and Pending MD Medicaid |
2 |
Medicaid |
14 |
MD Medicaid MCO (payer specified in PAYER1_X/PAYER2_X) |
05 |
Commercial Insurance (HMO/POS/PPO/PPN/TPA) |
3 |
Private Insurance |
19 |
Behavioral Health Plan |
06 |
Other government program |
6 |
Other |
07 |
Worker's Compensation |
10 |
Other |
18 |
International (beginning 7/1/2014) |
77, 98, 99 |
Unknown |
. |
Missing |
Blank |
Missing |
27, 29, 37, 67 |
Unknown/invalid values |
.A |
Invalid |
Any values not documented by the data source |
Maryland
|
(Valid beginning in 2017-2021 Q2 SID, SASD, SEDD)
|
PAY1_X and PAY2_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
01 |
Medicare FFS |
1 |
Medicare |
15 |
Medicare Managed Care (payer specified in PAYER1_X/PAYER2_X) |
02 |
MD Medicaid FFS only and Pending MD Medicaid |
2 |
Medicaid |
14 |
MD Medicaid HMO (payer specified in PAYER1_X/PAYER2_X) |
04 |
Blue Cross of Maryland |
3 |
Private Insurance |
16 |
Blue Cross of the National Capital Area |
17 |
Blue Cross (other state) |
05 |
Commercial Insurance, Other Than Blue Cross |
12 |
HMO (payer specified in PAYER1_X/ PAYER2_X) |
08 |
Self-pay |
4 |
Self-pay |
09 |
Charity - no charge |
5 |
No charge |
11 |
Donor |
03 |
Title V |
6 |
Other |
06 |
Other government program, including out-of-state (non-MD) Medicaid |
07 |
Worker's Compensation |
10 |
Other |
18 |
International (beginning 7/1/14) |
98, 99 |
Unknown |
. |
Missing |
Blank |
Missing |
13 |
Do not use |
.A |
Invalid |
27, 29, 37, 67, 77 |
Unknown/invalid values |
Any values not documented by the data source |
Maryland
|
(Valid beginning in 1998-2016 SID, SASD, SEDD)
|
PAY1_X and PAY2_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
01 |
Medicare FFS |
1 |
Medicare |
15 |
Medicare Managed Care (payer specified in PAYER1_X/PAYER2_X) |
02 |
MD Medicaid FFS only and Pending MD Medicaid |
2 |
Medicaid |
14 |
MD Medicaid HMO (payer specified in PAYER1_X/PAYER2_X) |
04 |
Blue Cross of Maryland |
3 |
Private Insurance |
16 |
Blue Cross of the National Capital Area |
17 |
Blue Cross (other state) |
05 |
Commercial Insurance, Other Than Blue Cross |
12 |
HMO (payer specified in PAYER1_X/ PAYER2_X) |
08 |
Self-pay |
4 |
Self-pay |
09 |
Charity - no charge |
5 |
No charge |
03 |
Title V |
6 |
Other |
06 |
Other government program, including out-of-state (non-MD) Medicaid |
07 |
Worker's Compensation |
10 |
Other |
11 |
Donor |
18 |
International (beginning 7/1/14) |
98, 99 |
Unknown |
. |
Missing |
Blank |
Missing |
13 |
Do not use |
.A |
Invalid |
27, 29, 37, 67, 77 |
Unknown/invalid values |
Any values not documented by the data source |
Maryland
|
(Valid from 1996-1997 SID, SASD)
|
PAY1_X and PAY2_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
1, 15 |
Medicare; Medicare HMO |
1 |
Medicare |
2,14 |
Medicaid; Medicaid HMO |
2 |
Medicaid |
4, 16, 17 |
Blue Cross; Blue Cross NCA; Blue Cross - other State |
3 |
Private Insurance |
5 |
Commercial Insurance |
12 |
HMO |
8 |
Self-pay |
4 |
Self-pay |
9 |
Charity |
5 |
No charge |
3 |
Title V |
6 |
Other |
7 |
Workers' Compensation |
6 |
Other government program |
10, 11 |
Other; Donor |
99, blank |
Primary Payer Unknown; missing |
. |
Missing |
99, 77, blank |
Secondary Payer Unknown; not applicable; missing |
. |
Missing |
Other Values |
|
.A |
Invalid |
Maryland
|
(Valid from 1993-1995 SID, SASD)
|
PAY1_X and PAY2_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
1 |
Medicare |
1 |
Medicare |
2, 13,14 |
Medicaid; Medicaid (state only); Medicaid HMO |
2 |
Medicaid |
4 |
Blue Cross |
3 |
Private Insurance |
5 |
Commercial Insurance |
12 |
HMO |
8 |
Self-pay |
4 |
Self-pay |
9 |
Charity |
5 |
No charge |
3 |
Title V |
6 |
Other |
7 |
Workers' Compensation |
6 |
Other government program |
10, 11 |
Other; Donor |
99, blank |
Primary Payer Unknown; missing |
. |
Missing |
99, 77, blank |
Secondary Payer Unknown; not applicable; missing |
. |
Missing |
Other Values |
|
.A |
Invalid |
Maryland
|
(Valid from 1990-1992 SID, SASD)
|
PAY1_X and PAY2_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
1 |
Medicare |
1 |
Medicare |
2, 13,14 |
Medicaid; Medicaid (state only); Medicaid HMO |
2 |
Medicaid |
4 |
Blue Cross |
3 |
Private Insurance |
5 |
Commercial Insurance |
12 |
HMO |
8 |
Self-pay |
4 |
Self-pay |
9 |
Charity |
5 |
No charge |
3 |
Title V |
6 |
Other |
7 |
Workers' Compensation |
6 |
Other government program |
10, 11 |
Other; Donor |
99, blank |
Unknown; missing |
. |
Missing |
Other Values |
|
.A |
Invalid |
Massachusetts (SEDD)
Massachusetts
|
PAY1_X and PAY2_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
3 |
Medicare |
1 |
Medicare |
F |
Medicare Managed Care (includes Medicare Advantage) |
S |
Senior Care Options/Integrated Care Organization (Effective 10/01/2020) |
2 |
Medicaid |
1 |
Medicare |
4 |
Medicaid |
A |
Medicaid Accountable Care Organization (Effective 10/01/2020) |
6 |
Blue Cross (valid prior to 10/01/2020) |
3 |
Private Insurance |
C |
Blue Cross Managed Care (valid prior to 10/01/2020) |
C |
Commercial Accountable Care Organization (Effective 10/01/2020) |
7 |
Other Commercial Insurance not listed elsewhere |
D |
Commercial Managed Care |
8 |
HMO |
E |
PPO and Other Managed Care not listed elsewhere |
J |
Point of Service Plan |
K |
Exclusive Provider Plan |
T |
Auto Insurance |
Z |
Dental Plans |
1 |
Self-pay |
4 |
Self-pay |
9 |
Free care (No charge,charity care) |
5 |
No charge |
H |
Health Safety Net (Beginning in 2009) |
6 |
Other |
2 |
Worker's Compensation |
5 |
Other government payment |
0 |
Other non-managed care plans |
Q |
Commonwealth Care Plans(CommCare) |
N, Blank |
None, Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
In the first version of the 2009 MA SEDD (dated prior to
August 2012), 4.8% of the SEDD discharges had the data
element for expected payer (PAY1 or PAY2) miscoded. These
records are concentrated in the fourth quarter of the year
(DQTR=4). The
provided
file includes the corrected mapping of payer codes.
Most of the affect records (3.6%) had the payer code set
to invalid when it should have been set to private
insurance, other insurance, or Medicare. Another 0.9%
had the payer code set to private, Medicare, or Medicaid,
when it should be coded as invalid. A corrected version
of the 2009 MA SEDD was created in August 2012.
Massachusetts
|
(Valid beginning 2012 through 2019 - SEDD)
|
PAY1_X and PAY2_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
121 |
Medicare |
1 |
Medicare |
125 |
Medicare HMO - Fallon Senior Plan |
127 |
Medicare HMO - Health New England Medicare Wrap |
128 |
Medicare HMO - HMO Blue for Seniors |
129 |
Medicare HMO - Kaiser Medicare Plus Plan |
131 |
Medicare HMO - Pilgrim Enhance 65 |
133 |
Medicare HMO -Tufts Medicare Supplement (TMS) |
134 |
Medicare HMO - Other (not listed elsewhere) |
135 |
Out-Of-State Medicare |
168 |
Advantra Freedom |
173 |
Aetna Medicare Open |
180 |
Fresenius Medical Care Health Plan (Medicare Advantage Plan) |
210 |
Medicare HMO - Pilgrim Preferred 65 |
211 |
Medicare HMO - Neighborhood Health Plan Senior Health Plus |
212 |
Medicare HMO - Healthsource CMHC Central Care Supplement |
213 |
Medicare HMO - Medicare Complete Plans offered by SecureHorizons |
214 |
Medicare HMO - Harvard Pilgrim Health Plan - Medicare Enhance |
215 |
Tufts Medicare HMO - Medicare Preferred |
216 |
Medicare Special Needs Plan - Commonwealth Care Alliance |
217 |
Medicare Special Needs Plan - Fallon Community Health Plan |
218 |
Medicare Special Needs Plan - Senior Whole Health |
219 |
Medicare Special Needs Plan - United Health Group Evercare Mass. SCO and Evercare Plan IP |
220 |
Medicare HMO - Blue Care 65 |
221 |
Medicare HMO - Harvard Community Health Plan 65 |
223 |
Medicare HMO - Harvard Pilgrim Health Care of New England Care Plus |
224 |
Medicare HMO - Tufts Secure Horizons |
225 |
Medicare HMO - US Healthcare |
230 |
Medicare HMO - HCHP First Seniority Freedom |
231 |
Medicare HMO - Pilgrim Prime |
232 |
Medicare HMO - Senior Care Direct |
233 |
Medicare HMO - Senior Care Plus |
234 |
Medicare HMO - Managed Blue for Seniors |
245 |
Trail Blazer Health Enterprises, LLC |
252 |
Health New England (HNE) Medicare Advantage Plan |
253 |
Blue Medicare PFFS |
254 |
Cigna Medicare Access Plans |
255 |
Health Net Pearl |
256 |
Humana Gold PFFS |
257 |
Today's Options Premier from Universal American |
258 |
Unicare Security Choice |
273 |
MassHealth Senior Care Options |
275 |
Medicare SCO - NaviCare (HMO) |
276 |
Medicare SCO - Tufts Senior Care Options |
277 |
Medicare SCO - United Health Care |
278 |
Medicare SCO - Commonwealth Care Alliance |
279 |
Medicare One Care - Fallon Total Care |
280 |
Medicare One Care - Network Health |
281 |
Medicare One Care - Commonwealth Care Alliance |
824 |
Principal Plan Dental |
912 |
Beacon Health Partners (effective 10/01/2020) |
103 |
Medicaid (includes MassHealth) |
2 |
Medicaid |
104 |
Medicaid Managed Care - Primary Care Clinician (PCC) |
107 |
Medicaid Managed Care - Community Health Plan |
108 |
Medicaid Managed Care - Fallon Community Health Plan |
110 |
Medicaid Managed Care - Health New England |
111 |
Medicaid Managed Care - HMO Blue |
113 |
Medicaid Managed Care - Neighborhood Health Plan |
114 |
Medicaid Managed Care - United Health Plans of NE |
115 |
Medicaid Managed Care - Pilgrim Health Care |
116 |
Medicaid Managed Care Tufts Associated Health Plan |
118 |
Medicaid Mental Health & Substance Abuse Plan - Mass Behavioral Health Partnership |
119 |
Medicaid Managed Care Other (not listed elsewhere) |
120 |
Out-Of-State Medicaid (valid beginning in 2016) |
207 |
Network Health (Cambridge Health Alliance MCD Program) |
208 |
HealthNet (Boston Medical Center MCD Program) |
273 |
MassHealth Senior Care Options |
274 |
Medicaid Managed Care - Network Health |
282 |
BMC MassHealth CarePlus |
283 |
Fallon MassHealth CarePlus |
284 |
NHP MassHealth CarePlus |
285 |
Network Health MassHealth CarePlus |
286 |
Celticare MassHealth CarePlus |
287 |
MassHealth CarePlus |
311 |
Medicaid: Other ACO |
312 |
Medicaid: Fallon 365 Care (ACO) |
313 |
Medicaid: Be Healthy Partnership with Health New England (ACO) |
314 |
Medicaid: Berkshire Fallon Health Collaborative (ACO) |
315 |
Medicaid: BMC HealthNet Plan Community Alliance (ACO) |
316 |
Medicaid: BMC HealthNet Plan Mercy Alliance (ACO) |
317 |
Medicaid: BMC HealthNet Plan Signature Alliance (ACO) |
318 |
Medicaid: BMC HealthNet Plan Southcoast Alliance (ACO) |
320 |
Medicaid: Community Care Cooperative (ACO) |
321 |
Medicaid: My Care Family with AllWays Health Plan (ACO) |
322 |
Medicaid: Partners Healthcare Choice (ACO) |
323 |
Medicaid: Steward Health Choice (ACO) |
324 |
Medicaid: Tufts Health Together with Atrius Health (ACO) |
325 |
Medicaid: Tufts Health Together with BIDCO (ACO) |
326 |
Medicaid: Tufts Health Together with Boston Children's (ACO) |
327 |
Medicaid: Tufts Health Together with CHA (ACO) |
328 |
Medicaid: Wellforce Care Plan (ACO) |
816 |
DentaQuest MassHealth |
821 |
Guardian Dental |
1 |
Harvard Community Health Plan |
3 |
Private |
2 |
Bay State - a product of HMO Blue |
3 |
Network Blue (PPO) |
4 |
Fallon Community Health Plan |
7 or 07 |
Tufts Associated Health Plan |
8 |
Pilgrim Health Care |
9 |
United Health Plan of New England (Ocean State) |
10 |
Pilgrim Advantage - PPO |
11 |
Blue Care Elect |
13 |
Community Health Plan Options (New York) |
19 |
Matthew Thornton |
21 |
Commonwealth PPO |
22 |
Aetna Open Choice PPO |
23 |
Guardian Life Insurance Company PPO |
24 |
Health New England Inc. |
25 |
Pioneer Plan |
28 |
Great West Life PPO |
30 |
CIGNA (Indemnity) |
31 |
One Health Plan HMO (Great West Life) |
35 |
United Healthcare Insurance Company - HMO(New for 1997) |
36 |
United Healthcare Insurance Company - PPO (new for 1997) |
37 |
HCHP - Pilgrim HMO (integrated product) |
38 |
Health New England Select (self-funded) |
40 |
Kaiser Foundation |
42 |
ConnectiCare of Massachusetts |
46 |
Blue ChiP (BCBS Rhode Island) |
47 |
Neighborhood Health Plan |
48 |
US Healthcare |
49 |
Healthsource CMHC Plus PPO |
51 |
Aetna Life Insurance |
55 |
Guardian Life Insurance |
56 |
Hartford L & A Insurance |
57 |
John Hancock Life Insurance |
62 |
Mutual of Omaha Insurance |
70 |
Union Labor LIfe Insurance |
71 |
ADMAR |
74 |
United Healthcare Insurance Company |
75 |
Prudential Healthcare HMO |
77 |
Options for Healthcare PPO |
79 |
Pioneer Health Care PPO |
80 |
Tufts Total Health Plan PPO |
81 |
HMO Blue |
82 |
John Hancock Preferred |
84 |
Private Healthcare Systems PPO |
85 |
Liberty Mutal |
87 |
CIGNA PPO |
88 |
Freedom Care |
89 |
Great West/NE Care |
93 |
Psychological Health Plan |
95 |
Pilgrim Select - PPO |
96 |
Metrahealth (United Health Care of NE) |
97 |
Unicare |
99 or 099 |
Other POS (not listed elsewhere) |
102 |
Wausau Insurance Company |
136 |
BCBS Medex |
137 |
AARP/Medigap Supplement |
138 |
Banker's Life and Casualty Insurance |
140 |
Combined Insurance Company of America ** |
141 |
Other Medigap (not listed elsewhere) |
142 |
Blue Cross Indemnity |
147 |
Other Commercial (not listed elsewhere) |
148 |
Other HMO (not listed elsewhere) |
149 |
PPO and Other Managed Care (not listed elsewhere) |
154 |
BCBS Other (not listed elsewhere) |
155 |
Blue Cross Managed Care Other (not listed elsewhere) |
156 |
Out of State BCBS |
157 |
Metrahealth - PPO (United Health Care of NE) |
158 |
Metrahealth - HMO (United Health Care of NE) |
160 |
Blue Choice |
161 |
Aetna Managed Choice POS |
162 |
Great West Life POS |
163 |
United Healthcare Insurance Company - POS(New for 1997) |
166 |
Private Healthcare Systems POS |
167 |
Fallon POS |
171 |
CIGNA POS |
174 |
Aetna Health Inc. - Quality POS |
175 |
Aetna Health Inc - HMO |
176 |
Carelink (CIGNA & Tufts) |
177 |
Chesapeake Life Insurance Company |
179 |
First Health Life and Health Insurance Company |
182 |
Unicare Preferred Plus Managed Access EPO |
184 |
Private Healthcare Systems EPO |
185 |
Connecticut General Life - Indemnity |
186 |
Connecticut General Life - POS |
187 |
Connecticut General Life - PPO |
188 |
Fallon Flex POS |
189 |
Fallon Major Medical - Indemnity |
190 |
Fallon Preferred Care - PPO |
191 |
Genworth Preferred PPO |
192 |
Guarantee Trust Life Insurance Company - PPO |
193 |
Harvard Pilgrim - Indemnity |
194 |
Harvard Pilgrim - POS |
195 |
Harvard Pilgrim - PPO |
196 |
Harvard Pilgrim Health Care, Inc. (HMO) |
197 |
Health Insurance Plan of New York (HIP) |
198 |
John Alden Life Insurance Company |
199 |
Other EPO (not listed elsewhere) |
200 |
Hartford Life Insurance Co. |
201 |
Mutual of Omaha |
204 |
Christian Brothers Employee |
205 |
Health New England Select Premier PPO |
206 |
Health New England Guaranteed Issue - Individual Plans |
209 |
Mid-West National Life Insurance Company of Tennessee |
226 |
United Health Care of New England, Inc. |
227 |
Northeast Health Direct - PPO |
228 |
Oxford Health Plans |
229 |
Professional Insurance Company (Indemnity) |
235 |
Trustmark Life Insurance Company |
236 |
Tufts Health Maintenance Organization, Inc. (TAHMO) |
237 |
Tufts Insurance Company PPO |
238 |
Tufts Associated Health Maintenance Organization, Inc. PPO |
239 |
Tufts Associated Health Maintenance Organization, Inc. POS Plan |
240 |
Unicare PPO |
241 |
Union Security Insurance Company |
242 |
Wellcare Health Plans, Inc. |
243 |
Pioneer Health Network |
244 |
Tufts Medicare Complement (TMC) |
246 |
Preferred Blue PPO |
247 |
Humana Insurance Company |
248 |
Mail Handlers Benefit Plan |
249 |
MEGA Life and Health Insurance Company |
250 |
CIGNA HMO |
251 |
Healthsource CMHC HMO |
259 |
Celticare Health Plan of Massachusetts / HMO Plans (includes Celticare Premier, Solution, Saver, and Young Adults with or without RX) |
270 |
UniCare Preferred Plus PPO |
272 |
Auto Insurance |
295 |
Meritain |
310 |
Other: Commercial ACO Plan |
800 |
Aetna Dental |
801 |
Aflac |
802 |
AllState |
803 |
Altus Dental |
804 |
Ameritas Life Insurance Corp |
805 |
Anthem Blue Cross Blue Shield |
806 |
Assurant |
807 |
Blue Cross Blue Shield of MA |
808 |
Blue Cross Blue Shield of RI |
810 |
Cigna Dental |
811 |
Creative PLan Dental Administrators |
812 |
Delta Dental of MA |
813 |
Delta Dental - Other |
814 |
Delta Dental of New York |
817 |
DentaQuest Senior Whole Heatlh |
818 |
EverCare Dental |
819 |
Fallon Health Plus |
820 |
Great West Dental |
822 |
Harvard Pilgrim Health Care |
823 |
MetLife Dental |
825 |
Unicare Dental |
827 |
United HealthCare: Dental |
828 |
Alicare |
829 |
Adventist Risk Management INC |
830 |
Blue Cross Blue Shield of Texas |
831 |
Brokers National LIfe Insurance |
832 |
Cba Blue Dental |
833 |
Chesterfield Resources |
834 |
Companion Life insurance |
835 |
Dental Health Alliance |
836 |
EBS Benefit Solutions |
837 |
Empire Blue Cross |
838 |
Excellus Blue Cross |
839 |
Fortis |
840 |
GEHA Connection Dental |
841 |
GHI |
842 |
Lincoln Financial Group |
843 |
London Health Administrators |
844 |
Midwest Life Insurance |
845 |
Premier Access Dental Plans |
846 |
Sentry Life Insurance |
847 |
Sonoco |
848 |
Sun Life Dental Benefits |
849 |
Symetra Life Insurance Company |
851 |
Dentemax Insurance |
901 |
Other Commercial Managed Care (not listed elsewhere) |
910 |
Allways Health Partners (effective 10/01/2020) |
911 |
Anthem (effective 10/01/2020) |
913 |
Health Plans Inc. (effective 10/01/2020) |
914 |
Insurance Programmers (effective 10/01/2020) |
915 |
Key Benefit (effective 10/01/2020) |
916 |
Lifetime Benefit Solutions (effective 10/01/2020) |
917 |
Nationwide (effective 10/01/2020) |
918 |
QCC Insurance Company (effective 10/01/2020) |
919 |
State Farm (effective 10/01/2020) |
920 |
UMR Inc. (effective 10/01/2020) |
145 |
Self-Pay |
4 |
Self-pay |
143 |
Free Care |
5 |
No charge |
990 |
Free Care - Co-pay, deductible or co-insurance (when billing for free care services use #143) |
996 |
Charity Care |
26 |
CHAMPUS/TriCare (effective 10/01/2020) |
6 |
Other |
98 |
Healthy Start |
120 |
Out-Of-State Medicaid (valid prior to 2016) |
144 |
Other Government |
146 |
Worker's Compensation |
150 |
Other Non-Managed Care (not listed elsewhere) |
151 |
CHAMPUS |
152 |
Foundation |
153 |
Grant |
178 |
Children's Medical Security Plan (CMSP) |
288 |
Boston Medical Center HealthNet ConnectorCare |
289 |
CeltiCareConnectorCare |
290 |
Fallon ConnectorCare |
291 |
Health New England ConnectorCare |
292 |
Minuteman Health ConnectorCare |
293 |
Neighborhood Health ConnectorCare |
294 |
Network Health ConnectorCare |
296 |
Commonwealth Care Alliance (effective 10/01/2020) |
300 |
CommCare: BMC HealthNet Plan/Commonwealth Care - General Classification (For use only when no specific level for this plan can be identified) |
301 |
CommCare: BMC HealthNet Plan/Commonwealth Care - Plan Type I |
302 |
CommCare: BMC HealthNet Plan/Commonwealth Care - Plan Type II |
303 |
CommCare: BMC HealthNet Plan/Commonwealth Care - Plan Type III |
400 |
CommCare: Cambridge Network Health Forward - General Classification (For use only when no specific level for this plan can be identified) |
401 |
CommCare: Cambridge Network Health Forward - Plan Type I |
402 |
CommCare: Cambridge Network Health Forward - Plan Type II |
403 |
CommCare: Cambridge Network Health Forward - Plan Type III |
500 |
CommCare: Fallon Community Health Care: Commonwealth Care FCHP Direct Care - General Classification (For use only when no specific level for this plan can be identified) |
501 |
CommCare: Fallon Community Health Care: Commonwealth Care FCHP Direct Care - Plan 1 (Group No. 4445077) |
502 |
CommCare: Fallon Community Health Care: Commonwealth Care FCHP Direct Care - Plan 2 (Group No. 4455220) |
503 |
CommCare: Fallon Community Health Care: Commonwealth Care FCHP Direct Care - Plan 3 (Group No. 4455221) |
600 |
CommCare: Neighborhood Health Plan- General Classification (For use only when no specific level for this plan can be identified) |
601 |
CommCare: Neighborhood Health Plan - NHP Commonwealth Care Plan - Plan Type I (9CC1) |
602 |
CommCare: Neighborhood Health Plan - NHP Commonwealth Care Plan - Plan Type II (9CC2) |
603 |
CommCare: Neighborhood Health Plan - NHP Commonwealth Care Plan - Plan Type III (9CC3) |
700 |
CommCare: Celticare Health Plan of Massachusetts / Commonwealth Care - General Classification |
701 |
CommCare: Celticare Health Plan of Massachusetts / Commonwealth Care - Plan 1 |
702 |
CommCare: Celticare Health Plan of Massachusetts / Commonwealth Care - Plan 2 |
703 |
CommCare: Celticare Health Plan of Massachusetts / Commonwealth Care - Plan 3 |
704 |
CommCare: Celticare Health Plan of Massachusetts / Commonwealth Care Bridge Program |
809 |
Children's Medical Security |
815 |
DentaQuest Commonwealth Care |
826 |
United Concordia |
850 |
Tricare Dental |
903 |
Unlisted International Source |
905 |
Other Connector Care Plan (not listed elsewhere) |
921 |
Zenith (effective 10/01/2020) |
922 |
Senior Whole Health (effective 10/01/2020) |
930 |
VA Benefits (not listed elsewhere) (effective 10/01/2020) |
931 |
Other Government Program (not listed elsewhere) (effective 10/01/2020) |
932 |
Other Third Party Programs (not listed elsewhere) (ex. Vision TPA, Hospice, Transplant programs) (effective 10/01/2020) |
995 |
Health Safety Net |
Blank |
Missing |
. |
Missing |
159 |
None (valid only for secondary source of payment) |
.A |
Invalid for PAY1 |
159 |
None (valid only for secondary source of payment) |
. |
Missing for PAY2 |
Other not documented values, 800-827 |
.A |
Invalid |
Massachusetts
|
(Valid beginning 2010 through 2011 - SEDD)
|
PAY1_X and PAY2_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
121 |
Medicare |
1 |
Medicare |
125 |
Medicare HMO - Fallon Senior Plan |
128 |
Medicare HMO - HMO Blue for Seniors |
131 |
Medicare HMO - Pilgrim Enhance 65 |
133 |
Medicare HMO -Tufts Medicare Supplement (TMS) |
134 |
Medicare HMO - Other (not listed elsewhere) |
135 |
Out-Of-State Medicare |
168 |
Advantra Freedom |
173 |
Aetna Medicare Open |
180 |
Fresenius Medical Care Health Plan (Medicare Advantage Plan) |
210 |
Medicare HMO - Pilgrim Preferred 65 |
213 |
Medicare HMO - Medicare Complete Plans offered by SecureHorizons |
214 |
Medicare HMO - Harvard Pilgrim Health Plan - Medicare Enhance |
215 |
Tufts Medicare HMO - Medicare Preferred |
216 |
Medicare Special Needs Plan - Commonwealth Care Alliance |
217 |
Medicare Special Needs Plan - Fallon Community Health Plan |
218 |
Medicare Special Needs Plan - Senior Whole Health |
219 |
Medicare Special Needs Plan - United Health Group Evercare Mass. SCO and Evercare Plan IP |
220 |
Medicare HMO - Blue Care 65 |
224 |
Medicare HMO - Tufts Secure Horizons |
230 |
Medicare HMO - HCHP First Seniority Freedom |
231 |
Medicare HMO - Pilgrim Prime |
232 |
Medicare HMO - Senior Care Direct |
233 |
Medicare HMO - Senior Care Plus |
234 |
Medicare HMO - Managed Blue for Seniors |
245 |
Trail Blazer Health Enterprises, LLC |
252 |
Health New England (HNE) Medicare Advantage Plan |
253 |
Blue Medicare PFFS |
254 |
Cigna Medicare Access Plans |
255 |
Health Net Pearl |
256 |
Humana Gold PFFS |
257 |
Today's Options Premier from Universal American |
258 |
Unicare Security Choice |
273 |
MassHealth Senior Care Options |
2 |
Medicare for PAY 1 |
273 |
MassHealth Senior Care Options |
2 |
Medicaid for PAY 2 |
103 |
Medicaid (includes MassHealth) |
2 |
Medicaid |
104 |
Medicaid Managed Care-Primary Care Clinician (PCC) |
108 |
Medicaid Managed Care-Fallon Community Health Plan |
113 |
Medicaid Managed Care-Neighborhood Health Plan |
118 |
Medicaid Mental Health & Substance Abuse Plan - Mass Behavioral Health Partnership |
119 |
Medicaid Managed Care Other (not listed elsewhere) |
207 |
Network Health (Cambridge Health Alliance MCD Program) |
208 |
HealthNet (Boston Medical Center MCD Program) |
11 |
Blue Care Elect |
3 |
Private |
136 |
BCBS Medex |
142 |
Blue Cross Indemnity |
154 |
BCBS Other (not listed elsewhere) |
156 |
Out of State BCBS |
30 |
CIGNA (Indemnity) |
51 |
Aetna Life Insurance |
55 |
Guardian Life Insurance |
57 |
John Hancock Life Insurance |
62 |
Mutual of Omaha Insurance |
74 |
United Healthcare Insurance Company |
89 |
Great West/NE Care |
97 |
Unicare |
102 |
Wausau Insurance Company |
137 |
AARP/Medigap Supplement |
138 |
Banker's Life and Casualty Insurance |
141 |
Other Medigap (not listed elsewhere) |
147 |
Other Commercial (not listed elsewhere) |
176 |
Carelink (CIGNA & Tufts) |
177 |
Chesapeake Life Insurance Company |
179 |
First Health Life and Health Insurance Company |
185 |
Connecticut General Life - Indemnity |
189 |
Fallon Major Medical - Indemnity |
193 |
Harvard Pilgrim - Indemnity |
197 |
Health Insurance Plan of New York (HIP) |
198 |
John Alden Life Insurance Company |
206 |
Health New England Guaranteed Issue - Individual Plans |
209 |
Mid-West National Life Insurance Company of Tennessee |
228 |
Oxford Health Plans |
229 |
Professional Insurance Company (Indemnity) |
235 |
Trustmark Life Insurance Company |
241 |
Union Security Insurance Company |
242 |
Wellcare Health Plans, Inc. |
244 |
Tufts Medicare Complement (TMC) |
247 |
Humana Insurance Company |
248 |
Mail Handlers Benefit Plan |
249 |
MEGA Life and Health Insurance Company |
4 |
Fallon Community Health Plan |
38 |
Health New England Select (self-funded) |
42 |
ConnectiCare of Massachusetts |
46 |
Blue ChiP (BCBS Rhode Island) |
47 |
Neighborhood Health Plan |
148 |
Other HMO (not listed elsewhere) |
174 |
Aetna Health Inc. - Quality POS |
175 |
Aetna Health Inc - HMO |
194 |
Harvard Pilgrim - POS |
195 |
Harvard Pilgrim - PPO |
196 |
Harvard Pilgrim Health Care, Inc. (HMO) |
236 |
Tufts Health Maintenance Organization, Inc. (TAHMO) |
238 |
Tufts Associated Health Maintenance Organization, Inc. PPO |
239 |
Tufts Associated Health Maintenance Organization, Inc. POS Plan |
243 |
Pioneer Health Network |
259 |
Celticare Health Plan of Massachusetts / HMO Plans (includes Celticare Premier, Solution, Saver, and Young Adults with or without RX) |
81 |
HMO Blue |
155 |
Blue Cross Managed Care Other (not listed elsewhere) |
160 |
Blue Choice |
246 |
Preferred Blue PPO |
161 |
Aetna Managed Choice POS |
162 |
Great West Life POS |
171 |
CIGNA POS |
182 |
Unicare Preferred Plus Managed Access EPO |
190 |
Fallon Preferred Care - PPO |
191 |
Genworth Preferred PPO |
192 |
Guarantee Trust Life Insurance Company - PPO |
226 |
United Health Care of New England, Inc. |
250 |
CIGNA HMO |
28 |
Great West Life PPO |
31 |
One Health Plan HMO (Great West Life) |
36 |
United Healthcare Insurance Company - PPO (new for 1997) |
82 |
John Hancock Preferred |
84 |
Private Healthcare Systems PPO |
149 |
PPO and Other Managed Care (not listed elsewhere) |
187 |
Connecticut General Life - PPO |
205 |
Health New England Select Premier PPO |
227 |
Northeast Health Direct - PPO |
237 |
Tufts Insurance Company PPO |
240 |
Unicare PPO |
99 |
Other POS (not listed elsewhere) |
166 |
Private Healthcare Systems POS |
186 |
Connecticut General Life - POS |
188 |
Fallon Flex POS |
184 |
Private Healthcare Systems EPO |
199 |
Other EPO (not listed elsewhere) |
272 |
Auto Insurance |
22 |
Aetna Open Choice PPO |
23 |
Guardian Life Insurance Company PPO |
87 |
CIGNA PPO |
24 |
Health New England Inc. |
79 |
Pioneer Health Care PPO |
145 |
Self-Pay |
4 |
Self-pay |
996 |
Charity Care |
5 |
No charge |
98 |
Healthy Start |
6 |
Other |
150 |
Other Non-Managed Care (not listed elsewhere) |
152 |
Foundation |
153 |
Grant |
146 |
Worker's Compensation |
120 |
Out-Of-State Medicaid |
144 |
Other Government |
151 |
CHAMPUS |
178 |
Children's Medical Security Plan (CMSP) |
995 |
Health Safety Net |
300 |
CommCare: BMC HealthNet Plan/Commonwealth Care - General Classification (For use only when no specific level for this plan can be identified) |
301 |
CommCare: BMC HealthNet Plan/Commonwealth Care - Plan Type I |
302 |
CommCare: BMC HealthNet Plan/Commonwealth Care - Plan Type II |
303 |
CommCare: BMC HealthNet Plan/Commonwealth Care - Plan Type III |
400 |
CommCare: Cambridge Network Health Forward - General Classification (For use only when no specific level for this plan can be identified) |
401 |
CommCare: Cambridge Network Health Forward - Plan Type I |
402 |
CommCare: Cambridge Network Health Forward - Plan Type II |
403 |
CommCare: Cambridge Network Health Forward - Plan Type III |
500 |
CommCare: Fallon Community Health Care: Commonwealth Care FCHP Direct Care - General Classification (For use only when no specific level for this plan can be identified) |
501 |
CommCare: Fallon Community Health Care: Commonwealth Care FCHP Direct Care - Plan 1 (Group No. 4445077) |
502 |
CommCare: Fallon Community Health Care: Commonwealth Care FCHP Direct Care - Plan 2 (Group No. 4455220) |
503 |
CommCare: Fallon Community Health Care: Commonwealth Care FCHP Direct Care - Plan 3 (Group No. 4455221) |
600 |
CommCare: Neighborhood Health Plan- General Classification (For use only when no specific level for this plan can be identified) |
601 |
CommCare: Neighborhood Health Plan - NHP Commonwealth Care Plan - Plan Type I (9CC1) |
602 |
CommCare: Neighborhood Health Plan - NHP Commonwealth Care Plan - Plan Type II (9CC2) |
603 |
CommCare: Neighborhood Health Plan - NHP Commonwealth Care Plan - Plan Type III (9CC3) |
700 |
CommCare: Celticare Health Plan of Massachusetts / Commonwealth Care - General Classification |
701 |
CommCare: Celticare Health Plan of Massachusetts / Commonwealth Care - Plan 1 |
702 |
CommCare: Celticare Health Plan of Massachusetts / Commonwealth Care - Plan 2 |
703 |
CommCare: Celticare Health Plan of Massachusetts / Commonwealth Care - Plan 3 |
704 |
CommCare: Celticare Health Plan of Massachusetts / Commonwealth Care Bridge Program |
159 |
None (valid only for secondary source of payment) |
. |
Missing for PAY2 |
Blank |
Missing |
. |
Missing |
159 |
None (valid only for secondary source of payment) |
.A |
Invalid for PAY1 |
Other not documented values, 800-827 |
.A |
Invalid |
Massachusetts
|
(Valid 2002 through 2009 - SEDD)
|
PAY1_X and PAY2_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
121 |
Medicare |
1 |
Medicare |
220 |
Medicare HMO - Blue Care 65 |
125 |
Medicare HMO - Fallon Senior Plan |
221 |
Medicare HMO - Harvard Community Health Plan 65 |
223 |
Medicare HMO - Harvard Pilgrim Health Care of New England Care Plus |
230 |
Medicare HMO - HCHP First Seniority |
127 |
Medicare HMO - Health New England Medicare Wrap |
222 |
Medicare HMO - Healthsource CMHC |
212 |
Medicare HMO - Healthsource CMHC Central Care Supplement |
128 |
Medicare HMO - HMO Blue for Seniors |
129 |
Medicare HMO - Kaiser Medicare Plus Plan |
234 |
Medicare HMO - Managed Blue for Seniors |
132 |
Medicare HMO - Matthew Thornton Senior Plan |
211 |
Medicare HMO - Neighborhood Health Plan Senior Health Plus |
134 |
Medicare HMO - Other (not listed elsewhere) |
131 |
Medicare HMO - Pilgrim Enhance 65 |
210 |
Medicare HMO - Pilgrim Preferred 65 |
231 |
Medicare HMO - Pilgrim Prime |
232 |
Medicare HMO - Seniorcare Direct |
233 |
Medicare HMO - Seniorcare Plus |
224 |
Medicare HMO - Tufts Secure Horizons |
225 |
Medicare HMO - US Healthcare |
133 |
Medicare HMO - Tufts Medicare Supplement (TMS) |
135 |
Out-of-State Medicare |
208 |
HealthNet (Boston Medical Center MCD Program) |
2 |
Medicaid |
103 |
Medicaid (includes MassHealth) |
107 |
Medicaid Managed Care - Community Health Plan |
108 |
Medicaid Managed Care - Fallon Community Health Plan |
109 |
Medicaid Managed Care - Harvard Community Health Plan |
110 |
Medicaid Managed Care - Health New England |
111 |
Medicaid Managed Care - HMO Blue |
112 |
Medicaid Managed Care - Kaiser Foundation Plan |
113 |
Medicaid Managed Care - Neighborhood Health Plan |
115 |
Medicaid Managed Care - Pilgrim Health Care |
114 |
Medicaid Managed Care - United Health Plans of NE (Ocean State Physician's Plan) |
119 |
Medicaid Managed Care Other (not listed elsewhere) |
106 |
Medicaid Managed Care - Central Mass. Health Care |
104 |
Medicaid Managed Care - Primary Care Clinician (PCC) |
116 |
Medicaid Managed Care - Tufts Associated Health Plan |
118 |
Medicaid Mental Health & Substance Abuse Plan - Mass Behavioral Health Partnerships |
207 |
Network Health (Cambridge Health Alliance MCD Program) |
120 |
Out-of-State Medicaid |
71 |
ADMAR |
3 |
Private Insurance |
137 |
AARP/Medigap supplement |
51 |
Aetna Life Insurance |
161 |
Aetna Managed Choice POS |
22 |
Aetna Open Choice PPO |
272 |
Auto Insurance |
138 |
Banker's Life and Casualty Insurance |
139 |
Banker's Multiple LIne |
2 |
Bay State - a product of HMO Blue |
136 |
BCBS Medex |
11 |
Blue Care Elect |
46 |
Blue Chip (BCBS Rhode Island) |
160 |
Blue Choice (incl. Healthflex Blue) - POS |
142 |
Blue Cross Indemnity |
50 |
Blue Health Plan for Kids |
52 |
Boston Mutual Insurance |
154 |
BCBS Other (not listed elsewhere) |
155 |
Blue Cross Managed Care Other (not listed elsewhere) |
204 |
Christian Brothers Employee |
30 |
CIGNA (Indemnity) |
250 |
CIGNA HMO |
171 |
CIGNA POS |
87 |
CIGNA PPO |
140 |
Combined Insurance Company of America |
21 |
Commonwealth PPO |
44 |
Community Health Plan |
13 |
Community Health Plan Options (New York) |
42 |
ConnectiCare of Massachusetts |
54 |
Continental Assurance Insurance |
69 |
Corporate Health Insurance Liberty Plan |
4 |
Fallon Community Health Plan (includes Fallon Plus, Fallon Affiliates, Fallon Umass) |
167 |
Fallon POS |
67 |
First Allmerica Financial Life Insurance |
181 |
First Allmerica Financial Life Insurance EPO |
27 |
First Allmerica Financial Life Insurance PPO |
88 |
Freedom Care |
162 |
Great West Life POS |
28 |
Great West Life PPO |
89 |
Great West/NE Care |
55 |
Guardian Life Insurance |
23 |
Guardian Life Insurance Company PPO |
56 |
Hartford L & A Insurance |
200 |
Hartford Life Insurance Co. |
1 |
Harvard Community Health Plan |
20 |
HCHP of New England (formerly RIGHA) |
37 |
HCHP - Pilgrim HMO (integrated product) |
14 |
Health New England Advantage POS |
38 |
Health New England Select (self funded) |
24 |
Health New England, Inc. |
45 |
Health Source New Hampshire |
251 |
Healthsource CMHC HMO |
164 |
Healthsource CMHC Plus POS |
49 |
Healthsource CMHC Plus PPO |
72 |
Healthsource New Hampshire |
165 |
Healthsource New Hampshire POS (self funded) |
90 |
Healthsource Preferred (self funded) |
271 |
Hillcrest HMO |
81 |
HMO Blue |
57 |
John Hancock Life Insurance |
82 |
John Hancock Preferred |
169 |
Kaiser Added Choice |
40 |
Kaiser Foundation |
58 |
Liberty Life Insurance |
85 |
Liberty Mutual |
59 |
Lincoln National Insurance |
19 |
Matthew Thornton |
43 |
MEDTAC |
96 |
Metrahealth (United Care of NE) |
158 |
Metrahealth - HMO (United Care of NE) |
172 |
Metrahealth - POS (United Care of NE) |
157 |
Metrahealth - PPO (United Care of NE) |
201 |
Mutual of Omaha |
62 |
Mutual of Omaha Insurance |
33 |
Mutual of Omaha PPO |
47 |
Neighborhood Health Plan |
3 |
Network Blue (PPO) |
91 |
New England Benefits |
63 |
Mutual of Omaha Insurance (Valid 2002 only) |
63 |
New England Mutual Insurance (Valid beginning in 2003) |
64 |
New York Life Care Indemnity (New York Life Insurance) |
34 |
New York Life Care PPO |
202 |
New York Life Insurance |
199 |
Other EPO (not listed elsewhere) |
31 |
One Health Plan HMO (Great West Life) |
77 |
Options for Healthcare PPO |
147 |
Other commercial insurance (not listed elsewhere) |
148 |
Other HMO (not listed elsewhere) |
141 |
Other Medigap (not listed elsewhere) |
99 |
Other POS (not listed elsewhere) |
156 |
Out-of-State BCBS |
65 |
Paul Revere Life Insurance |
78 |
Phoenix Preferred PPO |
10 |
Pilgrim Advantage - PPO |
39 |
Pilgrim Direct |
8 |
Pilgrim Health Care |
95 |
Pilgrim Select - PPO |
183 |
Pioneer Health Care EPO |
79 |
Pioneer Health Care PPO |
25 |
Pioneer Plan |
149 |
PPO and Other Managed Care (not listed elsewhere) |
203 |
Principal Financial Group (Prinicipal Mutual Life) |
184 |
Private Healthcare Systems EPO |
166 |
Private Healthcare Systems POS |
84 |
Private Healthcare Systems PPO |
75 |
Prudential Healthcare HMO |
17 |
Prudential Healthcare POS |
18 |
Prudential Healthcare PPO |
66 |
Prudential Insurance |
93 |
Psychological Health Plan |
101 |
Quarto Claims |
94 |
Time Insurance Co. |
100 |
Transport Life Insurance |
7 |
Tufts Associated Health Plan |
80 |
Tufts Total Health Plan PPO |
97 |
Unicare |
182 |
Unicare Preferred Plus Managed Access PPO |
270 |
Unicare Preferred Plus PPO |
70 |
Union Labor LIfe Insurance |
86 |
United Health & Life PPO (subsidiary of United Health Plans of NE) |
73 |
United Health & Life (subsidiary of United Health Plans of NE) |
9 |
United Health Plan of New England (Ocean State) |
74 |
United Healthcare Insurance Company |
35 |
United Healthcare Insurance Company - HMO (new for 1997) |
163 |
United Healthcare Insurance Company - POS (new for 1997) |
36 |
United Healthcare Insurance Company - PPO (new for 1997) |
48 |
US Healthcare |
83 |
US Healthcare Quality Network Choice PPO |
170 |
US Healthcare Quality POS |
102 |
Wausau Insurance Company |
145 |
Self-Pay |
4 |
Self-pay |
143 |
Free Care |
5 |
No charge |
990 |
Free Care - co-pay, deductible, or co-insurance (when billing for free care services use #143) |
98 |
Healthy Start |
151 |
CHAMPUS |
6 |
Other |
152 |
Foundation |
153 |
Grant |
144 |
Other Government |
150 |
Other Non-Managed Care (not listed elsewhere) |
146 |
Worker's Compensation |
Blank |
Missing |
. |
Missing |
159 |
None (Valid only for secondary source of payment) |
Any values not documented by the data source |
.A |
Invalid |
Massachusetts (SID)
Massachusetts
|
(Valid beginning in 1998 - SID)
|
PAY1_X and PAY2_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
3 |
Medicare |
1 |
Medicare |
F |
Medicare Managed Care (includes Medicare Advantage) |
S |
Senior Care Options/Integrated Care Organization (Effective 10/01/2020) |
4 |
Medicaid |
2 |
Medicaid |
A |
Medicaid Accountable Care Organization (Effective 10/01/2020) |
B |
Medicaid Managed Care/MCO |
6 |
Blue Cross (valid prior to 10/01/2020) |
3 |
Private Insurance |
C |
Blue Cross Managed Care (valid prior to 10/01/2020) |
C |
Commercial Accountable Care Organization (Effective 10/01/2020) |
7 |
Other Commercial Insurance not listed elsewhere |
D |
Commercial Managed Care |
8 |
HMO |
E |
PPO and Other Managed Care not listed elsewhere |
J |
Point of Service Plan |
K |
Exclusive Provider Plan |
T |
Auto Insurance |
Z |
Dental Plans |
1 |
Self-pay |
4 |
Self-pay |
9 |
Free care (no charge) |
5 |
No charge |
2 |
Worker's Compensation |
6 |
Other |
H |
Health Safety Net (Beginning in 2009) |
5 |
Other government payment |
0 |
Other non-managed care plans |
Q |
CommCare |
N, Blank |
None, Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Massachusetts
|
(Valid from 1996-1997 - SID)
|
PAY1_X and PAY2_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
3, F |
Medicare; Medicare managed care |
1 |
Medicare |
4, B |
Medicaid; Medicaid managed care |
2 |
Medicaid |
6, C |
Blue Cross; Blue Cross managed care |
3 |
Private Insurance |
7, D, E |
Commercial Insurance; Commercial managed care; PPO and other managed care not listed elsewhere |
8, J |
HMO; Point of Service (added 4th Qtr 1997) |
1 |
Self-pay |
4 |
Self-pay |
9 |
Free care (no charge) |
5 |
No charge |
2 |
Worker's Compensation |
6 |
Other |
5 |
Other government payment |
0 |
Primary Payer: Other non-managed care |
0, A |
Secondary Payer: Other non-managed care; Other or principal source of payment covered in full |
Blank |
Primary Payer:
|
. |
Missing |
Blank |
Secondary Payer:
|
. |
Missing |
Other values |
|
.A |
Invalid |
Massachusetts
|
(Valid from Quarter 4, 1993 through 1995 - SID)
|
PAY1_X and PAY2_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
3, F |
Medicare; Medicare managed care |
1 |
Medicare |
4, B |
Medicaid; Medicaid managed care |
2 |
Medicaid |
6, C |
Blue Cross; Blue Cross managed care |
3 |
Private Insurance |
7, D |
Commercial Insurance; Commercial managed care |
8, J |
HMO |
1 |
Self-pay |
4 |
Self-pay |
9 |
Free care (no charge) |
5 |
No charge |
2 |
Workers' Compensation |
6 |
Other |
5 |
Other government payment |
0, E |
Primary Payer: Other non-managed care; PPO and other managed care not listed elsewhere |
0, A, E |
Secondary Payer: Other non-managed care; Other or principal source of payment covered in full; PPO and other managed care not listed elsewhere |
Blank |
Primary Payer:
|
. |
Missing |
"N",Blank |
Secondary Payer:None |
. |
Missing |
Other values |
|
.A |
Invalid |
Massachusetts
|
(Valid from 1988 through Quarter 3, 1993 - SID)
|
PAY1_X and PAY2_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
3 |
Medicare |
1 |
Medicare |
4 |
Medicaid |
2 |
Medicaid |
6 |
Blue Cross |
3 |
Private Insurance |
7 |
Commercial Insurance |
8 |
HMO |
1 |
Self-pay |
4 |
Self-pay |
9 |
Free care (no charge) |
5 |
No charge |
2 |
Workers' Compensation |
6 |
Other |
5 |
Other government payment |
0 |
Primary Payer: Other |
0, A |
Secondary Payer: Other; Other or principal source of payment covered in full |
Blank |
Primary Payer:
|
. |
Missing |
"N",Blank |
Secondary Payer:None |
. |
Missing |
Other values |
|
.A |
Invalid |
Minnesota (SID and SEDD)
Minnesota
|
(Valid beginning in 2001 - SID, SASD, SEDD)
|
PAY1_X, PAY2_X and PAY3_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
2000000 |
Medicare |
1 |
Medicare |
6000003 |
Blue Cross, Medicare |
6000103 |
Blue Cross, MN, Medicare |
6009903 |
Blue Cross, Other, Medicare |
7000102 |
Medica - Choice, Medicare |
7000202 |
Group Health, Medicare |
7000402 |
Medica - Primary, Medicare |
7000502 |
MedCenters, Medicare |
7000602 |
UCare, Medicare |
7000702 |
Blue Plus, Medicare |
7000802 |
Metro. Health Plan, Medicare |
7001002 |
Health Partners, Medicare |
7001302 |
First Plan HMO, Medicare |
7001402 |
Altru Health Plan, Medicare |
7001502 |
Sioux Valley, Medicare |
7000902 |
Blue Cross HMO, Medicare |
7009902 |
Other HMO, Medicare |
8000302 |
SelectCare, Medicare |
8000402 |
Preferred One, Medicare |
8000502 |
America's PPO, Medicare |
8000602 |
Aetna PPO, Medicare |
8000902 |
Blue Cross PPO, Medicare |
8001302 |
Private Health Care System, Medicare |
8001502 |
LaborCare PPO, Medicare |
8009902 |
Other PPO, Medicare |
3000000 |
Medicaid |
2 |
Medicaid |
3000001 |
Medicaid Pending |
3000100 |
Medicaid, Minnesota |
3000101 |
Pending, MN, Medicaid |
3000200 |
Medicaid, Wisconsin |
3000201 |
Medicaid, Wisconsin, Pending |
7000301 |
Ramsey Care, Medicaid |
3000900 |
Medicaid, South Dakota |
3000901 |
Medicaid, South Dakota, Pending |
3001101 |
Medicaid, Iowa, Pending |
3001000 |
Medicaid, North Dakota |
3001100 |
Medicaid, Iowa |
3009900 |
Medicaid, Other |
3009901 |
Medicaid, Other, Pending Eligible |
4000500 |
General Assistance Medical Care (GAMC)/GA/Welfare (Starting in 2010) |
4000800 |
PrimeWest, Cty Based Purchased (Starting in 2010) |
4000900 |
Itasca Medical Care, CBP (Starting in 2010) |
4001000 |
So. Country Hlth Alliance, CBP (Starting in 2010) |
7000101 |
Medica - Choice, Medicaid |
7000103 |
Medica - Choice, GAMC (Starting in 2010) |
7000201 |
Group Health, Medicaid |
7000301 |
Ramsey Care, Medicaid |
7000303 |
Ramsey Care, GAMC, etc. (Starting in 2010) |
7000401 |
Medica - Primary, Medicaid |
7000501 |
MedCenters, Medicaid |
7000601 |
Ucare, Medicaid |
7000603 |
Ucare, GAMC, etc. (Starting in 2010) |
7000701 |
Blue Plus, Medicaid |
7000703 |
Blue Plus, GAMC, etc. (Starting 2010) |
7000801 |
Metro. Health Plan, Medicaid |
7000803 |
Metro. Health Plan, GAMC, etc. (Starting in 2010) |
7000901 |
Blue Cross HMO, Medicaid |
7001001 |
Health Partners, Medicaid |
7001003 |
Health Partners, GAMC, etc. (Starting in 2010) |
7001201 |
Northwest National Life (NWNL) Health Network, Medicaid |
7001301 |
First Plan HMO, Medicaid |
7001401 |
Altru Health Plan, Medicaid |
7001501 |
Sioux Valley, Medicaid |
7009901 |
Other HMO, Medicaid |
7009903 |
Other HMO, GAMC/GA/Welfare (Starting in 2010) |
8000301 |
SelectCare, Medicaid |
8000401 |
Preferred One, Medicaid |
8000501 |
America's PPO, Medicaid |
8000701 |
Group Health PPO, Medicaid |
8000901 |
Blue Cross PPO, Medicaid |
8001001 |
Medica Choice PPO, Medicaid |
8001501 |
LaborCare PPO, Medicaid |
8009901 |
Other PPO, Medicaid |
5000000 |
Commercial |
3 |
Private insurance |
5009900 |
Commercial |
5009901 |
Commercial (Regina) |
6000000 |
Blue Cross |
6000001 |
Blue Cross, Aware |
6000100 |
Blue Cross, MN |
6000101 |
Blue Cross, MN, Aware |
6000102 |
Blue Cross, Preferred Gold |
6000200 |
Blue Cross, North Dakota |
6000201 |
Blue Cross, North Dakota, Aware |
6000202 |
Blue Cross, North Dakota, Preferred Gold |
6009900 |
Blue Cross, Non-MN |
6009901 |
Blue Cross, Non-MN Aware |
6009902 |
Blue Cross, Other, Preferred Gold |
7000000 |
Other HMO |
7000100 |
Medica - Choice |
7000200 |
Group Health |
7000300 |
Ramsey Health |
7000400 |
Medica - Primary |
7000500 |
MedCenters |
7000600 |
Ucare |
7000700 |
Blue Plus |
7000800 |
Metro. Health Plan |
7000900 |
Blue Cross HMO |
7001000 |
Health Partners |
7001200 |
Northwest National Life (NWNL) Health Network |
7001300 |
First Plan HMO |
7001400 |
Altru Health Plan |
7001500 |
Sioux Valley |
7009900 |
Other HMO |
8000000 |
Other PPO |
8000300 |
SelectCare |
8000320 |
SelectCare, Union |
8000400 |
Preferred One |
8000420 |
Preferred One, Union |
8000500 |
ARAZ, Union (formerly, Ethix Midwest; also known as America's PPO) |
8000520 |
ARAZ (formerly Ethix Midwest; also known as America's PPO) |
8000600 |
Aetna PPO |
8000620 |
Aetna PPO, Union |
8000700 |
Group Health PPO |
8000800 |
HealthEast Care, Inc. |
8000900 |
Blue Cross PPO |
8001000 |
Medica Choice PPO |
8001020 |
Medica, Union |
8001200 |
Northwest National LIfe (NWNL) PPO |
8002300 |
Private Health Care System |
8001400 |
Prudential Plus |
8001500 |
LaborCare PPO |
8001520 |
LaborCare PPO, Union |
8500100 |
Self Insured, Choice Plus |
8509900 |
Other Self Insured |
8009900 |
Other PPO |
8009920 |
Other PPO, union |
9001000 |
Other, Self-Insured Co. |
9002000 |
Other, Unions |
1000000 |
Self-Pay |
4 |
Self-Pay |
1000100 |
Self-Pay |
1000102 |
Self-Pay |
1000200 |
Self-Pay, No Charge |
-- |
-- |
5 |
No charge |
3060000 |
Minnesota Care |
6 |
Other |
3060100 |
Minnesota Care |
4000000 |
Other Government |
4000100 |
Title V |
4000200 |
Worker's Comp |
4000201 |
Worker's Comp, Minnesota (Starting in 2015) |
4000202 |
Worker's Comp, Out of State (Starting in 2015) |
4000203 |
Worker's Comp, Federal (Starting in 2015) |
4000300 |
TRICARE/CHAMPUS |
4000400 |
MN Comp. Health Care |
4000402 |
MN Comp. Health Care (Out of State) (Starting in 2015) |
4000500 |
General Assistance Medical Care (GAMC)/GA/Welfare (Prior to 2010) |
4000600 |
Aid to Families with Dependent Children (AFDC) |
4000700 |
Children's Health Plan |
4000800 |
PrimeWest, Cty Based Purchased (Prior to 2010) |
4000900 |
Itasca Medical Care, CBP (Prior to 2010) |
4001000 |
So. Country Hlth Alliance, CBP (Prior to 2010) |
4009900 |
Other Govt., Other |
7000103 |
Medica - Choice, GAMC (Prior to 2010) |
7000104 |
Medica-Choice, MNCare |
7000204 |
HMO, Group Health Plan, MNCARE |
7000303 |
Ramsey Care, GAMC, etc. (Prior to 2010) |
7000404 |
Medica-Primary, MNCare |
7000603 |
Ucare, GAMC, etc. (Prior to 2010) |
7000604 |
U-Care, MNCare |
7000703 |
Blue Plus, GAMC, etc. (Prior to 2010) |
7000704 |
Blue Plus, MNCare |
7000803 |
Metro. Health Plan, GAMC, etc. (Prior to 2010) |
7000804 |
Metro. Health Plan, MNCare |
7000904 |
Blue Cross HMO, MNCare |
7001003 |
Health Partners, GAMC, etc. (Prior to 2010) |
7001004 |
Health Partners, MNCare |
7001304 |
First Plan HMO, MNCare |
7001404 |
Altru Health Plan, MNCare |
7001504 |
Sioux Valley, MNCare |
7009903 |
Other HMO, GAMC/GA/Welfare (Prior to 2010) |
7009904 |
Other HMO, MNCare |
8000404 |
Preferred One, MNCare |
8000504 |
America's PPO, MNCare |
8000604 |
Aetna PPO, MNCare |
8000804 |
HealthEast Care, Inc. MNCare |
8000920 |
PPO, Blue Cross PPO, Union |
8000904 |
Blue Cross PPO, MNCare |
8001304 |
Private Hlth Care Sys MNCare |
8001404 |
Prudential Plus, MNCare |
8001504 |
LaborCare PPO MNCare |
8009904 |
Other PPO, MNCare |
9000000 |
Other |
9009900 |
Other |
Blank |
Missing |
. |
Missing |
8888888 |
Missing/Unknown (or insurance master) |
9999999 |
Missing/Unknown (not on insurance master) |
Any values not documented by the data source |
.A |
Invalid |
Missouri (SID and SEDD)
Missouri
|
(Valid beginning in 1995 - SID, Valid beginning in 1999 - SASD and SEDD)
|
PAY1_X and PAY2_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
01 |
Medicare |
1 |
Medicare |
02 |
Medicaid |
2 |
Medicaid |
04 |
Blue Cross/Blue Shield |
3 |
Private Insurance |
07 |
Commercial/Private Insurance |
06 |
Self-pay |
4 |
Self-pay |
08 |
No charge (charity) |
5 |
No charge |
03 |
Maternal and Child Health |
6 |
Other |
05 |
Worker's Compensation |
09 |
Other government (CHAMPUS) |
10 |
Other |
99, Blank |
Unknown, Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Separate information on HMO and PPO providers is not provided.
|
Nebraska (SID and SEDD)
Prior to data year 2016, some Medicaid managed care patients may have been categorized in the data under private insurance instead of Medicaid because the Medicaid program was managed by a commercial insurance company. Beginning with data year 2016, there are large increases in the number of Medicaid records and proportionate decreases in records categorized as private insurance because the Nebraska Partner organization improved the process for the identification of patients covered by Medicaid managed care programs managed by commercial insurance companies.
Nebraska
|
Value
|
Description
|
Value
|
Description
|
(Begin in 2020)
|
MA |
Medicare Part A |
1 |
Medicare |
MB |
Medicare Part B |
16 |
Health Maintenance Organization (HMO) Medicare Risk |
MC |
Medicaid |
2 |
Medicaid |
AM |
Automobile Medical |
3 |
Private Insurance |
BL |
Blue Cross/BlueShield |
CI |
Commercial Insurance Co. |
FI |
Federal Employees Program |
HM |
Health Maintenance Organization |
LI |
Liability |
LM |
Liability Medical |
10 |
Central Certification |
12 |
Preferred Provider Organization (PPO) |
13 |
Point of Service (POS) |
14 |
Exclusive Provider Organization (EPO) |
15 |
Indemnity Insurance |
15 |
Indemnity Insurance |
17 |
Dental Maintenance Organization |
09 |
Self-pay |
4 |
Self-pay |
-- |
-- |
5 |
No charge |
CH |
Champus/Champva |
6 |
Other |
11 |
Other Non-Federal Programs |
DS |
Disability |
OF |
Other Federal Program |
TV |
Title V |
VA |
Veteran Administration Plan |
WC |
Workers' Compensation Health Claim |
Blank, ZZ |
Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Nebraska
|
(Valid SID, SASD, SEDD)
|
PAY1_X, PAY2_X and PAY3_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
(Prior to 2020)
|
02 |
Medicare |
1 |
Medicare |
04 |
Medicaid |
2 |
Medicaid |
12 |
Medicaid |
01 |
Commercial Insurance |
3 |
Private Insurance |
03 |
Commercial Insurance |
08 |
Commercial Insurance |
11 |
Commercial Insurance |
13 |
Commercial Insurance |
14 |
Commercial Insurance |
09, 9 |
Self-pay |
4 |
Self-pay |
-- |
-- |
5 |
No charge |
05 |
Worker's Compensation |
6 |
Other |
06 |
Champus/Champva |
07 |
Other Federal and State Programs |
10 |
Other (For PAY2 and PAY3 only, a value of other was reported instead of missing in the 2014 data.) |
Blank |
Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Nevada (SID and SEDD)
Nevada
|
(Valid beginning 2012 - SID, SASD, SEDD)
|
PAY1_X and PAY2_X and PAY3_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
10 |
Medicare |
1 |
Medicare |
27 |
Medicare HMO |
16 |
Nevada Medicaid |
2 |
Medicaid |
17 |
Other Medicaid |
28 |
Nevada Medicaid HMO |
20 |
Commercial Insurer |
3 |
Private insurance |
21 |
Negotiated Discounts e.g. Preferred Provider Organization (PPO) |
22 |
Health Maintenance Organization (HMO) |
18 |
Self Pay |
4 |
Self-pay |
12 |
Charity |
5 |
No charge |
13 |
Hill-Burton Free Care (HBFC) (starting in 2012) |
11 |
Black Lung |
6 |
Other |
13 |
Hill-Burton Free Care (HBFC) (prior to 2012) |
14 |
CHAMPUS / CHAMPVA |
19 |
Miscellaneous - does not fit any of the other categories. This field covers insurers that are not licensed to sell insurance in Nevada |
23 |
County Indigent Referral (Patient has already been approved for County Coverage) |
24 |
All Worker's Compensation Cases |
29 |
Section 1011 undocumented Aliens/unknown |
99, Blank |
Missing, unknown |
. |
Missing |
other |
|
.A |
Invalid |
Nevada
|
(Valid 2008-2011 - SID, SASD, SEDD)
|
PAY1_X and PAY2_X and PAY3_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
10 |
Medicare |
1 |
Medicare |
27 |
Medicare HMO |
16 |
Nevada Medicaid |
2 |
Medicaid |
17 |
Other Medicaid |
28 |
Nevada Medicaid HMO |
20 |
Commercial Insurer |
3 |
Private insurance |
21 |
Negotiated Discounts e.g. Preferred Provider Organization (PPO) |
22 |
Health Maintenance Organization (HMO) |
24 |
All Worker's Compensation Cases |
25 |
Nevada Blue Cross / Blue Shield |
26 |
Other Blue Cross / Blue Shield |
18 |
Self Pay |
4 |
Self-pay |
12 |
Charity |
5 |
No charge |
11 |
Black Lung (beginning in 2006, Black Lung was coded as 11 instead of 6) |
6 |
Other |
13 |
Hill-Burton Free Care (HBFC) |
14 |
CHAMPUS / CHAMPVA |
19 |
Miscellaneous - does not fit any of the other categories. This field covers insurers that are not licensed to sell insurance in Nevada |
23 |
County Indigent Referral (Patient has already been approved for County Coverage) |
29 |
Section 1011 undocumented Aliens/unknown |
99, Blank |
Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Expected payer information from two hospitals in the 2006 Nevada source data was unreliable; consequently, PAY1 was set to "Invalid" (.A) for these two hospitals.
Nevada
|
(Valid 2002-2007 - SID)
|
PAY1_X and PAY2_X and PAY3_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
10 |
Medicare |
1 |
Medicare |
27 |
Medicare HMO |
16 |
Nevada Medicaid |
2 |
Medicaid |
17 |
Other Medicaid |
28 |
Medicaid HMO |
20 |
Commercial Insurer |
3 |
Private insurance |
21 |
Negotiated Discounts e.g. Preferred Provider Organization (PPO) |
22 |
Health Maintenance Organization (HMO) |
24 |
State Industrial Insurance System (SIIS) (beginning in 2005) |
25 |
Nevada Blue Cross/Blue Shield (BC) |
26 |
Other Blue Cross/Blue Shield (BS) |
18 |
Self Pay |
4 |
Self-pay |
12 |
Charity |
5 |
No charge |
11 |
Black Lung (beginning in 2006, Black Lung was coded as 11 instead of 6) |
6 |
Other |
13 |
Hill-Burton Free Care (HBFC) |
14 |
CHAMPUS (or successor) |
15 |
CHAMPVA (or successor) |
19 |
Miscellaneous - does not fit any of the other categories. This field covers insurers that are not licensed to sell insurance in Nevada |
23 |
County Indigent Referral (those already qualified for, or being referred to, the County Indigent program) |
29 |
Section 1011 undocumented Aliens/unknown |
99, Blank |
Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
New Hampshire (SID and SEDD)
New Hampshire
|
(Valid beginning in 2019)
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
MEDICARE |
Medicare |
1 |
Medicare |
MEDICAID |
Medicaid |
2 |
Medicaid |
COMMERCIAL |
Commercial |
3 |
Private Insurance |
UNINSURED |
Uninsured |
4 |
Self-pay |
SELF-PAY |
Self-pay |
OTHER FEDERAL GOVERNMENT |
Other Federal Government |
6 |
Other |
WORKER COMPENSATION |
workers Compensation |
OTHER |
Other |
Blank |
Unknown, Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
New Hampshire
|
(Valid through 2009)
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
3 |
Medicare |
1 |
Medicare |
10 |
Medicare Managed Care |
4 |
Medicaid |
2 |
Medicaid |
11 |
Medicaid Managed Care |
5 |
HMO |
3 |
Private Insurance |
7 |
Blue Cross |
8 |
Commercial insurance |
1 |
Self-Pay |
4 |
Self-pay |
-- |
|
5 |
No charge |
2 |
Worker's Compensation |
6 |
Other |
6 |
Other government |
9 |
Other |
Blank |
Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
New Jersey (SID and SEDD)
New Jersey |
(Valid beginning 2020 - SID, SASD, SEDD) |
PAY1_X and PAY2_X and PAY3_X |
PAY1 and PAY2 |
Value |
Description |
Value |
Description |
100 | Medicare | 1 | Medicare |
110 | Medicare Managed Care |
111 | Medicare HMO |
112 | Medicare PPO |
113 | Medicare POS |
119 | Medicare Manage Care Other |
120 | Medicare Non-Managed Care |
121 | Medicare FFS |
122 | Medicare Drug Benefit |
123 | Medicare medical Savings Account |
129 | Medicare Non-Managed Care Other |
130 | Medicare Hospice |
140 | Dual Eligibility Medicare/Medicaid |
190 | Medicare Other |
191 | Medicare Pharmacy Benefit Manager |
523 | Medicare Supplemental Policy |
008 | NJ Family Care | 2 | Medicaid |
200 | Medicaid |
210 | Medicaid Managed Care |
211 | Medicaid HMO |
212 | Medicaid PPO |
213 | Medicaid Primary Care Case Management |
219 | Medicaid Managed care Other |
220 | Medicaid Non-Managed Care Plan |
230 | Medicaid/SCHIP |
250 | Medicaid-Out of State |
260 | Medicaid-Long Term Care |
290 | Medicaid Other |
291 | Medicaid Pharmacy Benefit Manager |
299 | Medicaid-Dental |
361 | State SCHIP Program |
199 | Other Commercial Insurance | 3 | Private Insurance |
500 | Private Heath Insurance |
510 | Managed Care-Private |
511 | Commercial Managed Care-HMO |
512 | Commercial Managed Care-PPO |
513 | Commercial Managed Care-POS |
514 | Exclusive Provider Organization |
515 | Gatekeeper PPO |
516 | Commerical Managed Care-Pharmacy Benefit Manager |
517 | Commercial managed Care-Dental |
519 | Other Managed Care, Non HMO |
520 | Private Heath Insurance-Indemnity |
521 | Commercial Indemnity |
522 | Self-Insured Administrative Services |
524 | Imdenity Insurance-Dental |
529 | Other Commercial Indemnity Private |
530 | Managed Care (Private) or Private Health Insurance (Indemnity) Not Otherwise Specified |
540 | Organized Delivery System |
550 | Small Employer Purchasing Group |
560 | Specialized Stand Alone Plan |
590 | Other Private Insurance |
600 | Blue Cross/Blue Shield |
610 | Blue Cross Managed Care |
611 | Blue Cross Managed Care-HMO |
612 | Blue Cross Managed Care-PPO |
613 | Blue Cross Managed Care-POS |
614 | Blue Cross Managed Care-Dental |
619 | Other Blue Cross Managed Care |
621 | Blue Cross Indemnity |
622 | Blue Cross Self-Insured |
623 | Blue Cross Medicare Supplemental |
624 | Blue Cross Indemnity-Dental |
710 | HMO |
720 | PPO |
730 | POS |
790 | Other Manage Care |
960 | Auto Insurance (includes No Fault) |
039 | Other Source of Patient Payment | 4 | Self-Pay |
800 | No Payment from an organization/agency/program/private payer listed |
810 | Self-Pay |
083 | Refusal to pay/bad debt | | 5No Charge |
820 | No Charge |
821 | Charity Care |
822 | Professional Courtesy |
823 | Research/Clinical Trial |
300 | Other Government (Federal, State, Local) | 6 | Other |
310 | Department of Defense |
311 | Champus |
312 | Military Treatment Facility |
313 | Dental-Stand Alone |
320 | Department of Veterans Affairs |
321 | Veteran Care |
322 | Non-Veteran Care |
330 | Indian Health Service or Tribe |
331 | Indian Health Service-Regular |
332 | Indian Health Service-Contract |
333 | Indian Health Service-Managed Care |
334 | Indian Health-Sponsored Coverage |
340 | HRSA Progam |
341 | HRSA Title V |
342 | Migrant Health Program |
343 | Ryan White Act |
349 | Other HRSA Program |
362 | Specific State Program |
369 | State, Not Otherwise Specified |
370 | Local Government |
371 | Local Managed Care |
372 | FFS/Indemnity |
379 | Other Local, County |
380 | Other Government (Federal, State, Local Not Specified) |
381 | Federal, State, Local Not Specified Managed Care |
382 | Federal, State, Local Not Specified-FFS |
383 | Federal, State, Local Not Specified-HMO |
384 | Federal, State, Local Not Specified-PPO |
385 | Federal, State, Local Not Specified-POS |
386 | Federal, State, Local Not Specified-Not Specified Managed Care |
389 | Federal, State, Local Not Specified-Other |
390 | Other Federal |
391 | Federal Employee Health Plan |
400 | Departments of Corrections |
410 | Corrections Federal |
420 | Corrections State |
430 | Corrections Local |
440 | Corrections Unknown Level |
910 | Foreign/National |
920 | Other (Non-government) |
921 | Other (Government) |
930 | Disability Insurance |
940 | Long-Term Care Insurance |
950 | Workers Compensation |
951 | Workers Compensation HMO |
953 | Workers Compensation FFS |
954 | Workers Compensation Other Managed Care |
959 | Workers Compensation Other Unspecified |
970 | Legal Liability |
980 | Other Specified but not otherwise classifiable |
990 | No Typology Code Available for Payment Source | . | Missing |
999 | Unavailable/No Payer Specified/Blank | . | Missing |
Blank | Not Available, Missing | . | Missing |
Any values not documented by the data source | .A | Invalid |
New Jersey |
(Valid from 2017-2019 - SID, SASD, SEDD) |
PAY1_X and PAY2_X and PAY3_X |
PAY1 and PAY2 |
Value |
Description |
Value |
Description |
009 |
Medicare: Other |
1 |
Medicare |
011 |
Medicare Part A |
015 |
Medicare Part B |
017 |
Medicare Part B |
082 |
Medicare HMO (Beginning in 2003) |
008 |
NJ Family Care |
2 |
Medicaid |
012 |
Title XIX (Medicaid) |
083 |
Medicaid HMO (Beginning in 2003) |
010 |
Blue Cross Plan |
3 |
Private Insurance |
018 |
State Employee Insurance (Beginning in 1998) |
020 |
Blue Cross Plan |
022 |
Blue Cross Plan |
025 |
Blue Cross Plan |
026 |
Blue Cross Plan |
029 |
Blue Cross Plan |
030 |
Blue Cross Plan |
040 |
Blue Cross Plan |
041 |
Blue Cross Plan (1994 only) |
042 |
Blue Cross Plan (1994 only) |
050 |
Blue Cross Plan |
060 |
Blue Cross Plan |
070 |
Blue Cross Plan |
080 |
Blue Cross Plan |
090 |
Blue Cross Plan |
100 |
Blue Cross Plan (1994 only) |
101 |
Blue Cross Plan |
110 |
Blue Cross Plan |
121 |
Blue Cross Plan |
130 |
Blue Cross Plan |
140 |
Blue Cross Plan |
141 |
Blue Cross Plan (discontinued 1/1/15) |
150 |
Blue Cross Plan |
160 |
Blue Cross Plan |
170 |
Blue Cross Plan |
180 |
Blue Cross Plan |
190 |
Blue Cross Plan |
200 |
Blue Cross Plan |
210 |
Blue Cross Plan |
220 |
Blue Cross Plan |
230 |
Blue Cross Plan |
240 |
Blue Cross Plan |
241 |
Blue Cross Plan |
250 |
Blue Cross Plan |
260 |
Blue Cross Plan |
265 |
Blue Cross Plan |
270 |
Blue Cross Plan |
280 |
Blue Cross Plan |
281 |
Blue Cross Plan (valid beginning 1/93) |
290 |
Blue Cross Plan |
300 |
Blue Cross Plan (1994 only) |
301 |
Blue Cross Plan |
303 |
Blue Cross Plan |
304 |
Blue Cross Plan |
305 |
Blue Cross Plan |
306 |
Blue Cross Plan |
307 |
Blue Cross Plan (1994 only) |
308 |
Blue Cross Plan (1994 only) |
310 |
Blue Cross Plan |
320 |
Blue Cross Plan |
331 |
Blue Cross Plan (1994 only) |
332 |
Blue Cross Plan |
333 |
Blue Cross Plan |
334 |
Blue Cross Plan (1994 only) |
335 |
Blue Cross Plan (1994 only) |
337 |
Blue Cross Plan (1994 only) |
338 |
Blue Cross Plan (1994 only) |
340 |
Blue Cross Plan |
350 |
Blue Cross Plan |
351 |
Blue Cross Plan |
360 |
Blue Cross Plan (1994 only) |
361 |
Blue Cross plan |
362 |
Blue Cross Plan |
363 |
Blue Cross plan |
364 |
Blue Cross plan |
370 |
Blue Cross plan |
380 |
Blue Cross plan |
390 |
Blue Cross Plan |
392 |
Blue Cross Plan |
400 |
Blue Cross plan |
410 |
Blue Cross plan |
415 |
Blue Cross plan |
423 |
Blue Cross plan |
424 |
Blue Cross Plan (1994 only) |
430 |
Blue Cross Plan |
441 |
Blue Cross Plan (1994 only) |
443 |
Blue Cross Plan |
444 |
Blue Cross Plan (1994 only) |
450 |
Blue Cross Plan |
460 |
Blue Cross Plan |
470 |
Blue Cross Plan |
471 |
Blue Cross Plan (effective beginning 1/93) |
865 |
Blue Cross Plan (effective beginning 1/95) |
932 |
Blue Cross Plan (1994 only) |
936 |
Blue Cross Plan (1994 only) |
971 |
Blue Cross Plan (1994 only) |
105 |
Commercial |
106 |
Commercial |
107 |
Commercial (effective beginning 4/1/95) |
115 |
Commercial |
120 |
Commercial |
125 |
Commercial |
131 |
Commercial |
135 |
Commercial |
142 |
Commercial |
145 |
Commercial |
151 |
Commercial |
155 |
Commercial |
161 |
Commercial |
165 |
Commercial |
171 |
Commercial |
175 |
Commercial |
181 |
Commercial |
185 |
Commercial |
186 |
Commercial |
187 |
Commercial |
188 |
Commercial |
189 |
Commercial |
191 |
Commercial |
192 |
Commercial |
193 |
Commercial |
194 |
Commercial |
195 |
Commercial |
196 |
Commercial |
197 |
Commercial |
198 |
Commercial |
199 |
Commercial |
032 |
HMO (effective 11/96) |
033 |
HMO (effective 11/96) |
034 |
HMO (effective 8/96) |
035 |
HMO (effective 11/95) |
036 |
HMO (effective 8/97) |
037 |
HMO (effective 8/97) |
043 |
HMO (1994 only) |
044 |
HMO (1994 only) |
045 |
HMO |
046 |
HMO (1994 only) |
047 |
HMO |
048 |
HMO |
049 |
HMO (1994 only) |
051 |
HMO (1994 only) |
052 |
HMO (1994 only) |
053 |
HMO (discontinued 6/98) |
054 |
HMO (1994 only) |
055 |
HMO (1994 only) |
056 |
HMO |
057 |
HMO (1994 only) |
058 |
HMO |
059 |
HMO |
061 |
HMO (discontinued 6/98) |
062 |
HMO (discontinued 6/98) |
063 |
HMO (1994 only) |
064 |
HMO (1994 only) |
065 |
HMO (1994 only) |
066 |
HMO (discontinued 6/98) |
067 |
HMO (discontinued 6/98) |
068 |
HMO (discontinued 6/98) |
069 |
HMO (discontinued 6/98) |
071 |
HMO (discontinued 6/98) |
072 |
HMO |
073 |
HMO |
074 |
HMO |
075 |
HMO (1994 only) |
077 |
HMO |
078 |
HMO |
081 |
HMO (effective 11/96) |
082 |
HMO (discontinued 6/98) |
083 |
HMO (discontinued 6/98) |
084 |
HMO (effective 11/96) |
085 |
HMO (discontinued 6/98) |
086 |
HMO (discontinued 6/98) |
087 |
HMO (effective 11/96) |
088 |
HMO (effective 11/96) |
089 |
HMO (discontinued 6/98) |
094 |
HMO (effective 11/96) |
097 |
HMO (effective 11/96) |
076 |
Miscellaneous |
091 |
Miscellaneous: Union Insurance |
093 |
Miscellaneous (effective 1/95) |
096 |
Miscellaneous (effective 1/95) |
309 |
No Fault |
311 |
No Fault |
315 |
No Fault |
399 |
No Fault |
095 |
Miscellaneous (discontinued 2012) |
4 |
Self-pay |
031 |
Patient |
039 |
Patient |
098 |
Miscellaneous: Hospital Responsibility |
5 |
No charge |
007 |
Affordable Care Health Insurance (effective 1/1/14) This code may include some newly eligible Medicaid enrollees |
6 |
Other |
014 |
Champus |
016 |
Other Government |
092 |
Personnel Health Program |
095 |
Indigent (effective starting 2013): New Jersey Hospital Care Payment Assistance Program (Charity Care Assistance) |
099 |
Miscellaneous: Other |
018 |
Other Government (effective between 1988 and 1997) |
019 |
Other Government |
013 |
Title V (Material and Child Health) |
205 |
Worker's Compensation |
211 |
Worker's Compensation |
215 |
Worker's Compensation |
221 |
Worker's Compensation |
225 |
Worker's Compensation |
231 |
Worker's Compensation |
299 |
Worker's Compensation |
000, Blank |
Not Available, Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
New Jersey |
(Valid beginning 2011-2016 - SID, SASD, SEDD) |
PAY1_X and PAY2_X and PAY3_X |
PAY1 and PAY2 |
Value |
Description |
Value |
Description |
009 |
Medicare: Other |
1 |
Medicare |
011 |
Medicare Part A |
015 |
Medicare Part B |
017 |
Medicare Part B |
082 |
Medicare HMO (Beginning in 2003) |
008 |
NJ Family Care |
2 |
Medicaid |
012 |
Title XIX (Medicaid) |
083 |
Medicaid HMO (Beginning in 2003) |
010 |
Blue Cross Plan |
3 |
Private Insurance |
018 |
Other Government (beginning in 1998) |
020 |
Blue Cross Plan |
022 |
Blue Cross Plan |
025 |
Blue Cross Plan |
026 |
Blue Cross Plan |
029 |
Blue Cross Plan |
030 |
Blue Cross Plan |
040 |
Blue Cross Plan |
041 |
Blue Cross Plan (1994 only) |
042 |
Blue Cross Plan (1994 only) |
050 |
Blue Cross Plan |
060 |
Blue Cross Plan |
070 |
Blue Cross Plan |
080 |
Blue Cross Plan |
090 |
Blue Cross Plan |
100 |
Blue Cross Plan (1994 only) |
101 |
Blue Cross Plan |
110 |
Blue Cross Plan |
121 |
Blue Cross Plan |
130 |
Blue Cross Plan |
140 |
Blue Cross Plan |
141 |
Blue Cross Plan (discontinued 1/1/15) |
150 |
Blue Cross Plan |
160 |
Blue Cross Plan |
170 |
Blue Cross Plan |
180 |
Blue Cross Plan |
190 |
Blue Cross Plan |
200 |
Blue Cross Plan |
210 |
Blue Cross Plan |
220 |
Blue Cross Plan |
230 |
Blue Cross Plan |
240 |
Blue Cross Plan |
241 |
Blue Cross Plan |
250 |
Blue Cross Plan |
260 |
Blue Cross Plan |
265 |
Blue Cross Plan |
270 |
Blue Cross Plan |
280 |
Blue Cross Plan |
281 |
Blue Cross Plan (valid beginning 1/93) |
290 |
Blue Cross Plan |
300 |
Blue Cross Plan (1994 only) |
301 |
Blue Cross Plan |
303 |
Blue Cross Plan |
304 |
Blue Cross Plan |
305 |
Blue Cross Plan |
306 |
Blue Cross Plan |
307 |
Blue Cross Plan (1994 only) |
308 |
Blue Cross Plan (1994 only) |
310 |
Blue Cross Plan |
320 |
Blue Cross Plan |
331 |
Blue Cross Plan (1994 only) |
332 |
Blue Cross Plan |
333 |
Blue Cross Plan |
334 |
Blue Cross Plan (1994 only) |
335 |
Blue Cross Plan (1994 only) |
337 |
Blue Cross Plan (1994 only) |
338 |
Blue Cross Plan (1994 only) |
340 |
Blue Cross Plan |
350 |
Blue Cross Plan |
351 |
Blue Cross Plan |
360 |
Blue Cross Plan (1994 only) |
361 |
Blue Cross plan |
362 |
Blue Cross Plan |
363 |
Blue Cross plan |
364 |
Blue Cross plan |
370 |
Blue Cross plan |
380 |
Blue Cross plan |
390 |
Blue Cross Plan |
392 |
Blue Cross Plan |
400 |
Blue Cross plan |
410 |
Blue Cross plan |
415 |
Blue Cross plan |
423 |
Blue Cross plan |
424 |
Blue Cross Plan (1994 only) |
430 |
Blue Cross Plan |
441 |
Blue Cross Plan (1994 only) |
443 |
Blue Cross Plan |
444 |
Blue Cross Plan (1994 only) |
450 |
Blue Cross Plan |
460 |
Blue Cross Plan |
470 |
Blue Cross Plan |
471 |
Blue Cross Plan (effective beginning 1/93) |
865 |
Blue Cross Plan (effective beginning 1/95) |
932 |
Blue Cross Plan (1994 only) |
936 |
Blue Cross Plan (1994 only) |
971 |
Blue Cross Plan (1994 only) |
105 |
Commercial |
106 |
Commercial |
107 |
Commercial (effective beginning 4/1/95) |
115 |
Commercial |
120 |
Commercial |
125 |
Commercial |
131 |
Commercial |
135 |
Commercial |
142 |
Commercial |
145 |
Commercial |
151 |
Commercial |
155 |
Commercial |
161 |
Commercial |
165 |
Commercial |
171 |
Commercial |
175 |
Commercial |
181 |
Commercial |
185 |
Commercial |
186 |
Commercial |
187 |
Commercial |
188 |
Commercial |
189 |
Commercial |
191 |
Commercial |
192 |
Commercial |
193 |
Commercial |
194 |
Commercial |
195 |
Commercial |
196 |
Commercial |
197 |
Commercial |
198 |
Commercial |
199 |
Commercial |
032 |
HMO (effective 11/96) |
033 |
HMO (effective 11/96) |
034 |
HMO (effective 8/96) |
035 |
HMO (effective 11/95) |
036 |
HMO (effective 8/97) |
037 |
HMO (effective 8/97) |
043 |
HMO (1994 only) |
044 |
HMO (1994 only) |
045 |
HMO |
046 |
HMO (1994 only) |
047 |
HMO |
048 |
HMO |
049 |
HMO (1994 only) |
051 |
HMO (1994 only) |
052 |
HMO (1994 only) |
053 |
HMO (discontinued 6/98) |
054 |
HMO (1994 only) |
055 |
HMO (1994 only) |
056 |
HMO |
057 |
HMO (1994 only) |
058 |
HMO |
059 |
HMO |
061 |
HMO (discontinued 6/98) |
062 |
HMO (discontinued 6/98) |
063 |
HMO (1994 only) |
064 |
HMO (1994 only) |
065 |
HMO (1994 only) |
066 |
HMO (discontinued 6/98) |
067 |
HMO (discontinued 6/98) |
068 |
HMO (discontinued 6/98) |
069 |
HMO (discontinued 6/98) |
071 |
HMO (discontinued 6/98) |
072 |
HMO |
073 |
HMO |
074 |
HMO |
075 |
HMO (1994 only) |
077 |
HMO |
078 |
HMO |
081 |
HMO (effective 11/96) |
082 |
HMO (discontinued 6/98) |
083 |
HMO (discontinued 6/98) |
084 |
HMO (effective 11/96) |
085 |
HMO (discontinued 6/98) |
086 |
HMO (discontinued 6/98) |
087 |
HMO (effective 11/96) |
088 |
HMO (effective 11/96) |
089 |
HMO (discontinued 6/98) |
094 |
HMO (effective 11/96) |
097 |
HMO (effective 11/96) |
076 |
Miscellaneous |
091 |
Miscellaneous |
093 |
Miscellaneous (effective 1/95) |
096 |
Miscellaneous (effective 1/95) |
309 |
No Fault |
311 |
No Fault |
315 |
No Fault |
399 |
No Fault |
095 |
Miscellaneous (discontinued 2012) |
4 |
Self-pay |
031 |
Patient |
039 |
Patient |
098 |
Hospital Responsibility |
5 |
No charge |
007 |
Affordable Care Health Insurance (effective 1/1/14) This code may include some newly eligible Medicaid enrollees |
6 |
Other |
014 |
Champus |
016 |
Other Government |
092 |
Miscellaneous |
095 |
Indigent (effective starting 2013): New Jersey Hospital Care Payment Assistance Program (Charity Care Assistance) |
099 |
Miscellaneous: Other |
018 |
Other Government (effective between 1988 and 1997) |
019 |
Other Government |
013 |
Title V (Material and Child Health) |
205 |
Worker's Compensation |
211 |
Worker's Compensation |
215 |
Worker's Compensation |
221 |
Worker's Compensation |
225 |
Worker's Compensation |
231 |
Worker's Compensation |
299 |
Worker's Compensation |
000, Blank |
Not Available, Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
New Jersey |
(Valid 2010 - SID, SASD, SEDD) |
PAY1_X and PAY2_X and PAY3_X |
PAY1 and PAY2 |
Value |
Description |
Value |
Description |
009 |
Medicare: Other |
1 |
Medicare |
011 |
Medicare Part A |
015 |
Medicare Part B |
017 |
Medicare Part B |
082 |
Medicare HMO (Beginning in 2003) |
012 |
Title XIX (Medicaid) |
2 |
Medicaid |
083 |
Medicaid HMO (Beginning in 2003) |
010 |
Blue Cross Plan |
3 |
Private Insurance |
018 |
Other Government (beginning in 1998) |
020 |
Blue Cross Plan |
022 |
Blue Cross Plan |
025 |
Blue Cross Plan |
026 |
Blue Cross Plan |
029 |
Blue Cross Plan |
030 |
Blue Cross Plan |
040 |
Blue Cross Plan |
041 |
Blue Cross Plan (1994 only) |
042 |
Blue Cross Plan (1994 only) |
050 |
Blue Cross Plan |
060 |
Blue Cross Plan |
070 |
Blue Cross Plan |
080 |
Blue Cross Plan |
090 |
Blue Cross Plan |
100 |
Blue Cross Plan (1994 only) |
101 |
Blue Cross Plan |
110 |
Blue Cross Plan |
121 |
Blue Cross Plan |
130 |
Blue Cross Plan |
140 |
Blue Cross Plan |
141 |
Blue Cross Plan |
150 |
Blue Cross Plan |
160 |
Blue Cross Plan |
170 |
Blue Cross Plan |
180 |
Blue Cross Plan |
190 |
Blue Cross Plan |
200 |
Blue Cross Plan |
210 |
Blue Cross Plan |
220 |
Blue Cross Plan |
230 |
Blue Cross Plan |
240 |
Blue Cross Plan |
241 |
Blue Cross Plan |
250 |
Blue Cross Plan |
260 |
Blue Cross Plan |
265 |
Blue Cross Plan |
270 |
Blue Cross Plan |
280 |
Blue Cross Plan |
281 |
Blue Cross Plan (valid beginning 1/93) |
290 |
Blue Cross Plan |
300 |
Blue Cross Plan (1994 only) |
301 |
Blue Cross Plan |
303 |
Blue Cross Plan |
304 |
Blue Cross Plan |
305 |
Blue Cross Plan |
306 |
Blue Cross Plan |
307 |
Blue Cross Plan (1994 only) |
308 |
Blue Cross Plan (1994 only) |
310 |
Blue Cross Plan |
320 |
Blue Cross Plan |
331 |
Blue Cross Plan (1994 only) |
332 |
Blue Cross Plan |
333 |
Blue Cross Plan |
334 |
Blue Cross Plan (1994 only) |
335 |
Blue Cross Plan (1994 only) |
337 |
Blue Cross Plan (1994 only) |
338 |
Blue Cross Plan (1994 only) |
340 |
Blue Cross Plan |
350 |
Blue Cross Plan |
351 |
Blue Cross Plan |
360 |
Blue Cross Plan (1994 only) |
361 |
Blue Cross plan |
362 |
Blue Cross Plan |
363 |
Blue Cross plan |
364 |
Blue Cross plan |
370 |
Blue Cross plan |
380 |
Blue Cross plan |
390 |
Blue Cross Plan |
392 |
Blue Cross Plan |
400 |
Blue Cross plan |
410 |
Blue Cross plan |
415 |
Blue Cross plan |
423 |
Blue Cross plan |
424 |
Blue Cross Plan (1994 only) |
430 |
Blue Cross Plan |
441 |
Blue Cross Plan (1994 only) |
443 |
Blue Cross Plan |
444 |
Blue Cross Plan (1994 only) |
450 |
Blue Cross Plan |
460 |
Blue Cross Plan |
470 |
Blue Cross Plan |
471 |
Blue Cross Plan (effective beginning 1/93) |
865 |
Blue Cross Plan (effective beginning 1/95) |
932 |
Blue Cross Plan (1994 only) |
936 |
Blue Cross Plan (1994 only) |
971 |
Blue Cross Plan (1994 only) |
105 |
Commercial |
106 |
Commercial |
107 |
Commercial (effective beginning 4/1/95) |
115 |
Commercial |
120 |
Commercial |
125 |
Commercial |
131 |
Commercial |
135 |
Commercial |
142 |
Commercial |
145 |
Commercial |
151 |
Commercial |
155 |
Commercial |
161 |
Commercial |
165 |
Commercial |
171 |
Commercial |
175 |
Commercial |
181 |
Commercial |
185 |
Commercial |
186 |
Commercial |
187 |
Commercial |
188 |
Commercial |
189 |
Commercial |
191 |
Commercial |
192 |
Commercial |
193 |
Commercial |
194 |
Commercial |
195 |
Commercial |
196 |
Commercial |
197 |
Commercial |
198 |
Commercial |
199 |
Commercial |
032 |
HMO (effective 11/96) |
033 |
HMO (effective 11/96) |
034 |
HMO (effective 8/96) |
035 |
HMO (effective 11/95) |
036 |
HMO (effective 8/97) |
037 |
HMO (effective 8/97) |
043 |
HMO (1994 only) |
044 |
HMO (1994 only) |
045 |
HMO |
046 |
HMO (1994 only) |
047 |
HMO |
048 |
HMO |
049 |
HMO (1994 only) |
051 |
HMO (1994 only) |
052 |
HMO (1994 only) |
053 |
HMO (discontinued 6/98) |
054 |
HMO (1994 only) |
055 |
HMO (1994 only) |
056 |
HMO |
057 |
HMO (1994 only) |
058 |
HMO |
059 |
HMO |
061 |
HMO (discontinued 6/98) |
062 |
HMO (discontinued 6/98) |
063 |
HMO (1994 only) |
064 |
HMO (1994 only) |
065 |
HMO (1994 only) |
066 |
HMO (discontinued 6/98) |
067 |
HMO (discontinued 6/98) |
068 |
HMO (discontinued 6/98) |
069 |
HMO (discontinued 6/98) |
071 |
HMO (discontinued 6/98) |
072 |
HMO |
073 |
HMO |
074 |
HMO |
075 |
HMO (1994 only) |
077 |
HMO |
078 |
HMO |
081 |
HMO (effective 11/96) |
082 |
HMO (discontinued 6/98) |
083 |
HMO (discontinued 6/98) |
084 |
HMO (effective 11/96) |
085 |
HMO (discontinued 6/98) |
086 |
HMO (discontinued 6/98) |
087 |
HMO (effective 11/96) |
088 |
HMO (effective 11/96) |
089 |
HMO (discontinued 6/98) |
094 |
HMO (effective 11/96) |
097 |
HMO (effective 11/96) |
076 |
Miscellaneous |
091 |
Miscellaneous |
093 |
Miscellaneous (effective 1/95) |
096 |
Miscellaneous (effective 1/95) |
309 |
No Fault |
311 |
No Fault |
315 |
No Fault |
399 |
No Fault |
095 |
Miscellaneous |
4 |
Self-pay |
031 |
Patient |
039 |
Patient |
098 |
Miscellaneous |
5 |
No charge |
014 |
Champus |
6 |
Other |
016 |
Other Government |
092 |
Miscellaneous |
099 |
Miscellaneous |
018 |
Other Government (effective between 1988 and 1997) |
019 |
Other Government |
013 |
Title V (Material and Child Health) |
205 |
Worker's Compensation |
211 |
Worker's Compensation |
215 |
Worker's Compensation |
221 |
Worker's Compensation |
225 |
Worker's Compensation |
231 |
Worker's Compensation |
299 |
Worker's Compensation |
000, Blank |
Not Available, Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
New Jersey |
(Valid 2009 - SID, SASD, SEDD) |
PAY1_X and PAY2_X and PAY3_X |
PAY1 and PAY2 |
Value |
Description |
Value |
Description |
009 |
Section 1011 Undocumented Aliens |
1 |
Medicare |
011 |
Title XVII (Medicare) Part A |
015 |
Title XVII (Medicare) Part B |
017 |
Title XVII (Medicare) Part B - Physician Charges |
082 |
Medicare HMO (Beginning in 2003) |
012 |
Title XIX (Medicaid) |
2 |
Medicaid |
083 |
Medicaid HMO (Beginning in 2003) |
010 |
Blue Cross Plan: Alabama |
3 |
Private Insurance |
018 |
New Jersey State Health Benefits Plan |
020 |
Blue Cross Plan: Arkansas |
022 |
Blue Cross Plan: New Jersey - FEP |
025 |
Blue Cross Plan: New Jersey - Garden State |
026 |
Blue Cross Plan: New Jersey - Host |
029 |
Blue Cross Plan: Other Blue Cross |
030 |
Blue Cross Plan: Arizona |
040 |
Blue Cross Plan: California - all other groups |
050 |
Blue Cross Plan: Colorado |
060 |
Blue Cross Plan: Connecticut |
070 |
Blue Cross Plan: Delaware |
080 |
Blue Cross Plan: District of Columbia |
090 |
Blue Cross Plan: Florida |
101 |
Blue Cross Plan: Georgia - all other groups |
110 |
Blue Cross Plan: Idaho |
121 |
Blue Cross Plan: Illinois |
130 |
Blue Cross Plan: Indiana |
140 |
Blue Cross Plan: Iowa - all other groups |
150 |
Blue Cross Plan: Kansas |
160 |
Blue Cross Plan: Kentucky |
170 |
Blue Cross Plan: Louisiana |
180 |
Blue Cross Plan: Maine |
190 |
Blue Cross Plan: Maryland |
200 |
Blue Cross Plan: Massachusetts |
210 |
Blue Cross Plan: Michigan |
220 |
Blue Cross Plan: Minnesota |
230 |
Blue Cross Plan: Mississippi |
240 |
Blue Cross Plan: Missouri - Kansas City |
241 |
Blue Cross Plan: Missouri - St. Louis |
250 |
Blue Cross Plan: Montana |
260 |
Blue Cross Plan: Nebraska |
265 |
Blue Cross Plan: Nevada |
270 |
Blue Cross Plan: New Hampshire |
280 |
Blue Cross Plan: New Jersey - all other groups |
281 |
Blue Cross Plan: New Jersey - non group line of business |
290 |
Blue Cross Plan: New Mexico |
301 |
Blue Cross Plan: New York - Buffalo |
303 |
Blue Cross Plan: New York - New York |
304 |
Blue Cross Plan: New York - Rochester |
305 |
Blue Cross Plan: New York - Syracuse |
306 |
Blue Cross Plan: New York - Utica |
310 |
Blue Cross Plan: North Carolina |
320 |
Blue Cross Plan: North Dakota |
332 |
Blue Cross Plan: Ohio, Cincinnati |
333 |
Blue Cross Plan: Ohio - Cleveland |
340 |
Blue Cross Plan: Oklahoma |
350 |
Blue Cross Plan: Oregon |
351 |
Blue Cross Plan: Portland |
361 |
Blue Cross plan: Pennsylvania - Harrisburg |
362 |
Blue Cross Plan: Pennsylvania - Philadelphia |
363 |
Blue Cross plan: Pennsylvania - Pittsburgh |
364 |
Blue Cross plan: Pennsylvania - Wilks-Barre |
370 |
Blue Cross plan: Rhode Island |
380 |
Blue Cross plan: South Carolina |
390 |
Blue Cross Plan: Tennessee - Chattanooga |
392 |
Blue Cross Plan: Tennessee - Memphis |
400 |
Blue Cross plan: Texas |
410 |
Blue Cross plan: Utah |
415 |
Blue Cross plan: Vermont |
423 |
Blue Cross plan: Virginia - all other groups |
430 |
Blue Cross Plan: Alaska/Washington |
443 |
Blue Cross Plan: West Virginia - all other groups |
450 |
Blue Cross Plan: Wisconsin |
460 |
Blue Cross Plan: Wyoming |
470 |
Blue Cross Plan: Puerto Rico |
471 |
Blue Cross Plan: Hawaii - all other groups |
865 |
Blue Cross Plan: Pennsylvania - Camp Hill (effective 1/95) |
105 |
Commercial: Aetna |
106 |
Commercial: NJ Carpenter's Health Fund |
107 |
Commercial: AARP (effective 4/95) |
115 |
Commercial: Connecticut General |
120 |
Commercial: Continental Assurance |
125 |
Commercial: Equitable |
131 |
Commercial: Guardian Life |
135 |
Commercial: Intercontinental |
142 |
Commercial: John Hancock |
145 |
Commercial: Massachusetts Mutual |
151 |
Commercial: Metropolitan Life |
155 |
Commercial: Mutual of Omaha |
161 |
Commercial: New York Life |
165 |
Commercial: Provident Alliance |
171 |
Commercial: Prudential |
175 |
Commercial: Travelers |
181 |
Commercial: Washington National Insurance |
185 |
Commercial: New Jersey Auto Dealers Association |
186 |
Commercial: Allstate |
187 |
Commercial: Mutual Life of New York |
188 |
Commercial: National Association of Letter Carriers |
189 |
Commercial: Local Union Insurance |
191 |
Commercial: Lincoln National |
192 |
Commercial: New Jersey Turnpike Authority |
193 |
Commercial: Rasmussen |
194 |
Commercial: Inter County Health Plan |
195 |
Commercial: American Postal Workers |
196 |
Commercial: Leader Administrators |
197 |
Commercial: Fred S. James (James Benefit) |
198 |
Commercial: Mail Handlers Benefit Plan |
199 |
Commercial: Other Commercial Insurance |
032 |
HMO: Americaid Inc. (effective 11/96) |
033 |
HMO: American Preferred Provider Plan, Inc. (effective 11/96) |
034 |
HMO: United Health Care (effective 8/96) |
035 |
HMO: MEDI-Group, Inc. (HMO Blue) (effective 11/95) |
036 |
HMO: Principal HMO (effective 8/97) |
037 |
HMO: Mission Health Plans (effective 8/97) |
045 |
HMO: HIP of NJ |
047 |
HMO: HMO Blue (Medigroup Central) |
048 |
HMO: HMO of PA-NJ (US Healthcare) & (Aetna Health Plans of NJ, Inc.) |
049 |
HMO: Rutgers Community Health Plan (1994 only) |
051 |
HMO: Southern Inter-County Med Assn (1994 only) |
056 |
HMO: CIGNA Healthcare of Northern NJ, Inc. |
058 |
HMO: PruCare of NJ |
059 |
HMO: Other HMO |
072 |
HMO: Oxford Health Plan |
073 |
HMO: NYL Care Health Plans of NJ, Inc. |
074 |
HMO: CIGNA Health Care of NJ, Inc. South |
077 |
HMO: QUALMED/Greater Atlantic Health Services |
078 |
HMO: Amerihealth HMO, Inc. |
081 |
HMO: Atlanticare Health Plan (effective 11/96) |
084 |
HMO: First Option Health Plan (effective 11/96) |
087 |
HMO: Liberty Health Plan (effective 11/96) |
088 |
HMO: Managed Health Care Systems of New Jersey, Inc. (effective 11/96) |
094 |
HMO: Physician Health Services of New Jersey, Inc. (effective 11/96) |
097 |
HMO: University Health Plans, Inc. (effective 11/96) |
076 |
Miscellaneous: Premier Preferred Care of New Jersey |
091 |
Miscellaneous: Union Insurance |
093 |
Miscellaneous: MAGNET (Magna Care) (effective 1/95) |
096 |
Miscellaneous: QualCare (effective 1/95) |
309 |
No Fault: Allstate |
311 |
No Fault: New Jersey Manufacturers |
315 |
No Fault: State Farm |
399 |
No Fault: Other |
095 |
Miscellaneous: Indigent |
4 |
Self-pay |
031 |
Patient: Direct |
039 |
Patient: Other Source of Patient Pay |
098 |
Miscellaneous: Hospital Responsibility |
5 |
No charge |
014 |
CHAMPUS |
6 |
Other |
016 |
Department of Vocational Rehabilitation |
092 |
Miscellaneous: Personal Health Program |
099 |
Miscellaneous: Other |
019 |
Other Government |
013 |
Title V (Material and Child Health) |
205 |
Worker's Compensation: Aetna |
211 |
Worker's Compensation: Insurance Company of North America |
215 |
Worker's Compensation: Liberty Mutual |
221 |
Worker's Compensation: Employers Mutual |
225 |
Worker's Compensation: New Jersey Manufacturers |
231 |
Worker's Compensation: Travelers |
299 |
Worker's Compensation: Other
|
000, Blank |
Not Available, Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
New Jersey |
(Valid 2008 - SID, SASD, SEDD) |
PAY1_X and PAY2_X and PAY3_X |
PAY1 and PAY2 |
Value |
Description |
Value |
Description |
009 |
Section 1011 Undocumented Aliens |
1 |
Medicare |
011 |
Title XVII (Medicare) Part A |
015 |
Title XVII (Medicare) Part B |
017 |
Title XVII (Medicare) Part B - Physician Charges |
082 |
Medicare HMO (Beginning in 2003) |
012 |
Title XIX (Medicaid) |
2 |
Medicaid |
083 |
Medicaid HMO (Beginning in 2003) |
010 |
Blue Cross Plan: Alabama |
3 |
Private Insurance |
020 |
Blue Cross Plan: Arkansas |
022 |
Blue Cross Plan: New Jersey - FEP |
025 |
Blue Cross Plan: New Jersey - Garden State |
026 |
Blue Cross Plan: New Jersey - Host |
029 |
Blue Cross Plan: Other Blue Cross |
030 |
Blue Cross Plan: Arizona |
040 |
Blue Cross Plan: California - all other groups |
041 |
Blue Cross Plan: Oakland, CA (1994 only) |
042 |
Blue Cross Plan: San Francisco, CA (1994 only) |
050 |
Blue Cross Plan: Colorado |
060 |
Blue Cross Plan: Connecticut |
070 |
Blue Cross Plan: Delaware |
080 |
Blue Cross Plan: District of Columbia |
090 |
Blue Cross Plan: Florida |
100 |
Blue Cross Plan: Columbus, GA (1994 only) |
101 |
Blue Cross Plan: Georgia - all other groups |
110 |
Blue Cross Plan: Idaho |
121 |
Blue Cross Plan: Illinois |
130 |
Blue Cross Plan: Indiana |
140 |
Blue Cross Plan: Iowa - all other groups |
141 |
Blue Cross Plan: Sioux City, IA (1994 only) |
150 |
Blue Cross Plan: Kansas |
160 |
Blue Cross Plan: Kentucky |
170 |
Blue Cross Plan: Louisiana |
180 |
Blue Cross Plan: Maine |
190 |
Blue Cross Plan: Maryland |
200 |
Blue Cross Plan: Massachusetts |
210 |
Blue Cross Plan: Michigan |
220 |
Blue Cross Plan: Minnesota |
230 |
Blue Cross Plan: Mississippi |
240 |
Blue Cross Plan: Missouri - Kansas City |
241 |
Blue Cross Plan: Missouri - St. Louis |
250 |
Blue Cross Plan: Montana |
260 |
Blue Cross Plan: Nebraska |
265 |
Blue Cross Plan: Nevada |
270 |
Blue Cross Plan: New Hampshire |
280 |
Blue Cross Plan: New Jersey - all other groups |
281 |
Blue Cross Plan: New Jersey - non group line of business |
290 |
Blue Cross Plan: New Mexico |
300 |
Blue Cross Plan: Albany, NY (1994 only) |
301 |
Blue Cross Plan: New York - Buffalo |
303 |
Blue Cross Plan: New York - New York |
304 |
Blue Cross Plan: New York - Rochester |
305 |
Blue Cross Plan: New York - Syracuse |
306 |
Blue Cross Plan: New York - Utica |
307 |
Blue Cross Plan: Watertown, NY (1994 only) |
308 |
Blue Cross Plan: Part A only (NY) (1994 only) |
310 |
Blue Cross Plan: North Carolina |
320 |
Blue Cross Plan: North Dakota |
331 |
Blue Cross Plan: Canton, OH (1994 only) |
332 |
Blue Cross Plan: Ohio, Cincinnati |
333 |
Blue Cross Plan: Ohio - Cleveland |
334 |
Blue Cross Plan: Columbus, OH (1994 only) |
335 |
Blue Cross Plan: Lima, OH (1994 only) |
337 |
Blue Cross Plan: Toledo, OH (1994 only) |
338 |
Blue Cross Plan: Youngstown, OH (1994 only) |
340 |
Blue Cross Plan: Oklahoma |
350 |
Blue Cross Plan: Oregon |
351 |
Blue Cross Plan: Portland |
360 |
Blue Cross Plan: Allentown, PA (1994 only) |
361 |
Blue Cross plan: Pennsylvania - Harrisburg |
362 |
Blue Cross Plan: Pennsylvania - Philadelphia |
363 |
Blue Cross plan: Pennsylvania - Pittsburgh |
364 |
Blue Cross plan: Pennsylvania - Wilks-Barre |
370 |
Blue Cross plan: Rhode Island |
380 |
Blue Cross plan: South Carolina |
390 |
Blue Cross Plan: Tennessee - Chattanooga |
392 |
Blue Cross Plan: Tennessee - Memphis |
400 |
Blue Cross plan: Texas |
410 |
Blue Cross plan: Utah |
415 |
Blue Cross plan: Vermont |
423 |
Blue Cross plan: Virginia - all other groups |
424 |
Blue Cross Plan: Roanoke, VA (1994 only) |
430 |
Blue Cross Plan: Alaska/Washington |
441 |
Blue Cross Plan: Charleston, WV (1994 only) |
443 |
Blue Cross Plan: West Virginia - all other groups |
444 |
Blue Cross Plan: Wheeling, WV (1994 only) |
450 |
Blue Cross Plan: Wisconsin |
460 |
Blue Cross Plan: Wyoming |
470 |
Blue Cross Plan: Puerto Rico |
471 |
Blue Cross Plan: Hawaii - all other groups |
865 |
Blue Cross Plan: Pennsylvania - Camp Hill (effective 1/95) |
932 |
Blue Cross Plan: Seattle, WA/AK (1994 only) |
936 |
Blue Cross Plan: Spokane, WA/AK (1994 only) |
971 |
Blue Cross Plan: Blue Shield (HI) (1994 only) |
105 |
Commercial: Aetna |
106 |
Commercial: NJ Carpenter's Health Fund |
107 |
Commercial: AARP (effective 4/95) |
115 |
Commercial: Connecticut General |
120 |
Commercial: Continental Assurance |
125 |
Commercial: Equitable |
131 |
Commercial: Guardian Life |
135 |
Commercial: Intercontinental |
142 |
Commercial: John Hancock |
145 |
Commercial: Massachusetts Mutual |
151 |
Commercial: Metropolitan Life |
155 |
Commercial: Mutual of Omaha |
161 |
Commercial: New York Life |
165 |
Commercial: Provident Alliance |
171 |
Commercial: Prudential |
175 |
Commercial: Travelers |
181 |
Commercial: Washington National Insurance |
185 |
Commercial: New Jersey Auto Dealers Association |
186 |
Commercial: Allstate |
187 |
Commercial: Mutual Life of New York |
188 |
Commercial: National Association of Letter Carriers |
189 |
Commercial: Local Union Insurance |
191 |
Commercial: Lincoln National |
192 |
Commercial: New Jersey Turnpike Authority |
193 |
Commercial: Rasmussen |
194 |
Commercial: Inter County Health Plan |
195 |
Commercial: American Postal Workers |
196 |
Commercial: Leader Administrators |
197 |
Commercial: Fred S. James (James Benefit) |
198 |
Commercial: Mail Handlers Benefit Plan |
199 |
Commercial: Other Commercial Insurance |
032 |
HMO: Americaid Inc. (effective 11/96) |
033 |
HMO: American Preferred Provider Plan, Inc. (effective 11/96) |
034 |
HMO: United Health Care (effective 8/96) |
035 |
HMO: MEDI-Group, Inc. (HMO Blue) (effective 11/95) |
036 |
HMO: Principal HMO (effective 8/97) |
037 |
HMO: Mission Health Plans (effective 8/97) |
043 |
HMO: Crossroad Health Plan (1994 only) |
044 |
HMO: Cumberland Regional Health Plan (1994 only) |
045 |
HMO: HIP of NJ |
046 |
HMO: HIP of Greater NJ (1994 only) |
047 |
HMO: HMO Blue (Medigroup Central) |
048 |
HMO: HMO of PA-NJ (US Healthcare) & (Aetna Health Plans of NJ, Inc.) |
049 |
HMO: Rutgers Community Health Plan (1994 only) |
051 |
HMO: Southern Inter-County Med Assn (1994 only) |
052 |
HMO: Valley Health Plan (1994 only) |
053 |
HMO: AETNA Health Plans of New Jersey, Inc. (discontinued 6/98) |
054 |
HMO: HMO of NJ (1994 only) |
055 |
HMO: Omni Care (1994 only) |
056 |
HMO: CIGNA Healthcare of Northern NJ, Inc. |
057 |
HMO: Bergen County IPA (1994 only) |
058 |
HMO: PruCare of NJ |
059 |
HMO: Other HMO |
061 |
HMO: MetraHealth Care Plan of Upstate New York (discontinued 6/98) |
062 |
HMO: Garden State Health Plan (discontinued 6/98) |
063 |
HMO: HMO of PA (1994 only) |
064 |
HMO: PruCare (1994 only) |
065 |
HMO: MAXICARE (1994 only) |
066 |
HMO: HMO Blue (Medigroup Metro) (discontinued 6/98) |
067 |
HMO: HMO Blue (Medigroup North) (discontinued 6/98) |
068 |
HMO: HMO Blue (Medigroup South) (discontinued 6/98) |
069 |
HMO: HMO Blue (Medigroup Shoreline) (discontinued 6/98) |
071 |
HMO: MetraHealth Care Plan of NJ (discontinued 6/98) |
072 |
HMO: Oxford Health Plan |
073 |
HMO: NYL Care Health Plans of NJ, Inc. |
074 |
HMO: CIGNA Health Care of NJ, Inc. South |
075 |
HMO: Corporate Health Administrators (1994 only) |
077 |
HMO: QUALMED/Greater Atlantic Health Services |
078 |
HMO: Amerihealth HMO, Inc. |
081 |
HMO: Atlanticare Health Plan (effective 11/96) |
082 |
HMO: ChubbHealth Plan (discontinued 6/98) |
083 |
HMO: Community Health Care and Development Corp (discontinued 6/98) |
084 |
HMO: First Option Health Plan (effective 11/96) |
085 |
HMO: Harmony Health Plan (discontinued 6/98) |
086 |
HMO: HMO Blue (Blue Cross/Blue Shield of New Jersey) (discontinued 6/98) |
087 |
HMO: Liberty Health Plan (effective 11/96) |
088 |
HMO: Managed Health Care Systems of New Jersey, Inc. (effective 11/96) |
089 |
HMO: Physician Health Care Plan of New Jersey (discontinued 6/98) |
094 |
HMO: Physician Health Services of New Jersey, Inc. (effective 11/96) |
097 |
HMO: University Health Plans, Inc. (effective 11/96) |
076 |
Miscellaneous: Premier Preferred Care of New Jersey |
091 |
Miscellaneous: Union Insurance |
093 |
Miscellaneous: MAGNET (Magna Care) (effective 1/95) |
096 |
Miscellaneous: QualCare (effective 1/95) |
018 |
New Jersey State Health Benefits Plan |
309 |
No Fault: Allstate |
311 |
No Fault: New Jersey Manufacturers |
315 |
No Fault: State Farm |
399 |
No Fault: Other |
095 |
Miscellaneous: Indigent |
4 |
Self-pay |
031 |
Patient: Direct |
039 |
Patient: Other Source of Patient Pay |
098 |
Miscellaneous: Hospital Responsibility |
5 |
No charge |
014 |
CHAMPUS |
6 |
Other |
016 |
Department of Vocational Rehabilitation |
092 |
Miscellaneous: Personal Health Program |
099 |
Miscellaneous: Other |
019 |
Other Government |
013 |
Title V (Material and Child Health) |
205 |
Worker's Compensation: Aetna |
211 |
Worker's Compensation: Insurance Company of North America |
215 |
Worker's Compensation: Liberty Mutual |
221 |
Worker's Compensation: Employers Mutual |
225 |
Worker's Compensation: New Jersey Manufacturers |
231 |
Worker's Compensation: Travelers |
299 |
Worker's Compensation: Other
|
000, Blank |
Not Available, Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
New Jersey |
(Valid 2007 - SID, SASD, SEDD) |
PAY1_X and PAY2_X and PAY3_X |
PAY1 and PAY2 |
Value |
Description |
Value |
Description |
009 |
Section 1011 Undocumented Aliens |
1 |
Medicare |
011 |
Title XVII (Medicare) Part A |
015 |
Title XVII (Medicare) Part B |
017 |
Title XVII (Medicare) Part B - Physician Charges |
082 |
Medicare HMO (Beginning in 2003) |
012 |
Title XIX (Medicaid) |
2 |
Medicaid |
083 |
Medicaid HMO (Beginning in 2003) |
010 |
Blue Cross Plan: Alabama |
3 |
Private Insurance |
020 |
Blue Cross Plan: Arkansas |
022 |
Blue Cross Plan: New Jersey - FEP |
025 |
Blue Cross Plan: New Jersey - Garden State |
026 |
Blue Cross Plan: New Jersey - Host |
029 |
Blue Cross Plan: Other Blue Cross |
030 |
Blue Cross Plan: Arizona |
040 |
Blue Cross Plan: California - all other groups |
041 |
Blue Cross Plan: Oakland, CA (1994 only) |
042 |
Blue Cross Plan: San Francisco, CA (1994 only) |
050 |
Blue Cross Plan: Colorado |
060 |
Blue Cross Plan: Connecticut |
070 |
Blue Cross Plan: Delaware |
080 |
Blue Cross Plan: District of Columbia |
090 |
Blue Cross Plan: Florida |
100 |
Blue Cross Plan: Columbus, GA (1994 only) |
101 |
Blue Cross Plan: Georgia - all other groups |
110 |
Blue Cross Plan: Idaho |
121 |
Blue Cross Plan: Illinois |
130 |
Blue Cross Plan: Indiana |
140 |
Blue Cross Plan: Iowa - all other groups |
141 |
Blue Cross Plan: Sioux City, IA (1994 only) |
150 |
Blue Cross Plan: Kansas |
160 |
Blue Cross Plan: Kentucky |
170 |
Blue Cross Plan: Louisiana |
180 |
Blue Cross Plan: Maine |
190 |
Blue Cross Plan: Maryland |
200 |
Blue Cross Plan: Massachusetts |
210 |
Blue Cross Plan: Michigan |
220 |
Blue Cross Plan: Minnesota |
230 |
Blue Cross Plan: Mississippi |
240 |
Blue Cross Plan: Missouri - Kansas City |
241 |
Blue Cross Plan: Missouri - St. Louis |
250 |
Blue Cross Plan: Montana |
260 |
Blue Cross Plan: Nebraska |
265 |
Blue Cross Plan: Nevada |
270 |
Blue Cross Plan: New Hampshire |
280 |
Blue Cross Plan: New Jersey - all other groups |
281 |
Blue Cross Plan: New Jersey - non group line of business |
290 |
Blue Cross Plan: New Mexico |
300 |
Blue Cross Plan: Albany, NY (1994 only) |
301 |
Blue Cross Plan: New York - Buffalo |
303 |
Blue Cross Plan: New York - New York |
304 |
Blue Cross Plan: New York - Rochester |
305 |
Blue Cross Plan: New York - Syracuse |
306 |
Blue Cross Plan: New York - Utica |
307 |
Blue Cross Plan: Watertown, NY (1994 only) |
308 |
Blue Cross Plan: Part A only (NY) (1994 only) |
310 |
Blue Cross Plan: North Carolina |
320 |
Blue Cross Plan: North Dakota |
331 |
Blue Cross Plan: Canton, OH (1994 only) |
332 |
Blue Cross Plan: Ohio, Cincinnati |
333 |
Blue Cross Plan: Ohio - Cleveland |
334 |
Blue Cross Plan: Columbus, OH (1994 only) |
335 |
Blue Cross Plan: Lima, OH (1994 only) |
337 |
Blue Cross Plan: Toledo, OH (1994 only) |
338 |
Blue Cross Plan: Youngstown, OH (1994 only) |
340 |
Blue Cross Plan: Oklahoma |
350 |
Blue Cross Plan: Oregon |
351 |
Blue Cross Plan: Portland |
360 |
Blue Cross Plan: Allentown, PA (1994 only) |
361 |
Blue Cross plan: Pennsylvania - Harrisburg |
362 |
Blue Cross Plan: Pennsylvania - Philadelphia |
363 |
Blue Cross plan: Pennsylvania - Pittsburgh |
364 |
Blue Cross plan: Pennsylvania - Wilks-Barre |
370 |
Blue Cross plan: Rhode Island |
380 |
Blue Cross plan: South Carolina |
390 |
Blue Cross Plan: Tennessee - Chattanooga |
392 |
Blue Cross Plan: Tennessee - Memphis |
400 |
Blue Cross plan: Texas |
410 |
Blue Cross plan: Utah |
415 |
Blue Cross plan: Vermont |
423 |
Blue Cross plan: Virginia - all other groups |
424 |
Blue Cross Plan: Roanoke, VA (1994 only) |
430 |
Blue Cross Plan: Alaska/Washington |
441 |
Blue Cross Plan: Charleston, WV (1994 only) |
443 |
Blue Cross Plan: West Virginia - all other groups |
444 |
Blue Cross Plan: Wheeling, WV (1994 only) |
450 |
Blue Cross Plan: Wisconsin |
460 |
Blue Cross Plan: Wyoming |
470 |
Blue Cross Plan: Puerto Rico |
471 |
Blue Cross Plan: Hawaii - all other groups |
865 |
Blue Cross Plan: Pennsylvania - Camp Hill (effective 1/95) |
932 |
Blue Cross Plan: Seattle, WA/AK (1994 only) |
936 |
Blue Cross Plan: Spokane, WA/AK (1994 only) |
971 |
Blue Cross Plan: Blue Shield (HI) (1994 only) |
105 |
Commercial: Aetna |
106 |
Commercial: NJ Carpenter's Health Fund |
107 |
Commercial: AARP (effective 4/95) |
115 |
Commercial: Connecticut General |
120 |
Commercial: Continental Assurance |
125 |
Commercial: Equitable |
131 |
Commercial: Guardian Life |
135 |
Commercial: Intercontinental |
142 |
Commercial: John Hancock |
145 |
Commercial: Massachusetts Mutual |
151 |
Commercial: Metropolitan Life |
155 |
Commercial: Mutual of Omaha |
161 |
Commercial: New York Life |
165 |
Commercial: Provident Alliance |
171 |
Commercial: Prudential |
175 |
Commercial: Travelers |
181 |
Commercial: Washington National Insurance |
185 |
Commercial: New Jersey Auto Dealers Association |
186 |
Commercial: Allstate |
187 |
Commercial: Mutual Life of New York |
188 |
Commercial: National Association of Letter Carriers |
189 |
Commercial: Local Union Insurance |
191 |
Commercial: Lincoln National |
192 |
Commercial: New Jersey Turnpike Authority |
193 |
Commercial: Rasmussen |
194 |
Commercial: Inter County Health Plan |
195 |
Commercial: American Postal Workers |
196 |
Commercial: Leader Administrators |
197 |
Commercial: Fred S. James (James Benefit) |
198 |
Commercial: Mail Handlers Benefit Plan |
199 |
Commercial: Other Commercial Insurance |
032 |
HMO: Americaid Inc. (effective 11/96) |
033 |
HMO: American Preferred Provider Plan, Inc. (effective 11/96) |
034 |
HMO: United Health Care (effective 8/96) |
035 |
HMO: MEDI-Group, Inc. (HMO Blue) (effective 11/95) |
036 |
HMO: Principal HMO (effective 8/97) |
037 |
HMO: Mission Health Plans (effective 8/97) |
043 |
HMO: Crossroad Health Plan (1994 only) |
044 |
HMO: Cumberland Regional Health Plan (1994 only) |
045 |
HMO: HIP of NJ |
046 |
HMO: HIP of Greater NJ (1994 only) |
047 |
HMO: HMO Blue (Medigroup Central) |
048 |
HMO: HMO of PA-NJ (US Healthcare) & (Aetna Health Plans of NJ, Inc.) |
049 |
HMO: Rutgers Community Health Plan (1994 only) |
051 |
HMO: Southern Inter-County Med Assn (1994 only) |
052 |
HMO: Valley Health Plan (1994 only) |
053 |
HMO: AETNA Health Plans of New Jersey, Inc. (discontinued 6/98) |
054 |
HMO: HMO of NJ (1994 only) |
055 |
HMO: Omni Care (1994 only) |
056 |
HMO: CIGNA Healthcare of Northern NJ, Inc. |
057 |
HMO: Bergen County IPA (1994 only) |
058 |
HMO: PruCare of NJ |
059 |
HMO: Other HMO |
061 |
HMO: MetraHealth Care Plan of Upstate New York (discontinued 6/98) |
062 |
HMO: Garden State Health Plan (discontinued 6/98) |
063 |
HMO: HMO of PA (1994 only) |
064 |
HMO: PruCare (1994 only) |
065 |
HMO: MAXICARE (1994 only) |
066 |
HMO: HMO Blue (Medigroup Metro) (discontinued 6/98) |
067 |
HMO: HMO Blue (Medigroup North) (discontinued 6/98) |
068 |
HMO: HMO Blue (Medigroup South) (discontinued 6/98) |
069 |
HMO: HMO Blue (Medigroup Shoreline) (discontinued 6/98) |
071 |
HMO: MetraHealth Care Plan of NJ (discontinued 6/98) |
072 |
HMO: Oxford Health Plan |
073 |
HMO: NYL Care Health Plans of NJ, Inc. |
074 |
HMO: CIGNA Health Care of NJ, Inc. South |
075 |
HMO: Corporate Health Administrators (1994 only) |
077 |
HMO: QUALMED/Greater Atlantic Health Services |
078 |
HMO: Amerihealth HMO, Inc. |
081 |
HMO: Atlanticare Health Plan (effective 11/96) |
084 |
HMO: First Option Health Plan (effective 11/96) |
085 |
HMO: Harmony Health Plan (discontinued 6/98) |
086 |
HMO: HMO Blue (Blue Cross/Blue Shield of New Jersey) (discontinued 6/98) |
087 |
HMO: Liberty Health Plan (effective 11/96) |
088 |
HMO: Managed Health Care Systems of New Jersey, Inc. (effective 11/96) |
089 |
HMO: Physician Health Care Plan of New Jersey (discontinued 6/98) |
094 |
HMO: Physician Health Services of New Jersey, Inc. (effective 11/96) |
097 |
HMO: University Health Plans, Inc. (effective 11/96) |
076 |
Miscellaneous: Premier Preferred Care of New Jersey |
091 |
Miscellaneous: Union Insurance |
093 |
Miscellaneous: MAGNET (Magna Care) (effective 1/95) |
096 |
Miscellaneous: QualCare (effective 1/95) |
018 |
New Jersey State Health Benefits Plan |
309 |
No Fault: Allstate |
311 |
No Fault: New Jersey Manufacturers |
315 |
No Fault: State Farm |
399 |
No Fault: Other |
095 |
Miscellaneous: Indigent |
4 |
Self-pay |
031 |
Patient: Direct |
039 |
Patient: Other Source of Patient Pay |
098 |
Miscellaneous: Hospital Responsibility |
5 |
No charge |
014 |
CHAMPUS |
6 |
Other |
016 |
Department of Vocational Rehabilitation |
092 |
Miscellaneous: Personal Health Program |
099 |
Miscellaneous: Other |
019 |
Other Government |
013 |
Title V (Material and Child Health) |
205 |
Worker's Compensation: Aetna |
211 |
Worker's Compensation: Insurance Company of North America |
215 |
Worker's Compensation: Liberty Mutual |
221 |
Worker's Compensation: Employers Mutual |
225 |
Worker's Compensation: New Jersey Manufacturers |
231 |
Worker's Compensation: Travelers |
299 |
Worker's Compensation: Other
|
000, Blank |
Not Available, Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
New Jersey |
(Valid 2005-2006 - SID, SASD, SEDD) |
PAY1_X and PAY2_X and PAY3_X |
PAY1 and PAY2 |
Value |
Description |
Value |
Description |
011 |
Title XVII (Medicare) Part A |
1 |
Medicare |
015 |
Title XVII (Medicare) Part B |
017 |
Title XVII (Medicare) Part B - Physician Charges |
082 |
Medicare HMO (Beginning in 2003) |
012 |
Title XIX (Medicaid) |
2 |
Medicaid |
083 |
Medicaid HMO (Beginning in 2003) |
010 |
Blue Cross Plan: Alabama |
3 |
Private Insurance |
020 |
Blue Cross Plan: Arkansas |
022 |
Blue Cross Plan: New Jersey - FEP |
025 |
Blue Cross Plan: New Jersey - Garden State |
026 |
Blue Cross Plan: New Jersey - Host |
029 |
Blue Cross Plan: Other Blue Cross |
030 |
Blue Cross Plan: Arizona |
040 |
Blue Cross Plan: California - all other groups |
041 |
Blue Cross Plan: Oakland, CA (1994 only) |
042 |
Blue Cross Plan: San Francisco, CA (1994 only) |
050 |
Blue Cross Plan: Colorado |
060 |
Blue Cross Plan: Connecticut |
070 |
Blue Cross Plan: Delaware |
080 |
Blue Cross Plan: District of Columbia |
090 |
Blue Cross Plan: Florida |
100 |
Blue Cross Plan: Columbus, GA (1994 only) |
101 |
Blue Cross Plan: Georgia - all other groups |
110 |
Blue Cross Plan: Idaho |
121 |
Blue Cross Plan: Illinois |
130 |
Blue Cross Plan: Indiana |
140 |
Blue Cross Plan: Iowa - all other groups |
141 |
Blue Cross Plan: Sioux City, IA (1994 only) |
150 |
Blue Cross Plan: Kansas |
160 |
Blue Cross Plan: Kentucky |
170 |
Blue Cross Plan: Louisiana |
180 |
Blue Cross Plan: Maine |
190 |
Blue Cross Plan: Maryland |
200 |
Blue Cross Plan: Massachusetts |
210 |
Blue Cross Plan: Michigan |
220 |
Blue Cross Plan: Minnesota |
230 |
Blue Cross Plan: Mississippi |
240 |
Blue Cross Plan: Missouri - Kansas City |
241 |
Blue Cross Plan: Missouri - St. Louis |
250 |
Blue Cross Plan: Montana |
260 |
Blue Cross Plan: Nebraska |
265 |
Blue Cross Plan: Nevada |
270 |
Blue Cross Plan: New Hampshire |
280 |
Blue Cross Plan: New Jersey - all other groups |
281 |
Blue Cross Plan: New Jersey - non group line of business |
290 |
Blue Cross Plan: New Mexico |
300 |
Blue Cross Plan: Albany, NY (1994 only) |
301 |
Blue Cross Plan: New York - Buffalo |
303 |
Blue Cross Plan: New York - New York |
304 |
Blue Cross Plan: New York - Rochester |
305 |
Blue Cross Plan: New York - Syracuse |
306 |
Blue Cross Plan: New York - Utica |
307 |
Blue Cross Plan: Watertown, NY (1994 only) |
308 |
Blue Cross Plan: Part A only (NY) (1994 only) |
310 |
Blue Cross Plan: North Carolina |
320 |
Blue Cross Plan: North Dakota |
331 |
Blue Cross Plan: Canton, OH (1994 only) |
332 |
Blue Cross Plan: Ohio, Cincinnati |
333 |
Blue Cross Plan: Ohio - Cleveland |
334 |
Blue Cross Plan: Columbus, OH (1994 only) |
335 |
Blue Cross Plan: Lima, OH (1994 only) |
337 |
Blue Cross Plan: Toledo, OH (1994 only) |
338 |
Blue Cross Plan: Youngstown, OH (1994 only) |
340 |
Blue Cross Plan: Oklahoma |
350 |
Blue Cross Plan: Oregon |
351 |
Blue Cross Plan: Portland |
360 |
Blue Cross Plan: Allentown, PA (1994 only) |
361 |
Blue Cross plan: Pennsylvania - Harrisburg |
362 |
Blue Cross Plan: Pennsylvania - Philadelphia |
363 |
Blue Cross plan: Pennsylvania - Pittsburgh |
364 |
Blue Cross plan: Pennsylvania - Wilks-Barre |
370 |
Blue Cross plan: Rhode Island |
380 |
Blue Cross plan: South Carolina |
390 |
Blue Cross Plan: Tennessee - Chattanooga |
392 |
Blue Cross Plan: Tennessee - Memphis |
400 |
Blue Cross plan: Texas |
410 |
Blue Cross plan: Utah |
415 |
Blue Cross plan: Vermont |
423 |
Blue Cross plan: Virginia - all other groups |
424 |
Blue Cross Plan: Roanoke, VA (1994 only) |
430 |
Blue Cross Plan: Alaska/Washington |
441 |
Blue Cross Plan: Charleston, WV (1994 only) |
443 |
Blue Cross Plan: West Virginia - all other groups |
444 |
Blue Cross Plan: Wheeling, WV (1994 only) |
450 |
Blue Cross Plan: Wisconsin |
460 |
Blue Cross Plan: Wyoming |
470 |
Blue Cross Plan: Puerto Rico |
471 |
Blue Cross Plan: Hawaii - all other groups |
865 |
Blue Cross Plan: Pennsylvania - Camp Hill (effective 1/95) |
932 |
Blue Cross Plan: Seattle, WA/AK (1994 only) |
936 |
Blue Cross Plan: Spokane, WA/AK (1994 only) |
971 |
Blue Cross Plan: Blue Shield (HI) (1994 only) |
105 |
Commercial: Aetna |
106 |
Commercial: NJ Carpenter's Health Fund |
107 |
Commercial: AARP (effective 4/95) |
115 |
Commercial: Connecticut General |
120 |
Commercial: Continental Assurance |
125 |
Commercial: Equitable |
131 |
Commercial: Guardian Life |
135 |
Commercial: Intercontinental |
142 |
Commercial: John Hancock |
145 |
Commercial: Massachusetts Mutual |
151 |
Commercial: Metropolitan Life |
155 |
Commercial: Mutual of Omaha |
161 |
Commercial: New York Life |
165 |
Commercial: Provident Alliance |
171 |
Commercial: Prudential |
175 |
Commercial: Travelers |
181 |
Commercial: Washington National Insurance |
185 |
Commercial: New Jersey Auto Dealers Association |
186 |
Commercial: Allstate |
187 |
Commercial: Mutual Life of New York |
188 |
Commercial: National Association of Letter Carriers |
189 |
Commercial: Local Union Insurance |
191 |
Commercial: Lincoln National |
192 |
Commercial: New Jersey Turnpike Authority |
193 |
Commercial: Rasmussen |
194 |
Commercial: Inter County Health Plan |
195 |
Commercial: American Postal Workers |
196 |
Commercial: Leader Administrators |
197 |
Commercial: Fred S. James (James Benefit) |
198 |
Commercial: Mail Handlers Benefit Plan |
199 |
Commercial: Other Commercial Insurance |
032 |
HMO: Americaid Inc. (effective 11/96) |
033 |
HMO: American Preferred Provider Plan, Inc. (effective 11/96) |
034 |
HMO: United Health Care (effective 8/96) |
035 |
HMO: MEDI-Group, Inc. (HMO Blue) (effective 11/95) |
036 |
HMO: Principal HMO (effective 8/97) |
037 |
HMO: Mission Health Plans (effective 8/97) |
043 |
HMO: Crossroad Health Plan (1994 only) |
044 |
HMO: Cumberland Regional Health Plan (1994 only) |
045 |
HMO: HIP of NJ |
046 |
HMO: HIP of Greater NJ (1994 only) |
047 |
HMO: HMO Blue (Medigroup Central) |
048 |
HMO: HMO of PA-NJ (US Healthcare) & (Aetna Health Plans of NJ, Inc.) |
049 |
HMO: Rutgers Community Health Plan (1994 only) |
051 |
HMO: Southern Inter-County Med Assn (1994 only) |
052 |
HMO: Valley Health Plan (1994 only) |
053 |
HMO: AETNA Health Plans of New Jersey, Inc. (discontinued 6/98) |
054 |
HMO: HMO of NJ (1994 only) |
055 |
HMO: Omni Care (1994 only) |
056 |
HMO: CIGNA Healthcare of Northern NJ, Inc. |
057 |
HMO: Bergen County IPA (1994 only) |
058 |
HMO: PruCare of NJ |
059 |
HMO: Other HMO |
061 |
HMO: MetraHealth Care Plan of Upstate New York (discontinued 6/98) |
062 |
HMO: Garden State Health Plan (discontinued 6/98) |
063 |
HMO: HMO of PA (1994 only) |
064 |
HMO: PruCare (1994 only) |
065 |
HMO: MAXICARE (1994 only) |
066 |
HMO: HMO Blue (Medigroup Metro) (discontinued 6/98) |
067 |
HMO: HMO Blue (Medigroup North) (discontinued 6/98) |
068 |
HMO: HMO Blue (Medigroup South) (discontinued 6/98) |
069 |
HMO: HMO Blue (Medigroup Shoreline) (discontinued 6/98) |
071 |
HMO: MetraHealth Care Plan of NJ (discontinued 6/98) |
072 |
HMO: Oxford Health Plan |
073 |
HMO: NYL Care Health Plans of NJ, Inc. |
074 |
HMO: CIGNA Health Care of NJ, Inc. South |
075 |
HMO: Corporate Health Administrators (1994 only) |
077 |
HMO: QUALMED/Greater Atlantic Health Services |
078 |
HMO: Amerihealth HMO, Inc. |
081 |
HMO: Atlanticare Health Plan (effective 11/96) |
084 |
HMO: First Option Health Plan (effective 11/96) |
085 |
HMO: Harmony Health Plan (discontinued 6/98) |
086 |
HMO: HMO Blue (Blue Cross/Blue Shield of New Jersey) (discontinued 6/98) |
087 |
HMO: Liberty Health Plan (effective 11/96) |
088 |
HMO: Managed Health Care Systems of New Jersey, Inc. (effective 11/96) |
089 |
HMO: Physician Health Care Plan of New Jersey (discontinued 6/98) |
094 |
HMO: Physician Health Services of New Jersey, Inc. (effective 11/96) |
097 |
HMO: University Health Plans, Inc. (effective 11/96) |
076 |
Miscellaneous: Premier Preferred Care of New Jersey |
091 |
Miscellaneous: Union Insurance |
093 |
Miscellaneous: MAGNET (Magna Care) (effective 1/95) |
096 |
Miscellaneous: QualCare (effective 1/95) |
018 |
New Jersey State Health Benefits Plan |
309 |
No Fault: Allstate |
311 |
No Fault: New Jersey Manufacturers |
315 |
No Fault: State Farm |
399 |
No Fault: Other |
095 |
Miscellaneous: Indigent |
4 |
Self-pay |
031 |
Patient: Direct |
039 |
Patient: Other Source of Patient Pay |
098 |
Miscellaneous: Hospital Responsibility |
5 |
No charge |
014 |
CHAMPUS |
6 |
Other |
016 |
Department of Vocational Rehabilitation |
092 |
Miscellaneous: Personal Health Program |
099 |
Miscellaneous: Other |
019 |
Other Government |
013 |
Title V (Material and Child Health) |
205 |
Worker's Compensation: Aetna |
211 |
Worker's Compensation: Insurance Company of North America |
215 |
Worker's Compensation: Liberty Mutual |
221 |
Worker's Compensation: Employers Mutual |
225 |
Worker's Compensation: New Jersey Manufacturers |
231 |
Worker's Compensation: Travelers |
299 |
Worker's Compensation: Other
|
000, Blank |
Not Available, Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
New Jersey |
(Valid 2003-2004 - SID, SASD, SEDD) |
PAY1_X and PAY2_X and PAY3_X |
PAY1 and PAY2 |
Value |
Description |
Value |
Description |
011 |
Title XVII (Medicare) Part A |
1 |
Medicare |
015 |
Title XVII (Medicare) Part B |
017 |
Title XVII (Medicare) Part B - Physician Charges |
082 |
Medicare HMO (Beginning in 2003) |
012 |
Title XIX (Medicaid) |
2 |
Medicaid |
083 |
Medicaid HMO (Beginning in 2003) |
010 |
Blue Cross Plan: Alabama |
3 |
Private Insurance |
020 |
Blue Cross Plan: Arkansas |
022 |
Blue Cross Plan: New Jersey - FEP |
025 |
Blue Cross Plan: New Jersey - Garden State |
026 |
Blue Cross Plan: New Jersey - Host |
029 |
Blue Cross Plan: Other Blue Cross |
030 |
Blue Cross Plan: Arizona |
040 |
Blue Cross Plan: California - all other groups |
041 |
Blue Cross Plan: Oakland, CA (1994 only) |
042 |
Blue Cross Plan: San Francisco, CA (1994 only) |
050 |
Blue Cross Plan: Colorado |
060 |
Blue Cross Plan: Connecticut |
070 |
Blue Cross Plan: Delaware |
080 |
Blue Cross Plan: District of Columbia |
090 |
Blue Cross Plan: Florida |
100 |
Blue Cross Plan: Columbus, GA (1994 only) |
101 |
Blue Cross Plan: Georgia - all other groups |
110 |
Blue Cross Plan: Idaho |
121 |
Blue Cross Plan: Illinois |
130 |
Blue Cross Plan: Indiana |
140 |
Blue Cross Plan: Iowa - all other groups |
141 |
Blue Cross Plan: Sioux City, IA (1994 only) |
150 |
Blue Cross Plan: Kansas |
160 |
Blue Cross Plan: Kentucky |
170 |
Blue Cross Plan: Louisiana |
180 |
Blue Cross Plan: Maine |
190 |
Blue Cross Plan: Maryland |
200 |
Blue Cross Plan: Massachusetts |
210 |
Blue Cross Plan: Michigan |
220 |
Blue Cross Plan: Minnesota |
230 |
Blue Cross Plan: Mississippi |
240 |
Blue Cross Plan: Missouri - Kansas City |
241 |
Blue Cross Plan: Missouri - St. Louis |
250 |
Blue Cross Plan: Montana |
260 |
Blue Cross Plan: Nebraska |
265 |
Blue Cross Plan: Nevada |
270 |
Blue Cross Plan: New Hampshire |
280 |
Blue Cross Plan: New Jersey - all other groups |
281 |
Blue Cross Plan: New Jersey - non group line of business |
290 |
Blue Cross Plan: New Mexico |
300 |
Blue Cross Plan: Albany, NY (1994 only) |
301 |
Blue Cross Plan: New York - Buffalo |
303 |
Blue Cross Plan: New York - New York |
304 |
Blue Cross Plan: New York - Rochester |
305 |
Blue Cross Plan: New York - Syracuse |
306 |
Blue Cross Plan: New York - Utica |
307 |
Blue Cross Plan: Watertown, NY (1994 only) |
308 |
Blue Cross Plan: Part A only (NY) (1994 only) |
310 |
Blue Cross Plan: North Carolina |
320 |
Blue Cross Plan: North Dakota |
331 |
Blue Cross Plan: Canton, OH (1994 only) |
332 |
Blue Cross Plan: Ohio, Cincinnati |
333 |
Blue Cross Plan: Ohio - Cleveland |
334 |
Blue Cross Plan: Columbus, OH (1994 only) |
335 |
Blue Cross Plan: Lima, OH (1994 only) |
337 |
Blue Cross Plan: Toledo, OH (1994 only) |
338 |
Blue Cross Plan: Youngstown, OH (1994 only) |
340 |
Blue Cross Plan: Oklahoma |
350 |
Blue Cross Plan: Oregon |
351 |
Blue Cross Plan: Portland |
360 |
Blue Cross Plan: Allentown, PA (1994 only) |
361 |
Blue Cross plan: Pennsylvania - Harrisburg |
362 |
Blue Cross Plan: Pennsylvania - Philadelphia |
363 |
Blue Cross plan: Pennsylvania - Pittsburgh |
364 |
Blue Cross plan: Pennsylvania - Wilks-Barre |
370 |
Blue Cross plan: Rhode Island |
380 |
Blue Cross plan: South Carolina |
390 |
Blue Cross Plan: Tennessee - Chattanooga |
392 |
Blue Cross Plan: Tennessee - Memphis |
400 |
Blue Cross plan: Texas |
410 |
Blue Cross plan: Utah |
415 |
Blue Cross plan: Vermont |
423 |
Blue Cross plan: Virginia - all other groups |
424 |
Blue Cross Plan: Roanoke, VA (1994 only) |
430 |
Blue Cross Plan: Alaska/Washington |
441 |
Blue Cross Plan: Charleston, WV (1994 only) |
443 |
Blue Cross Plan: West Virginia - all other groups |
444 |
Blue Cross Plan: Wheeling, WV (1994 only) |
450 |
Blue Cross Plan: Wisconsin |
460 |
Blue Cross Plan: Wyoming |
470 |
Blue Cross Plan: Puerto Rico |
471 |
Blue Cross Plan: Hawaii - all other groups |
865 |
Blue Cross Plan: Pennsylvania - Camp Hill (effective 1/95) |
932 |
Blue Cross Plan: Seattle, WA/AK (1994 only) |
936 |
Blue Cross Plan: Spokane, WA/AK (1994 only) |
971 |
Blue Cross Plan: Blue Shield (HI) (1994 only) |
105 |
Commercial: Aetna |
106 |
Commercial: NJ Carpenter's Health Fund |
107 |
Commercial: AARP (effective 4/95) |
115 |
Commercial: Connecticut General |
120 |
Commercial: Continental Assurance |
125 |
Commercial: Equitable |
131 |
Commercial: Guardian Life |
135 |
Commercial: Intercontinental |
142 |
Commercial: John Hancock |
145 |
Commercial: Massachusetts Mutual |
151 |
Commercial: Metropolitan Life |
155 |
Commercial: Mutual of Omaha |
161 |
Commercial: New York Life |
165 |
Commercial: Provident Alliance |
171 |
Commercial: Prudential |
175 |
Commercial: Travelers |
181 |
Commercial: Washington National Insurance |
185 |
Commercial: New Jersey Auto Dealers Association |
186 |
Commercial: Allstate |
187 |
Commercial: Mutual Life of New York |
188 |
Commercial: National Association of Letter Carriers |
189 |
Commercial: Local Union Insurance |
191 |
Commercial: Lincoln National |
192 |
Commercial: New Jersey Turnpike Authority |
193 |
Commercial: Rasmussen |
194 |
Commercial: Inter County Health Plan |
195 |
Commercial: American Postal Workers |
196 |
Commercial: Leader Administrators |
197 |
Commercial: Fred S. James (James Benefit) |
198 |
Commercial: Mail Handlers Benefit Plan |
199 |
Commercial: Other Commercial Insurance |
032 |
HMO: Americaid Inc. (effective 11/96) |
033 |
HMO: American Preferred Provider Plan, Inc. (effective 11/96) |
034 |
HMO: United Health Care (effective 8/96) |
035 |
HMO: MEDI-Group, Inc. (HMO Blue) (effective 11/95) |
036 |
HMO: Principal HMO (effective 8/97) |
037 |
HMO: Mission Health Plans (effective 8/97) |
043 |
HMO: Crossroad Health Plan (1994 only) |
044 |
HMO: Cumberland Regional Health Plan (1994 only) |
045 |
HMO: HIP of NJ |
046 |
HMO: HIP of Greater NJ (1994 only) |
047 |
HMO: HMO Blue (Medigroup Central) |
048 |
HMO: HMO of PA-NJ (US Healthcare) & (Aetna Health Plans of NJ, Inc.) |
049 |
HMO: Rutgers Community Health Plan (1994 only) |
051 |
HMO: Southern Inter-County Med Assn (1994 only) |
052 |
HMO: Valley Health Plan (1994 only) |
053 |
HMO: AETNA Health Plans of New Jersey, Inc. (discontinued 6/98) |
054 |
HMO: HMO of NJ (1994 only) |
055 |
HMO: Omni Care (1994 only) |
056 |
HMO: CIGNA Healthcare of Northern NJ, Inc. |
057 |
HMO: Bergen County IPA (1994 only) |
058 |
HMO: PruCare of NJ |
059 |
HMO: Other HMO |
061 |
HMO: MetraHealth Care Plan of Upstate New York (discontinued 6/98) |
062 |
HMO: Garden State Health Plan (discontinued 6/98) |
063 |
HMO: HMO of PA (1994 only) |
064 |
HMO: PruCare (1994 only) |
065 |
HMO: MAXICARE (1994 only) |
066 |
HMO: HMO Blue (Medigroup Metro) (discontinued 6/98) |
067 |
HMO: HMO Blue (Medigroup North) (discontinued 6/98) |
068 |
HMO: HMO Blue (Medigroup South) (discontinued 6/98) |
069 |
HMO: HMO Blue (Medigroup Shoreline) (discontinued 6/98) |
071 |
HMO: MetraHealth Care Plan of NJ (discontinued 6/98) |
072 |
HMO: Oxford Health Plan |
073 |
HMO: NYL Care Health Plans of NJ, Inc. |
074 |
HMO: CIGNA Health Care of NJ, Inc. South |
075 |
HMO: Corporate Health Administrators (1994 only) |
077 |
HMO: QUALMED/Greater Atlantic Health Services |
078 |
HMO: Amerihealth HMO, Inc. |
081 |
HMO: Atlanticare Health Plan (effective 11/96) |
084 |
HMO: First Option Health Plan (effective 11/96) |
085 |
HMO: Harmony Health Plan (discontinued 6/98) |
086 |
HMO: HMO Blue (Blue Cross/Blue Shield of New Jersey) (discontinued 6/98) |
087 |
HMO: Liberty Health Plan (effective 11/96) |
088 |
HMO: Managed Health Care Systems of New Jersey, Inc. (effective 11/96) |
089 |
HMO: Physician Health Care Plan of New Jersey (discontinued 6/98) |
094 |
HMO: Physician Health Services of New Jersey, Inc. (effective 11/96) |
097 |
HMO: University Health Plans, Inc. (effective 11/96) |
076 |
Miscellaneous: Premier Preferred Care of New Jersey |
091 |
Miscellaneous: Union Insurance |
093 |
Miscellaneous: MAGNET (Magna Care) (effective 1/95) |
096 |
Miscellaneous: QualCare (effective 1/95) |
309 |
No Fault: Allstate |
311 |
No Fault: New Jersey Manufacturers |
315 |
No Fault: State Farm |
399 |
No Fault: Other |
095 |
Miscellaneous: Indigent |
4 |
Self-pay |
031 |
Patient: Direct |
039 |
Patient: Other Source of Patient Pay |
098 |
Miscellaneous: Hospital Responsibility |
5 |
No charge |
014 |
CHAMPUS |
6 |
Other |
016 |
Department of Vocational Rehabilitation |
092 |
Miscellaneous: Personal Health Program |
099 |
Miscellaneous: Other |
018 |
New Jersey State Health Benefits Plan |
019 |
Other Government |
013 |
Title V (Material and Child Health) |
205 |
Worker's Compensation: Aetna |
211 |
Worker's Compensation: Insurance Company of North America |
215 |
Worker's Compensation: Liberty Mutual |
221 |
Worker's Compensation: Employers Mutual |
225 |
Worker's Compensation: New Jersey Manufacturers |
231 |
Worker's Compensation: Travelers |
299 |
Worker's Compensation: Other
|
000, Blank |
Not Available, Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
New Jersey |
(Valid 2001-2002 - SID, SASD) |
PAY1_X and PAY2_X and PAY3_X |
PAY1 and PAY2 |
Value |
Description |
Value |
Description |
011 |
Title XVII (Medicare) Part A |
1 |
Medicare |
015 |
Title XVII (Medicare) Part B |
017 |
Title XVII (Medicare) Part B - Physician Charges |
012 |
Title XIX (Medicaid) |
2 |
Medicaid |
010 |
Blue Cross Plan: Alabama |
3 |
Private Insurance |
020 |
Blue Cross Plan: Arkansas |
022 |
Blue Cross Plan: New Jersey - FEP |
025 |
Blue Cross Plan: New Jersey - Garden State |
026 |
Blue Cross Plan: New Jersey - Host |
029 |
Blue Cross Plan: Other Blue Cross |
030 |
Blue Cross Plan: Arizona |
040 |
Blue Cross Plan: California - all other groups |
041 |
Blue Cross Plan: Oakland, CA (1994 only) |
042 |
Blue Cross Plan: San Francisco, CA (1994 only) |
050 |
Blue Cross Plan: Colorado |
060 |
Blue Cross Plan: Connecticut |
070 |
Blue Cross Plan: Delaware |
080 |
Blue Cross Plan: District of Columbia |
090 |
Blue Cross Plan: Florida |
100 |
Blue Cross Plan: Columbus, GA (1994 only) |
101 |
Blue Cross Plan: Georgia - all other groups |
110 |
Blue Cross Plan: Idaho |
121 |
Blue Cross Plan: Illinois |
130 |
Blue Cross Plan: Indiana |
140 |
Blue Cross Plan: Iowa - all other groups |
141 |
Blue Cross Plan: Sioux City, IA (1994 only) |
150 |
Blue Cross Plan: Kansas |
160 |
Blue Cross Plan: Kentucky |
170 |
Blue Cross Plan: Louisiana |
180 |
Blue Cross Plan: Maine |
190 |
Blue Cross Plan: Maryland |
200 |
Blue Cross Plan: Massachusetts |
210 |
Blue Cross Plan: Michigan |
220 |
Blue Cross Plan: Minnesota |
230 |
Blue Cross Plan: Mississippi |
240 |
Blue Cross Plan: Missouri - Kansas City |
241 |
Blue Cross Plan: Missouri - St. Louis |
250 |
Blue Cross Plan: Montana |
260 |
Blue Cross Plan: Nebraska |
265 |
Blue Cross Plan: Nevada |
270 |
Blue Cross Plan: New Hampshire |
280 |
Blue Cross Plan: New Jersey - all other groups |
281 |
Blue Cross Plan: New Jersey - non group line of business |
290 |
Blue Cross Plan: New Mexico |
300 |
Blue Cross Plan: Albany, NY (1994 only) |
301 |
Blue Cross Plan: New York - Buffalo |
303 |
Blue Cross Plan: New York - New York |
304 |
Blue Cross Plan: New York - Rochester |
305 |
Blue Cross Plan: New York - Syracuse |
306 |
Blue Cross Plan: New York - Utica |
307 |
Blue Cross Plan: Watertown, NY (1994 only) |
308 |
Blue Cross Plan: Part A only (NY) (1994 only) |
310 |
Blue Cross Plan: North Carolina |
320 |
Blue Cross Plan: North Dakota |
331 |
Blue Cross Plan: Canton, OH (1994 only) |
332 |
Blue Cross Plan: Ohio, Cincinnati |
333 |
Blue Cross Plan: Ohio - Cleveland |
334 |
Blue Cross Plan: Columbus, OH (1994 only) |
335 |
Blue Cross Plan: Lima, OH (1994 only) |
337 |
Blue Cross Plan: Toledo, OH (1994 only) |
338 |
Blue Cross Plan: Youngstown, OH (1994 only) |
340 |
Blue Cross Plan: Oklahoma |
350 |
Blue Cross Plan: Oregon |
351 |
Blue Cross Plan: Portland |
360 |
Blue Cross Plan: Allentown, PA (1994 only) |
361 |
Blue Cross plan: Pennsylvania - Harrisburg |
362 |
Blue Cross Plan: Pennsylvania - Philadelphia |
363 |
Blue Cross plan: Pennsylvania - Pittsburgh |
364 |
Blue Cross plan: Pennsylvania - Wilks-Barre |
370 |
Blue Cross plan: Rhode Island |
380 |
Blue Cross plan: South Carolina |
390 |
Blue Cross Plan: Tennessee - Chattanooga |
392 |
Blue Cross Plan: Tennessee - Memphis |
400 |
Blue Cross plan: Texas |
410 |
Blue Cross plan: Utah |
415 |
Blue Cross plan: Vermont |
423 |
Blue Cross plan: Virginia - all other groups |
424 |
Blue Cross Plan: Roanoke, VA (1994 only) |
430 |
Blue Cross Plan: Alaska/Washington |
441 |
Blue Cross Plan: Charleston, WV (1994 only) |
443 |
Blue Cross Plan: West Virginia - all other groups |
444 |
Blue Cross Plan: Wheeling, WV (1994 only) |
450 |
Blue Cross Plan: Wisconsin |
460 |
Blue Cross Plan: Wyoming |
470 |
Blue Cross Plan: Puerto Rico |
471 |
Blue Cross Plan: Hawaii - all other groups |
865 |
Blue Cross Plan: Pennsylvania - Camp Hill (effective 1/95) |
932 |
Blue Cross Plan: Seattle, WA/AK (1994 only) |
936 |
Blue Cross Plan: Spokane, WA/AK (1994 only) |
971 |
Blue Cross Plan: Blue Shield (HI) (1994 only) |
105 |
Commercial: Aetna |
106 |
Commercial: NJ Carpenter's Health Fund |
107 |
Commercial: AARP (effective 4/95) |
115 |
Commercial: Connecticut General |
120 |
Commercial: Continental Assurance |
125 |
Commercial: Equitable |
131 |
Commercial: Guardian Life |
135 |
Commercial: Intercontinental |
142 |
Commercial: John Hancock |
145 |
Commercial: Massachusetts Mutual |
151 |
Commercial: Metropolitan Life |
155 |
Commercial: Mutual of Omaha |
161 |
Commercial: New York Life |
165 |
Commercial: Provident Alliance |
171 |
Commercial: Prudential |
175 |
Commercial: Travelers |
181 |
Commercial: Washington National Insurance |
185 |
Commercial: New Jersey Auto Dealers Association |
186 |
Commercial: Allstate |
187 |
Commercial: Mutual Life of New York |
188 |
Commercial: National Association of Letter Carriers |
189 |
Commercial: Local Union Insurance |
191 |
Commercial: Lincoln National |
192 |
Commercial: New Jersey Turnpike Authority |
193 |
Commercial: Rasmussen |
194 |
Commercial: Inter County Health Plan |
195 |
Commercial: American Postal Workers |
196 |
Commercial: Leader Administrators |
197 |
Commercial: Fred S. James (James Benefit) |
198 |
Commercial: Mail Handlers Benefit Plan |
199 |
Commercial: Other Commercial Insurance |
032 |
HMO: Americaid Inc. (effective 11/96) |
033 |
HMO: American Preferred Provider Plan, Inc. (effective 11/96) |
034 |
HMO: United Health Care (effective 8/96) |
035 |
HMO: MEDI-Group, Inc. (HMO Blue) (effective 11/95) |
036 |
HMO: Principal HMO (effective 8/97) |
037 |
HMO: Mission Health Plans (effective 8/97) |
043 |
HMO: Crossroad Health Plan (1994 only) |
044 |
HMO: Cumberland Regional Health Plan (1994 only) |
045 |
HMO: HIP of NJ |
046 |
HMO: HIP of Greater NJ (1994 only) |
047 |
HMO: HMO Blue (Medigroup Central) |
048 |
HMO: HMO of PA-NJ (US Healthcare) & (Aetna Health Plans of NJ, Inc.) |
049 |
HMO: Rutgers Community Health Plan (1994 only) |
051 |
HMO: Southern Inter-County Med Assn (1994 only) |
052 |
HMO: Valley Health Plan (1994 only) |
053 |
HMO: AETNA Health Plans of New Jersey, Inc. (discontinued 6/98) |
054 |
HMO: HMO of NJ (1994 only) |
055 |
HMO: Omni Care (1994 only) |
056 |
HMO: CIGNA Healthcare of Northern NJ, Inc. |
057 |
HMO: Bergen County IPA (1994 only) |
058 |
HMO: PruCare of NJ |
059 |
HMO: Other HMO |
061 |
HMO: MetraHealth Care Plan of Upstate New York (discontinued 6/98) |
062 |
HMO: Garden State Health Plan (discontinued 6/98) |
063 |
HMO: HMO of PA (1994 only) |
064 |
HMO: PruCare (1994 only) |
065 |
HMO: MAXICARE (1994 only) |
066 |
HMO: HMO Blue (Medigroup Metro) (discontinued 6/98) |
067 |
HMO: HMO Blue (Medigroup North) (discontinued 6/98) |
068 |
HMO: HMO Blue (Medigroup South) (discontinued 6/98) |
069 |
HMO: HMO Blue (Medigroup Shoreline) (discontinued 6/98) |
071 |
HMO: MetraHealth Care Plan of NJ (discontinued 6/98) |
072 |
HMO: Oxford Health Plan |
073 |
HMO: NYL Care Health Plans of NJ, Inc. |
074 |
HMO: CIGNA Health Care of NJ, Inc. South |
075 |
HMO: Corporate Health Administrators (1994 only) |
077 |
HMO: QUALMED/Greater Atlantic Health Services |
078 |
HMO: Amerihealth HMO, Inc. |
081 |
HMO: Atlanticare Health Plan (effective 11/96) |
082 |
HMO: ChubbHealth Plan (discontinued 6/98) |
083 |
HMO: Community Health Care and Development Corp (discontinued 6/98) |
084 |
HMO: First Option Health Plan (effective 11/96) |
085 |
HMO: Harmony Health Plan (discontinued 6/98) |
086 |
HMO: HMO Blue (Blue Cross/Blue Shield of New Jersey) (discontinued 6/98) |
087 |
HMO: Liberty Health Plan (effective 11/96) |
088 |
HMO: Managed Health Care Systems of New Jersey, Inc. (effective 11/96) |
089 |
HMO: Physician Health Care Plan of New Jersey (discontinued 6/98) |
094 |
HMO: Physician Health Services of New Jersey, Inc. (effective 11/96) |
097 |
HMO: University Health Plans, Inc. (effective 11/96) |
076 |
Miscellaneous: Premier Preferred Care of New Jersey |
091 |
Miscellaneous: Union Insurance |
093 |
Miscellaneous: MAGNET (Magna Care) (effective 1/95) |
096 |
Miscellaneous: QualCare (effective 1/95) |
309 |
No Fault: Allstate |
311 |
No Fault: New Jersey Manufacturers |
315 |
No Fault: State Farm |
399 |
No Fault: Other |
095 |
Miscellaneous: Indigent |
4 |
Self-pay |
031 |
Patient: Direct |
039 |
Patient: Other Source of Patient Pay |
098 |
Miscellaneous: Hospital Responsibility |
5 |
No charge |
014 |
CHAMPUS |
6 |
Other |
016 |
Department of Vocational Rehabilitation |
092 |
Miscellaneous: Personal Health Program |
099 |
Miscellaneous: Other |
018 |
New Jersey State Health Benefits Plan |
019 |
Other Government |
013 |
Title V (Material and Child Health) |
205 |
Worker's Compensation: Aetna |
211 |
Worker's Compensation: Insurance Company of North America |
215 |
Worker's Compensation: Liberty Mutual |
221 |
Worker's Compensation: Employers Mutual |
225 |
Worker's Compensation: New Jersey Manufacturers |
231 |
Worker's Compensation: Travelers |
299 |
Worker's Compensation: Other
|
000, Blank |
Not Available, Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
New Jersey |
(Valid 1998-2000 - SID, SASD) |
PAY1_X and PAY2_X and PAY3_X |
PAY1 and PAY2 |
Value |
Description |
Value |
Description |
011 |
Title XVII (Medicare) Part A |
1 |
Medicare |
015 |
Title XVII (Medicare) Part B |
017 |
Title XVII (Medicare) Part B - Physician Charges |
012 |
Title XIX (Medicaid) |
2 |
Medicaid |
010 |
Blue Cross Plan: Alabama |
3 |
Private Insurance |
020 |
Blue Cross Plan: Arkansas |
022 |
Blue Cross Plan: New Jersey - FEP |
025 |
Blue Cross Plan: New Jersey - Garden State |
026 |
Blue Cross Plan: New Jersey - Host |
029 |
Blue Cross Plan: Other Blue Cross |
030 |
Blue Cross Plan: Arizona |
040 |
Blue Cross Plan: California - all other groups |
041 |
Blue Cross Plan: Oakland, CA (1994 only) |
042 |
Blue Cross Plan: San Francisco, CA (1994 only) |
050 |
Blue Cross Plan: Colorado |
060 |
Blue Cross Plan: Connecticut |
070 |
Blue Cross Plan: Delaware |
080 |
Blue Cross Plan: District of Columbia |
090 |
Blue Cross Plan: Florida |
100 |
Blue Cross Plan: Columbus, GA (1994 only) |
101 |
Blue Cross Plan: Georgia - all other groups |
110 |
Blue Cross Plan: Idaho |
121 |
Blue Cross Plan: Illinois |
130 |
Blue Cross Plan: Indiana |
140 |
Blue Cross Plan: Iowa - all other groups |
141 |
Blue Cross Plan: Sioux City, IA (1994 only) |
150 |
Blue Cross Plan: Kansas |
160 |
Blue Cross Plan: Kentucky |
170 |
Blue Cross Plan: Louisiana |
180 |
Blue Cross Plan: Maine |
190 |
Blue Cross Plan: Maryland |
200 |
Blue Cross Plan: Massachusetts |
210 |
Blue Cross Plan: Michigan |
220 |
Blue Cross Plan: Minnesota |
230 |
Blue Cross Plan: Mississippi |
240 |
Blue Cross Plan: Missouri - Kansas City |
241 |
Blue Cross Plan: Missouri - St. Louis |
250 |
Blue Cross Plan: Montana |
260 |
Blue Cross Plan: Nebraska |
265 |
Blue Cross Plan: Nevada |
270 |
Blue Cross Plan: New Hampshire |
280 |
Blue Cross Plan: New Jersey - all other groups |
281 |
Blue Cross Plan: New Jersey - non group line of business |
290 |
Blue Cross Plan: New Mexico |
300 |
Blue Cross Plan: Albany, NY (1994 only) |
301 |
Blue Cross Plan: New York - Buffalo |
303 |
Blue Cross Plan: New York - New York |
304 |
Blue Cross Plan: New York - Rochester |
305 |
Blue Cross Plan: New York - Syracuse |
306 |
Blue Cross Plan: New York - Utica |
307 |
Blue Cross Plan: Watertown, NY (1994 only) |
308 |
Blue Cross Plan: Part A only (NY) (1994 only) |
310 |
Blue Cross Plan: North Carolina |
320 |
Blue Cross Plan: North Dakota |
331 |
Blue Cross Plan: Canton, OH (1994 only) |
332 |
Blue Cross Plan: Ohio, Cincinnati |
333 |
Blue Cross Plan: Ohio - Cleveland |
334 |
Blue Cross Plan: Columbus, OH (1994 only) |
335 |
Blue Cross Plan: Lima, OH (1994 only) |
337 |
Blue Cross Plan: Toledo, OH (1994 only) |
338 |
Blue Cross Plan: Youngstown, OH (1994 only) |
340 |
Blue Cross Plan: Oklahoma |
350 |
Blue Cross Plan: Oregon |
351 |
Blue Cross Plan: Portland |
360 |
Blue Cross Plan: Allentown, PA (1994 only) |
361 |
Blue Cross plan: Pennsylvania - Harrisburg |
362 |
Blue Cross Plan: Pennsylvania - Philadelphia |
363 |
Blue Cross plan: Pennsylvania - Pittsburgh |
364 |
Blue Cross plan: Pennsylvania - Wilks-Barre |
370 |
Blue Cross plan: Rhode Island |
380 |
Blue Cross plan: South Carolina |
390 |
Blue Cross Plan: Tennessee - Chattanooga |
392 |
Blue Cross Plan: Tennessee - Memphis |
400 |
Blue Cross plan: Texas |
410 |
Blue Cross plan: Utah |
415 |
Blue Cross plan: Vermont |
423 |
Blue Cross plan: Virginia - all other groups |
424 |
Blue Cross Plan: Roanoke, VA (1994 only) |
430 |
Blue Cross Plan: Alaska/Washington |
441 |
Blue Cross Plan: Charleston, WV (1994 only) |
443 |
Blue Cross Plan: West Virginia - all other groups |
444 |
Blue Cross Plan: Wheeling, WV (1994 only) |
450 |
Blue Cross Plan: Wisconsin |
460 |
Blue Cross Plan: Wyoming |
470 |
Blue Cross Plan: Puerto Rico |
471 |
Blue Cross Plan: Hawaii - all other groups |
865 |
Blue Cross Plan: Pennsylvania - Camp Hill (effective 1/95) |
932 |
Blue Cross Plan: Seattle, WA/AK (1994 only) |
936 |
Blue Cross Plan: Spokane, WA/AK (1994 only) |
971 |
Blue Cross Plan: Blue Shield (HI) (1994 only) |
105 |
Commercial: Aetna |
106 |
Commercial: NJ Carpenter's Health Fund |
107 |
Commercial: AARP (effective 4/95) |
115 |
Commercial: Connecticut General |
120 |
Commercial: Continental Assurance |
125 |
Commercial: Equitable |
131 |
Commercial: Guardian Life |
135 |
Commercial: Intercontinental |
142 |
Commercial: John Hancock |
145 |
Commercial: Massachusetts Mutual |
151 |
Commercial: Metropolitan Life |
155 |
Commercial: Mutual of Omaha |
161 |
Commercial: New York Life |
165 |
Commercial: Provident Alliance |
171 |
Commercial: Prudential |
175 |
Commercial: Travelers |
181 |
Commercial: Washington National Insurance |
185 |
Commercial: New Jersey Auto Dealers Association |
186 |
Commercial: Allstate |
187 |
Commercial: Mutual Life of New York |
188 |
Commercial: National Association of Letter Carriers |
189 |
Commercial: Local Union Insurance |
191 |
Commercial: Lincoln National |
192 |
Commercial: New Jersey Turnpike Authority |
193 |
Commercial: Rasmussen |
194 |
Commercial: Inter County Health Plan |
195 |
Commercial: American Postal Workers |
196 |
Commercial: Leader Administrators |
197 |
Commercial: Fred S. James (James Benefit) |
198 |
Commercial: Mail Handlers Benefit Plan |
199 |
Commercial: Other Commercial Insurance |
032 |
HMO: Americaid Inc. (effective 11/96) |
033 |
HMO: American Preferred Provider Plan, Inc. (effective 11/96) |
034 |
HMO: United Health Care (effective 8/96) |
035 |
HMO: MEDI-Group, Inc. (HMO Blue) (effective 11/95) |
036 |
HMO: Principal HMO (effective 8/97) |
037 |
HMO: Mission Health Plans (effective 8/97) |
043 |
HMO: Crossroads Health Plan (1994 only) |
044 |
HMO: Cumberland Regional Health Plan (1994 only) |
045 |
HMO: HIP of NJ |
046 |
HMO: HIP of Greater NJ (1994 only) |
047 |
HMO: HMO Blue (Medigroup Central) |
048 |
HMO: HMO of PA-NJ (US Healthcare) & (Aetna Health Plans of NJ, Inc.) |
049 |
HMO: Rutgers Community Health Plan (1994 only) |
051 |
HMO: Southern Inter-County Med Assn (1994 only) |
052 |
HMO: Valley Health Plan (1994 only) |
053 |
HMO: AETNA Health Plans of New Jersey, Inc. (discontinued 6/98) |
054 |
HMO: HMO of NJ (1994 only) |
055 |
HMO: Omni Care (1994 only) |
056 |
HMO: CIGNA Healthcare of Northern NJ, Inc. |
057 |
HMO: Bergen County IPA (1994 only) |
058 |
HMO: PruCare of NJ |
059 |
HMO: Other HMO |
061 |
HMO: MetraHealth Care Plan of Upstate New York (discontinued 6/98) |
062 |
HMO: Garden State Health Plan (discontinued 6/98) |
063 |
HMO: HMO of PA (1994 only) |
064 |
HMO: PruCare (1994 only) |
065 |
HMO: MAXICARE (1994 only) |
066 |
HMO: HMO Blue (Medigroup Metro) (discontinued 6/98) |
067 |
HMO: HMO Blue (Medigroup North) (discontinued 6/98) |
068 |
HMO: HMO Blue (Medigroup South) (discontinued 6/98) |
069 |
HMO: HMO Blue (Medigroup Shoreline) (discontinued 6/98) |
071 |
HMO: MetraHealth Care Plan of NJ (discontinued 6/98) |
072 |
HMO: Oxford Health Plan |
073 |
HMO: NYL Care Health Plans of NJ, Inc. |
074 |
HMO: CIGNA Health Care of NJ, Inc. South |
075 |
HMO: Corporate Health Administrators (1994 only) |
077 |
HMO: QUALMED/Greater Atlantic Health Services |
078 |
HMO: Amerihealth HMO, Inc. |
081 |
HMO: Atlanticare Health Plan (effective 11/96) |
082 |
HMO: ChubbHealth Plan (discontinued 6/98) |
083 |
HMO: Community Health Care and Development Corp (discontinued 6/98) |
084 |
HMO: First Option Health Plan (effective 11/96) |
085 |
HMO: Harmony Health Plan (discontinued 6/98) |
086 |
HMO: HMO Blue (Blue Cross/Blue Shield of New Jersey) (discontinued 6/98) |
087 |
HMO: Liberty Health Plan (effective 11/96) |
088 |
HMO: Managed Health Care Systems of New Jersey, Inc. (effective 11/96) |
089 |
HMO: Physician Health Care Plan of New Jersey (discontinued 6/98) |
094 |
HMO: Physician Health Services of New Jersey, Inc. (effective 11/96) |
097 |
HMO: University Health Plans, Inc. (effective 11/96) |
076 |
Miscellaneous: Premier Preferred Care of New Jersey |
091 |
Miscellaneous: Union Insurance |
093 |
Miscellaneous: MAGNET (Magna Care) (effective 1/95) |
096 |
Miscellaneous: QualCare (effective 1/95) |
309 |
No Fault: Allstate |
311 |
No Fault: New Jersey Manufacturers |
315 |
No Fault: State Farm |
399 |
No Fault: Other |
095 |
Miscellaneous: Indigent |
4 |
Self-pay |
031 |
Patient: Direct |
039 |
Patient: Other Source of Patient Pay |
098 |
Miscellaneous: Hospital Responsibility |
5 |
No charge |
014 |
CHAMPUS |
6 |
Other |
016 |
Department of Vocational Rehabilitation |
092 |
Miscellaneous: Personal Health Program |
099 |
Miscellaneous: Other |
018 |
New Jersey State Health Benefits Plan |
019 |
Other Government |
013 |
Title V (Material and Child Health) |
205 |
Worker's Compensation: Aetna |
211 |
Worker's Compensation: Insurance Company of North America |
215 |
Worker's Compensation: Liberty Mutual |
221 |
Worker's Compensation: Employers Mutual |
225 |
Worker's Compensation: New Jersey Manufacturers |
231 |
Worker's Compensation: Travelers |
299 |
Worker's Compensation: Other
|
000, Blank |
Not Available, Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
New York (SID)
New York
|
(Valid beginning 2017)
|
Payer typology mapping for Version 7.0 Effective June 2016 |
PAY1_X, PAY2_X, PAY3_X
|
PAY1, PAY2, PAY3
|
Value
|
Description
|
Value
|
Description
|
1 |
Medicare |
1 |
Medicare |
11 |
Medicare Managed Care (Includes Medicare Advantage Plans) |
111 |
Medicare HMO |
112 |
Medicare PPO |
113 |
Medicare POS |
119 |
Medicare Managed Care Other |
1111 |
Dual Eligible Special Needs Plan (D-SNP) |
1112 |
Fully Integrated Dual Eligible Special Needs Plans (FIDE-SNP) |
12 |
Medicare (Non-managed Care) |
121 |
Medicare FFS |
122 |
Medicare Drug Benefit |
123 |
Medicare Medical Savings Account (MSA) |
129 |
Medicare Non-managed Care (Other) |
13 |
Medicare Hospice |
14 |
Dual Eligibility Medicare/Medicaid Organization |
141 |
Medicare Chronic Condition Special Needs Plan (C-SNP) |
142 |
Medicare Chronic Condition Special Needs Plan (C-SNP) |
19 |
Medicare (Other) |
191 |
Medicare Pharmacy Benefit Manager |
2 |
Medicaid |
2 |
Medicaid |
21 |
Medicaid (Managed Care) |
211 |
Medicaid HMO |
2111 |
Family Health Plus (NYS ADDITION)* |
2112 |
Healthy New York (NYS ADDITION)* |
212 |
Medicaid PPO |
213 |
Medicaid PCCM (Primary Care Case Management) |
219 |
Medicaid Managed Care (Other) |
22 |
Medicaid (Non-managed Care Plan) |
23 |
Medicaid/SCHIP |
24 |
Medicaid Applicant |
25 |
Medicaid (Out of State) |
26 |
Medicaid - Long Term Care |
29 |
Medicaid (Other) |
291 |
Medicaid Pharmacy Benefit Manager |
299 |
Medicaid - Dental |
361 |
State SCHIP Program |
391 |
Federal Employee Health Plan (beginning 2020) |
3 |
Private Insurance |
5 |
Private Health Insurance (other than Blue Cross/Blue Shield) |
51 |
Managed Care (Private) |
511 |
Commercial Managed Care (HMO) |
512 |
Commercial Managed Care (PPO) |
513 |
Commercial Managed Care (POS) |
514 |
Exclusive Provider Organization |
515 |
Gatekeeper PPO (GPPO) |
516 |
Commercial Managed Care - Pharmacy Benefit Manager |
517 |
Commercial Managed Care - Dental |
519 |
Managed Care, Other (non-HMO) |
52 |
Private Health Insurance (Indemnity) |
521 |
Commercial Indemnity (e.g. high option/low option) |
522 |
Self-insured (ERISA) Administrative Services Only (ASO) plan |
523 |
Medicare supplemental policy (as second payer) |
524 |
Indemnity Insurance - Dental |
529 |
Private health insurance-other commercial Indemnity |
53 |
Private Managed Care or private health insurance (indemnity), not otherwise specified |
54 |
Private Organized Delivery System |
55 |
Small Employer Purchasing Group |
56 |
Specialized Stand Alone Plan |
59 |
Other Private Insurance* |
561 |
Specialized Stand Alone Plan - Dental |
562 |
Specialized Stand Alone Plan - Vision |
6 |
Blue Cross/Blue Shield |
61 |
BC Managed Care |
611 |
BC Managed Care (HMO) |
612 |
BC Managed Care (PPO) |
613 |
BC Managed Care (POS) |
614 |
BC Managed Care (Dental) |
619 |
BC Managed Care (Other) |
62 |
BC Insurance Indemnity |
621 |
BC Indemnity |
622 |
BC Self-insured (ERISA) Administrative Services Only (ASO) Plan |
623 |
BC Medicare Supplemental Plan |
629 |
BC Indemnity - Dental |
63 |
BC (Indemnity or Managed Care) - Out of State* |
64 |
BC (Indemnity or Managed Care) - Unspecified* |
69 |
BC (Indemnity or Managed Care) - Other* |
7 |
Managed Care (to be used only if one can't distinguish public from private) |
71 |
Managed care (public or private) - HMO |
72 |
Managed care (public or private) - PPO |
73 |
Managed care (public or private) - POS |
79 |
Managed care (public or private) - Other |
96 |
Auto Insurance (no fault) |
8 |
NOPAYMENT from an Organization/Agency/Program/Private Payor Listed |
4 |
Self Pay |
81 |
Self Pay |
82 |
No Charge |
5 |
No charge |
821 |
Charity |
822 |
Professional Courtesy |
823 |
Research/Clinical Trial |
83 |
Refusal to Pay/Bad Debt |
84 |
Hill Burton Free Care |
85 |
Research/Donor |
89 |
No Payment |
3 |
Other Government (Federal/State/Government) |
6 |
Other |
31 |
Department of Defense |
311 |
TRICARE (CHAMPUS) |
3111 |
TRICARE Prime-HMO |
3112 |
TRICARE Extra-PPO |
3113 |
TRICARE Standard - fee for service |
3114 |
TRICARE For Life - Medicare Supplement |
3115 |
TRICARE Reserve Select |
3116 |
Uniformed Services Family Health Plan (USFHP) -- HMO |
3119 |
Department of Defense - (other) |
312 |
Military Treatment Facility (MTF) |
3121 |
MTF - Enrolled Prime-HMO |
3122 |
MTF - Non-enrolled Space Available |
3123 |
MTF - TRICARE For Life (TFL) |
313 |
Department of Defense - Dental Stand Alone |
32 |
Department of Veterans Affairs (VA) |
321 |
VA - Care provided to Veterans |
3211 |
VA - Direct Care in VA facilities |
3212 |
VA - Indirect Care (outside VA facilities) |
32121 |
VA - Indirect Care - Fee basis |
32122 |
VA - Indirect Care - Foreign Medical program |
32123 |
VA - Indirect Care - Community Nursing Home |
32124 |
VA - Indirect Care - State Veterans Home |
32125 |
VA - Indirect Care - Sharing Agreements |
32126 |
VA - Indirect Care - Other Federal Agency |
32127 |
VA - Indirect Care - Dental Care |
32128 |
VA - Indirect Care - Vision Care |
322 |
VA - Non-veteran care |
3221 |
VA - Civilian Health and Medical Program for the VA |
3222 |
VA - Spina Bifida Health Care Program |
3223 |
VA - Children of Women Vietnam Veterans |
3229 |
VA - Other non-veteran care |
33 |
Indian Health Service or Tribe |
331 |
Indian Health Service (Regular) |
332 |
Indian Health Service (Contract) |
333 |
Indian Health Service (Managed Care) |
334 |
Indian Tribe (Sponsored Coverage) |
34 |
HRSA Program |
341 |
Title V (MCH Block Grant) |
342 |
Migrant Health Program |
343 |
Ryan White Act |
344 |
Disaster-related (includes Covid-19) (valid beginning 2020) |
349 |
Other |
35 |
Black Lung |
36 |
State Government |
362 |
Specific State Programs |
369 |
State, not otherwise specified (other state) |
37 |
Local Government |
371 |
Local (Managed Care) |
3711 |
Local government HMO |
3712 |
Local government POS |
3713 |
Local government PPO |
372 |
FFS/Indemnity |
379 |
Local, not otherwise specified (other local, county) |
38 |
Other Government (Federal, State, Local not specified) |
381 |
Federal, State, Local not specified (Managed care) |
3811 |
Federal, State, Local not specified (HMO) |
3812 |
Federal, State, Local not specified (PPO) |
3813 |
Federal, State, Local not specified (POS) |
3819 |
Federal, State, Local not specified (Other managed care) |
382 |
Federal, State, Local not specified (FFS) |
389 |
Federal, State, Local not specified (Other) |
39 |
Other Federal |
4 |
Department of Corrections |
41 |
Corrections Federal |
42 |
Corrections State |
43 |
Corrections Local |
44 |
Corrections (Unknown Level) |
9 |
Miscellaneous/Other |
91 |
Foreign National |
92 |
Other (Non-government) |
93 |
Disability Insurance |
94 |
Long-term Care Insurance |
95 |
Worker's Compensation |
951 |
Worker's Comp (HMO) |
953 |
Worker's Comp (Fee-for-Service) |
954 |
Worker's Comp (Other Managed Care) |
959 |
Worker's Comp (Other unspecified) |
97 |
Legal Liability / Liability Insurance |
98 |
Other specified but not otherwise classifiable (includes Hospice - Unspecified plan) |
99 |
No Typology Code available for payment source |
blank |
Not reported |
. |
Missing |
9999 |
No payer specified |
ZZZ |
Missing Data |
Any values not documented by the data source |
.A |
Invalid |
*Based on NY documentation of values |
New York
|
(Valid from 1993-2016)
|
PAY1_X, (PAY2_X beginning in 1995), (PAY3_X beginning in 1998)
|
PAY1, PAY2, PAY3
|
Value
|
Description
|
Value
|
Description
|
03 |
Medicare |
1 |
Medicare |
16 |
Medicare HMO |
04 |
Medicaid |
2 |
Medicaid |
17 |
Medicaid HMO |
06 |
Blue Cross |
3 |
Private Insurance |
08 |
Commercial Insurance Company |
11 |
HMO (Other) |
13 |
No-fault |
15 |
Self-insured, Self-administered plans |
01 |
Self-pay |
4 |
Self-pay |
09 |
No charge |
5 |
No charge |
02 |
Workers' Compensation |
6 |
Other |
07 |
Other Government |
10 |
Other |
12 |
CHAMPUS/VA |
18 |
Corrections Federal (starting in 1996) |
19 |
Corrections State (starting in 1996) |
20 |
Corrections Local (starting in 1996) |
Blank |
Missing |
. |
Missing |
Other |
|
.A |
Invalid |
New York
|
(Valid for 1988-1992)
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
03 |
Medicare |
1 |
Medicare |
04 |
Medicaid |
2 |
Medicaid |
06 |
Blue Cross |
3 |
Private Insurance |
08 |
Commercial Insurance |
11 |
Other HMO |
13 |
No-fault (starting in 1992) |
15 |
Self-insured, Self-administered plans (starting in 1992) |
01 |
Self-pay |
4 |
Self-pay |
09 |
No charge |
5 |
No charge |
02 |
Worker's Compensation |
6 |
Other |
07 |
Other Government |
14 |
Corrections (federal, state, or local) |
10 |
Other |
12 |
CHAMPUS/VA (starting in 1992) |
Blank |
Primary |
. |
Missing |
Blank, 00 |
Missing |
Other values |
|
.A |
Invalid |
New York
|
(Valid for 1992)
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
03 |
Medicare |
1 |
Medicare |
04 |
Medicaid |
2 |
Medicaid |
06 |
Blue Cross |
3 |
Private Insurance |
08, 13, 15 |
Commercial Insurance; no-fault; self-insured, self-administered plan |
11 |
Other HMO |
01 |
Self-pay |
4 |
Self-pay |
09 |
No charge |
5 |
No charge |
02 |
Workers' Compensation |
6 |
Other |
12 |
CHAMPUS/VA |
07, 14 |
Other government; Corrections (state, county, or city) |
10 |
Other |
Blank |
Primary |
. |
Missing |
Blank, 00 |
Secondary |
. |
Missing |
Other Values |
|
.A |
Invalid |
New York
|
(Valid from 1988-1991)
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
03 |
Medicare |
1 |
Medicare |
04 |
Medicaid |
2 |
Medicaid |
06 |
Blue Cross |
3 |
Private Insurance |
08 |
Commercial Insurance |
11 |
Other HMO |
01 |
Self-pay |
4 |
Self-pay |
09 |
No charge |
5 |
No charge |
02 |
Workers' Compensation |
6 |
Other |
07 |
Other government; Corrections (state, county, or city) |
10 |
Other |
Blank |
Primary:
|
. |
Missing |
Blank, 00 |
Secondary:
|
. |
Missing |
Other Values |
|
.A |
Invalid |
New York (SEDD)
For 2018, New York did not provide payer code 2 and 3.
New York
|
(Valid beginning 2017)
|
Payer typology mapping for Version 7.0 Effective June 2016 |
PAY1_X, PAY2_X, PAY3_X
|
PAY1, PAY2, PAY3
|
Value
|
Description
|
Value
|
Description
|
1 |
Medicare |
1 |
Medicare |
11 |
Medicare (Managed Care) |
111 |
Medicare HMO |
112 |
Medicare PPO |
113 |
Medicare POS |
119 |
Medicare Managed Care (Other) |
12 |
Medicare (Non-managed Care) |
121 |
Medicare FFS |
122 |
Medicare Drug Benefit |
123 |
Medicare Medical Savings Account (MSA) |
129 |
Medicare Non-managed Care (Other) |
13 |
Medicare Hospice |
14 |
Dual Eligibility Medicare/Medicaid Organization |
19 |
Medicare (Other) |
191 |
Medicare Pharmacy Benefit Manager |
2 |
Medicaid |
2 |
Medicaid |
21 |
Medicaid (Managed Care) |
211 |
Medicaid HMO |
2111 |
Family Health Plus (NYS ADDITION)* |
2112 |
Healthy New York (NYS ADDITION)* |
212 |
Medicaid PPO |
213 |
Medicaid PCCM (Primary Care Case Management) |
219 |
Medicaid Managed Care (Other) |
22 |
Medicaid (Non-managed Care Plan) |
23 |
Medicaid/SCHIP |
24 |
Medicaid Applicant |
25 |
Medicaid (Out of State) |
26 |
Medicaid - Long Term Care |
29 |
Medicaid (Other) |
291 |
Medicaid Pharmacy Benefit Manager |
299 |
Medicaid - Dental |
361 |
State SCHIP Program |
5 |
Private Health Insurance (other than Blue Cross/Blue Shield) |
3 |
Private Insurance |
51 |
Managed Care (Private) |
511 |
Commercial Managed Care (HMO) |
512 |
Commercial Managed Care (PPO) |
513 |
Commercial Managed Care (POS) |
514 |
Exclusive Provider Organization |
515 |
Gatekeeper PPO (GPPO) |
516 |
Commercial Managed Care - Pharmacy Benefit Manager |
517 |
Commercial Managed Care - Dental |
519 |
Managed Care, Other (non-HMO) |
52 |
Private Health Insurance (Indemnity) |
521 |
Commercial Indemnity (e.g. high option/low option) |
522 |
Self-insured (ERISA) Administrative Services Only (ASO) plan |
523 |
Medicare supplemental policy (as second payer) |
524 |
Indemnity Insurance - Dental |
529 |
Private health insurance-other commercial Indemnity |
53 |
Private Managed Care or private health insurance (indemnity), not otherwise specified |
54 |
Private Organized Delivery System |
55 |
Small Employer Purchasing Group |
56 |
Specialized Stand Alone Plan |
59 |
Other Private Insurance* |
561 |
Specialized Stand Alone Plan - Dental |
562 |
Specialized Stand Alone Plan - Vision |
6 |
Blue Cross/Blue Shield |
61 |
BC Managed Care |
611 |
BC Managed Care (HMO) |
612 |
BC Managed Care (PPO) |
613 |
BC Managed Care (POS) |
614 |
BC Managed Care (Dental) |
619 |
BC Managed Care (Other) |
62 |
BC Insurance Indemnity |
621 |
BC Indemnity |
622 |
BC Self-insured (ERISA) Administrative Services Only (ASO) Plan |
623 |
BC Medicare Supplemental Plan |
629 |
BC Indemnity - Dental |
63 |
BC (Indemnity or Managed Care) - Out of State* |
64 |
BC (Indemnity or Managed Care) - Unspecified* |
69 |
BC (Indemnity or Managed Care) - Other* |
7 |
Managed Care (to be used only if one can't distinguish public from private) |
71 |
Managed care (public or private) - HMO |
72 |
Managed care (public or private) - PPO |
73 |
Managed care (public or private) - POS |
79 |
Managed care (public or private) - Other |
96 |
Auto Insurance (no fault) |
8 |
NOPAYMENT from an Organization/Agency/Program/Private Payor Listed |
4 |
Self Pay |
81 |
Self Pay |
82 |
No Charge |
5 |
No charge |
821 |
Charity |
822 |
Professional Courtesy |
823 |
Research/Clinical Trial |
83 |
Refusal to Pay/Bad Debt |
84 |
Hill Burton Free Care |
85 |
Research/Donor |
89 |
No Payment |
3 |
Other Government (Federal/State/Government) |
6 |
Other |
31 |
Department of Defense |
311 |
TRICARE (CHAMPUS) |
3111 |
TRICARE Prime-HMO |
3112 |
TRICARE Extra-PPO |
3113 |
TRICARE Standard - fee for service |
3114 |
TRICARE For Life - Medicare Supplement |
3115 |
TRICARE Reserve Select |
3116 |
Uniformed Services Family Health Plan (USFHP) -- HMO |
3119 |
Department of Defense - (other) |
312 |
Military Treatment Facility (MTF) |
3121 |
MTF - Enrolled Prime-HMO |
3122 |
MTF - Non-enrolled Space Available |
3123 |
MTF - TRICARE For Life (TFL) |
313 |
Department of Defense - Dental Stand Alone |
32 |
Department of Veterans Affairs (VA) |
321 |
VA - Care provided to Veterans |
3211 |
VA - Direct Care in VA facilities |
3212 |
VA - Indirect Care (outside VA facilities) |
32121 |
VA - Indirect Care - Fee basis |
32122 |
VA - Indirect Care - Foreign Medical program |
32123 |
VA - Indirect Care - Community Nursing Home |
32124 |
VA - Indirect Care - State Veterans Home |
32125 |
VA - Indirect Care - Sharing Agreements |
32126 |
VA - Indirect Care - Other Federal Agency |
32127 |
VA - Indirect Care - Dental Care |
32128 |
VA - Indirect Care - Vision Care |
322 |
VA - Non-veteran care |
3221 |
VA - Civilian Health and Medical Program for the VA |
3222 |
VA - Spina Bifida Health Care Program |
3223 |
VA - Children of Women Vietnam Veterans |
3229 |
VA - Other non-veteran care |
33 |
Indian Health Service or Tribe |
331 |
Indian Health Service (Regular) |
332 |
Indian Health Service (Contract) |
333 |
Indian Health Service (Managed Care) |
334 |
Indian Tribe (Sponsored Coverage) |
34 |
HRSA Program |
341 |
Title V (MCH Block Grant) |
342 |
Migrant Health Program |
343 |
Ryan White Act |
349 |
Other |
35 |
Black Lung |
36 |
State Government |
362 |
Specific State Programs |
369 |
State, not otherwise specified (other state) |
37 |
Local Government |
371 |
Local (Managed Care) |
3711 |
Local government HMO |
3712 |
Local government POS |
3713 |
Local government PPO |
372 |
FFS/Indemnity |
379 |
Local, not otherwise specified (other local, county) |
38 |
Other Government (Federal, State, Local not specified) |
381 |
Federal, State, Local not specified (Managed care) |
3811 |
Federal, State, Local not specified (HMO) |
3812 |
Federal, State, Local not specified (PPO) |
3813 |
Federal, State, Local not specified (POS) |
3819 |
Federal, State, Local not specified (Other managed care) |
382 |
Federal, State, Local not specified (FFS) |
389 |
Federal, State, Local not specified (Other) |
39 |
Other Federal |
391 |
Federal Employee Health Plan |
4 |
Department of Corrections |
41 |
Corrections Federal |
42 |
Corrections State |
43 |
Corrections Local |
44 |
Corrections (Unknown Level) |
9 |
Miscellaneous/Other |
91 |
Foreign National |
92 |
Other (Non-government) |
93 |
Disability Insurance |
94 |
Long-term Care Insurance |
95 |
Worker's Compensation |
951 |
Worker's Comp (HMO) |
953 |
Worker's Comp (Fee-for-Service) |
954 |
Worker's Comp (Other Managed Care) |
959 |
Worker's Comp (Other unspecified) |
97 |
Legal Liability / Liability Insurance |
98 |
Other specified but not otherwise classifiable (includes Hospice - Unspecified plan) |
99 |
No Typology Code available for payment source |
blank |
Not reported |
. |
Missing |
9999 |
No payer specified |
ZZZ |
Missing Data |
Any values not documented by the data source |
.A |
Invalid |
*Based on NY documentation of values |
New York
|
(Applies to PAY1_X and PAY1 2005 - 2016)
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
03 |
Medicare |
1 |
Medicare |
16 |
Medicare HMO |
04 |
Medicaid |
2 |
Medicaid |
17 |
Medicaid HMO |
06 |
Blue Cross |
3 |
Private Insurance |
08 |
Commercial Insurance Company |
11 |
HMO (Other) |
13 |
No-fault |
15 |
Self-insured, Self-administered plans |
01 |
Self-pay |
4 |
Self-pay |
09 |
No charge |
5 |
No charge |
02 |
Worker's Compensation |
6 |
Other |
07 |
Other Government |
10 |
Other |
12 |
CHAMPUS/VA |
18 |
Corrections Federal |
19 |
Corrections State |
20 |
Corrections Local |
Blank |
Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
New York
|
(Applies to PAY1_X and PAY1 for 2007-2010; PAY2_X, PAY2, and PAY3_X starting in 2005; and PAY3 starting in 2010)
|
PAYn_X
|
PAYn
|
Value
|
Description
|
Value
|
Description
|
C |
Medicare |
1 |
Medicare |
D |
Medicaid |
2 |
Medicaid |
F |
Insurance Company, HMO, PHSP (Medicaid managed care patients may be reported under this source value, in addition to privately insured managed care patients. Starting in data year 2011, Medicaid managed care patients are reported under a separate source value.) |
3 |
Private Insurance |
G |
Blue Cross |
L |
Automobile Medical (effective prior to 2015) |
A |
Self-pay |
4 |
Self-pay |
B |
Workers' Compensation |
6 |
Other |
E |
Other Federal Program |
H |
CHAMPUS |
I |
Other Non-Federal Program |
J |
Disability |
K |
Title V |
L |
Unknown |
. |
Missing |
Blank |
Missing |
Any values not documented by the data source |
.A |
Invalid |
New York Note: New York reports source of payment on their ED records instead of expected payer. The coding scheme uses alphabetic characters A through L defined in the recode table. New York reports expected payer for ambulatory surgery data (coding scheme is numeric). For 2007-2010, NY used both alphabetic characters A through L and numeric coding schemes for PAY1_X. If an ambulatory surgery record has evidence of ED services (either ED charge or an admission source), then the record is also included in the HCUP SEDD.
North Carolina (SID and SEDD)
Beginning in Q4 2010, the payer data element was modified to two characters in length and the values change. Records with PAYn_X assigned Autmobile Medical (AM) were erroneously mapped to PAYn as "Invalid" instead of "Private Insurance".
North Carolina
|
(Valid from October 2010)
|
PAY1_X, PAY2_X, and PAY3_X
|
PAY1, PAY2, and PAY3
|
Value
|
Description
|
Value
|
Description
|
MA |
Medicare |
1 |
Medicare |
M |
Medicare Part A (Valid 2011-2015) |
MB |
Medicare Part B |
MC |
Medicaid |
2 |
Medicaid |
MM |
Medicaid Managed Care (starting in 2020) |
BL |
Blue Cross |
3 |
Private insurance |
B |
Blue Cross & Blue Shield (Valid 2011-2015) |
H |
HMO - PPO (Valid 2012-2015) |
HM |
HMO - PPO |
CI |
Commercial Insurance |
A |
Automobile Medical (Valid 2012-2015) |
AM |
Automobile Medical |
14 |
Exclusive Provider Org |
16 |
Health Maintenance Org |
15 |
Indemnity Insurance |
17 |
Dental Maintenance Organization (starting in 2020) |
FI |
Federal Employees Program (starting in 2020) |
LI |
Liability |
LM |
Liability Medical |
13 |
Point of Service |
12 |
Preferred Provider Org |
S |
Self Insured (Valid 2011-2015) |
Y |
POS (Valid 2012-2015) |
09, 9 |
Self-pay |
4 |
Self-pay |
P |
Self-pay (Valid 2011-2015) |
-- |
|
5 |
No charge |
CH |
Champus |
6 |
Other |
C |
Champus (Valid 2011-2015) |
DS |
Disability |
G |
Disability (Valid 2011-2015) |
OF |
Other Federal Program |
E |
Other Government (Valid 2012-2015) |
N |
Other Government (Valid 2011-2015) |
11 |
Other Non-Federal Program |
X |
Other Non-Federal Program (Valid 2011-2015) |
TV |
Title V |
VA |
Veteran Administration Plan |
WC |
Workers' Compensation |
O |
Other (Valid 2011-2015) |
99 |
Missing (starting in 2020) |
. |
Missing |
ZZ |
Mutually Defined (starting in 2020) |
00, U, UN, ZZ, Blank |
Documented by source as unknown values |
98 |
Invalid (starting in 2020) |
.A |
Invalid |
Any values not documented by the data source |
North Carolina
|
(Valid January 2010 through September 2010)
|
PAY1_X, PAY2_X, and PAY3_X
|
PAY1, PAY2, and PAY3
|
Value
|
Description
|
Value
|
Description
|
MA |
Medicare |
1 |
Medicare |
M |
Medicare Part A (Valid 2011) |
MB |
Medicare Part B |
MC |
Medicaid |
2 |
Medicaid |
BL |
Blue Cross |
3 |
Private insurance |
B |
Blue Cross & Blue Shield (Valid 2011) |
HM |
HMO - PPO |
CI |
Other Insurance Companies |
AM |
Automobile Medical |
14 |
Exclusive Provider Org |
16 |
Health Maintenance Org |
15 |
Indemnity Insurance |
LI |
Liability |
LM |
Liability Medical |
13 |
Point of Service |
12 |
Preferred Provider Org |
S |
Self Insured |
09, 9 |
Self-pay |
4 |
Self-pay |
-- |
|
5 |
No charge |
CH |
Champus |
6 |
Other |
DS |
Disability |
OF |
Other Federal Program |
11 |
Other Non-Federal Program |
TV |
Title V |
VA |
Veteran Administration Plan |
WC |
Workers' Compensation |
00, U, UN, ZZ, Blank |
Documented by source as unknown values |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
North Carolina
|
(Valid prior to 2010)
|
PAY1_X, PAY2_X, and PAY3_X
|
PAY1, PAY2, and PAY3
|
Value
|
Description
|
Value
|
Description
|
M |
Medicare |
1 |
Medicare |
T |
Medicare Part B |
D |
Medicaid |
2 |
Medicaid |
B |
Blue Cross |
3 |
Private insurance |
H |
HMO - PPO |
I |
Other Insurance Companies |
A |
Automobile Medical |
J |
Exclusive Provider Org |
K |
Health Maintenance Org |
L |
Indemnity Insurance |
Q |
Liability |
R |
Liability Medical |
Y |
Point of Service |
Z |
Preferred Provider Org |
P |
Self-pay |
4 |
Self-pay |
-- |
|
5 |
No charge |
C |
Champus |
6 |
Other |
O |
Other |
G |
Disability |
V |
Other Federal Program |
X |
Other Non-Federal Program |
1 |
Title V |
2 |
Veteran Administration Plan |
W |
Workers' Compensation |
U, Blank |
Documented by source as unknown values |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
North Dakota (SID and SEDD)
North Dakota
|
PAY1_X, PAY2_X and PAY3_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
2000000 |
Medicare |
1 |
Medicare |
6000003 |
Blue Cross, Medicare |
6000103 |
Blue Cross, MN, Medicare |
6009903 |
Blue Cross, Other, Medicare |
7000102 |
Medica - Choice, Medicare |
7000202 |
Group Health, Medicare |
7000402 |
Medica - Primary, Medicare |
7000502 |
MedCenters, Medicare |
7000602 |
UCare, Medicare |
7000702 |
Blue Plus, Medicare |
7000802 |
Metro. Health Plan, Medicare |
7001002 |
Health Partners, Medicare |
7001302 |
First Plan HMO, Medicare |
7001402 |
Altru Health Plan, Medicare |
7001502 |
Sioux Valley, Medicare |
7000902 |
Blue Cross HMO, Medicare |
7009902 |
Other HMO, Medicare |
8000302 |
SelectCare, Medicare |
8000402 |
Preferred One, Medicare |
8000502 |
America's PPO, Medicare |
8000602 |
Aetna PPO, Medicare |
8000902 |
Blue Cross PPO, Medicare |
8001302 |
Private Health Care System, Medicare |
8001502 |
LaborCare PPO, Medicare |
8009902 |
Other PPO, Medicare |
3000000 |
Medicaid |
2 |
Medicaid |
3000001 |
Medicaid Pending |
3000100 |
Medicaid, Minnesota |
3000101 |
Pending, MN, Medicaid |
3000200 |
Medicaid, Wisconsin |
3000201 |
Medicaid, Wisconsin, Pending |
3000900 |
Medicaid, South Dakota |
3000901 |
Medicaid, South Dakota, Pending |
3001101 |
Medicaid, Iowa, Pending |
3001000 |
Medicaid, North Dakota |
3001100 |
Medicaid, Iowa |
3009900 |
Medicaid, Other |
3009901 |
Medicaid, Other, Pending Eligible |
4000500 |
General Assistance Medical Care (GAMC)/GA/Welfare (Starting 2014) |
4000800 |
PrimeWest, Cty Based Purchased (Starting 2014) |
4000900 |
Itasca Medical Care, CBP (Starting 2014) |
4001000 |
So. Country Hlth Alliance, CBP (Starting 2014) |
7000101 |
Medica - Choice, Medicaid |
7000103 |
Medica - Choice, GAMC (Starting 2014) |
7000201 |
Group Health, Medicaid |
7000301 |
Ramsey Care, Medicaid |
7000303 |
Ramsey Care, GAMC, etc. (Starting 2014) |
7000401 |
Medica - Primary, Medicaid |
7000501 |
MedCenters, Medicaid |
7000601 |
Ucare, Medicaid |
7000603 |
Ucare, GAMC, etc. (Starting 2014) |
7000701 |
Blue Plus, Medicaid |
7000703 |
Blue Plus, GAMC, etc. (Starting 2014) |
7000801 |
Metro. Health Plan, Medicaid |
7000803 |
Metro. Health Plan, GAMC, etc. (Starting 2014) |
7000901 |
Blue Cross HMO, Medicaid |
7001001 |
Health Partners, Medicaid |
7001003 |
Health Partners, GAMC, etc. (Starting 2014) |
7001201 |
Northwest National Life (NWNL) Health Network, Medicaid |
7001301 |
First Plan HMO, Medicaid |
7001401 |
Altru Health Plan, Medicaid |
7001501 |
Sioux Valley, Medicaid |
7009901 |
Other HMO, Medicaid |
7009903 |
Other HMO, GAMC/GA/Welfare (Starting 2014) |
8000301 |
SelectCare, Medicaid |
8000401 |
Preferred One, Medicaid |
8000501 |
America's PPO, Medicaid |
8000701 |
Group Health PPO, Medicaid |
8000901 |
Blue Cross PPO, Medicaid |
8001001 |
Medica Choice PPO, Medicaid |
8001501 |
LaborCare PPO, Medicaid |
8009901 |
Other PPO, Medicaid |
5000000 |
Commercial |
3 |
Private insurance |
5009900 |
Commercial |
5009901 |
Commercial (Regina) |
6000000 |
Blue Cross |
6000001 |
Blue Cross, Aware |
6000100 |
Blue Cross, MN |
6000101 |
Blue Cross, MN, Aware |
6000102 |
Blue Cross, Preferred Gold |
6000200 |
Blue Cross, North Dakota |
6000201 |
Blue Cross, North Dakota, Aware |
6000202 |
Blue Cross, North Dakota, Preferred Gold |
6009900 |
Blue Cross, Non-MN |
6009901 |
Blue Cross, Non-MN Aware |
6009902 |
Blue Cross, Other, Preferred Gold |
7000000 |
Other HMO |
7000100 |
Medica - Choice |
7000200 |
Group Health |
7000300 |
Ramsey Health |
7000400 |
Medica - Primary |
7000500 |
MedCenters |
7000600 |
Ucare |
7000700 |
Blue Plus |
7000800 |
Metro. Health Plan |
7000900 |
Blue Cross HMO |
7001000 |
Health Partners |
7001200 |
Northwest National Life (NWNL) Health Network |
7001300 |
First Plan HMO |
7001400 |
Altru Health Plan |
7001500 |
Sioux Valley |
7009900 |
Other HMO |
8000000 |
Other PPO |
8000300 |
SelectCare |
8000320 |
SelectCare, Union |
8000400 |
Preferred One |
8000420 |
Preferred One, Union |
8000500 |
ARAZ, Union (formerly, Ethix Midwest; also known as America's PPO) |
8000520 |
ARAZ (formerly Ethix Midwest; also known as America's PPO) |
8000600 |
Aetna PPO |
8000620 |
Aetna PPO, Union |
8000700 |
Group Health PPO |
8000800 |
HealthEast Care, Inc. |
8000900 |
Blue Cross PPO |
8001000 |
Medica Choice PPO |
8001020 |
Medica, Union |
8001200 |
Northwest National LIfe (NWNL) PPO |
8002300 |
Private Health Care System |
8001400 |
Prudential Plus |
8001500 |
LaborCare PPO |
8001520 |
LaborCare PPO, Union |
8500100 |
Self Insured, Choice Plus |
8509900 |
Other Self Insured |
8009900 |
Other PPO |
8009920 |
Other PPO, union |
9001000 |
Other, Self-Insured Co. |
9002000 |
Other, Unions |
1000000 |
Self-Pay |
4 |
Self-Pay |
1000100 |
Self-Pay |
1000102 |
Self-Pay (Prior to 2014) |
1000200 |
Self-Pay, Charity Care |
-- |
-- |
5 |
No charge |
3060000 |
Minnesota Care |
6 |
Other |
3060100 |
Minnesota Care |
4000000 |
Other Government |
4000100 |
Title V |
4000200 |
Worker's Comp |
4000201 |
Worker's Comp, Minnesota (Starting in 2015) |
4000202 |
Worker's Comp, Out of State (Starting in 2015) |
4000203 |
Worker's Comp, Federal (Starting in 2015) |
4000300 |
TRICARE/CHAMPUS |
4000400 |
MN Comp. Health Care |
4000500 |
General Assistance Medical Care (GAMC)/GA/Welfare (Prior to 2014) |
4000600 |
Aid to Families with Dependent Children (AFDC) |
4000700 |
Children's Health Plan |
4000800 |
PrimeWest, Cty Based Purchased (Prior to 2014) |
4000900 |
Itasca Medical Care, CBP (Prior to 2014) |
4001000 |
So. Country Hlth Alliance, CBP (Prior to 2014) |
4009900 |
Other Govt., Other |
7000103 |
Medica - Choice, GAMC (Prior to 2014) |
7000104 |
Medica-Choice, MNCare |
7000204 |
HMO, Group Health Plan, MNCARE |
7000303 |
Ramsey Care, GAMC, etc. (Prior to 2014) |
7000404 |
Medica-Primary, MNCare |
7000603 |
Ucare, GAMC, etc. (Prior to 2014) |
7000604 |
U-Care, MNCare |
7000703 |
Blue Plus, GAMC, etc. (Prior to 2014) |
7000704 |
Blue Plus, MNCare |
7000803 |
Metro. Health Plan, GAMC, etc. (Prior to 2014) |
7000804 |
Metro. Health Plan, MNCare |
7000904 |
Blue Cross HMO, MNCare |
7001003 |
Health Partners, GAMC, etc. (Prior to 2014) |
7001004 |
Health Partners, MNCare |
7001304 |
First Plan HMO, MNCare |
7001404 |
Altru Health Plan, MNCare |
7001504 |
Sioux Valley, MNCare |
7009903 |
Other HMO, GAMC/GA/Welfare (Prior to 2014) |
7009904 |
Other HMO, MNCare |
8000404 |
Preferred One, MNCare |
8000504 |
America's PPO, MNCare |
8000604 |
Aetna PPO, MNCare |
8000804 |
HealthEast Care, Inc. MNCare |
8000920 |
PPO, Blue Cross PPO, Union |
8000904 |
Blue Cross PPO, MNCare |
8001304 |
Private Hlth Care Sys MNCare |
8001404 |
Prudential Plus, MNCare |
8001504 |
LaborCare PPO MNCare |
8009904 |
Other PPO, MNCare |
9000000 |
Other |
9009900 |
Other |
Blank |
Missing |
. |
Missing |
8888888 |
Missing/Unknown (or insurance master) |
9999999 |
Missing/Unknown (not on insurance master) |
Any values not documented by the data source |
.A |
Invalid |
Ohio (SID and SEDD)
Ohio |
(Beginning in 2006) |
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
C |
Medicare |
1 |
Medicare |
O |
Medicare Managed Care |
D |
Medicaid |
2 |
Medicaid |
M |
Medicaid Managed Care |
F |
Commercial Insurance |
3 |
Private insurance |
G |
Blue Cross Crossover |
J |
Blue Cross |
K |
HMO |
L |
PPO |
N |
Blue Cross HMO |
A |
Self Pay |
4 |
Self-pay |
P |
Bad Debt - beginning with 2003 |
5 |
No charge |
Q |
Charity - beginning with 2003 |
B |
Workers Compensation |
6 |
Other |
E |
Other Government |
H |
Champus |
I |
Other |
R |
Hospital Care Assurance Program (HCAP) - beginning with 2003 |
Z |
International Payor |
00, Blank, not provided |
Unknown, Missing, not provided |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Ohio (SID and SEDD)
Ohio
|
(Prior to 2006) |
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
03 |
Medicare |
1 |
Medicare |
15 |
Medicare HMO |
04 |
Medicaid |
2 |
Medicaid |
13 |
Medicaid HMO |
06 |
Commercial Insurance |
3 |
Private insurance |
07 |
Blue Cross Crossover |
10 |
Blue Cross Primary |
11 |
HMO |
12 |
PPO |
14 |
Blue Cross HMO |
01 |
Self Pay |
4 |
Self-pay |
16 |
Bad Debt - beginning with 2003 |
5 |
No charge |
17 |
Charity - beginning with 2003 |
02 |
Workers Compensation |
6 |
Other |
05 |
Other Federal |
08 |
Champus |
09 |
Other |
18 |
Hospital Care Assurance Program (HCAP) - beginning with 2003 |
00, Blank |
Unknown, Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Rhode Island (SID and SEDD)
Rhode Island
|
(Valid Beginning 2022)
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
3 |
Medicare |
1 |
Medicare |
2 |
Medicaid |
2 |
Medicaid |
1 |
Commercial Insurance |
3 |
Private Insurance |
4 |
Self-pay |
4 |
Self-pay |
5 |
Workers' Compensation/CHAMPUS |
6 |
Other |
6 |
Other |
9 |
Unknown/Missing |
. |
Missing |
Any values not documented by the data source |
|
.A |
Invalid |
Rhode Island
|
(Valid 2020-2021)
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
0 |
Medicare |
1 |
Medicare |
1 |
Medicaid |
2 |
Medicaid |
G |
RIte Care |
5 |
Blue Cross |
3 |
Private Insurance |
E |
Blue Cross |
H |
Neighborhood Health Plan of RI |
6 |
Commercial Insurance |
D |
United Healthcare |
7 |
Self-pay |
4 |
Self-pay |
B |
CHAMPUS |
6 |
Other |
8 |
Other |
4 |
Workers' Compensation |
X, Y, Z, Blank |
Insurance error, Missing Info |
. |
Missing |
Any values not documented by the data source |
|
.A |
Invalid |
Rhode Island
|
(Valid Prior 2020)
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
B 4000 |
Out of State Blue Cross, Medicare (managed care) |
1 |
Medicare |
H 4000 |
Coordinated Health Partners, Medicare (managed care) |
M |
Medicare Fee for Service |
M 2000 |
Medicare Fee for Service, commercial carrier (Effective 2015-2016) |
M 4000 |
Medicare Managed Care (Effective 2013-2016) |
N 4000 |
Neighborhood Health Plan, Medicare (Start in 2017) |
O 4000 |
Other, Medicare (managed care) |
R 4000 |
Medicare managed care by Rhode Island Blue Cross Starting 2015) |
U 4000 |
UHC, Medicare (managed care) |
B 3000 |
Out of State Blue Cross, Medicaid (managed care) |
2 |
Medicaid |
D |
Medicaid Fee for Service |
D 3000 |
Medicaid Managed Care (Starting 2013) |
H 3000 |
Coordinated Health Partners, Medicaid (managed care) |
N 3000 |
Neighborhood Health Plan, Medicaid (managed care) |
O 3000 |
Other, Medicaid (managed care) |
R 3000 |
Rhode Island Blue Cross, Medicaid (Sart in 2017) |
U 3000 |
UHC, Medicaid (managed care) |
B 2000 |
Out of State Blue Cross |
3 |
Private Insurance |
H 2000 |
Coordinated Health Partners |
N 2000 |
Neighborhood Health Plan |
O 2000 |
Other Commercial Insurance Plan |
R |
Rhode Island Blue Cross |
R 2000 |
Rhode Island Blue Cross (Commercial Insurance Plan) |
U 2000 |
United Health Care |
P |
Self-pay |
4 |
Self-pay |
Z |
Free (Effective prior to 2017) |
5 |
No charge |
C |
CHAMPUS |
6 |
Other |
O |
Other (Start in 2017) |
W |
Workers' Compensation |
W 2000 |
Workers' Compensation (Starting 2015) |
Y, Z, Blank |
Insurance error, Missing Info |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
Rhode Island
|
(Valid through 2002)
|
PAY1_X
|
PAY1
|
Value
|
Description
|
Value
|
Description
|
1 |
Medicare |
1 |
Medicare |
2 |
Medicare managed care |
3 |
Medicaid fee for service |
2 |
Medicaid |
4 |
Rite Care, Rhode Island's Medicaid managed care program |
5 |
Medicaid managed care, not otherwise specified |
9 |
Commercial |
3 |
Private Insurance |
6 |
Blue Cross |
7 |
Blue Chip, HMO Rhode Island |
8 |
United |
13 |
Self-pay |
4 |
Self-pay |
14 |
Free care, no charge |
5 |
No charge |
10 |
CHAMPUS |
6 |
Other |
11 |
Worker's Comp |
12 |
Other |
99, Blank |
Error, Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
South Carolina (SID and SEDD)
South Carolina
|
(Valid beginning in 2002)
|
PAY1_X, PAY2_X, and PAY3_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
1 |
Medicare |
1 |
Medicare |
2 |
Medicaid |
2 |
Medicaid |
4 |
Commercial (including Blue Cross) |
3 |
Private insurance |
5 |
HMO |
6 |
Self-Pay |
4 |
Self-pay |
-- |
|
5 |
No charge |
9 |
Workers' Compensation |
6 |
Other |
10 |
Tricare, CHAMPUS, CHAMPVA |
12 |
Other Agency, Charity (i.e. Medical Indigent Assistance Program (MAIP), Hill Burton, County Government, etc.) |
13 |
Other |
Blank |
Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
South Carolina
|
(Valid 2000-2001)
|
PAY1_X, PAY2_X, and PAY3_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
1 |
Medicare |
1 |
Medicare |
13 |
Medicare managed care |
2 |
Medicaid |
2 |
Medicaid |
14 |
Medicaid managed care |
4 |
Commercial, PPO |
3 |
Private insurance |
5 |
HMO |
6 |
Self-Pay |
4 |
Self-pay |
-- |
|
5 |
No charge |
9 |
Workers' Compensation |
6 |
Other |
10 |
CHAMPUS, CHAMPVA |
12 |
Other |
Blank |
Missing |
. |
Missing |
Any values not documented by the data source |
.A |
Invalid |
South Carolina
|
(Valid from 1998-1999)
|
PAY1_X and PAY2_X
|
PAY1 and PAY2
|
Value
|
Description
|
Value
|
Description
|
6 |
Medicare |
1 |
Medicare |
7 |
Medicaid |
2 |
Medicaid |
12 |
Commercial, unspecified |
3 |
Private insurance |
13 |
Commercial, unspecified |
14 |
Commercial, unspecified |
16 |
HMO |
1 |
Self-pay |
4 |
Self-pay |
-- | |