Central Distributor SEDD: Description of Data Elements

PAY1 - Expected primary payer, uniform

Documentation Sections:

PAY1 indicates the expected primary payer (Medicare, Medicaid, private insurance, etc.). To ensure uniformity of coding across data sources, PAY1 combines detailed categories in the more general groups. For example,

Medicare includes both fee-for-service and managed care Medicare patients.
Medicaid includes both fee-for-service and managed care Medicaid patients.
Private insurance (PAY1 = 3) includes Blue Cross, commercial carriers, and private HMOs and PPOs.
Other (PAY1 = 6) includes Worker's Compensation, CHAMPUS, CHAMPVA, Title V, and other government programs.

The HCUP data element PAY1_X retains the expected primary payer as provided by the data source. The State Specific Notes for PAY1 include information on how the source values contained in the PAY1_X are recoded into the HCUP uniform values of PAY1.

When there is a generic category for managed care such as "HMO/PPO" reported under PAY1_X, it is mapped to private insurance (PAY1 = 3) in the HCUP databases. However, it is possible that hospitals may inadvertently include patients covered by a Medicare managed care program administered by a private insurance company under a generic managed care category.

In the 1988-1997 data, the data element PAY1_N provides more detailed categories for private insurance and other payers. This data element is discontinued beginning in the 1998 data because of the difficulty of coding the information uniformly across States.

If information on secondary or tertiary payers is provided by the data source, the coding of the associated HCUP variables (PAY2, PAY2_X, PAY3, and PAY3_X) is included under the State Specific Notes for PAY1.

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Uniform Values

Variable	Description	Value	Value Description
PAY1	Expected primary payer, uniform	1	Medicare
		2	Medicaid
		3	Private insurance
		4	Self-pay
		5	No charge
		6	Other
		.	Missing
		.A	Invalid
		.B	Unavailable from source (coded in 1988-1997 data only)

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State Specific Notes

Alaska

Alaska
(Valid beginning in 2010 for SID only; valid beginning 2019 for SASD and SEDD)
PAY1_X		PAY1
Value	Description	Value	Description
01	Medicare	1	Medicare
02	Medicaid	2	Medicaid
03	Commercial/Private Insurance	3	Private insurance
05	Self-pay	4	Self-pay
10	Unreimbursed Native Health	5	No Charge
04	Worker's Compensation	6	Other
06	Indian Health Service
07	CHAMPUS/VA
08	Other miscellaneous
17	Elmendorf
09	Other government
99, Blank	Unknown, Missing	.	Missing
Any values not documented by the data source		.A	Invalid
Starting in the 4th quarter of 2011, the State-specific code (AK value 06) for Indian Health Service is infrequently used. Instead these patients are reported as having an expected payer of self-pay (AK value 05) to document unreimbursed care to Alaska Natives.

Arizona

Arizona
(Valid beginning 2003 SID, Valid beginning 2005 SEDD)
PAY1_X		PAY1
Value	Description	Value	Description
05, 5	Medicare	1	Medicare
11	Medicare Risk	1	Medicare
06	Arizona Health Care Cost Containment System (AHCCCS) Health Care Group/ Medicaid	2	Medicaid
08	Children's Rehab Services (valid beginning 2013)	2	Medicaid
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	.	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	1	Medicare
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	1	Medicare
04	Arizona Health Care Cost Containment System (AHCCCS) Health Care Group	2	Medicaid
06	AHCCCS/Medicaid	2	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	3	Private Insurance
--		4	Self-pay
--		5	No charge
5	Other (self-pay, unknown, charity, etc.)	6	Other
Blank		.	Missing
Other Values		.A	Invalid

Arkansas

The original source data for primary and secondary payer in two hospitals in the 2010 AR SID were identified as erroneous. As a result, the primary and secondary HCUP data elements (PAY1, PAY1_X, PAY2, and PAY2_X) for these two hospitals were set to missing during HCUP data processing. The total discharge count for these two hospitals was 18,785, 4.6% of all discharges in the 2010 AR SID. A corrected version of the AR SID is available.

Arkansas

Arkansas
(Valid beginning in 2016)
PAY1_X, PAY2_X, PAY3_X		PAY1, PAY2, PAY3
Value	Description	Value	Description
1	MEDICARE	1	Medicare
2	MEDICAID	2	Medicaid
5	PRIVATE HEALTH INSURANCE (Private Managed Care, Private Health Insurance - Indemnity , Other nonspecified	3	Private Insurance
6	BLUE CROSS/BLUE SHIELD (BC Indemnity, BC Managed Care, BC Out of State, BC Unspecified, BC Other)
7	MANAGED CARE, UNSPECIFIED (HMO, PPO, POS, Other Managed Care- Unknown if public or private)
8	NO PAYMENT from an Organization/Agency/Program/Private Payer Listed (Self-pay, No Charge, Refusal to Pay/Bad Debt, Hill Burton Free Care, Research/Donor, No Payment- Other)	4	Self pay
3	OTHER GOVERNMENT - FEDERAL/STATE/LOCAL (Includes Departments of Defense & Veterans Affairs, Indian Health Service or Tribe, HRSA Program, Black Lung, State Government, Other Government & Other Federal)	6	Other
4	DEPARTMENT OF CORRECTIONS (Includes federal, state, and local)
9	MISCELLANEOUS/OTHER (Foreign National, Other(Non-government), Disability Insurance, Long-term Care Insurance, Workerâ€™s Compensation, Auto Insurance (no fault), Other specified (includes Hospice) , NoTypology Code available for payment source)
Blank	Missing	.	Missing
other		.A	Invalid

Arkansas
(Valid in 2015)
PAY1_X, PAY2_X, PAY3_X		PAY1, PAY2, PAY3
Value	Description	Value	Description
1	MEDICARE	1	Medicare
2	MEDICAID	2	Medicaid
5	PRIVATE HEALTH INSURANCE (Private Managed Care, Private Health Insurance - Indemnity , Other nonspecified	3	Private Insurance
6	BLUE CROSS/BLUE SHIELD (BC Indemnity, BC Managed Care, BC Out of State, BC Unspecified, BC Other)
7	MANAGED CARE, UNSPECIFIED (HMO, PPO, POS, Other Managed Care- Unknown if public or private)
8	NO PAYMENT from an Organization/Agency/Program/Private Payer Listed (Self-pay, No Charge, Refusal to Pay/Bad Debt, Hill Burton Free Care, Research/Donor, No Payment- Other)	4	Self pay
3	OTHER GOVERNMENT - FEDERAL/STATE/LOCAL (Includes Departments of Defense & Veterans Affairs, Indian Health Service or Tribe, HRSA Program, Black Lung, State Government, Other Government & Other Federal)	6	Other
9	MISCELLANEOUS/OTHER (Foreign National, Other(Non-government), Disability Insurance, Long-term Care Insurance, Workerâ€™s Compensation, Auto Insurance (no fault), Other specified (includes Hospice) , NoTypology Code available for payment source)	6	Other
Blank	Missing	.	Missing
other		.A	Invalid

Arkansas
(Valid through 2014)
PAY1_X and PAY2_X		PAY1 and PAY2
Value	Description	Value	Description
M	Medicare	1	Medicare
D	Medicaid	2	Medicaid
I	Commercial Insurance	3	Private Insurance
B	Blue Cross/Blue Shield, Medi-Pak, Medi-Pak Plus
H	HMO/Managed Care
S	Self Insured
E	County or State (ex: state or county employees) (Valid beginning in 2010)
P	Self-pay	4	Self pay
Z	Medically Indigent/Free	5	No charge
C	CHAMPUS	6	Other
E	County or State (ex: state or county employees) (Valid prior to 2010)
L	Managed Assistance
N	Division of Health Services
O	Other
V	Other Federal Programs
W	Worker's Compensation
Blank	Missing	.	Missing
Any values not documented by the data source		.A	Invalid

California

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	.	Missing
(other)		.A	Invalid
* HMOs are regulated in California under the Knox Keene Health Care Service Plan Act of 1975.

Colorado

Colorado
(Valid beginning in 2017)
PAY1_X		PAY1
Value	Description	Value	Description
Medicare	Medicare	1	Medicare
Medicaid	Medicaid	2	Medicaid
Commercial	Commercial	3	Private insurance
Liability	Liability	3	Private insurance
Self Pay	Self pay	4	Self-pay
No Charge	No charge	5	No charge
Workers Comp	Worker's Comp	6	Other
Tricare	Tricare
Other	Other
Blank	Missing	.	Missing
Other	Any undocumented value	.A	Invalid

District of Columbia

District of Columbia
PAY1_X and PAY2_X		PAY1 and PAY2
Value	Description	Value	Description
M	Medicare	1	Medicare
Maaa	Medicare with payer type (Effective starting in 2014)
Q	Medicare Psychiatric
Qaaa	Medicare Psychiatric
R	Medicare Rehabilitation
Raaa	Medicare Rehabilitation
D	Medicaid (out of region)	2	Medicaid
Daaa	Medicaid (out of region) with payer type (Effective starting in 2014)
F	D.C. Medicaid
Faaa	D.C. Medicaid with payer type (Efective starting in 2014)
G	Maryland Medicaid
Gaaa	Maryland Medicaid with payer type (Effective starting in 2014)
4	Medicaid Pending
5	Medicaid Pending with payer type (Effective starting in 2014)
5aaa	Medicaid Pending with payer type (Effective starting in 2014)
J	Virginia Medicaid
Jaaa	Virginia Medicaid with payer type (Effective starting in 2014)
B	Blue Cross Blue Shield	3	Private insurance
Baaa	Blue Cross Blue Shield with payer type (Effective starting in 2014)
I	Indemnity Insurance
Iaaa	Indemnity Insurance with payer type (Effective starting in 2014)
S	Self Insured
Saaa	Self Insured with payer type (Effective starting in 2014)
P	Self-pay	4	Self-pay
Paaa	Self-pay with payer type (Effective starting in 2014)	4	Self-pay
Z	Medically Indigent/Free/Charity Care	5	No charge
Zaaa	Medically Indigent/Free/Charity Care with payer type (Effective starting in 2014)	5	No charge
5	D.C. Healthcare Allianc3	6	Other
5	D.C. Healthcare Alliance (Valid 2013)
C	Federal Employees, Champus (military)
Caaa	Federal Employees, Champus (military) with payer type (Effective starting in 2014)
W	Workers' Compensation
Waaa	Workers' Compensation with payer type (Effective starting in 2014)
O, Oaaa, Blank	Documented by source as unknown values	.	Missing
Any values not documented by the data source		.A	Invalid
aaa	Payer Types
CON	Contract
FFS	Fee-for-service
HMO	Health maintenance organization
POS	Point of service
PPO	Preferred provider organization

Florida

Florida
(Valid beginning in 2010)
PAY1_X		PAY1
Value	Description	Value	Description
A	Medicare	1	Medicare
B	Medicare Managed Care	1	Medicare
C	Medicaid	2	Medicaid
D	Medicaid Managed Care
O	KidCare (Valid beginning 2017)
E	Commercial Health Insurance	3	Private Insurance
Q	Commercial Liability Coverage	3	Private Insurance
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	.	Missing
Other	Any undocumented value	.A	Invalid

Florida

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	1	Medicare
C	Medicaid	2	Medicaid
D	Medicaid HMO	2	Medicaid
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	.	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	3	Private Insurance
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	3	Private Insurance
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

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

Hawaii

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

Indiana

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	1	Medicare
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	3	Private Insurance
11	Self-pay	4	Self-pay
12	No Charge	5	No Charge
09	Workers Compensation	6	Other
10	Other Federal Government	6	Other
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	1	Medicare
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	3	Private Insurance
11	Self-pay	4	Self-pay
12	No Charge	5	No Charge
09	Workers Compensation	6	Other
10	Other Federal Government	6	Other
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	3	Private Insurance
6	Self-pay	4	Self-pay
--		5	No charge
3	Other/Government	6	Other
7	Other/Unknown	6	Other
Blank (PAY1_X only), Blank; 0 (PAY2_X only)	Missing	.	Missing
Any values not documented by the data source		.A	Invalid

Iowa

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	1	Medicare
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)	3	Private Insurance
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

Kansas

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	1	Medicare
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	1	Medicare
002, 2, 02	Medicaid	2	Medicaid
102	Medicaid Managed Care	2	Medicaid
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

Kentucky

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	1	Medicare
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	5	No charge
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	1	Medicare
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	1	Medicare
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	5	No charge
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

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	1	Medicare
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

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 (payer specified in PAYER1_X/PAYER2_X)	1	Medicare
02	MD Medicaid FFS only and Pending MD Medicaid	2	Medicaid
14	MD Medicaid MCO (payer specified in PAYER1_X/PAYER2_X)	2	Medicaid
05	Commercial Insurance (HMO/POS/PPO/PPN/TPA)	3	Private Insurance
19	Behavioral Health Plan	3	Private Insurance
08	Self-pay	4	Self-pay
09	Charity - no charge	5	No charge
06	Other government program	6	Other
07	Worker's Compensation
10	Other
18	International (beginning 7/1/2014)
77	Not Applicable	.	Missing
99	Unknown
Blank	Missing
Any values not documented by the data source		.A	Invalid

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)	1	Medicare
02	MD Medicaid FFS only and Pending MD Medicaid	2	Medicaid
14	MD Medicaid HMO (payer specified in PAYER1_X/PAYER2_X)	2	Medicaid
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	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
18	International (beginning 7/1/14)
98, 99	Unknown	.	Missing
Blank	Missing	.	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)	1	Medicare
02	MD Medicaid FFS only and Pending MD Medicaid	2	Medicaid
14	MD Medicaid HMO (payer specified in PAYER1_X/PAYER2_X)	2	Medicaid
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	.	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

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)	.	Missing
Any values not documented by the data source		.A	Invalid

Michigan

Michigan
PAY1_X and PAY2_X		PAY1 and PAY2
Value	Description	Value	Description
01	Medicare Fee for Service	1	Medicare
30	Medicare Managed Care Plans
31	Medicare Type of Plan Unknown
02	Medicaid Fee for Service	2	Medicaid
40	Medicaid Managed Care Plans
41	Medicaid Type of Plan Unknown
22	HMSA QUEST - valid 2006 -2007
06	Blue Cross/Blue Shield	3	Private insurance
07	Other commercial insurance company
09	Managed care type unknown
11	Blue Cross/Blue Shield HMO
12	Other HMO 1
13	Other HMO 2
14	Other HMO 3
15	Other HMO 4
16	Other HMO 5
17	Blue Cross/Blue Shield PPO/PPA
18	Other PPO/PPA 1
19	Other PPO/PPA 2
20	Other PPO/PPA 3
21	Other PPO/PPA 4
22	Other PPO/PPA 5
52	Auto Insurance
08	Self-pay	4	Self-pay
10	No charge	5	No charge
51	No charge	5	No charge
03	Title V	6	Other
04	Other government source
05	Worker's Compensation
23	State Mental Health Contract
24	Other Mental Health Contract
25	State Corrections Contract
26	Other Corrections Contract
99	Other
00, Blank	Missing or invalid	.	Missing
Any values not documented by the data source		.A	Invalid

Minnesota

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

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	3	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

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	2	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

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	1	Medicare
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)	5	No charge
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	1	Medicare
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	1	Medicare
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 Jersey

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	5	No 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)	2	Medicaid
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)	2	Medicaid
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)	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)
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)	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)
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)	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)
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)	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)
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

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	4	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	1	Medicare
04	Medicaid	2	Medicaid
17	Medicaid HMO	2	Medicaid
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	.	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

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)	2	Medicaid
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)	4	Self-pay
--		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		.A	Invalid

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	1	Medicare
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

Oregon

Oregon
(Valid Beginning in 2008 - SID only) (Valid Beginning in 2010 - SASD only; Valid Beginning in 2015 - SEDD only)
PAY1_X, PAY2_X, and PAY3_X		PAY1 and PAY2
Value	Description	Value	Description
11	Medicare (Managed Care)	1	Medicare
12	Medicare (Fee-For-Service)	1	Medicare
21	Medicaid (Managed Care)	2	Medicaid
22	Medicaid (Fee-For-Service)
25	Medicaid - Out Of State
51	HMO/Managed Care	3	Private Insurance
511	Kaiser Permanente
52	Private Health Insurance - Indemnity
521	Commercial Indemnity
522	Self Insured
61	Regence Blue Cross Managed Care
62	Regence Blue Cross Indemnity
81	Self Pay	4	Self-pay
84	Hill Burton Free Care (prior to 2013)	4	Self-pay
82	No Charge	5	No charge
84	Hill Burton Free Care (starting in 2013)
821	Charity
83	Refusal to Pay/Bad Debt
31	Department of Defense	6	Other
311	Tricare (Champus)
32	Department of Veterans Affairs
33	Indian Health Service or Tribe
34	HRSA Program
36	State Government
37	Local Government
39	Other Federal
95	Workers Compensation
98	Other Payer
ZZZ	Missing Data	.	Missing
(blank)		.	Missing
(other)		.A	Invalid

Oregon
(Valid 1998 - 2007)
PAY1_X, PAY2_X, and PAY3_X		PAY1 and PAY2
Value	Description	Value	Description
M	Medicare	1	Medicare
D	Medicaid	2	Medicaid
X	HMO/Oregon Health Plan (Medicaid)	2	Medicaid
B	Blue Cross/Blue Shield	3	Private Insurance
I	Commercial Insurance
S	Self-Insured
H	HMO/Managed Care
K	Kaiser Permanente
Y	PPO
P	Self Pay	4	Self-pay
Z	Medically Indigent, Free, Research	5	No charge
W	Workers Compensation	6	Other
C	CHAMPUS
E	County or State
L	Managed Assistance
N	Division of Health Services
O	Other
T	Title V
Blank	Missing	.	Missing
Any values not documented by the data source		.A	Invalid

Oregon
(Valid from 1995-1997)
PAY1_X, PAY2_X, and PAY3_X		PAY1 and PAY2
Value	Description	Value	Description
M	Medicare	1	Medicare
D, X	Medicaid: HMO/Oregon Health Plan (Medicaid)	2	Medicaid
B	Blue Cross/Blue Shield	3	Private Insurance
I, Y, S	Commercial Insurance; PPO; Self-insured
H, K	HMO/Managed Care; Kaiser Permanente
P	Self Pay	4	Self-pay
Z	Medically Indigent/Free/Research	5	No charge
T	Title V	6	Other
W	Workers' Compensation
C	CHAMPUS
E, L, N	County of State; Managed Assistance; Division of Health Services
O	Other
Blank	Missing	.	Missing
Other Values		.A	Invalid

Oregon
(Valid from 1993-1994)
PAY1_X		PAY1
Value	Description	Value	Description
1	Medicare	1	Medicare
2	Medicaid	2	Medicaid
6	Blue Cross	3	Private Insurance
7	Other commercial insurance	3	Private Insurance
8	Self-pay	4	Self-pay
--		5	No charge
3	Title V	6	Other
5	Workers' Compensation
4	Other government
9	Other
0, blank	Missing	.	Missing
Other Values		.A	Invalid

Rhode Island

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	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	2	Medicaid
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	1	Medicare
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

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	3	Private insurance
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	1	Medicare
2	Medicaid	2	Medicaid
14	Medicaid managed care	2	Medicaid
4	Commercial, PPO	3	Private insurance
5	HMO	3	Private insurance
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
--		5	No charge
2	State or county indigent program, unspecified	6	Other
3	State or county indigent program, unspecified
4	State or county indigent program, unspecified
5	Champus
8	State or county indigent program, unspecified
9	Worker's Compensation
10	State or county indigent program, unspecified
11	State or county indigent program, unspecified
15, Blank	Not Stated, Missing	.	Missing
Any values not documented by the data source		.A	Invalid

South Carolina
(Valid from 1993-1997)
PAY1_X and PAY2_X		PAY1 and PAY2
Value	Description	Value	Description
02	Medicare	1	Medicare
03	Medicaid	2	Medicaid
04, 16	Blue Cross/Commercial; HMO	3	Private insurance
01	Self-pay	4	Self-pay
--		5	No charge
05, 06, 07	Workers' Comp; Indigent/Charity; Other government	6	Other
08, Blank	Missing	.	Missing
--	Other	.A	Invalid

South Dakota

South Dakota
(Beginning in 2004)
PAY1_X		PAY1
Value	Description	Value	Description
1, 01	Medicare (Title 18)	1	Medicare
11	Medicare - Managed Care (e.g. HMO, PPO, PCCM) (beginning 2008)	1	Medicare
2, 02	Medicaid (Title 19)	2	Medicaid
12	Medicaid - Managed Care (e.g. HMO, PPI, PCCM) (beginning 2008)	2	Medicaid
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 auto insurances)	3	Private insurance
8, 08	Self pay (The patient has no insusrance, 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	South Dakota Government State (e.g. Mental Health State Papers etc.)	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

South Dakota
(Valid through 2003)
PAY1_X		PAY1
Value	Description	Value	Description
01	Medicare (Title 18)	1	Medicare
11	Medicare managed care	1	Medicare
02	Medicaid (Title 19)	2	Medicaid
12	Medicaid managed care	2	Medicaid
06	Blue Cross	3	Private insurance
07	Commercial (private or group plans other than HMO, PPO, ODS)
13	HMO
14	PPO
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	6	Other
04	County
05	Champus
09	Workers' Compensation
15	Indian Health Services
Blank	Missing	.	Missing
Any values not documented by the data source		.A	Invalid

Utah

Beginning in 2015, Utah supplies free-form text fields. The fields are used by HCUP to create PAY1_X and PAY1.

In Utah, hospitals report plan-specific expected payer codes. The data organization that provides the Utah source files to HCUP (the Office of Health Care Statistics, Utah of Department of Health) maps the plan-specific payer codes into grouped payer categories. The data source reports that self-pay/uninsured are not identified very effectively since the original data are mostly based on billing information and they do not have any way to determine whether the payer declined to pay. There is a field for "patient as payer" on the source file, but it is not reliable coded and is only submitted by a small number of hospitals. HCUP receives only the grouped payer code.

Utah
(Beginning in 2015)
PAY1_X, PAY2_X and PAY3_X		PAY1 and PAY2
Value	Description	Value	Description
Medicare	Medicare	1	Medicare
Medicaid	Medicaid	2	Medicaid
CHIP (Valid beginning 2017)	CHIP (Valid beginning 2017)	2	Medicaid
Blue Cross/Blue Shield	Blue Cross/Blue Shield	3	Private Insurance
Auto Insurance	Auto Insurance
Private Health Insurance	Private Health Insurance
Self pay	Self pay	4	Self-pay
No charge	No charge	5	No charge
CHIP (valid prior to 2017)	CHIP (valid prior to 2017)	6	Other
Workers Compensation	Workers Compensation
TRICARE/CHAMPUS	TRICARE/CHAMPUS
Department of Veterans Affairs	Department of Veterans Affairs
Indian Health Service	Indian Health Service
Primary Care Network	Primary Care Network
Department of Corrections	Department of Corrections
Other Government	Other Government
Unknown	Unknown	.	Missing
(other)	Any undocumented value	.A	Invalid

Utah
(Valid beginning in 1998)
PAY1_X, PAY2_X and PAY3_X		PAY1 and PAY2
Value	Description	Value	Description
01	Medicare	1	Medicare
02	Medicaid	2	Medicaid
04	Blue Cross/Blue Shield	3	Private Insurance
05	Other commercial
06	Managed care (HMO and PPO)
07	Self pay	4	Self-pay
09	Charity/Unclassified	5	No charge
03	Other government	6	Other
08	Industrial and Worker's compensation
09	Unclassified (Valid prior to 2006)
12	Other (Valid prior to 2006)
13	Children's Health Insurance Plan (CHIP)
10, 99, Blank	Unknown, Not reported, Missing	.	Missing
Any values not documented by the data source		.A	Invalid

Utah
(Valid for 1997)
PAY1_X, PAY2_X and PAY3_X		PAY1 and PAY2
Value	Description	Value	Description
01	Medicare	1	Medicare
02	Medicaid	2	Medicaid
04	Blue Cross/Blue Shield	3	Private Insurance
05	Other commercial
06	Managed care (HMO and PPO)
07	Self pay	4	Self-pay
--		5	No charge
03	Other government	6	Other
08	Industrial and Worker's compensation
09	Unclassified
12	Other
10, 99, Blank	Unknown, Not reported, Missing	.	Missing
Any values not documented by the data source		.A	Invalid

Vermont

Vermont
(Valid beginning in 2001)
PAY1_X, PAY2_X, PAY3_X		PAY1
Value	Description	Value	Description
M	Medicare (managed care plans can be identified by using PAYER1_X)	1	Medicare
D	Medicaid (managed care plans can be identified by using PAYER1_X)	2	Medicaid
B	Blue Cross	3	Private insurance
H	HMO
I	Commercial (managed care plans can be identified by using PAYER1_X)
G	MVP
P	Self Pay	4	Self-pay
X	Charity	5	No charge
Z	Medically Indigent/Free	5	No charge
E	Other Government Plans	6	Other
C	Champus
W	Worker's Compensation
U	Unknown	.	Missing
Blank	Missing	.	Missing
Any values not documented by the data source		.A	Invalid

Vermont

Increases in Medicaid in the 2015 data year should be considered an anomaly. Vermont briefly modified their billing process in late 2014, which led to increases in records with a primary expected payer value of Medicaid. In 2016 data, the coding of Medicaid returns to a normal level that is consistent with historical data.

Wisconsin

Wisconsin
(Valid beginning in 2018)
PAY1_X and PAY2_X		PAY1 and PAY2
Value	Description	Value	Description
MEDnn, mednn	Medicare	1	Medicare
T18nn, t18nn	Medicare
MPC09	Medicare
BGRnn,bgrnn	Badger Care (family coverage)	2	Medicaid
T19nn, t19nn	Wisconsin Medicaid
OTH51, oth51	Medicaid, Out of State
OTH54, oth54	Wisconsin Family Care Program (WI - DHS Program) (Beginning 2019)
A4109, a4109	My Choice Wisconsin Health Plan (Beginning 2021)
A1009, a1009	Aetna	3	Private Insurance
A1109, a1109	Ambetter from MHS Health (Managed Health Services Insurance Corp.)
A1209, a1209	Blue Cross and Blue Shield
A1309, a1309	Aspirus Health Plan (formerly Aspirus Arise) Updated Q12021
A1409, a1409	Celtic Insurance Company
A1509, a1509	Cigna
A1609, a1609	Common Ground Healthcare Cooperative
A1709, a1709	Dean Health Plan, Inc.
A1809, a1809	Group Health Cooperative of South Central Wisconsin
A1909, a1909	Quartz (formerly Gundersen Health Plan, Inc.)
A2009, a2009	Health Partners
A2109, a2109	Health Tradition Health Plan
A2209, a2209	Humana Insurance Company
A2309, a2309	Independent Care Health Plan
A2409, a2409	Medica Health Plans of Wisconsin
A2509, a2509	MercyCare HMO, Inc. and MercyCare Insurance Company
A2609, a2609	Molina Healthcare of Wisconsin, Inc.
A2709, a2709	Network Health Plan
A2809, a2809	Physicians Plus Insurance Corporation
A2909, a2909	Security Health Plan of Wisconsin, Inc.
A3009, a3009	UnitedHealthcare
A3109, a3109	Quartz (Formerly Unity Health Plans Insurance Corporation)
A3209, a3209	Wisconsin Physicians Service (WPS) Insurance Corporation
A3309, a3309	Managed Health Services Insurance Corp.
A3409, a3409	WPS (formerly Arise Health Plan) Updated Q12021
A3509, a3509	ARM Health EOS/HealthEOS/MultiPlan
A3609, a3609	Children's Community Health Plan, Inc.
A3709, a3709	Community Care Health Plan, Inc.
A3809, a3809	Compcare Health Services Insurance Corp.
A3909, a3909	Group Health Cooperative of Eau Claire
A4009, a4009	The Medical Associates Clinic Health Plan of Wisconsin
A4109, a4109	Trilogy Health Insurance, Inc. (Prior to 2021)
A4209, a4209	Wisconsin Collaborative, Ins. Co.
A4309, a4309	Quartz Health Plan
A4409, a4409	Choice Plus UHC/UMR
A4509, a4509	WEA Trust
A4609, a4609	Federated Mutual Insurance Company
A4709, a4709	US Health and Life Insurance Company
A4809, a4809	All Savers Insurance Company (beginning 2020)
A9909, a9909	Other Commercial or Private Insurance Carrier/out of state (not listed here)
OTH21, oth21	Employer self-funded - Fee for service
OTH22, oth22	Employer self-funded - HMO/PPO (beginning 2020)
OTH31, oth31	Other organization self-funded - Fee for service/HMO/PPO
OTH61, oth61	Self-pay	4	Self-pay
OTH71, oth71	Research Grant (Beginning 2019)	5	No charge
C1980, c1980	COVID-19 HRSA Uninsured Program - COVID19 HRSA Uninsured Testing & Treatment Fund - COVID19 HRSA Uninsured Treatment Fund (beginning 2020)	6	Other
CHAnn, chann	CHAMPUS/CHAMPVA/TRICARE
OTH41, oth41	Workers' Compensation
OTH52, oth52	Other Government: 51.42 / 51.437 / 46.23 County Board
OTH54, oth54	Wisconsin Family Care Program (WI - DHS Program) (Prior to 2019)
OTH55, oth55	TRICARE (CHAMPUS) Supplement (Military/Veteran)
OTH59, oth59	Other government agency or program
OTH71, oth71	Research Grant (Prior to 2019)
OTH98, oth98	Other
OTH99, oth99	Unknown	.	Missing
(blank)	Missing	.	Missing
(other)	Any undocumented value	.A	Invalid
(other)		.A	Invalid

PAYn_X is created by concatenating the source variables PAYID and PAYTYPE (i.e. PAY1_X = PAYID || PAYTYPE).

Code Structure for Payer Identifier (PAYID)
Code	Description
Ann	Commercial payer
T18, MED	Medicare
MPC	Medicare Advantage Plans (Part C)
T19	Wisconsin Medical Assistance (Medicaid)
CHA	CHAMPUS/CHAMPVA/TRICARE
BGR	BadgerCare (family coverage)
OTH	Payer not identified above

Code structure for Payer Type (PAYTYPE) for use with MED, T18, T19, CHA, or BGR
Code	Description
1	Fee-for-service, non-HMO Medicare, or non-HMO Medicaid
2	Alternative Health Care Insurance Plans (HMO, PPO)
3	CHAMPUS/CHAMPVA/TRICARE
9	Unable to determine insurance type

Code structure for Payer Type (PAYTYPE) for use with OTH
Code	Description
21	Employer self-funded - Fee-for-Service/HMO/PPO
31	Other organization Self-Funded - Fee-for-Service/HMO/PPO
41	Workers' Compensation
51	Medicaid Out of State
52	Other Government: 51.42/51.437/46.23 County Board
54	Wisconsin Family Care Program (WI - DHS Program)
55	TRICARE (CHAMPUS) supplement (Military/Veteran)
59	Other government agency or program
61	Self-pay
71	Research grant
98	Other or Unknown
99	Other or Unknown Payer, Unknown Type

Wisconsin documentation indicates that for 2014-2015, three facilities misclassified records as Out of State Medicaid (OTH/51). The records should have been reported as Wisconsin Medicaid (T19/01) or Wisconsin Medicaid/BadgerCare (T19/02).

Wisconsin
(Valid 2011-2017)
PAY1_X and PAY2_X		PAY1 and PAY2
Value	Description	Value	Description
MEDnn	Medicare	1	Medicare
T18nn	Medicare
BGRnn	Badger Care (family coverage)	2	Medicaid
MAXnn	Badger Care Expansion (childless Adults) (discontinued Q2 2014)
T19nn	Wisconsin Medicaid
OTH51	Non-Wisconsin Medicaid
WPSnn	Non-Medicaid Wisconsin Physicians Service (discontinued Q2 2014)	3	Private Insurance
OTH11	Commercial or private insurance - Fee for service
OTH12	Commercial or private insurance - HMO or PPO
OTH19	Commercial or private insurance - type unknown
OTH21	Employer self-funded - Fee for service
OTH22	Employer self-funded - HMO or PPO
OTH29	Employer self-funded - type unknown
OTH31	Other organization self-funded - Fee for service
OTH32	Other organization self-funded - HMO or PPO
OTH39	Other organization self-funded - type unknown
nnnnn	Blue Cross/Blue Shield
BCSnn	Blue Cross - Fee for service
OTH61	Self-pay	4	Self-pay
--	--	5	No charge
CHAnn	CHAMPUS/CHAMPVA/TRICARE	6	Other
OTH41	Worker's Compensation
OTH52	51.42 / 51.437 / 46.23 County Board
OTH53	General Relief / GAMP (discontinued Q2 2014)
OTH54	WisconsinCare
OTH55	TRICARE (CHAMPUS) Supplement
OTH56	HIRSP (discontinued Q2 2014)
OTH59	Other government
OTH71	Research Grant
OTH98	Other
OTH99	Unknown	.	Missing
(blank)	Missing
(other)	Any undocumented value	.A	Invalid
Prior to 2006: PAYn_X is created by concatenating the source variables PAYID and PAYCAT (i.e. PAY1_X = PAYID \|\| PAYCAT). Beginning 2006: PAYn_X is created by concatenating the source variables PAYID and PAYTYPE (i.e. PAY1_X = PAYID \|\| PAYTYPE).

PAYn_X is created by concatenating the source variables PAYID and PAYTYPE (i.e. PAY1_X = PAYID \|\| PAYTYPE). Code Structure for Payer Identifier (PAYID)
Code		Description
T18, MED		Medicare
T19		Wisconsin Medical Assistance (Medicaid)
BCS, nnn		3-digit plan code or BCS for Blue Cross/Blue Shield
WPS		Non-Medicaid Wisconsin Physicians Service
CHA		CHAMPUS/CHAMPVA/TRICARE
MAX		Badger Care Expansion (childless adults) Effective Q1 10
BGR		BadgerCare (family coverage)
OTH		Payer not identified above

Code structure for Payer Type (PAYTYPE) for use with MED, T18, T19, nnn (BC/BS), WPS, CHA, BGR or MAX
Code		Description
01		Fee-for-service, non-HMO Medicare, or non-HMO Medicaid
02		Alternative Health Care Insurance Plans (HMO, PPO)
03		CHAMPUS/CHAMPVA/TRICARE
09		Unable to determine insurance type.

Code structure for Payer Type (PAYTYPE) for use with OTH
Code		Description
11		Commercial or private insurance - fee-for-service
12		Commercial or private insurance - alternative health care insurance plan (HMO or PPO)
19		Commercial or private insurance - unable to determine insurance type
21		Employer self-funded - fee-for-service
22		Employer self-funded - alternative health care insurance plan (HMO or PPO)
29		Employer self-funded - unable to determine insurance type
31		Other organization self-funded - fee-for-service
32		Other organization self-funded - alternative health care insurance plan (HMO or PPO)
39		Other organization self-funded - unable to determine insurance type
41		Workers' Compensation
51		Non-Wisconsin Medicaid
52		51.42/51.437/46.23 County Board
53		General Relief / GAMP
54		WisconCare
55		TRICARE (CHAMPUS) supplement
56		HIRSP
59		Other government agency or program
61		Self-pay
71		Research grant
98		Other
99		Unknown

Wisconsin
(Valid from 1998 - 2010 SID and SASD, 2005 SEDD)
PAY1_X and PAY2_X		PAY1 and PAY2
Value	Description	Value	Description
MED01	Medicare - Fee for service, non-HMO Medicare, or non-HMO Medicaid	1	Medicare
MED02	Medicare - Alternative health care insurance plans (HMO, PPO, PPA, etc.)
MED09	Medicare - Unable to determine insurance type
T1801	Medicare - Fee for service
T1802	Medicare - Alternative health care insurance plans (HMO, PPO, PPA, etc.)
T1809	Medicare - Unable to determine insurance type
MAX01	Badger Care Plus - Fee for service	2	Medicaid
MAX02	Badger Care Plus - Alternative health care insurance plans (HMO, PPO, PPA, etc.)
MAX09	Badger Care Plus - type unknown
T1901	Wisconsin Medicaid - Fee for service
T1902	Wisconsin Medicaid - Alternative health care insurance plans
T1909	Wisconsin Medicaid - type unknown
OTH51	Non-Wisconsin Medicaid
WPS01	Wisconsin Physicians Service - Fee for service	3	Private Insurance
WPS02	Wisconsin Physicians Service - Alternative health care insurance plans
WPS09	Wisconsin Physicians Service - type unknown
OTH11	Commercial or private insurance - Fee for service
OTH12	Commercial or private insurance - Alternative health care insurance plans
OTH19	Commercial or private insurance - type unknown
OTH21	Employer self-funded - Fee for service
OTH22	Employer self-funded - Alternative health care insurance plans
OTH29	Employer self-funded - type unknown
OTH31	Other organization self-funded - Fee for service
OTH32	Other organization self-funded - Alternative health care insurance plans
OTH39	Other organization self-funded - type unknown
nnn01, where nnn is a 3-digit code	Blue Cross - Fee for service
nnn02, where nnn is a 3-digit code	Blue Cross - Alternative health care insurance plans
nnn09, where nnn is a 3-digit code	Blue Cross - type unknown
BCS01	Blue Cross - Fee for service
BCS02	Blue Cross - Alternative health care insurance plans
BCS09	Blue Cross - type unknown
OTH61	Self-pay	4	Self-pay
--		5	No charge
BGR01	Badger Care - Fee for service	6	Other
BGR02	Badger Care - Alternative health care insurance plans (HMO, PPO, PPA, etc.)
BGR09	Badger Care - type unknown
CHA01	CHAMPUS, CHAMPVA (effective beginning in 1994)
CHA02	CHAMPUS, CHAMPVA (effective beginning in 1994)
CHA03	CHAMPUS, CHAMPVA (effective beginning in 1994)
OTH41	Worker's Compensation
OTH52	51.42 / 51.437 / 46.23 Board
OTH53	General Relief
OTH54	WisconsinCare
OTH55	CHAMPUS Supplement
OTH56	HIRSP
OTH59	Other government (Not in the 2004 data but documented)
OTH71	Research Grant
OTH98	Other
bbb01, where b is a blank	Other - Fee for service (beginning in 1998)
OTH01	Other - Fee for service (effective from 1989-1997)
OTH99	Unknown	.	Missing
bbb00, where b is a blank	Unknown
Blank	Missing
Any values not documented by the data source		.A	Invalid
Prior to 2006: PAYn_X is created by concatenating the source variables PAYID and PAYCAT (i.e. PAY1_X = PAYID \|\| PAYCAT). Beginning 2006: PAYn_X is created by concatenating the source variables PAYID and PAYTYPE (i.e. PAY1_X = PAYID \|\| PAYTYPE).

Wisconsin
(Valid from 1989-1997 SID)
PAY1_X and PAY2_X		PAY1 and PAY2
Value	Description	Value	Description
MED01	Medicare - Fee for service, non-HMO Medicare, or non-HMO Medicaid	1	Medicare
MED02	Medicare - Alternative health care insurance plans (HMO, PPO, PPA, etc.)
MED09	Medicare - Unable to determine insurance type
T1901	Wisconsin Medicaid - Fee for service	2	Medicaid
T1902	Wisconsin Medicaid - Alternative health care insurance plans
T1909	Wisconsin Medicaid - type unknown
OTH51	Non-Wisconsin Medicaid
WPS01	Wisconsin Physicians Service - Fee for service	3	Private Insurance
WPS02	Wisconsin Physicians Service - Alternative health care insurance plans
WPS09	Wisconsin Physicians Service - type unknown
OTH11	Commercial or private insurance - Fee for service
OTH12	Commercial or private insurance - Alternative health care insurance plans
OTH19	Commercial or private insurance - type unknown
OTH21	Employer self-funded - Fee for service
OTH22	Employer self-funded - Alternative health care insurance plans
OTH29	Employer self-funded - type unknown
OTH31	Other organization self-funded - Fee for service
OTH32	Other organization self-funded - Alternative health care insurance plans
OTH39	Other organization self-funded - type unknown
nnn01, where nnn is a 3-digit code	Blue Cross - Fee for service
nnn02, where nnn is a 3-digit code	Blue Cross - Alternative health care insurance plans
nnn09, where nnn is a 3-digit code	Blue Cross - type unknown
OTH61	Self-pay	4	Self-pay
--		5	No charge
CHA01	CHAMPUS, CHAMPVA (effective beginning in 1994)	6	Other
CHA02	CHAMPUS, CHAMPVA (effective beginning in 1994)
CHA03	CHAMPUS, CHAMPVA (effective beginning in 1994)
OTH41	Worker's Compensation
OTH52	51.42 / 51.437 / 46.23 Board
OTH53	General Relief
OTH54	WisconsinCare
OTH55	CHAMPUS Supplement
OTH56	HIRSP
OTH59	Other government
OTH98	Other
OTH01	Other - Fee for service (effective from 1989-1997)
OTH99	Unknown	.	Missing
bbb00, where b is a blank	Unknown
Blank	Missing
Any values not documented by the data source		.A	Invalid

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Central Distributor SEDD: Description of Data Elements