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Value Set NamePayer
Code SystemSOP
OID2.16.840.1.114222.4.11.3591
TypeExtensional
Definition Version20180227
StewardHL7 Terminology
ProgramC-CDA,C-CDA R2.1 2018-06-15 using this value set
Expansion VersionC-CDA R2.1 2018-06-15
Expanded Code List
CodeDescriptionCode SystemCode System VersionCode System OIDTTY
1MEDICARESOP8.02.16.840.1.113883.3.221.5PT
11Medicare (Managed Care)SOP8.02.16.840.1.113883.3.221.5PT
111Medicare HMOSOP8.02.16.840.1.113883.3.221.5PT
112Medicare PPOSOP8.02.16.840.1.113883.3.221.5PT
113Medicare POSSOP8.02.16.840.1.113883.3.221.5PT
119Medicare Managed Care OtherSOP8.02.16.840.1.113883.3.221.5PT
12Medicare (Non-managed Care)SOP8.02.16.840.1.113883.3.221.5PT
121Medicare FFSSOP8.02.16.840.1.113883.3.221.5PT
122Medicare Drug BenefitSOP8.02.16.840.1.113883.3.221.5PT
123Medicare Medical Savings Account (MSA)SOP8.02.16.840.1.113883.3.221.5PT
129Medicare Non-managed Care OtherSOP8.02.16.840.1.113883.3.221.5PT
13Medicare HospiceSOP8.02.16.840.1.113883.3.221.5PT
14Dual Eligibility Medicare/Medicaid OrganizationSOP8.02.16.840.1.113883.3.221.5PT
19Medicare OtherSOP8.02.16.840.1.113883.3.221.5PT
191Medicare Pharmacy Benefit ManagerSOP8.02.16.840.1.113883.3.221.5PT
2MEDICAIDSOP8.02.16.840.1.113883.3.221.5PT
21Medicaid (Managed Care)SOP8.02.16.840.1.113883.3.221.5PT
211Medicaid HMOSOP8.02.16.840.1.113883.3.221.5PT
212Medicaid PPOSOP8.02.16.840.1.113883.3.221.5PT
213Medicaid PCCM (Primary Care Case Management)SOP8.02.16.840.1.113883.3.221.5PT
219Medicaid Managed Care OtherSOP8.02.16.840.1.113883.3.221.5PT
22Medicaid (Non-managed Care Plan)SOP8.02.16.840.1.113883.3.221.5PT
23Medicaid/SCHIPSOP8.02.16.840.1.113883.3.221.5PT
25Medicaid - Out of StateSOP8.02.16.840.1.113883.3.221.5PT
26Medicaid -- Long Term CareSOP8.02.16.840.1.113883.3.221.5PT
29Medicaid OtherSOP8.02.16.840.1.113883.3.221.5PT
291Medicaid Pharmacy Benefit ManagerSOP8.02.16.840.1.113883.3.221.5PT
299Medicaid - DentalSOP8.02.16.840.1.113883.3.221.5PT
3OTHER GOVERNMENT (Federal/State/Local) (excluding Department of Corrections)SOP8.02.16.840.1.113883.3.221.5PT
31Department of DefenseSOP8.02.16.840.1.113883.3.221.5PT
311TRICARE (CHAMPUS)SOP8.02.16.840.1.113883.3.221.5PT
3111TRICARE Prime--HMOSOP8.02.16.840.1.113883.3.221.5PT
3112TRICARE Extra--PPOSOP8.02.16.840.1.113883.3.221.5PT
3113TRICARE Standard - Fee For ServiceSOP8.02.16.840.1.113883.3.221.5PT
3114TRICARE For Life--Medicare SupplementSOP8.02.16.840.1.113883.3.221.5PT
3115TRICARE Reserve SelectSOP8.02.16.840.1.113883.3.221.5PT
3116Uniformed Services Family Health Plan (USFHP) -- HMOSOP8.02.16.840.1.113883.3.221.5PT
3119Department of Defense - (other)SOP8.02.16.840.1.113883.3.221.5PT
312Military Treatment FacilitySOP8.02.16.840.1.113883.3.221.5PT
3121Enrolled Prime--HMOSOP8.02.16.840.1.113883.3.221.5PT
3122Non-enrolled Space AvailableSOP8.02.16.840.1.113883.3.221.5PT
3123TRICARE For Life (TFL)SOP8.02.16.840.1.113883.3.221.5PT
313Dental --Stand AloneSOP8.02.16.840.1.113883.3.221.5PT
32Department of Veterans AffairsSOP8.02.16.840.1.113883.3.221.5PT
321Veteran care--Care provided to VeteransSOP8.02.16.840.1.113883.3.221.5PT
3211Direct Care--Care provided in VA facilitiesSOP8.02.16.840.1.113883.3.221.5PT
3212Indirect Care--Care provided outside VA facilitiesSOP8.02.16.840.1.113883.3.221.5PT
32121Fee BasisSOP8.02.16.840.1.113883.3.221.5PT
32122Foreign Fee/Foreign Medical Program (FMP)SOP8.02.16.840.1.113883.3.221.5PT
32123Contract Nursing Home/Community Nursing HomeSOP8.02.16.840.1.113883.3.221.5PT
32124State Veterans HomeSOP8.02.16.840.1.113883.3.221.5PT
32125Sharing AgreementsSOP8.02.16.840.1.113883.3.221.5PT
32126Other Federal AgencySOP8.02.16.840.1.113883.3.221.5PT
32127Dental CareSOP8.02.16.840.1.113883.3.221.5PT
32128Vision CareSOP8.02.16.840.1.113883.3.221.5PT
322Non-veteran careSOP8.02.16.840.1.113883.3.221.5PT
3221Civilian Health and Medical Program for the VA (CHAMPVA)SOP8.02.16.840.1.113883.3.221.5PT
3222Spina Bifida Health Care Program (SB)SOP8.02.16.840.1.113883.3.221.5PT
3223Children of Women Vietnam Veterans (CWVV)SOP8.02.16.840.1.113883.3.221.5PT
3229Other non-veteran careSOP8.02.16.840.1.113883.3.221.5PT
33Indian Health Service or TribeSOP8.02.16.840.1.113883.3.221.5PT
331Indian Health Service -- RegularSOP8.02.16.840.1.113883.3.221.5PT
332Indian Health Service -- ContractSOP8.02.16.840.1.113883.3.221.5PT
333Indian Health Service - Managed CareSOP8.02.16.840.1.113883.3.221.5PT
334Indian Tribe - Sponsored CoverageSOP8.02.16.840.1.113883.3.221.5PT
34HRSA ProgramSOP8.02.16.840.1.113883.3.221.5PT
341Title V (MCH Block Grant)SOP8.02.16.840.1.113883.3.221.5PT
342Migrant Health ProgramSOP8.02.16.840.1.113883.3.221.5PT
343Ryan White ActSOP8.02.16.840.1.113883.3.221.5PT
349OtherSOP8.02.16.840.1.113883.3.221.5PT
35Black LungSOP8.02.16.840.1.113883.3.221.5PT
36State GovernmentSOP8.02.16.840.1.113883.3.221.5PT
361State SCHIP program (codes for individual states)SOP8.02.16.840.1.113883.3.221.5PT
362Specific state programs (list/ local code)SOP8.02.16.840.1.113883.3.221.5PT
369State, not otherwise specified (other state)SOP8.02.16.840.1.113883.3.221.5PT
37Local GovernmentSOP8.02.16.840.1.113883.3.221.5PT
371Local - Managed careSOP8.02.16.840.1.113883.3.221.5PT
3711HMOSOP8.02.16.840.1.113883.3.221.5PT
3712PPOSOP8.02.16.840.1.113883.3.221.5PT
3713POSSOP8.02.16.840.1.113883.3.221.5PT
372FFS/IndemnitySOP8.02.16.840.1.113883.3.221.5PT
379Local, not otherwise specified (other local, county)SOP8.02.16.840.1.113883.3.221.5PT
38Other Government (Federal, State, Local not specified)SOP8.02.16.840.1.113883.3.221.5PT
381Federal, State, Local not specified managed careSOP8.02.16.840.1.113883.3.221.5PT
3811Federal, State, Local not specified - HMOSOP8.02.16.840.1.113883.3.221.5PT
3812Federal, State, Local not specified - PPOSOP8.02.16.840.1.113883.3.221.5PT
3813Federal, State, Local not specified - POSSOP8.02.16.840.1.113883.3.221.5PT
3819Federal, State, Local not specified - not specified managed careSOP8.02.16.840.1.113883.3.221.5PT
382Federal, State, Local not specified - FFSSOP8.02.16.840.1.113883.3.221.5PT
389Federal, State, Local not specified - OtherSOP8.02.16.840.1.113883.3.221.5PT
39Other FederalSOP8.02.16.840.1.113883.3.221.5PT
391Federal Employee Health Plan - Use when knownSOP8.02.16.840.1.113883.3.221.5PT
4DEPARTMENTS OF CORRECTIONSSOP8.02.16.840.1.113883.3.221.5PT
41Corrections FederalSOP8.02.16.840.1.113883.3.221.5PT
42Corrections StateSOP8.02.16.840.1.113883.3.221.5PT
43Corrections LocalSOP8.02.16.840.1.113883.3.221.5PT
44Corrections Unknown LevelSOP8.02.16.840.1.113883.3.221.5PT
5PRIVATE HEALTH INSURANCESOP8.02.16.840.1.113883.3.221.5PT
51Managed Care (Private)SOP8.02.16.840.1.113883.3.221.5PT
511Commercial Managed Care - HMOSOP8.02.16.840.1.113883.3.221.5PT
512Commercial Managed Care - PPOSOP8.02.16.840.1.113883.3.221.5PT
513Commercial Managed Care - POSSOP8.02.16.840.1.113883.3.221.5PT
514Exclusive Provider OrganizationSOP8.02.16.840.1.113883.3.221.5PT
515Gatekeeper PPO (GPPO)SOP8.02.16.840.1.113883.3.221.5PT
516Commercial Managed Care - Pharmacy Benefit ManagerSOP8.02.16.840.1.113883.3.221.5PT
517Commercial Managed Care - DentalSOP8.02.16.840.1.113883.3.221.5PT
519Managed Care, Other (non HMO)SOP8.02.16.840.1.113883.3.221.5PT
52Private Health Insurance - IndemnitySOP8.02.16.840.1.113883.3.221.5PT
521Commercial IndemnitySOP8.02.16.840.1.113883.3.221.5PT
522Self-insured (ERISA) Administrative Services Only (ASO) planSOP8.02.16.840.1.113883.3.221.5PT
523Medicare supplemental policy (as second payer)SOP8.02.16.840.1.113883.3.221.5PT
524Indemnity Insurance - DentalSOP8.02.16.840.1.113883.3.221.5PT
529Private health insurance--other commercial IndemnitySOP8.02.16.840.1.113883.3.221.5PT
53Managed Care (private) or private health insurance (indemnity), not otherwise specifiedSOP8.02.16.840.1.113883.3.221.5PT
54Organized Delivery SystemSOP8.02.16.840.1.113883.3.221.5PT
55Small Employer Purchasing GroupSOP8.02.16.840.1.113883.3.221.5PT
56Specialized Stand Alone PlanSOP8.02.16.840.1.113883.3.221.5PT
561DentalSOP8.02.16.840.1.113883.3.221.5PT
562VisionSOP8.02.16.840.1.113883.3.221.5PT
59Other Private InsuranceSOP8.02.16.840.1.113883.3.221.5PT
6BLUE CROSS/BLUE SHIELDSOP8.02.16.840.1.113883.3.221.5PT
61BC Managed CareSOP8.02.16.840.1.113883.3.221.5PT
611BC Managed Care -- HMOSOP8.02.16.840.1.113883.3.221.5PT
612BC Managed Care -- PPOSOP8.02.16.840.1.113883.3.221.5PT
613BC Managed Care -- POSSOP8.02.16.840.1.113883.3.221.5PT
614BC Managed Care - DentalSOP8.02.16.840.1.113883.3.221.5PT
619BC Managed Care -- OtherSOP8.02.16.840.1.113883.3.221.5PT
62BC Insurance IndemnitySOP8.02.16.840.1.113883.3.221.5PT
621BC IndemnitySOP8.02.16.840.1.113883.3.221.5PT
622BC Self-insured (ERISA) Administrative Services Only (ASO)PlanSOP8.02.16.840.1.113883.3.221.5PT
623BC Medicare Supplemental PlanSOP8.02.16.840.1.113883.3.221.5PT
629BC Indemnity - DentalSOP8.02.16.840.1.113883.3.221.5PT
7MANAGED CARE, UNSPECIFIED (to be used only if one can't distinguish public from private)SOP8.02.16.840.1.113883.3.221.5PT
71HMOSOP8.02.16.840.1.113883.3.221.5PT
72PPOSOP8.02.16.840.1.113883.3.221.5PT
73POSSOP8.02.16.840.1.113883.3.221.5PT
79Other Managed CareSOP8.02.16.840.1.113883.3.221.5PT
8NO PAYMENT from an Organization/Agency/Program/Private Payer ListedSOP8.02.16.840.1.113883.3.221.5PT
81Self-pay (Includes applicants for insurance and Medicaid applicants)SOP8.02.16.840.1.113883.3.221.5PT
82No ChargeSOP8.02.16.840.1.113883.3.221.5PT
821CharitySOP8.02.16.840.1.113883.3.221.5PT
822Professional CourtesySOP8.02.16.840.1.113883.3.221.5PT
823Research/Clinical TrialSOP8.02.16.840.1.113883.3.221.5PT
83Refusal to Pay/Bad DebtSOP8.02.16.840.1.113883.3.221.5PT
84Hill Burton Free CareSOP8.02.16.840.1.113883.3.221.5PT
85Research/DonorSOP8.02.16.840.1.113883.3.221.5PT
89No Payment, OtherSOP8.02.16.840.1.113883.3.221.5PT
9MISCELLANEOUS/OTHERSOP8.02.16.840.1.113883.3.221.5PT
91Foreign NationalSOP8.02.16.840.1.113883.3.221.5PT
92Other (Non-government)SOP8.02.16.840.1.113883.3.221.5PT
93Disability InsuranceSOP8.02.16.840.1.113883.3.221.5PT
94Long-term Care InsuranceSOP8.02.16.840.1.113883.3.221.5PT
95Worker's CompensationSOP8.02.16.840.1.113883.3.221.5PT
951Worker's Comp HMOSOP8.02.16.840.1.113883.3.221.5PT
953Worker's Comp Fee-for-ServiceSOP8.02.16.840.1.113883.3.221.5PT
954Worker's Comp Other Managed CareSOP8.02.16.840.1.113883.3.221.5PT
959Worker's Comp, Other unspecifiedSOP8.02.16.840.1.113883.3.221.5PT
96Auto Insurance (includes no fault)SOP8.02.16.840.1.113883.3.221.5PT
97Legal Liability / Liability InsuranceSOP8.02.16.840.1.113883.3.221.5PT
98Other specified but not otherwise classifiable (includes Hospice - Unspecified plan)SOP8.02.16.840.1.113883.3.221.5PT
99No Typology Code available for payment sourceSOP8.02.16.840.1.113883.3.221.5PT
9999Unavailable / No Payer Specified / BlankSOP8.02.16.840.1.113883.3.221.5PT