https://nahdo.org/sopt|9.2
name
SOP
SOP
package
us.nlm.vsac@0.21.0
us.nlm.vsac@0.21.0
content
complete
complete
status
active
active
date
2021-01-01 05:00:00.0
2021-01-01 05:00:00.0
Source of Payment Typology
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"date" : "2021-01-01T05:00:00Z",
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"content" : "complete",
"name" : "SOP",
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"resourceType" : "CodeSystem",
"title" : "Source of Payment Typology",
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"status" : "active",
"id" : "c2c39e15-ca86-539e-a555-e04288f286ec",
"count" : 167,
"url" : "https://nahdo.org/sopt",
"identifier" : [ {
"value" : "urn:oid:2.16.840.1.113883.3.221.5",
"system" : "urn:ietf:rfc:3986"
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"concept" : [ {
"code" : "1",
"display" : "MEDICARE"
}, {
"code" : "11",
"display" : "Medicare Managed Care (Includes Medicare Advantage Plans)"
}, {
"code" : "111",
"display" : "Medicare HMO"
}, {
"code" : "1111",
"display" : "Medicare Chronic Condition Special Needs Plan (C-SNP)"
}, {
"code" : "1112",
"display" : "Medicare Institutional Special Needs Plan (I-SNP)"
}, {
"code" : "112",
"display" : "Medicare PPO"
}, {
"code" : "113",
"display" : "Medicare POS"
}, {
"code" : "119",
"display" : "Medicare Managed Care Other"
}, {
"code" : "12",
"display" : "Medicare (Non-managed Care)"
}, {
"code" : "121",
"display" : "Medicare FFS"
}, {
"code" : "122",
"display" : "Medicare Drug Benefit"
}, {
"code" : "123",
"display" : "Medicare Medical Savings Account (MSA)"
}, {
"code" : "129",
"display" : "Medicare Non-managed Care Other"
}, {
"code" : "13",
"display" : "Medicare Hospice"
}, {
"code" : "14",
"display" : "Dual Eligibility Medicare/Medicaid Organization"
}, {
"code" : "141",
"display" : "Dual Eligible Special Needs Plan (D-SNP)"
}, {
"code" : "142",
"display" : "Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP)"
}, {
"code" : "19",
"display" : "Medicare Other"
}, {
"code" : "191",
"display" : "Medicare Pharmacy Benefit Manager"
}, {
"code" : "2",
"display" : "MEDICAID"
}, {
"code" : "21",
"display" : "Medicaid (Managed Care)"
}, {
"code" : "211",
"display" : "Medicaid HMO"
}, {
"code" : "212",
"display" : "Medicaid PPO"
}, {
"code" : "213",
"display" : "Medicaid PCCM (Primary Care Case Management)"
}, {
"code" : "219",
"display" : "Medicaid Managed Care Other"
}, {
"code" : "22",
"display" : "Medicaid (Non-managed Care Plan)"
}, {
"code" : "23",
"display" : "Medicaid/SCHIP"
}, {
"code" : "25",
"display" : "Medicaid - Out of State"
}, {
"code" : "26",
"display" : "Medicaid - Long Term Care"
}, {
"code" : "29",
"display" : "Medicaid Other"
}, {
"code" : "291",
"display" : "Medicaid Pharmacy Benefit Manager"
}, {
"code" : "299",
"display" : "Medicaid - Dental"
}, {
"code" : "3",
"display" : "OTHER GOVERNMENT (Federal/State/Local) (excluding Department of Corrections)"
}, {
"code" : "31",
"display" : "Department of Defense"
}, {
"code" : "311",
"display" : "TRICARE (CHAMPUS)"
}, {
"code" : "3111",
"display" : "TRICARE Prime--HMO"
}, {
"code" : "3112",
"display" : "TRICARE Extra--PPO"
}, {
"code" : "3113",
"display" : "TRICARE Standard - Fee For Service"
}, {
"code" : "3114",
"display" : "TRICARE For Life--Medicare Supplement"
}, {
"code" : "3115",
"display" : "TRICARE Reserve Select"
}, {
"code" : "3116",
"display" : "Uniformed Services Family Health Plan (USFHP) -- HMO"
}, {
"code" : "3119",
"display" : "Department of Defense - (other)"
}, {
"code" : "312",
"display" : "Military Treatment Facility"
}, {
"code" : "3121",
"display" : "Enrolled Prime--HMO"
}, {
"code" : "3122",
"display" : "Non-enrolled Space Available"
}, {
"code" : "3123",
"display" : "TRICARE For Life (TFL)"
}, {
"code" : "313",
"display" : "Dental --Stand Alone"
}, {
"code" : "32",
"display" : "Department of Veterans Affairs"
}, {
"code" : "321",
"display" : "Veteran care-Care provided to Veterans"
}, {
"code" : "3211",
"display" : "Direct Care-Care provided in VA facilities"
}, {
"code" : "3212",
"display" : "Indirect Care-Care provided outside VA facilities"
}, {
"code" : "32121",
"display" : "Fee Basis"
}, {
"code" : "32122",
"display" : "Foreign Fee/Foreign Medical Program (FMP)"
}, {
"code" : "32123",
"display" : "Contract Nursing Home/Community Nursing Home"
}, {
"code" : "32124",
"display" : "State Veterans Home"
}, {
"code" : "32125",
"display" : "Sharing Agreements"
}, {
"code" : "32126",
"display" : "Other Federal Agency"
}, {
"code" : "32127",
"display" : "Dental Care"
}, {
"code" : "32128",
"display" : "Vision Care"
}, {
"code" : "322",
"display" : "Non-veteran care"
}, {
"code" : "3221",
"display" : "Civilian Health and Medical Program for the VA (CHAMPVA)"
}, {
"code" : "3222",
"display" : "Spina Bifida Health Care Program (SB)"
}, {
"code" : "3223",
"display" : "Children of Women Vietnam Veterans (CWVV)"
}, {
"code" : "3229",
"display" : "Other non-veteran care"
}, {
"code" : "33",
"display" : "Indian Health Service or Tribe"
}, {
"code" : "331",
"display" : "Indian Health Service - Regular"
}, {
"code" : "332",
"display" : "Indian Health Service - Contract"
}, {
"code" : "333",
"display" : "Indian Health Service - Managed Care"
}, {
"code" : "334",
"display" : "Indian Tribe - Sponsored Coverage"
}, {
"code" : "34",
"display" : "HRSA Program"
}, {
"code" : "341",
"display" : "Title V (MCH Block Grant)"
}, {
"code" : "342",
"display" : "Migrant Health Program"
}, {
"code" : "343",
"display" : "Ryan White Act"
}, {
"code" : "344",
"display" : "Disaster-related (includes Covid-19)"
}, {
"code" : "349",
"display" : "Other"
}, {
"code" : "35",
"display" : "Black Lung"
}, {
"code" : "36",
"display" : "State Government"
}, {
"code" : "361",
"display" : "State SCHIP program (codes for individual states)"
}, {
"code" : "362",
"display" : "Specific state programs (list/ local code)"
}, {
"code" : "369",
"display" : "State, not otherwise specified (other state)"
}, {
"code" : "37",
"display" : "Local Government"
}, {
"code" : "371",
"display" : "Local - Managed care"
}, {
"code" : "3711",
"display" : "HMO"
}, {
"code" : "3712",
"display" : "PPO"
}, {
"code" : "3713",
"display" : "POS"
}, {
"code" : "372",
"display" : "FFS/Indemnity"
}, {
"code" : "379",
"display" : "Local, not otherwise specified (other local, county)"
}, {
"code" : "38",
"display" : "Other Government (Federal, State, Local not specified)"
}, {
"code" : "381",
"display" : "Federal, State, Local not specified managed care"
}, {
"code" : "3811",
"display" : "Federal, State, Local not specified - HMO"
}, {
"code" : "3812",
"display" : "Federal, State, Local not specified - PPO"
}, {
"code" : "3813",
"display" : "Federal, State, Local not specified - POS"
}, {
"code" : "3819",
"display" : "Federal, State, Local not specified - not specified managed care"
}, {
"code" : "382",
"display" : "Federal, State, Local not specified - FFS"
}, {
"code" : "389",
"display" : "Federal, State, Local not specified - Other"
}, {
"code" : "39",
"display" : "Other Federal"
}, {
"code" : "391",
"display" : "Federal Employee Health Plan - Use when known"
}, {
"code" : "4",
"display" : "DEPARTMENTS OF CORRECTIONS"
}, {
"code" : "41",
"display" : "Corrections Federal"
}, {
"code" : "42",
"display" : "Corrections State"
}, {
"code" : "43",
"display" : "Corrections Local"
}, {
"code" : "44",
"display" : "Corrections Unknown Level"
}, {
"code" : "5",
"display" : "PRIVATE HEALTH INSURANCE"
}, {
"code" : "51",
"display" : "Managed Care (Private)"
}, {
"code" : "511",
"display" : "Commercial Managed Care - HMO"
}, {
"code" : "512",
"display" : "Commercial Managed Care - PPO"
}, {
"code" : "513",
"display" : "Commercial Managed Care - POS"
}, {
"code" : "514",
"display" : "Exclusive Provider Organization"
}, {
"code" : "515",
"display" : "Gatekeeper PPO (GPPO)"
}, {
"code" : "516",
"display" : "Commercial Managed Care - Pharmacy Benefit Manager"
}, {
"code" : "517",
"display" : "Commercial Managed Care - Dental"
}, {
"code" : "519",
"display" : "Managed Care, Other (non HMO)"
}, {
"code" : "52",
"display" : "Private Health Insurance - Indemnity"
}, {
"code" : "521",
"display" : "Commercial Indemnity"
}, {
"code" : "522",
"display" : "Self-insured (ERISA) Administrative Services Only (ASO) plan"
}, {
"code" : "523",
"display" : "Medicare supplemental policy (as second payer)"
}, {
"code" : "524",
"display" : "Indemnity Insurance - Dental"
}, {
"code" : "529",
"display" : "Private health insurance--other commercial Indemnity"
}, {
"code" : "53",
"display" : "Managed Care (private) or private health insurance (indemnity), not otherwise specified"
}, {
"code" : "54",
"display" : "Organized Delivery System"
}, {
"code" : "55",
"display" : "Small Employer Purchasing Group"
}, {
"code" : "56",
"display" : "Specialized Stand-Alone Plan"
}, {
"code" : "561",
"display" : "Dental"
}, {
"code" : "562",
"display" : "Vision"
}, {
"code" : "59",
"display" : "Other Private Insurance"
}, {
"code" : "6",
"display" : "BLUE CROSS/BLUE SHIELD"
}, {
"code" : "61",
"display" : "BC Managed Care"
}, {
"code" : "611",
"display" : "BC Managed Care - HMO"
}, {
"code" : "612",
"display" : "BC Managed Care - PPO"
}, {
"code" : "613",
"display" : "BC Managed Care - POS"
}, {
"code" : "614",
"display" : "BC Managed Care - Dental"
}, {
"code" : "619",
"display" : "BC Managed Care - Other"
}, {
"code" : "62",
"display" : "BC Insurance Indemnity"
}, {
"code" : "621",
"display" : "BC Indemnity"
}, {
"code" : "622",
"display" : "BC Self-insured (ERISA) Administrative Services Only (ASO)Plan"
}, {
"code" : "623",
"display" : "BC Medicare Supplemental Plan"
}, {
"code" : "629",
"display" : "BC Indemnity - Dental"
}, {
"code" : "7",
"display" : "MANAGED CARE, UNSPECIFIED (to be used only if one can't distinguish public from private)"
}, {
"code" : "71",
"display" : "HMO"
}, {
"code" : "72",
"display" : "PPO"
}, {
"code" : "73",
"display" : "POS"
}, {
"code" : "79",
"display" : "Other Managed Care"
}, {
"code" : "8",
"display" : "NO PAYMENT from an Organization/Agency/Program/Private Payer Listed"
}, {
"code" : "81",
"display" : "Self-pay (Includes applicants for insurance and Medicaid applicants)"
}, {
"code" : "82",
"display" : "No Charge"
}, {
"code" : "821",
"display" : "Charity"
}, {
"code" : "822",
"display" : "Professional Courtesy"
}, {
"code" : "823",
"display" : "Research/Clinical Trial"
}, {
"code" : "83",
"display" : "Refusal to Pay/Bad Debt"
}, {
"code" : "84",
"display" : "Hill Burton Free Care"
}, {
"code" : "85",
"display" : "Research/Donor"
}, {
"code" : "89",
"display" : "No Payment, Other"
}, {
"code" : "9",
"display" : "MISCELLANEOUS/OTHER"
}, {
"code" : "91",
"display" : "Foreign National"
}, {
"code" : "92",
"display" : "Other (Non-government)"
}, {
"code" : "93",
"display" : "Disability Insurance"
}, {
"code" : "94",
"display" : "Long-term Care Insurance"
}, {
"code" : "95",
"display" : "Worker's Compensation"
}, {
"code" : "951",
"display" : "Worker's Comp HMO"
}, {
"code" : "953",
"display" : "Worker's Comp Fee-for-Service"
}, {
"code" : "954",
"display" : "Worker's Comp Other Managed Care"
}, {
"code" : "959",
"display" : "Worker's Comp, Other unspecified"
}, {
"code" : "96",
"display" : "Auto Insurance (includes no fault)"
}, {
"code" : "97",
"display" : "Legal Liability / Liability Insurance"
}, {
"code" : "98",
"display" : "Other specified but not otherwise classifiable (includes Hospice - Unspecified plan)"
}, {
"code" : "99",
"display" : "No Typology Code available for payment source"
}, {
"code" : "9999",
"display" : "Unavailable / No Payer Specified / Blank"
} ],
"version" : "9.2"
}