{
"description": null,
"_filename": "CodeSystem-SOP.json",
"package_name": "us.nlm.vsac",
"date": "2021-01-01T00:00:00-05:00",
"meta": {
"profile": [ "http://hl7.org/fhir/StructureDefinition/shareablecodesystem" ],
"versionId": "1767982265",
"lastUpdated": "2021-01-14T00:00:00-05:00"
},
"publisher": null,
"content": "complete",
"name": "SOP",
"type": null,
"experimental": "false",
"resourceType": "CodeSystem",
"title": "Source of Payment Typology",
"package_version": "0.21.0",
"status": "active",
"id": "451d0825-3027-4bff-bec4-6b2fd415b880",
"kind": null,
"count": 167,
"url": "https://nahdo.org/sopt",
"identifier": [ {
"value": "urn:oid:2.16.840.1.113883.3.221.5",
"system": "urn:ietf:rfc:3986"
} ],
"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"
}