| Code | Display | Comments |
|---|
 prior-auth-include | Include in prior authorization | |
| initial-claim-include | Include in initial claim | |
| all-claims-include | Include in all claims | |
| reason-prior-auth | Prior authorization | |
| after-completion-action | After-completion action | |
| gold-card | Gold card | |
| detail-code | Detail code | |
| allowed-quantity | Maximum quantity | |
| allowed-period | Maximum allowed period | |
| in-network-copay | Copay for in-network | |
| out-network-copay | Copay for out-of-network | |
| auth-out-network-only | Authorization out-of-network only | |
| concurrent-review | Concurrent review | |
| appropriate-use-needed | Appropriate use | |
| conditional | Conditional | |
| covered | Covered | |
| not-covered | Not covered | |
| clinical | Clinical Documentation | |
| admin | Administrative Documentation | |
| both | Administrative & clinical doc | |
| no-auth | No Prior Authorization | |
| auth-needed | Prior Authorization Needed | |
| satisfied | Authorization Satisfied | |
| performer | Performer Needed | |
| location | Location Needed | |
| timeframe | Timeframe Needed | |
| contract-window | New Contract Window | |
| used | Authorization Token Used | |
| not-used | Authorization Token Not Used | |
| provider-src | Provider-sourced | |
| payer-src | Payer-sourced | |
| _cardType | Card Type (abstract) | |
| _HookType | CDS Hook Type (abstract) | |
| _docReason | Additional Information Purposes | |
| _cmsLocation | | CMS Location codes | |
jurisdiction[0]