• Include these codes as defined in http://hl7.org/fhir/us/ndh/CodeSystem/NdhPayerCharacteristicsCS

  Code	Display	Definition
  pcpov	Primary Care Visit to Treat an Injury or Illness	Benefit plan covers services rendered by a primary care physician during an office visit with the purpose to treat injury or illness, except for preventive care services.
  specialistov	Specialist Office Visit	Covered healthcare service rendered to a patient by a specialty provider.
  mlpov	Other Practitioner Office Visit (Nurse, Physician Assistant) - Mid Level Professional	Benefit plan covers covered health related services rendered by a practioner other than MD or DO and referred to as other practitioner.
  outpatient	Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	Benefit plan covers health related services rendered to patient at an outpatient facility, outside of a facility that requires a patient admission.
  outpatstx	Outpatient Surgery Physician/Surgical Services	Benefit plan covers surgical services rendered to patient outside of a facility admission, referred to as outpatient.
  hospserv	Hospice Services	Benefit plan covers hospice services.
  routinedental	Routine Dental Services (Adult)	Benefit plan covers routine dental services.
  infertilitytx	Infertility Treatment	Benefit plan covers eligible infertility treatment services.
  ltnhc	Long-Term/Custodial Nursing Home Care	Long-Term/Custodial Nursing Home Care.
  privatenurse	Private-Duty Nursing	Private-Duty Nursing.
  routineeye	Routine Eye Exam (Adult)	Routine Eye Exam (Adult).
  ucservice	Urgent Care Centers or Facilities	Urgent Care Centers or Facilities.
  homehealth	Home Health	Home health services insurance coverage.
  erservice	Emergency Room Services	Emergency Room Services.
  ambulance	Emergency Room Services	Emergency Room Services.
  inpatienthospital	Inpatient Hospital Services (e.g., Hospital Stay)	A person who is hospitalized for at least one night to receive treatment or participate in a study.
  inpatientprovider	Inpatient Physician and Surgical Services	A healthcare provider who is delivering healthcare services in a hospital environment.
  bariatricsurg	Bariatric Surgery	Bariatric surgery service Skilled nursing service (qualifier value).
  cosmeticsurg	Cosmetic Surgery	Cosmetic surgery service Skilled nursing service (qualifier value).
  skillednursing	Skilled Nursing Facility	Skilled nursing service (qualifier value).
  ppnatalcare	Prenatal and Postnatal Care	Prenatal and Postnatal services.
  maternitycare	Delivery and All Inpatient Services for Maternity Care	All maternity care services.
  menthlthoutp	Mental/Behavioral Health Outpatient Services	Mental health service delivered in an outpatient setting.
  menthlthinp	Mental/Behavioral Health Inpatient Services	Mental health service delivered in an hospital or inpatient facility setting.
  sadoutp	Substance Abuse Disorder Outpatient Services	Substance abuse related services delivered in a outpatient setting.
  sadinp	Substance Abuse Disorder Inpatient Services	Substance abuse related services delivered in a inpatient setting.
  drggenric	Generic Drugs	Generic drugs eligible benefits.
  drgbrand	Preferred Brand Drugs	Preferred brand drugs eligible benefits.
  drgnonpreferred	Non-Preferred Brand Drugs	Non-Preferred drugs brands eligible benefits.
  drgspecialty	Specialty Drugs	Benefit plan covers specialty drugs.
  rehaboutp	Outpatient Rehabilitation Services	Benefit plan covers outpatient rehabilitation services.
  servicehablitation	Habilitation Services	Habilitation Services.
  chiro	Chiropractic Care	Benefit plan covers chiropractor eligible benefits.
  dme	Durable Medical Equipment	Benefit plan covers Durable medical equipment eligible benefits.
  hearingaids	Hearing Aids	Benefit plan covers hearing aids.
  imgctpetmri	Imaging (CT/PET Scans, MRIs)	Benefit plan covers advances imaging techniques services (CT/PET Scans, MRIs) eligible services.
  prev	Preventive Care/Screening/Immunization	Routine healthcare services to prevent health related problems eligible benefits.
  rtnpod	Routine Foot Care	Routine Foot Care.
  acupuncture	Acupuncture	Benefit plan covers acupuncture treatment.
  weightloss	Weight Loss Programs	Benefit plan covers weight loss services eligible benefits.
  rtneyechld	Routine Eye Exam for Children	Routine eye exam for children eligible benefits.
  glasseschld	Eye Glasses for Children	Eye glasses children eligible benefits.
  rtndntlchld	Dental Check-Up for Children	Dental Check-Up for Children.
  speachthpy	Rehabilitative Speech Therapy	Benefit plan covers rehabilitative speech therapy eligible benefits.
  rehaboccandpt	Rehabilitative Occupational and Rehabilitative Physical Therapy	Benefit plan covers rehabilitative occupational and rehabilitative physical eligible benefits.
  wellbaby	Well Baby Visits and Care	Regularly scheduled, preventive care services, including immunizations, provided to children up to an age as specified by a health insurance company or mandated by a government agency.
  laboutp	Laboratory Outpatient and Professional Services	Benefit plan covers laboratory testing and related professional services received as outpatient.
  imagingdx	X-rays and Diagnostic Imaging	Benefit plan covers diagnostic imaging procedures that produce images of internal structures of the human body and uses radiation to diagnose and treat diseases.
  dntlbaschld	Basic Dental Care - Child	Benefit plan covers diagnostic basic dental care.
  orthochld	Orthodontia - Child	Benefit plan covers orthodontia for children.
  dntlmajchld	Major Dental Care - Child	Benefit plan covers major dental care for children.
  dntlbasadlt	Basic Dental Care - Adult	Benefit plan covers basic dental care for adults.
  orthodadlt	Orthodontia - Adult	Benefits plan covers services provided that are required for orthodontic purposes for an adult.
  dntlmajadlt	Major Dental Care - Adult	Benefit plan covers major dental care for adult.
  abortion	Abortion for Which Public Funding is Prohibited	Benefit plan covers services for abortion for which public funding is prohibited.
  transplant	Transplant	Benefit plan covers transplant related services.
  accdntl	Accidental Dental	Benefit plan covers dental care services related to an accident.
  dialysis	Dialysis	The plan benefit covers services used to treat end stage renal disease.
  testallrgy	Allergy Testing	The plan benefits covers services for diagnostic procedures ordered or performed to evaluate whether a sensitivity to a substance is present. This test may be associated with specimen collection and/or substance administration challenge activities.
  chemotherapy	Chemotherapy	The plan benefits cover services the use of drugs and approved chemicals to treat disease.
  radiation	Radiation	The plan benefits cover services the use radiation to treat disease.
  edudiab	Diabetes Education	The plan benefits cover services related to instruction or training that encourages behaviors most likely to optimize health potentials through information about diabetes; facilitates the prevention of diabetes.
  prosthetic	Prosthetic Devices	Plan benefit covers services related to prosthesis devices.
  infusiontx	Infusion Therapy	Plan benefit covers services related to infusion therapy.
  tmjtx	Treatment for Temporomandibular Joint Disorders	Plan benefit covers services related to treatment of Temporomandibular Joint disorder.
  nutrition	Nutritional Counseling	Nutritional Counseling.
  reconsurg	Reconstructive Surgery	Plan benefit covers services related to reconstructive surgery.

This value set contains 67 concepts

Expansion based on NDH Payer Characteristics Code System v1.0.0-ballot (CodeSystem)