• Include these codes as defined in http://terminology.hl7.org/CodeSystem/v3-ParticipationFunction version 2.1.0

  Code	Display	Definition
  CLMADJ	claims adjudication	**Definition:** Manages all operations required to adjudicate fee for service claims or managed care encounter reports.
  ENROLL	enrollment broker	**Definition:** Managing the enrollment of covered parties.
  FFSMGT	ffs management	**Definition:** Managing all operations required to administer a fee for service or indemnity health plan including enrolling covered parties and providing customer service, provider contracting, claims payment, care management and utilization review.
  MCMGT	managed care management	**Definition:** Managing all operations required to administer a managed care plan including enrolling covered parties and providing customer service,, provider contracting, claims payment, care management and utilization review.
  PROVMGT	provider management	**Definition:** Managing provider contracting, provider services, credentialing, profiling, performance measures, and ensuring network adequacy.
  UMGT	utilization management	**Definition:** Managing utilization of services by ensuring that providers adhere to, e.g., payeraTMs clinical protocols for medical appropriateness and standards of medical necessity. May include management of authorizations for services and referrals.

This value set expansion contains 6 concepts.