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NIS Description of Data Elements
The NIS is set of longitudinal hospital inpatient databases included in the HCUP family. These databases are created by AHRQ through a Federal-State-Industry partnership.
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PAY1 - Expected primary payer, uniform
 
Documentation Sections:
General Notes
Uniform Values
State Specific Notes
General Notes
 

PAY1 indicates the expected primary payer (Medicare, Medicaid, private insurance, etc.). To ensure uniformity of coding across data sources, PAY1 combines detailed categories in the more general groups. For example,

  • Medicare includes both fee-for-service and managed care Medicare patients.
  • Medicaid includes both fee-for-service and managed care Medicaid patients.
  • Private insurance (PAY1 = 3) includes Blue Cross, commercial carriers, and private HMOs and PPOs.
  • Other (PAY1 = 6) includes Worker's Compensation, CHAMPUS, CHAMPVA, Title V, and other government programs.

In the 1988-1997 data, the data element PAY1_N provides more detailed categories for private insurance and other payers. This data element is discontinued beginning in the 1998 data because of the difficulty of coding the information uniformly across States.

The HCUP data element PAY1_X retains the expected primary payer as provided by the data source. The State Specific Notes for PAY1 include information on how the source values contained in the PAY1_X are recoded into the HCUP uniform values of PAY1.

If information on secondary or tertiary payers is provided by the data source, the coding of the associated HCUP variables (PAY2, PAY2_X, and PAY3_X) is included under the State Specific Notes for PAY1.

HCUP is in the process of defining two new uniform payer variables that identify HMO and PPO payers (HMOPPO1 and HMOPPO2). These variables are under development and are not yet available on the HCUP Nationwide Inpatient Sample (NIS).

 
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Uniform Values
VariableDescriptionValueValue Description
PAY1Expected primary payer, uniform1Medicare
2Medicaid
3Private insurance
4Self-pay
5No charge
6Other
.Missing
.AInvalid
.BUnavailable from source (coded in 1988-1997 data only)
 
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State Specific Notes

Arkansas
Arkansas
PAY1_X and PAY2_X PAY1 and PAY2
Value Description Value Description
M Medicare 1 Medicare
D Medicaid 2 Medicaid
I Commercial Insurance 3 Private Insurance
B Blue Cross/Blue Shield, Medi-Pak, Medi-Pak Plus
H HMO/Managed Care
S Self Insured
E County or State (ex: state or county employees) (Valid beginning in 2010)
P Self-pay 4 Self pay
Z Medically Indigent/Free 5 No charge
C CHAMPUS 6 Other
E County or State (ex: state or county employees) (Valid prior to 2010)
L Managed Assistance
N Division of Health Services
O Other
V Other Federal Programs
W Worker's Compensation
Blank Missing . Missing
Any values not documented by the data source .A Invalid


Arizona
Arizona
(Valid beginning 2003)
PAY1_X PAY1
Value Description Value Description
05, 5 Medicare 1 Medicare
11 Medicare Risk
06 Arizona Health Care Cost Containment System (AHCCCS) Health Care Group/ Medicaid 2 Medicaid
01 Commercial (Indemnity) 3 Private Insurance
02 HMO
03, 3 PPO
04 Arizona Health Care Cost Containment System (AHCCCS) Health Care Group (for the self employed, small businesses (under 50 employees), and the uninsured employees of political subdivisions)
00 Self pay 4 Self pay
12 Charity 5 No charge
07 CHAMPUS/TRICARE 6 Other
08 Children's Rehab Services
09 Worker's Compensation
10 Indian Health Services
13 Foreign National
14 Other
15 Tobacco Tax (beginning in 1998)(discontinued 2007)
    . Missing
Blank Missing
Any values not documented by the data source .A Invalid



Arizona
(Valid July 2002 through December 2002)
PAY1_X PAY1
Value Description Value Description
F Medicare 1 Medicare
L Medicare Risk
G AHCCCS/Medicaid 2 Medicaid
B Commercial (Indemnity) 3 Private Insurance
C HMO
D PPO
E Arizona Health Care Cost Containment System (AHCCCS) Health Care Group (for the self employed, small businesses (under 50 employees), and the uninsured employees of political subdivisions)
A Self pay 4 Self pay
M Charity 5 No charge
H CHAMPUS/MEDEXCEL 6 Other
I Children's Rehab Services
J Worker's Compensation
K Indian Health Services
N Foreign National
O Other
?, Blank Unknown, Missing . Missing
Any values not documented by the data source .A Invalid



Arizona
(Valid 1995 to June 2002)
PAY1_X PAY1
Value Description Value Description
05, 5 Medicare 1 Medicare
11 Medicare Risk
04 Arizona Health Care Cost Containment System (AHCCCS) Health Care Group 2 Medicaid
06 AHCCCS/Medicaid
01 Commercial (Indemnity) 3 Private Insurance
02 HMO
03, 3 PPO
00 Self pay 4 Self pay
12 Charity 5 No charge
07 CHAMPUS/MEDEXCEL 6 Other
08 Children's Rehab Services
09 Worker's Compensation
10 Indian Health Services
13 Foreign National
14 Other
15 Tobacco Tax (Beginning in 1998)
Blank Missing . Missing
Any values not documented by the data source .A Invalid



Arizona
(Valid from 1989-1994)
PAY1_X PAY1
Value Description Value Description
3 Medicare 1 Medicare
4 AHCCCS/Medicaid 2 Medicaid
1 Commercial 3 Private Insurance
2 HMO/PHP/Blue Cross
--   4 Self-pay
--   5 No charge
5 Other (self-pay, unknown, charity, etc.) 6 Other
Blank   . Missing
Other Values   .A Invalid


California
California
(Valid beginning in 1999)
PAY1_X PAY1
Value Description Value Description
010 Medicare 1 Medicare
011 Medicare (HMO) 1 Medicare
012 Medicare (Managed care - Other) 1 Medicare
013 Medicare (fee for service) 1 Medicare
020 Medi-Cal 2 Medi-Cal
021 Medi-Cal (HMO) 2 Medi-Cal
022 Medi-Cal (Managed care - Other) 2 Medi-Cal
023 Medi-Cal (fee for service) 2 Medi-Cal
030 Private Coverage 3 Private insurance
031 Private Coverage (HMO) 3 Private insurance
032 Private Coverage (Managed care - Other) 3 Private insurance
033 Private Coverage (fee for service) 3 Private insurance
08n, where n=0-3 Self-pay 4 Self-pay
--   5 No charge
04n, where n=0-3 Worker's Compensation 6 Other
05n, where n=0-3 County Indigent Programs
06n, where n=0-3 Other Government
07n, where n=0-3 Other Indigent (includes charity care)
09n, where n=0-3 Other
0, 000 Type of coverage not considered applicable to the payer category . Missing
Any values not documented by the data source .A Invalid

The first two digits of PAY1_X describes the payer category (e.g., Medicare (01), Medi-Cal (02), Private coverage (03), Workers' Compensation (04), County Indigent Programs (05), Other Government (06), Other Indigent (07), Self Pay (08), and Other Payer (09)).

The third digit of PAY1_X describes the type of coverage (e.g., Knox-Keene (HMO)* or Medi-Cal County Organized Health Systems (MCOHS) plan (1), Managed Care Other (PPO, IPO, POS, etc.) (2), traditional coverage (fee for service) (3), and type of coverage not considered applicable to the payer category (0).

* HMOs are regulated in California under the Knox-Keene Health Care Service Plan Act of 1975.




California
(Valid from 1995-1998)
PAY1_X PAY1
Value Description Value Description
01 Medicare (Even if HMO or PPO) 1 Medicare
02 Medi-Cal (even if HMO or PPO) 2 Medicaid
07 HMO 3 Private insurance
08 PPO
09 Private Insurance Company (not HMO, not PPO)
10 Blue Cross/Blue Shield (not HMO, not PPO)
11 Self-pay 4 Self-pay
12 Charity 5 No charge
13 No Charge
03 Worker's Compensation 6 Other
04 County Indigent Programs
05 CHAMPUS/CHAMPVA/VA
06 Other Governmental
14 Other Non-Governmental
00, Blank Missing . Missing
Any values not documented by the data source .A Invalid



California
(Valid from 1988-1994)
PAY1_X PAY1
Value Description Value Description
01 Medicare 1 Medicare
02 Medi-Cal 2 Medicaid
06 Blue Cross/Blue Shield 3 Private insurance
07 Insurance Company
08 HMO/PHP
09 Self-pay 4 Self-pay
10 No-charge (free charity, special research, or teaching) 5 No charge
04 Title V 6 Other
03 Workers' Compensation
05, 12 Other government; Medically indigent services under Section 17000
11 Other non-government
Blank Valid before 1994 . Missing
00 Valid in 1994 . Missing
Other Values   .A Invalid


Colorado
Colorado
(Valid beginning in 1998)
PAY1_X PAY1
Value Description Value Description
04 Medicare 1 Medicare
05 Medicaid 2 Medicaid
01 Blue Cross / Blue Shield 3 Private Insurance
02 Commercial Ins / Indemnity Plans / Self Insured
03 Other Liability Ins / No Fault / Casualty
08 HMO-PPO / Managed Care / Discounted
12 Self-Pay 4 Self-pay
13 No Charge/Charity Research 5 No charge
06 Worker's Comp 6 Other
09 CHAMPUS/CHAMPVA
11 Other Government
14 Other
15 Colorado Medically Indigent
00 Missing . Missing
blank Missing
other Any undocumented values .A Invalid



Colorado
(Valid from 1993-1997)
PAY1_X PAY1
Value Description Value Description
04 Medicare 1 Medicare
05 Medicaid 2 Medicaid
01 Blue Cross/Blue Shield 3 Private insurance
02, 03 Commercial insurance/Indemnity plans/Self-insured; Other liability insurance/No fault/ Casualty
08 HMO-PPO/Managed Care/Discounted
12 Self-Pay 4 Self-pay
13 No Charge/Charity/Research 5 No charge
06 Workers' Comp 6 Other
09 CHAMPUS
11, 15 Other government; Colorado Medically Indigent
14 1993-1996: Other
Blank Unknown . Missing
00 Starting in 1996: Missing . Missing
Other Values   .A Invalid



Colorado
(Valid from 1988-1992)
PAY1_X PAY1
Value Description Value Description
3 Medicare 1 Medicare
4 Medicaid 2 Medicaid
7 Blue Cross/Blue Shield 3 Private insurance
8 Commercial insurance
B HMO-PPO
1 Self-Pay 4 Self-pay
9 No Charge 5 No charge
5 Title V 6 Other
2 Workers' Compensation
6 Other government
A, C Other; Other non-gov
"00", blank Unknown . Missing
Other Values   .A Invalid


Connecticut
Connecticut
(Valid beginning in 1998)
PAY1_X and PAY2_X PAY1 and PAY2
Value Description Value Description
C Medicare 1 Medicare
M Medicare managed care 1 Medicare
D Medicaid 2 Medicaid
J Medicaid managed care (beginning in 1998) 2 Medicaid
F Commercial Insurance 3 Private insurance
G Blue Cross (Blue Cross PPOs are coded as PPOs, value "T") 3 Private insurance
S HMO 3 Private insurance
T PPO 3 Private insurance
A Self-pay 4 Self-pay
R No charge 5 No charge
B Worker's Comp 6 Other
E Other Federal Program
H Champus
I Other
Q Title V
U Charter Oak
Blank Missing . Missing
Any values not documented by the data source .A Invalid



Connecticut
(Valid from 1993-1997)
PAY1_X and PAY2_X PAY1 and PAY2
Value Description Value Description
C, M (1997 only) Medicare 1 Medicare
D Medicaid 2 Medicaid
G Blue Cross 3 Private Insurance
F, T Commercial Insurance: PPO
S HMO
A Self-pay 4 Self-pay
R No charge 5 No charge
Q Title V 6 Other
B Workers' Compensation
H CHAMPUS
E Other federal programs
I Other
Blank   . Missing
Other Values   .A Invalid


Florida
Florida
(Valid beginning in 2010)
PAY1_X PAY1
Value Description Value Description
A Medicare 1 Medicare
B Medicare Managed Care
C Medicaid 2 Medicaid
D Medicaid Managed Care
E Commercial Health Insurance 3 Private Insurance
Q Commercial Liability Coverage
L Self pay 4 Self-pay
N Non-payment 5 No charge
H Worker's Compensation 6 Other
I TriCare or Other Federal Government
J VA
K Other State/Local Government
M Other
O KidCare
P Unknown . Missing
Blank  
Other Any undocumented value .A Invalid



Florida
(Valid 2006-2009)
PAY1_X PAY1
Value Description Value Description
A Medicare 1 Medicare
B Medicare HMO
C Medicaid 2 Medicaid
D Medicaid HMO
E Commercial Insurance 3 Private Insurance
F Commercial HMO
G Commercial PPO
L Self pay/Under-insured (No third party coverage or less than 30% estimated insurance coverage) 4 Self-pay
N Charity 5 No charge
H Worker's Compensation 6 Other
I Champus
J VA
K Other State/Local Government
M Other
O KidCare (Healthy Kids, MediKids, and Children's Medical Services - beginning 2003)
P Unknown. Reported only if information is not available, and type of service is "2" and patient status is "7" . Missing
Blank Missing
Any values not documented by the data source .A Invalid



Florida
(Valid beginning in 1998)
PAY1_X PAY1
Value Description Value Description
A Medicare 1 Medicare
B Medicare HMO or Medicare PPO
C Medicaid 2 Medicaid
D Medicaid HMO
E Commercial Insurance 3 Private Insurance
F Commercial HMO
G Commercial PPO
L Self pay/Under-insured (No third party coverage or less than 30% estimated insurance coverage) 4 Self-pay
N Charity 5 No charge
H Worker's Compensation 6 Other
I Champus
J VA
K Other State/Local Government
M Other
O KidCare (Healthy Kids, MediKids, and Children's Medical Services - beginning 2003)
Blank Missing . Missing
Any values not documented by the data source .A Invalid



Florida
(Valid for 1997)
PAY1_X PAY1
Value Description Value Description
A, B Medicare, Medicare HMO 1 Medicare
C, D Medicaid, Medicaid HMO 2 Medicaid
E, G Commercial insurance (includes self-insured and Blue Cross/Blue Shield); Commercial PPO 3 Private Insurance
F Commercial HMO
L Self-pay, charity, underinsured 4 Self-pay
N Charity 5 No charge
H Workers' Compensation 6 Other
I, J CHAMPUS; VA
K Other state/local government
M Other
Blank   . Missing
Other values   .A Missing



Florida
(Valid from 1992-1996)
PAY1_X PAY1
Value Description Value Description
A, B Medicare, Medicare HMO 1 Medicare
C, D Medicaid, Medicaid HMO 2 Medicaid
E, G Commercial insurance (includes self-insured and Blue Cross/Blue Shield); Commercial PPO 3 Private Insurance
F Commercial HMO
L Self-pay, charity, underinsured 4 Self-pay
--   5 No charge
H Workers' Compensation 6 Other
I, J CHAMPUS; VA
K Other state/local government
M Other
Blank   . Missing
Other values   .A Invalid



Florida
(Valid from 1988-1991)
PAY1_X PAY1
Value Description Value Description
A Medicare 1 Medicare
C Medicaid 2 Medicaid
E Commercial insurance (includes self-insured and Blue Cross/Blue Shield) 3 Private Insurance
--   4 Self-pay
--   5 No charge
M Other 6 Other
Blank   . Missing
Other values   .A Invalid


Florida
Florida
(Valid beginning in 2010)
PAY1_X PAY1
Value Description Value Description
A Medicare 1 Medicare
B Medicare Managed Care
C Medicaid 2 Medicaid
D Medicaid Managed Care
E Commercial Health Insurance 3 Private Insurance
Q Commercial Liability Coverage
L Self pay 4 Self-pay
N Non-payment 5 No charge
H Worker's Compensation 6 Other
I TriCare or Other Federal Government
J VA
K Other State/Local Government
M Other
O KidCare
Blank Missing . Missing
Other Any undocumented value .A Invalid



Florida
(Valid 1998-2009)
PAY1_X PAY1
Value Description Value Description
A Medicare 1 Medicare
B Medicare HMO or Medicare PPO
C Medicaid 2 Medicaid
D Medicaid HMO
E Commercial Insurance 3 Private Insurance
F Commercial HMO
G Commercial PPO
L Self pay/Under-insured (No third party coverage or less than 30% estimated insurance coverage) 4 Self-pay
N Charity 5 No charge
H Worker's Compensation 6 Other
I Champus
J VA
K Other State/Local Government
M Other
O KidCare (Healthy Kids, MediKids, and Children's Medical Services - beginning 2003)
Blank Missing . Missing
Any values not documented by the data source .A Invalid



Florida
(Valid for 1997)
PAY1_X PAY1
Value Description Value Description
A, B Medicare, Medicare HMO 1 Medicare
C, D Medicaid, Medicaid HMO 2 Medicaid
E, G Commercial insurance (includes self-insured and Blue Cross/Blue Shield); Commercial PPO 3 Private Insurance
F Commercial HMO
L Self-pay, charity, underinsured 4 Self-pay
N Charity 5 No charge
H Workers' Compensation 6 Other
I, J CHAMPUS; VA
K Other state/local government
M Other
Blank   . Missing
Other values   .A Missing



Florida
(Valid from 1992-1996)
PAY1_X PAY1
Value Description Value Description
A, B Medicare, Medicare HMO 1 Medicare
C, D Medicaid, Medicaid HMO 2 Medicaid
E, G Commercial insurance (includes self-insured and Blue Cross/Blue Shield); Commercial PPO 3 Private Insurance
F Commercial HMO
L Self-pay, charity, underinsured 4 Self-pay
--   5 No charge
H Workers' Compensation 6 Other
I, J CHAMPUS; VA
K Other state/local government
M Other
Blank   . Missing
Other values   .A Invalid



Florida
(Valid from 1988-1991)
PAY1_X PAY1
Value Description Value Description
A Medicare 1 Medicare
C Medicaid 2 Medicaid
E Commercial insurance (includes self-insured and Blue Cross/Blue Shield) 3 Private Insurance
--   4 Self-pay
--   5 No charge
M Other 6 Other
Blank   . Missing
Other values   .A Invalid


Georgia
Georgia
PAY1_X, PAY2_X, PAY3_X PAY1, PAY2, PAY3
Value Description Value Description
1 Medicare 1 Medicare
11 Medicare (Managed Care)
111 Medicare HMO
1111 Aetna Inc.
1112 Coventry Health Care, Inc.
1113 Humana Inc.
1114 Kaiser Foundation Health Plan, Inc.
1115 United HealthCare of Georgia, Inc.
1116 Wellcare of Georgia
1117 WellPoint, Inc.
1118 Other Medicare HMO
112 Medicare PPO
113 Medicare POS
119 Medicare Managed Care (Other)
12 Medicare (Non-managed Care)
121 Medicare FFS
122 Medicare Drug Benefit
123 Medicare Medical Savings Account (MSA)
124 Medicare Drug Benefit (Part D)
129 Medicare Non-managed Care (Other)
19 Medicare (Other)
2 Medicaid 2 Medicaid
21 Medicaid (Managed Care)
211 Medicaid HMO
2111 Amerigroup CMO
2112 PeachState CMO
2113 WellCare CMO
212 Medicaid PPO
213 Medicaid PCCM (Primary Care Case Management)
219 Medicaid Managed Care (Other)
22 Medicaid (Non-managed Care Plan)
23 Medicaid/SCHIP
24 Medicaid Applicant
25 Medicaid (Out of State)
29 Medicaid (Other)
5 Private Health Insurance (other than Blue Cross/Blue Shield) 3 Private Insurance
51 Managed Care (Private)
511 Commercial Managed Care (HMO)
512 Commercial Managed Care (PPO)
513 Commercial Managed Care (POS)
514 Exclusive Provider Organization
519 Managed Care, Other (non-HMO)
52 Private Health Insurance (Indemnity)
521 Indemnity (e.g. high option/low option)
522 ERISA ASO Plan
523 Commercial Indemnity
524 Self-insured (ERISA) ASO Plan
525 Medicare Supplemental Policy (as secondary payor)
53 Commercial (Indemnity or Managed Care, unspecified)
54 Organized Delivery System
55 Small Employer Purchasing Group
59 Other Private Insurance, not BC or Kaiser
6 Blue Cross/Blue Shield
61 BC Managed Care
611 BC Managed Care (HMO)
612 BC Managed Care (PPO)
613 BC Managed Care (POS)
619 BC Managed Care (Other)
62 BC Indemnity
63 BC Indemnity or Managed Care (Out of State)
64 BC Indemnity or Managed Care (Unspecified)
69 BC Indemnity or Managed Care (Other)
7 Managed Care (Unspecified)
71 HMO
72 PPO
73 POS
79 Other Managed Care (Unknown if public or private)
8 NOPAYMENT from an Organization/Agency/Program/Private Payor Listed 4 Self-pay
81 Self-pay
82 No Charge (Prior to 2009)
821 Charity
822 Professional Courtesy
823 Research/Clinical Trial
83 Refusal to Pay/Bad Debt
84 Hill Burton Free Care
85 Research/Donor
89 No Payment (Other - Prior to 2009)
82 No Charge (Begin 2009) 5 No charge
89 No Payment (Other - Begin 2009)
3 Other Government (Federal/State/Government) 6 Other
31 Department of Defense
311 CHAMPUS
3111 Indemnity
3112 TriCare
312 CHAMPVA
319 Department of Defense (not CHAMPUS)
32 VA
321 VA (Priority Veteran)
322 VA (Enrolled Veteran with Copay)
329 VA (Other)
33 Indian Health Service or Tribe
331 Indian Health Service (Regular)
332 Indian Health Service (Contract)
333 Indian Health Service (Managed Care)
334 Indian Tribe (Sponsored Coverage)
34 HRSA Program
341 Title V (MCH Block Grant)
342 Migrant Health Program
343 Ryan White Act
349 Other
35 Black Lung
36 State Government
361 State SCHIP Program
362 Specific State Programs
369 State, not otherwise specified (other state)
37 Local Government
371 Local (Managed Care)
3711 HMO
3712 POS
3713 PPO
372 FFS/Indemnity
379 Local, not otherwise specified (other local, county)
38 Other Government (Federal, State, Local not specified)
381 Federal, State, Local not specified (FFS)
382 Federal, State, Local not specified (HMO)
383 Federal, State, Local not specified (PPO)
384 Federal, State, Local not specified (POS)
389 Federal, State, Local not specified (Other)
39 Other Federal
4 Department of Corrections
41 Corrections Federal
42 Corrections State
43 Corrections Local
44 Corrections (Unknown Level)
9 Miscellaneous/Other
91 Foreign National
92 Other (Non-government)
93 Disability Insurance
94 Long-term Care Insurance
95 Worker's Compensation
951 Worker's Comp (Fee-for-Service)
952 Worker's Comp (HMO)
953 Worker's Comp (Other Managed Care)
96 Auto Insurance (no fault)
97 Other (not specified)
98 Other specified (includes Hospice - Unspecified plan)
99 Other Unspecified
  Not reported . Missing
- Invalid Code Scheme
ZZZ Missing Data
Any values not documented by the data source .A Invalid



Georgia
(Valid for 1997)
PAY1_X PAY1
Value Description Value Description
M Medicare 1 Medicare
D Medicaid 2 Medicaid
B Blue Cross and Blue Shield 3 Private Insurance
I, S Other Insurance Companies; Self Insured
H HMO-PPO
P Self-pay 4 Self-pay
Z Free 5 No charge
W Workers' Comp 6 Other
C CHAMPUS
E, N Other Government
L, O Other
3, 5, A, F, G, J, K, Y Unknown . Missing
Other values   .A Invalid


Hawaii

In 2008, source value 24 (QUEST (Any QUEST Plan except AlohaCare, HMSA Quest, Kaiser Quest)) was mapped to Private Insurance instead of Medicaid; not too many records were affected, but they have now been fixed starting in 2009.

Hawaii
(Valid beginning in 2003)
PAY1_X PAY1
Value Description Value Description
1 Medicare 1 Medicare
18 HMSA 65C+
19 Kaiser 65C+
25 Secure Horizons Medicare Advantage - beginning 2008
26 AlohaCare Advantage/Advantage Plus - beginning 2008
2 Medicaid 2 Medicaid
13 Hawaii QUEST (managed care) Beginning in 2006, the general QUEST category was discontinued and split into plan-specific categories
15 AlohaCare (plan participating in QUEST) beginning in 2003
22 HMSA QUEST - beginning 2006
23 Kaiser QUEST - beginning 2006
24 QUEST (Any QUEST Plan except AlohaCare, HMSA Quest, Kaiser Quest) - beginning 2006
14 HMSA's Health Plan Hawaii beginning in 2003 3 Private Insurance
16 Hawaii Management Alliance Association (HMAA) beginning in 2003
17 University Health Alliance (UHA) beginning in 2003
27 Summerlin Insurance
4 HMSA (any other HMSA plan)
5 Kaiser
6 Other Insurance
8 No Fault
7 Self pay 4 Self pay
--   5 No charge
9 Worker's Compensation 6 Other
10 Tricare/CHAMPUS/VA/Other Government - Discontinued in 2006
12 Department of Defense
20 Veterans Administration (VA) - Beginning 2006
21 Tricare/CHAMPUS/Other Government - Beginning 2006
11, Blank Unknown, Missing . Missing
Any values not documented by the data source .A Invalid



Hawaii
(Valid 1998-2002)
PAY1_X PAY1
Value Description Value Description
1 Medicare 1 Medicare
2 Medicaid 2 Medicaid
13 QUEST 2 Medicaid
4 HMSA (Blue Cross/Blue Shield affiliate that provides HMO, PPO and Fee for Service plans) 3 Private Insurance
5 Kaiser 3 Private Insurance
6 Other Insurance 3 Private Insurance
8 No Fault 3 Private Insurance
7 Self pay 4 Self pay
--   5 No charge
9 Worker's Compensation 6 Other
10 CHAMPUS/VA/Other Government
12 Department of Defense
11, Blank Unknown, Missing . Missing
Any values not documented by the data source .A Invalid



Hawaii
(Valid from 1996-1997)
PAY1_X PAY1
Value Description Value Description
"Medicare" Medicare 1 Medicare
"Medicaid", "SHIP", "Quest" Medicaid; SHIP; Quest 2 Medicaid
"Other Insurance", "HMSA", "No Fault" Other Insurance, HMSA, No Fault 3 Private Insurance
"Kaiser" Kaiser
"Self Pay" Self-pay 4 Self-pay
--   5 No charge
"Workers Comp" Worker's Comp 6 Other
"Champus", "DOD" CHAMPUS/VA/Other Government; Department of Defense
"Unknown", Blank Unknown . Missing
Other values   .A Invalid


Illinois
Illinois
(Valid beginning in 1998)
PAY1_X, PAY2_X, and PAY3_X PAY1 and PAY2
Value Description Value Description
A98910 Medicare 1 Medicare
B98916 Illinois Medicaid 2 Medicaid
B98917 Other Medicaid 2 Medicaid
Cnnn, where nnn is a 3-digit number Blue Cross Insurance 3 Private Insurance
Cnnnnnnnnn, where nnnnnnnnn is a 9-digit number Commercial Insurance (may include TPA and Worker's Compensation coverage) 3 Private Insurance
C98920 Other Commercial Insurance 3 Private Insurance
Dnnnnnnnnn, where nnnnnnnnn is a 9-digit number Commercial HMO 3 Private Insurance
Ennnnnnnnn, where nnnnnnnnn is a 9-digit number Self-administered or Self-insured plans 3 Private Insurance
E98930 Other Self-administered or Self-insured plans 3 Private Insurance
F98918 Self-pay 4 Self-pay
H98912 Charity 5 No charge
H98913 Hill Burton Free Care
H98911 Black Lung 6 Other
H98914 CHAMPUS
H98915 CHAMPVA
H98919 Miscellaneous
00000 Other
Blank Missing . Missing
Any values not documented by the data source .A Invalid

Primary, secondary, and tertiary expected payer information was provided in two fields: a one character payer category ("A" through "H") and detailed payer identifier of 3, 5, or 9 digits. The 3-digit identifiers refer to Blue Cross plans, but no source documentation was available to link the 3-digit identifier to a Blue Cross plan name. The 9-digit identifiers refer to commercial, HMO, and self-administered plans, but no source documentation was available to link the 9-digit identifier to a plan name. The Illinois Department of Insurance may have a list of the plan names for the 9-digit codes. All 5-digit identifiers were named. This information is included in the above table.

The one-character payer category and the detailed payer identifier were concatenated together to create the HCUP variables PAY1_X, PAY2_X, and PAY3_X.

During HCUP processing, PAY1/PAY2 and HMOPPO1/HMOPPO2 were assigned using the first character of PAY1_X/PAY2_X (e.g., "A", "B", "C", etc.) with the following exception. When PAY1_X/PAY2_X started with "H", PAY1/PAY2 and HMOPPO1/HMOPPO2 were assigned using the 6 character code.




Illinois
(Valid from 1995-1997)
PAY1_X, PAY2_X PAY1 and PAY2
Value Description Value Description
A98910 Medicare 1 Medicare
B98916 Illinois Medicaid 2 Medicaid
B98917 Other Medicaid 2 Medicaid
Cnnn, where nnn is a 3-digit number Blue Cross Insurance 3 Private Insurance
Cnnnnnnnnn, where nnnnnnnnn is a 9-digit number Commercial Insurance (may include TPA and Worker's Compensation coverage)
C98920 Other Commercial Insurance
Dnnnnnnnnn, where nnnnnnnnn is a 9-digit number Commercial HMO
Ennnnnnnnn, where nnnnnnnnn is a 9-digit number Self-administered or Self-insured plans
E98930 Other Self-administered or Self-insured plans
F98918 Self-pay 4 Self-pay
H98912 Charity 5 No charge
H98913 Hill Burton Free Care
H98911 Black Lung 6 Other
H98914 CHAMPUS
H98915 CHAMPVA
H98919 Miscellaneous
Blank Missing . Missing
Any values not documented by the data source .A Invalid

Primary, secondary, and tertiary expected payer information was provided in two fields: a one character payer category ("A" through "H") and detailed payer identifier of 3, 5, or 9 digits. The 3-digit identifiers refer to Blue Cross plans, but no source documentation was available to link the 3-digit identifier to a Blue Cross plan name. The 9-digit identifiers refer to commercial, HMO, and self-administered plans, but no source documentation was available to link the 9-digit identifier to a plan name. The Illinois Department of Insurance may have a list of the plan names for the 9-digit codes. All 5-digit identifiers were named. This information is included in the above table.

The one-character payer category and the detailed payer identifier were concatenated together to create the HCUP variables PAY1_X, PAY2_X, and PAY3_X.

During HCUP processing, PAY1/PAY2 were assigned using the first character of PAY1_X/PAY2_X (e.g., "A", "B", "C", etc.) with the following exception. When PAY1_X/PAY2_X started with "H", PAY1/PAY2 were assigned using the 6 character code.




Illinois
(Valid from 1993-1994)
PAY1_X, PAY2_X PAY1 and PAY2
Value Description Value Description
A Medicare 1 Medicare
B Medicaid 2 Medicaid
C, E Commercial, PPO; Self-administered 3 Private Insurance
D HMO
F Self-pay 4 Self-pay
--   5 No charge
H Other 6 Other
Blank   . Missing
Other Values   .A Invalid



Illinois
(Valid from 1988-1992)
PAY1_X and PAY2_X PAY1 and PAY2
Value Description Value Description
98910 Medicare 1 Medicare
98916 Illinois Medicaid 2 Medicaid
98917 Other Medicaid
3-digit codes Blue Cross Insurance 3 Private Insurance
061055955 HMO/PHP 3 Private Insurance
232312490 HMO/PHP 3 Private Insurance
237137598 HMO/PHP 3 Private Insurance
361236610 HMO/PHP 3 Private Insurance
362171705 HMO/PHP 3 Private Insurance
362302593 HMO/PHP 3 Private Insurance
362748320 HMO/PHP 3 Private Insurance
362835382 HMO/PHP 3 Private Insurance
362858588 HMO/PHP 3 Private Insurance
363050287 HMO/PHP 3 Private Insurance
363156930 HMO/PHP 3 Private Insurance
363208585 HMO/PHP 3 Private Insurance
363232147 HMO/PHP 3 Private Insurance
363242084 HMO/PHP 3 Private Insurance
363251800 HMO/PHP 3 Private Insurance
363257067 HMO/PHP 3 Private Insurance
363261533 HMO/PHP 3 Private Insurance
363280214 HMO/PHP 3 Private Insurance
363290114 HMO/PHP 3 Private Insurance
363293099 HMO/PHP 3 Private Insurance
363300107 HMO/PHP 3 Private Insurance
363303922 HMO/PHP 3 Private Insurance
363303927 HMO/PHP 3 Private Insurance
363333675 HMO/PHP 3 Private Insurance
363334929 HMO/PHP 3 Private Insurance
363346492 HMO/PHP 3 Private Insurance
363357619 HMO/PHP 3 Private Insurance
363359925 HMO/PHP 3 Private Insurance
363363036 HMO/PHP 3 Private Insurance
363379945 HMO/PHP 3 Private Insurance
363385638 HMO/PHP 3 Private Insurance
363387762 HMO/PHP 3 Private Insurance
363410844 HMO/PHP 3 Private Insurance
363426222 HMO/PHP 3 Private Insurance
363447577 HMO/PHP 3 Private Insurance
363464332 HMO/PHP 3 Private Insurance
363513970 HMO/PHP 3 Private Insurance
363576982 HMO/PHP 3 Private Insurance
36361797l HMO/PHP 3 Private Insurance
363617971 HMO/PHP 3 Private Insurance
363784962 HMO/PHP 3 Private Insurance
363807756 HMO/PHP 3 Private Insurance
363837523 HMO/PHP 3 Private Insurance
363864486 HMO/PHP 3 Private Insurance
371076964 HMO/PHP 3 Private Insurance
371105481 HMO/PHP 3 Private Insurance
371139917 HMO/PHP 3 Private Insurance
371153402 HMO/PHP 3 Private Insurance
371190216 HMO/PHP 3 Private Insurance
371192892 HMO/PHP 3 Private Insurance
371216698 HMO/PHP 3 Private Insurance
371221007 HMO/PHP 3 Private Insurance
371241037 HMO/PHP 3 Private Insurance
371260731 HMO/PHP 3 Private Insurance
376000511 HMO/PHP 3 Private Insurance
421172640 HMO/PHP 3 Private Insurance
421282065 HMO/PHP 3 Private Insurance
431131852 HMO/PHP 3 Private Insurance
431141117 HMO/PHP 3 Private Insurance
431361841 HMO/PHP 3 Private Insurance
431372307 HMO/PHP 3 Private Insurance
431386495 HMO/PHP 3 Private Insurance
541252797 HMO/PHP 3 Private Insurance
611013183 HMO/PHP 3 Private Insurance
611056884 HMO/PHP 3 Private Insurance
741844335 HMO/PHP 3 Private Insurance
953762261 HMO/PHP 3 Private Insurance
954053288 HMO/PHP 3 Private Insurance
963762261 HMO/PHP 3 Private Insurance
98920 Other commercial insurance 3 Private Insurance
98930 Other self-administered or self-insured plans 3 Private Insurance
98918 Self-pay 4 Self-pay
98912 Charity 5 No charge
98913 Hill Burton Free Care 5 No Charge
020140690 Workers' Compensation 6 Other
020172170 Workers' Compensation 6 Other
020177030 Workers' Compensation 6 Other
020304627 Workers' Compensation 6 Other
020308052 Workers' Compensation 6 Other
020311919 Workers' Compensation 6 Other
020342937 Workers' Compensation 6 Other
020349547 Workers' Compensation 6 Other
030316876 Workers' Compensation 6 Other
041027270 Workers' Compensation 6 Other
041282020 Workers' Compensation 6 Other
041288420 Workers' Compensation 6 Other
041543470 Workers' Compensation 6 Other
041590940 Workers' Compensation 6 Other
041924000 Workers' Compensation 6 Other
042177185 Workers' Compensation 6 Other
042475442 Workers' Compensation 6 Other
042656602 Workers' Compensation 6 Other
042680300 Workers' Compensation 6 Other
042739160 Workers' Compensation 6 Other
042794993 Workers' Compensation 6 Other
042974375 Workers' Compensation 6 Other
043058503 Workers' Compensation 6 Other
043058504 Workers' Compensation 6 Other
046017710 Workers' Compensation 6 Other
050303803 Workers' Compensation 6 Other
050393243 Workers' Compensation 6 Other
060237820 Workers' Compensation 6 Other
060291290 Workers' Compensation 6 Other
060294398 Workers' Compensation 6 Other
060303275 Workers' Compensation 6 Other
060303520 Workers' Compensation 6 Other
060336212 Workers' Compensation 6 Other
060383030 Workers' Compensation 6 Other
060464510 Workers' Compensation 6 Other
060480695 Workers' Compensation 6 Other
060529570 Workers' Compensation 6 Other
060566050 Workers' Compensation 6 Other
060640218 Workers' Compensation 6 Other
060732738 Workers' Compensation 6 Other
060848755 Workers' Compensation 6 Other
060876835 Workers' Compensation 6 Other
060907370 Workers' Compensation 6 Other
060949141 Workers' Compensation 6 Other
061008026 Workers' Compensation 6 Other
061008792 Workers' Compensation 6 Other
061010609 Workers' Compensation 6 Other
061024360 Workers' Compensation 6 Other
061053492 Workers' Compensation 6 Other
061055955 Workers' Compensation 6 Other
061067463 Workers' Compensation 6 Other
061092819 Workers' Compensation 6 Other
061117063 Workers' Compensation 6 Other
061182357 Workers' Compensation 6 Other
061206728 Workers' Compensation 6 Other
061222527 Workers' Compensation 6 Other
061325038 Workers' Compensation 6 Other
066032187 Workers' Compensation 6 Other
066033504 Workers' Compensation 6 Other
066033509 Workers' Compensation 6 Other
066105395 Workers' Compensation 6 Other
131675535 Workers' Compensation 6 Other
131941868 Workers' Compensation 6 Other
131941984 Workers' Compensation 6 Other
131963495 Workers' Compensation 6 Other
131963496 Workers' Compensation 6 Other
131988169 Workers' Compensation 6 Other
132559805 Workers' Compensation 6 Other
132611663 Workers' Compensation 6 Other
132653231 Workers' Compensation 6 Other
132661002 Workers' Compensation 6 Other
132669000 Workers' Compensation 6 Other
132673100 Workers' Compensation 6 Other
132758523 Workers' Compensation 6 Other
132781282 Workers' Compensation 6 Other
132791458 Workers' Compensation 6 Other
132832845 Workers' Compensation 6 Other
135277930 Workers' Compensation 6 Other
135283360 Workers' Compensation 6 Other
135303710 Workers' Compensation 6 Other
135316370 Workers' Compensation 6 Other
135339725 Workers' Compensation 6 Other
135358230 Workers' Compensation 6 Other
135379820 Workers' Compensation 6 Other
135459190 Workers' Compensation 6 Other
135460208 Workers' Compensation 6 Other
135481330 Workers' Compensation 6 Other
135539046 Workers' Compensation 6 Other
135540698 Workers' Compensation 6 Other
135616275 Workers' Compensation 6 Other
135617450 Workers' Compensation 6 Other
135669461 Workers' Compensation 6 Other
136081895 Workers' Compensation 6 Other
136104845 Workers' Compensation 6 Other
136107326 Workers' Compensation 6 Other
136108722 Workers' Compensation 6 Other
150476880 Workers' Compensation 6 Other
156020948 Workers' Compensation 6 Other
160366830 Workers' Compensation 6 Other
220731810 Workers' Compensation 6 Other
221608585 Workers' Compensation 6 Other
221708002 Workers' Compensation 6 Other
221721944 Workers' Compensation 6 Other
221721950 Workers' Compensation 6 Other
221964135 Workers' Compensation 6 Other
221964136 Workers' Compensation 6 Other
222005057 Workers' Compensation 6 Other
222053189 Workers' Compensation 6 Other
222227328 Workers' Compensation 6 Other
222227331 Workers' Compensation 6 Other
222342710 Workers' Compensation 6 Other
230342560 Workers' Compensation 6 Other
230580680 Workers' Compensation 6 Other
230723970 Workers' Compensation 6 Other
230959220 Workers' Compensation 6 Other
230961349 Workers' Compensation 6 Other
231330959 Workers' Compensation 6 Other
231471444 Workers' Compensation 6 Other
231502700 Workers' Compensation 6 Other
231614367 Workers' Compensation 6 Other
231620527 Workers' Compensation 6 Other
231624911 Workers' Compensation 6 Other
231641984 Workers' Compensation 6 Other
231642962 Workers' Compensation 6 Other
231740414 Workers' Compensation 6 Other
231742051 Workers' Compensation 6 Other
231892289 Workers' Compensation 6 Other
231903575 Workers' Compensation 6 Other
232182777 Workers' Compensation 6 Other
232640501 Workers' Compensation 6 Other
232643432 Workers' Compensation 6 Other
250410420 Workers' Compensation 6 Other
250687550 Workers' Compensation 6 Other
251118791 Workers' Compensation 6 Other
310396250 Workers' Compensation 6 Other
310501234 Workers' Compensation 6 Other
310542366 Workers' Compensation 6 Other
310708754 Workers' Compensation 6 Other
310826946 Workers' Compensation 6 Other
310926059 Workers' Compensation 6 Other
310970750 Workers' Compensation 6 Other
311160863 Workers' Compensation 6 Other
311241230 Workers' Compensation 6 Other
314177100 Workers' Compensation 6 Other
314177110 Workers' Compensation 6 Other
314316080 Workers' Compensation 6 Other
314423946 Workers' Compensation 6 Other
340368340 Workers' Compensation 6 Other
340438190 Workers' Compensation 6 Other
341022544 Workers' Compensation 6 Other
341172650 Workers' Compensation 6 Other
341316396 Workers' Compensation 6 Other
341532771 Workers' Compensation 6 Other
346513736 Workers' Compensation 6 Other
346516838 Workers' Compensation 6 Other
350145400 Workers' Compensation 6 Other
350198580 Workers' Compensation 6 Other
350293728 Workers' Compensation 6 Other
350293730 Workers' Compensation 6 Other
350410010 Workers' Compensation 6 Other
350410420 Workers' Compensation 6 Other
350913391 Workers' Compensation 6 Other
350988041 Workers' Compensation 6 Other
351044900 Workers' Compensation 6 Other
351288885 Workers' Compensation 6 Other
351372324 Workers' Compensation 6 Other
351492884 Workers' Compensation 6 Other
351495207 Workers' Compensation 6 Other
351495208 Workers' Compensation 6 Other
351524574 Workers' Compensation 6 Other
356018566 Workers' Compensation 6 Other
356021485 Workers' Compensation 6 Other
360705950 Workers' Compensation 6 Other
360719665 Workers' Compensation 6 Other
360727430 Workers' Compensation 6 Other
360727470 Workers' Compensation 6 Other
360810360 Workers' Compensation 6 Other
360901240 Workers' Compensation 6 Other
361022580 Workers' Compensation 6 Other
361236610 Workers' Compensation 6 Other
361404320 Workers' Compensation 6 Other
361410470 Workers' Compensation 6 Other
361412255 Workers' Compensation 6 Other
361475332 Workers' Compensation 6 Other
361649210 Workers' Compensation 6 Other
361877247 Workers' Compensation 6 Other
361999760 Workers' Compensation 6 Other
362114545 Workers' Compensation 6 Other
362349119 Workers' Compensation 6 Other
362403971 Workers' Compensation 6 Other
362467238 Workers' Compensation 6 Other
362489372 Workers' Compensation 6 Other
362490086 Workers' Compensation 6 Other
362512064 Workers' Compensation 6 Other
362542404 Workers' Compensation 6 Other
362545393 Workers' Compensation 6 Other
362594678 Workers' Compensation 6 Other
36260579 Workers' Compensation 6 Other
362661515 Workers' Compensation 6 Other
362661954 Workers' Compensation 6 Other
362663083 Workers' Compensation 6 Other
362667627 Workers' Compensation 6 Other
362674180 Workers' Compensation 6 Other
362678778 Workers' Compensation 6 Other
362690333 Workers' Compensation 6 Other
362694846 Workers' Compensation 6 Other
362704643 Workers' Compensation 6 Other
362704802 Workers' Compensation 6 Other
362705935 Workers' Compensation 6 Other
362709121 Workers' Compensation 6 Other
362711653 Workers' Compensation 6 Other
362719165 Workers' Compensation 6 Other
362722478 Workers' Compensation 6 Other
362738349 Workers' Compensation 6 Other
362742183 Workers' Compensation 6 Other
362748320 Workers' Compensation 6 Other
362748795 Workers' Compensation 6 Other
362753986 Workers' Compensation 6 Other
362755546 Workers' Compensation 6 Other
362756532 Workers' Compensation 6 Other
362759195 Workers' Compensation 6 Other
362760101 Workers' Compensation 6 Other
362763106 Workers' Compensation 6 Other
362781080 Workers' Compensation 6 Other
362789296 Workers' Compensation 6 Other
362797073 Workers' Compensation 6 Other
362797074 Workers' Compensation 6 Other
362811124 Workers' Compensation 6 Other
362857399 Workers' Compensation 6 Other
362874262 Workers' Compensation 6 Other
362930605 Workers' Compensation 6 Other
362944577 Workers' Compensation 6 Other
362950161 Workers' Compensation 6 Other
362994662 Workers' Compensation 6 Other
362999368 Workers' Compensation 6 Other
362999370 Workers' Compensation 6 Other
363027848 Workers' Compensation 6 Other
363028761 Workers' Compensation 6 Other
363030511 Workers' Compensation 6 Other
363040078 Workers' Compensation 6 Other
363051031 Workers' Compensation 6 Other
363078103 Workers' Compensation 6 Other
363101262 Workers' Compensation 6 Other
363105508 Workers' Compensation 6 Other
363105737 Workers' Compensation 6 Other
363141762 Workers' Compensation 6 Other
363155373 Workers' Compensation 6 Other
363186541 Workers' Compensation 6 Other
363230348 Workers' Compensation 6 Other
363312218 Workers' Compensation 6 Other
363316692 Workers' Compensation 6 Other
363341779 Workers' Compensation 6 Other
363423817 Workers' Compensation 6 Other
363426425 Workers' Compensation 6 Other
363432551 Workers' Compensation 6 Other
363441652 Workers' Compensation 6 Other
363468793 Workers' Compensation 6 Other
363492700 Workers' Compensation 6 Other
363510294 Workers' Compensation 6 Other
363522250 Workers' Compensation 6 Other
363529298 Workers' Compensation 6 Other
363530161 Workers' Compensation 6 Other
363579407 Workers' Compensation 6 Other
363585968 Workers' Compensation 6 Other
363586255 Workers' Compensation 6 Other
363614264 Workers' Compensation 6 Other
363649555 Workers' Compensation 6 Other
363672824 Workers' Compensation 6 Other
363714287 Workers' Compensation 6 Other
363715387 Workers' Compensation 6 Other
363765116 Workers' Compensation 6 Other
363774557 Workers' Compensation 6 Other
363789786 Workers' Compensation 6 Other
363789787 Workers' Compensation 6 Other
363806723 Workers' Compensation 6 Other
366033855 Workers' Compensation 6 Other
366033921 Workers' Compensation 6 Other
366042949 Workers' Compensation 6 Other
366043106 Workers' Compensation 6 Other
366049887 Workers' Compensation 6 Other
366054328 Workers' Compensation 6 Other
366064756 Workers' Compensation 6 Other
366067575 Workers' Compensation 6 Other
366071400 Workers' Compensation 6 Other
366077839 Workers' Compensation 6 Other
366084669 Workers' Compensation 6 Other
366115679 Workers' Compensation 6 Other
370268670 Workers' Compensation 6 Other
370277830 Workers' Compensation 6 Other
370301640 Workers' Compensation 6 Other
370344310 Workers' Compensation 6 Other
370396180 Workers' Compensation 6 Other
370420520 Workers' Compensation 6 Other
370530080 Workers' Compensation 6 Other
370533080 Workers' Compensation 6 Other
370533100 Workers' Compensation 6 Other
370558630 Workers' Compensation 6 Other
370637646 Workers' Compensation 6 Other
370807507 Workers' Compensation 6 Other
370815476 Workers' Compensation 6 Other
370855395 Workers' Compensation 6 Other
370915434 Workers' Compensation 6 Other
371054042 Workers' Compensation 6 Other
371111076 Workers' Compensation 6 Other
371184187 Workers' Compensation 6 Other
371277771 Workers' Compensation 6 Other
376028411 Workers' Compensation 6 Other
380315280 Workers' Compensation 6 Other
380828980 Workers' Compensation 6 Other
380829210 Workers' Compensation 6 Other
380865250 Workers' Compensation 6 Other
381184490 Workers' Compensation 6 Other
381630841 Workers' Compensation 6 Other
381869912 Workers' Compensation 6 Other
382145898 Workers' Compensation 6 Other
382312731 Workers' Compensation 6 Other
382430150 Workers' Compensation 6 Other
390264050 Workers' Compensation 6 Other
390273710 Workers' Compensation 6 Other
390301590 Workers' Compensation 6 Other
390333950 Workers' Compensation 6 Other
390475300 Workers' Compensation 6 Other
390712210 Workers' Compensation 6 Other
390941450 Workers' Compensation 6 Other
390972608 Workers' Compensation 6 Other
391190263 Workers' Compensation 6 Other
391338397 Workers' Compensation 6 Other
391341459 Workers' Compensation 6 Other
391401314 Workers' Compensation 6 Other
396058596 Workers' Compensation 6 Other
396062860 Workers' Compensation 6 Other
410299900 Workers' Compensation 6 Other
410406690 Workers' Compensation 6 Other
410417460 Workers' Compensation 6 Other
410729473 Workers' Compensation 6 Other
410881659 Workers' Compensation 6 Other
410963301 Workers' Compensation 6 Other
410986076 Workers' Compensation 6 Other
411232071 Workers' Compensation 6 Other
411353943 Workers' Compensation 6 Other
520976199 Workers' Compensation 6 Other
521050076 Workers' Compensation 6 Other
420111280 Workers' Compensation 6 Other
420223390 Workers' Compensation 6 Other
420234980 Workers' Compensation 6 Other
420245990 Workers' Compensation 6 Other
420301440 Workers' Compensation 6 Other
420594770 Workers' Compensation 6 Other
420618271 Workers' Compensation 6 Other
420645088 Workers' Compensation 6 Other
420645088 Workers' Compensation 6 Other
421015537 Workers' Compensation 6 Other
421019055 Workers' Compensation 6 Other
421234898 Workers' Compensation 6 Other
426054959 Workers' Compensation 6 Other
430613000 Workers' Compensation 6 Other
431037123 Workers' Compensation 6 Other
431139865 Workers' Compensation 6 Other
431245798 Workers' Compensation 6 Other
431249228 Workers' Compensation 6 Other
436028696 Workers' Compensation 6 Other
440194612 Workers' Compensation 6 Other
440237557 Workers' Compensation 6 Other
440307890 Workers' Compensation 6 Other
440648645 Workers' Compensation 6 Other
440652707 Workers' Compensation 6 Other
440666926 Workers' Compensation 6 Other
460368854 Workers' Compensation 6 Other
470159155 Workers' Compensation 6 Other
470355979 Workers' Compensation 6 Other
470360368 Workers' Compensation 6 Other
470444314 Workers' Compensation 6 Other
470490411 Workers' Compensation 6 Other
470498866 Workers' Compensation 6 Other
470574325 Workers' Compensation 6 Other
470698507 Workers' Compensation 6 Other
476022701 Workers' Compensation 6 Other
476024508 Workers' Compensation 6 Other
480470690 Workers' Compensation 6 Other
480921045 Workers' Compensation 6 Other
510098159 Workers' Compensation 6 Other
520266645 Workers' Compensation 6 Other
520403120 Workers' Compensation 6 Other
520515280 Workers' Compensation 6 Other
520616768 Workers' Compensation 6 Other
521137203 Workers' Compensation 6 Other
586020487 Workers' Compensation 6 Other
590733942 Workers' Compensation 6 Other
591027412 Workers' Compensation 6 Other
591320184 Workers' Compensation 6 Other
591847174 Workers' Compensation 6 Other
610904881 Workers' Compensation 6 Other
621101490 Workers' Compensation 6 Other
630598629 Workers' Compensation 6 Other
741280541 Workers' Compensation 6 Other
741296673 Workers' Compensation 6 Other
750620550 Workers' Compensation 6 Other
751444207 Workers' Compensation 6 Other
751670124 Workers' Compensation 6 Other
756013587 Workers' Compensation 6 Other
756013697 Workers' Compensation 6 Other
756017952 Workers' Compensation 6 Other
756020448 Workers' Compensation 6 Other
760154296 Workers' Compensation 6 Other
840513811 Workers' Compensation 6 Other
840583213 Workers' Compensation 6 Other
840982643 Workers' Compensation 6 Other
850165753 Workers' Compensation 6 Other
850277191 Workers' Compensation 6 Other
850282785 Workers' Compensation 6 Other
860274508 Workers' Compensation 6 Other
880119246 Workers' Compensation 6 Other
910341780 Workers' Compensation 6 Other
910449750 Workers' Compensation 6 Other
910895822 Workers' Compensation 6 Other
911115311 Workers' Compensation 6 Other
920040526 Workers' Compensation 6 Other
940781581 Workers' Compensation 6 Other
941032958 Workers' Compensation 6 Other
941390273 Workers' Compensation 6 Other
941517098 Workers' Compensation 6 Other
941610280 Workers' Compensation 6 Other
942532388 Workers' Compensation 6 Other
946078058 Workers' Compensation 6 Other
951077060 Workers' Compensation 6 Other
951078160 Workers' Compensation 6 Other
951429618 Workers' Compensation 6 Other
951479095 Workers' Compensation 6 Other
951542353 Workers' Compensation 6 Other
952371728 Workers' Compensation 6 Other
952575892 Workers' Compensation 6 Other
956016640 Workers' Compensation 6 Other
980032627 Workers' Compensation 6 Other
980033230 Workers' Compensation 6 Other
990041610 Workers' Compensation 6 Other
98914 CHAMPUS 6 Other
98915 CHAMPVA 6 Other
98911 Black Lung 6 Other
98919 Miscellaneous 6 Other
Blank, "000000000" Unknown . Missing
Other Values   .A Invalid


Iowa
Iowa
(Valid beginning in 2003)
PAY1_X PAY1
Value Description Value Description
1 Medicare (Title 18) 1 Medicare
11 Medicare Managed Care beginning 2008
2 Medicaid (Title 19) 2 Medicaid
12 Medicaid Managed Care beginning 2008
6 Blue Cross 3 Private Insurance
7 Commercial (private or group plans including HMO, PPO, ODS)
8 Self-pay (the patient has no insurance, is ineligible for governmental assistance and is not a "no charge" patient) 4 Self-pay
10 No charge 5 No charge
3 Other State (including State Papers) 6 Other
4 County
5 Other Federal Government
9 Workers Compensation
Blank Missing . Missing
Any values not documented by the data source .A Invalid



Iowa
(Valid 1998-2002)
PAY1_X PAY1
Value Description Value Description
01 Medicare (Title 18) 1 Medicare
11 Medicare Managed Care (Presently no predominant plans in Iowa) 1 Medicare
02 Medicaid (Title 19) 2 Medicaid
12 Medicaid Managed Care (e.g., Medipass, Heritage National, Care Choices, Principal Health Care) 2 Medicaid
06 Blue Cross (e.g., Blue Cross Alliance Select should be recorded as PPO; Blue Cross Unity Choice should be recorded as HMO) 3 Private Insurance
07 Commercial (private or group plans other than HMO, PPO, ODS) 3 Private Insurance
13 HMO (e.g., Care Choices, Medical Associates Health Plan, Inc., Principal Health Care of Iowa, Heritage National Healthplan, Inc., John Deere Family Health Plan, Principal Health Care of Nebraska, United Healthcare of the Midlands, Unity Choice) 3 Private Insurance
14 PPO (e.g., Alliance Select, Healthcare Preferred, Plaines Health Network) 3 Private Insurance
15 Organized Delivery Systems (ODS) (e.g., SecureCare of Iowa) 3 Private Insurance
08 Self-pay (the patient has no insurance, is ineligible for governmental assistance and is not a "no charge" patient) 4 Self-pay
10 No charge 5 No charge
03 Other State (including State Papers) 6 Other
04 County
05 CHAMPUS
09 Workers Compensation
Blank Missing . Missing
Any values not documented by the data source .A Invalid



Iowa
(Valid from 1991-1997)
PAY1_X PAY1
Value Description Value Description
01 Medicare (Title 18) 1 Medicare
02 Medicaid (Title 19) 2 Medicaid
06 Blue Cross (of Iowa, Western Iowa, or other state Blue Cross plans) 3 Private Insurance
08 Self-pay or relative 4 Self-pay
--   5 No charge
09 Workers' Compensation 6 Other
03, 04, 05 Other state; county (including state papers); Other federal government (including CHAMPUS, Veterans, Title V, Railroad, Hill-Burton, Crippled Children, etc.)
Blank   . Missing
Other Values   .A Invalid



Iowa
(Valid from 1988-1990)
PAY1_X PAY1
Value Description Value Description
01 Medicare (Title 18) 1 Medicare
02 Medicaid (Title 19) 2 Medicaid
06 Blue Cross (of Iowa, Western Iowa, or other state Blue Cross plans) 3 Private Insurance
07 Commercial (private or group)
08 Self-pay or relative 4 Self-pay
--   5 No charge
09 Workers' Compensation 6 Other
03, 04, 05 Other state government; Other county government; Other federal government
10 Other non-government
Blank   . Missing
Other Values   .A Invalid


Indiana
Indiana
(Valid beginning in 2008)
PAY1_X and PAY2_X PAY1 and PAY2
Value Description Value Description
1 Medicare 1 Medicare
2 Medicaid 2 Medicaid
4 Commercial Insurance 3 Private Insurance
5 Self-pay 4 Self-pay
6 Other/Unknown 6 Other
3 Other/Government
Blank Missing . Missing
Other   .A Invalid


Indiana
Indiana
(Valid 2003 - 2007)
PAY1_X and PAY2_X PAY1 and PAY2
Value Description Value Description
1 Medicare 1 Medicare
2 Medicaid 2 Medicaid
4 Commercial Insurance 3 Private Insurance
5 Managed Care
6 Self-pay 4 Self-pay
--   5 No charge
3 Other/Government 6 Other
7 Other/Unknown
Blank (PAY1_X only), Blank; 0 (PAY2_X only) Missing . Missing
Any values not documented by the data source .A Invalid


Kansas
Kansas
(Valid beginning in 2003)
PAY1_X and PAY2_X PAY1 and PAY2
Value Description Value Description
001, 1, 01 Medicare 1 Medicare
101 Medicare Managed Care
002, 2, 02 Medicaid 2 Medicaid
102 Medicaid Managed Care
004, 4, 04 Blue Cross/Blue Shield 3 Private Insurance
007, 7, 07 Commercial/Private
104 Blue Cross/Blue Shield Managed Care
107 All Commercial Payers Managed Care
006, 6, 06 Self-pay 4 Self-pay
008, 8 Charity/No Charge 5 No charge
005, 5,05 Workers Compensation 6 Other
009, 9, 09 Other Government
010, 10 Champus
011, 11 Other
103 HealthWave/ Health Connect Managed Care - Kansas' State Children's Health Insurance Program (SCHIP)
105 Workers Compensation Managed Care
109 Other Government Managed Care (not Champus)
110 Champus Managed Care
111 Other Managed Care
Blank, 00, 000 Missing . Missing
Any values not documented by the data source .A Invalid



Kansas
(Valid 1993-2002)
PAY1_X and PAY2_X PAY1 and PAY2
Value Description Value Description
1 Medicare 1 Medicare
2 Medicaid 2 Medicaid
3 Blue Cross 3 Private Insurance
4 Commercial
5 Self-pay 4 Self-pay
--   5 No charge
6 Other 6 Other
Blank Missing . Missing
Any values not documented by the data source .A Invalid

Separate information on HMO and PPO providers is not provided.



Kentucky
Kentucky
(Valid beginning in 2010)
PAY1_X, PAY2_X, PAY3_X PAY1 and PAY2
Value Description Value Description
C Medicare 1 Medicare
D Medicaid 2 Medicaid
R Medicaid Managed Care
P Passport Medicaid Managed Care (beginning with 2003 data)
F Commercial - Unknown 3 Private insurance
G Commercial - Unknown
J Commercial - Indemnity
K Commercial - Preferred Provider
L Commercial - HMO
M Commercial - Other Managed Care
N Commercial - Mix
A Self Pay 4 Self-pay
S Charity 5 No charge
B Workers' Compensation 6 Other
E Other federal programs
H Champus
I Other
Blank Missing . Missing
Any values not documented by the data source .A Invalid



Kentucky
(Valid beginning in 2009)
PAY1_X, PAY2_X, PAY3_X PAY1 and PAY2
Value Description Value Description
98910 Medicare (Excluding Medicare Managed Care) 1 Medicare
98945 Medicare Managed Care
98916 In State Medicaid (Excluding Passport) 2 Medicaid
98917 Out of State Medicaid
98940 Passport Medicaid Managed Care
98921 Commercial - Indemnity 3 Private insurance
98923 Commercial - PPO
98922 Commercial - HMO
98924 Commercial - Other
98930 Other Self Administered Plan
98918 Self Pay 4 Self-pay
98912 Charity 5 No charge
98913 Hill Burton Free Care
98911 Black Lung 6 Other
98950 Workers' Compensation
98914 Champus
98915 Champva
00000 Other
Blank Missing . Missing
Any values not documented by the data source .A Invalid



Kentucky
(Valid prior to 2009)
PAY1_X, PAY2_X, PAY3_X PAY1 and PAY2
Value Description Value Description
C Medicare 1 Medicare
D Medicaid 2 Medicaid
R Medicaid Managed Care
P Passport Medicaid Managed Care (beginning with 2003 data)
F Commercial - Unknown 3 Private insurance
G Commercial - Unknown
J Commercial - Indemnity
K Commercial - Preferred Provider
L Commercial - HMO
M Commercial - Managed Care
N Commercial - Mix
A Self Pay 4 Self-pay
S Charity 5 No charge
B Workers' Compensation 6 Other
E Other Federal programs
H Champus
I Other
Blank Missing . Missing
Any values not documented by the data source .A Invalid


Louisiana
Louisiana
PAY1_X, PAY2_X, PAY3_X PAY1 and PAY2
Value Description Value Description
M Medicare 1 Medicare
D Medicaid 2 Medicaid
B Blue Cross/Blue Shield 3 Private insurance
H HMO
I Other Health Insurance Company
S Self insured (Beginning in 2010)
P Self Pay 4 Self-pay
Z No Charge (Free, Charity, Sp. Research, Teaching) 5 No charge
C CHAMPUS 6 Other
O Other, unknown
S Self insured (Prior to 2010)
W Workers/StateCompensation
?, blank Missing . Missing
!, other   .A Invalid


Maryland
>
Maryland
(Valid beginning in 1998)
PAY1_X and PAY2_X PAY1 and PAY2
Value Description Value Description
01 Medicare 1 Medicare
15 Medicare HMO (payer specified in PAYER1_X/PAYER2_X) 1 Medicare
02 Medicaid 2 Medicaid
14 Medicaid HMO (payer specified in PAYER1_X/PAYER2_X) 2 Medicaid
04 Blue Cross of MD 3 Private Insurance
16 Blue Cross of the National Capital Area (HMO) 3 Private Insurance
17 Blue Cross (other state) 3 Private Insurance
05 Commercial/PPO 3 Private Insurance
12 Managed Care (payer specified in PAYER1_X/ PAYER2_X) 3 Private Insurance
08 Self-pay 4 Self-pay
09 Charity - no charge 5 No charge
03 Title V 6 Other
06 Other government program
07 Worker's Compensation
10 Other
11 Donor
99 Unknown . Missing
Blank Missing
13 Do not use .A Invalid
27, 29, 37, 67, 77Unknown/invalid values
Any values not documented by the data source



Maryland
(Valid from 1996-1997)
PAY1_X and PAY2_X PAY1 and PAY2
Value Description Value Description
1, 15 Medicare; Medicare HMO 1 Medicare
2,14 Medicaid; Medicaid HMO 2 Medicaid
4, 16, 17 Blue Cross; Blue Cross NCA; Blue Cross - other State 3 Private Insurance
5 Commercial Insurance
12 HMO
8 Self-pay 4 Self-pay
9 Charity 5 No charge
3 Title V 6 Other
7 Workers' Compensation
6 Other government program
10, 11 Other; Donor
99, blank Primary Payer Unknown; missing . Missing
99, 77, blank Secondary Payer Unknown; not applicable; missing . Missing
Other Values   .A Invalid



Maryland
(Valid from 1993-1995)
PAY1_X and PAY2_X PAY1 and PAY2
Value Description Value Description
1 Medicare 1 Medicare
2, 13,14 Medicaid; Medicaid (state only); Medicaid HMO 2 Medicaid
4 Blue Cross 3 Private Insurance
5 Commercial Insurance
12 HMO
8 Self-pay 4 Self-pay
9 Charity 5 No charge
3 Title V 6 Other
7 Workers' Compensation
6 Other government program
10, 11 Other; Donor
99, blank Primary Payer Unknown; missing . Missing
99, 77, blank Secondary Payer Unknown; not applicable; missing . Missing
Other Values   .A Invalid



Maryland
(Valid from 1990-1992)
PAY1_X and PAY2_X PAY1 and PAY2
Value Description Value Description
1 Medicare 1 Medicare
2, 13,14 Medicaid; Medicaid (state only); Medicaid HMO 2 Medicaid
4 Blue Cross 3 Private Insurance
5 Commercial Insurance
12 HMO
8 Self-pay 4 Self-pay
9 Charity 5 No charge
3 Title V 6 Other
7 Workers' Compensation
6 Other government program
10, 11 Other; Donor
99, blank Unknown; missing . Missing
Other Values   .A Invalid


Massachusetts
Massachusetts
(Valid beginning in 1998)
PAY1_X and PAY2_X PAY1 and PAY2
Value Description Value Description
3 Medicare 1 Medicare
F Medicare Managed Care 1 Medicare
4 Medicaid 2 Medicaid
B Medicaid Managed Care 2 Medicaid
6 Blue Cross 3 Private Insurance
C Blue Cross Managed Care
7 Commercial Insurance
D Commercial Managed Care
8 HMO
E PPO and Other Managed Care not listed elsewhere
J Point of Service Plan
K Exclusive Provider Plan
T Auto Insurance
1 Self-pay 4 Self-pay
9 Free care (no charge) 5 No charge
2 Worker's Compensation 6 Other
H Health Safety Net
5 Other government payment
0 Other non-managed care plans
Q CommCare
N, Blank None, Missing . Missing
Any values not documented by the data source .A Invalid



Massachusetts
(Valid from 1996-1997)
PAY1_X and PAY2_X PAY1 and PAY2
Value Description Value Description
3, F Medicare; Medicare managed care 1 Medicare
4, B Medicaid; Medicaid managed care 2 Medicaid
6, C Blue Cross; Blue Cross managed care 3 Private Insurance
7, D, E Commercial Insurance; Commercial managed care; PPO and other managed care not listed elsewhere
8, J HMO; Point of Service (added 4th Qtr 1997)
1 Self-pay 4 Self-pay
9 Free care (no charge) 5 No charge
2 Worker's Compensation 6 Other
5 Other government payment
0 Primary Payer: Other non-managed care
0, A Secondary Payer: Other non-managed care; Other or principal source of payment covered in full
Blank Primary Payer: . Missing
Blank Secondary Payer: . Missing
Other values   .A Invalid



Massachusetts
(Valid from Quarter 4 1993 through 1995)
PAY1_X and PAY2_X PAY1 and PAY2
Value Description Value Description
3, F Medicare; Medicare managed care 1 Medicare
4, B Medicaid; Medicaid managed care 2 Medicaid
6, C Blue Cross; Blue Cross managed care 3 Private Insurance
7, D Commercial Insurance; Commercial managed care
8, J HMO
1 Self-pay 4 Self-pay
9 Free care (no charge) 5 No charge
2 Workers' Compensation 6 Other
5 Other government payment
0, E Primary Payer: Other non-managed care; PPO and other managed care not listed elsewhere
0, A, E Secondary Payer: Other non-managed care; Other or principal source of payment covered in full; PPO and other managed care not listed elsewhere
Blank Primary Payer: . Missing
"N",Blank Secondary Payer:None . Missing
Other values   .A Invalid



Massachusetts
(Valid from 1988 through Quarters1-3, 1995)
PAY1_X and PAY2_X PAY1 and PAY2
Value Description Value Description
3 Medicare 1 Medicare
4 Medicaid 2 Medicaid
6 Blue Cross 3 Private Insurance
7 Commercial Insurance
8 HMO
1 Self-pay 4 Self-pay
9 Free care (no charge) 5 No charge
2 Workers' Compensation 6 Other
5 Other government payment
0 Primary Payer: Other
0, A Secondary Payer: Other; Other or principal source of payment covered in full
Blank Primary Payer: . Missing
"N",Blank Secondary Payer:None . Missing
Other values   .A Invalid


Maine
Maine
(Valid beginning in 1999)
PAY1_X, PAY2_X, PAY3_X PAY1, PAY 2
Value Description Value Description
01 Medicare 1 Medicare
02 Medicaid 2 Medicaid
05 Blue Cross 3 Private insurance
06 Other commercial carriers 3 Private insurance
10 HMO/PPO 3 Private insurance
08 Self-pay 4 Self-pay
07 Charity 5 No charge
03 U.S. Title V 6 Other
04 CHAMPUS/USVA
09 Worker's Compensation
11 Unknown
blank Missing . Missing
other   .A Invalid


Michigan
Michigan
PAY1_X and PAY2_X PAY1 and PAY2
Value Description Value Description
01 Medicare Fee for Service 1 Medicare
30 Medicare Managed Care Plans
31 Medicare Type of Plan Unknown
02 Medicaid Fee for Service 2 Medicaid
40 Medicaid Managed Care Plans
41 Medicaid Type of Plan Unknown
22 HMSA QUEST - valid 2006 -2007
06 Blue Cross/Blue Shield 3 Private insurance
07 Other commercial insurance company
09 Managed care or other
11 Blue Cross/Blue Shield HMO
12 Other HMO
17 Blue Cross/Blue Shield PPO/PPA
18 Other PPO/PPA
08 Self-pay 4 Self-pay
10 No charge 5 No charge
03 Title V 6 Other
04 Other government source
05 Worker's Compensation
23 Mental Health Contract
25 Corrections Contract
99 Other
00, Blank Missing or invalid . Missing
Any values not documented by the data source .A Invalid


Minnesota
Minnesota
(Valid beginning in 1995)
PAY1_X, PAY2_X and PAY3_X PAY1 and PAY2
Value Description Value Description
2000000 Medicare 1 Medicare
6000003 Blue Cross, Medicare
6000103 Blue Cross, MN, Medicare
6009903 Blue Cross, Other, Medicare
7000102 Medica - Choice, Medicare
7000202 Group Health, Medicare
7000402 Medica - Primary, Medicare
7000502 MedCenters, Medicare
7000602 UCare, Medicare
7000702 Blue Plus, Medicare
7000802 Metro. Health Plan, Medicare
7001002 Health Partners, Medicare
7001302 First Plan HMO, Medicare
7001402 Discharged/Transferred to a Federal Hospital
7001502 Sioux Valley, Medicare
7000902 Blue Cross HMO, Medicare
7009902 Other HMO, Medicare
8000302 SelectCare, Medicare
8000402 Preferred One, Medicare
8000502 America's PPO, Medicare
8000602 Aetna PPO, Medicare
8000902 Discharged/transferred to a psychiatric hospital or psychiatric distinct unit of a hospital
8001502 Discharged/transferred to a Critical Access Hospital (CAH) (1/1/06 discharges)
8009902 Other PPO, Medicare
3000000 Medicaid 2 Medicaid
3000001 Medicaid Pending
3000100 Medicaid, Minnesota
3000101 Pending, MN, Medicaid
3000200 Medicaid, Wisconsin
3000201 Medicaid, Wisconsin, Pending
7000301 Ramsey Care, Medicaid
3000900 Medicaid, South Dakota
3001000 Medicaid, North Dakota
3001100 Medicaid, Iowa
3009900 Medicaid, Other
3009901 Medicaid, Other, Pending Eligible
7000101 Medica - Choice, Medicaid
7000201 Group Health, Medicaid
7000401 Medica - Primary, Medicaid
7000501 MedCenters, Medicaid
7000601 Ucare, Medicaid
7000701 Blue Plus, Medicaid
7000801 Metro. Health Plan, Medicaid
7000901 Blue Cross HMO, Medicaid
7001001 Health Partners, Medicaid
7001201 Northwest National Life (NWNL) Health Network, Medicaid
7001301 First Plan HMO, Medicaid
7001401 Altru Health Plan, Medicaid
7001501 Sioux Valley, Medicaid
7009901 Other HMO, Medicaid
8000301 SelectCare, Medicaid
8000401 Preferred One, Medicaid
8000901 Blue Cross PPO, Medicaid
8001001 Medica Choice PPO, Medicaid
8001501 LaborCare PPO, Medicaid
8009901 Other PPO, Medicaid
5000000 Commercial 3 Private insurance
5009900 Commercial
5009901 Commercial (Regina)
6000000 Blue Cross
6000001 Blue Cross, Aware
6000100 Blue Cross, MN
6000101 Blue Cross, MN, Aware
6000102 Blue Cross, Preferred Gold
6000200 Blue Cross, North Dakota
6009900 Blue Cross, Non-MN
6009901 Blue Cross, Non-MN Aware
7000000 Other HMO
7000100 Medica - Choice
7000200 Group Health
7000300 Ramsey Health
7000400 Medica - Primary
7000500 MedCenters
7000600 Ucare
7000700 Blue Plus
7000800 Metro. Health Plan
7000900 Blue Cross HMO
7001000 Health Partners
7001200 Northwest National Life (NWNL) Health Network
7001300 First Plan HMO
7001400 Altru Health Plan
7001500 Sioux Valley
7009900 Other HMO
8000000 Other PPO
8000300 SelectCare
8000320 SelectCare, Union
8000400 Preferred One
8000500 ARAZ, Union (formerly, Ethix Midwest; also known as America's PPO)
8000520 ARAZ (formerly Ethix Midwest; also known as America's PPO)
8000600 Aetna PPO
8000700 Group Health PPO
8000800 HealthEast Care, Inc.
8000900 Blue Cross PPO
8001000 Medica Choice PPO
8001020 Medica, Union
8001200 Northwest National LIfe (NWNL) PPO
8002300 Private Health Care System
8001400 Prudential Plus
8001500 LaborCare PPO
8001520 LaborCare PPO, Union
8500100 Self Insured, Choice Plus
8509900 Other Self Insured
8009900 Other PPO
8009920 Other PPO, union
9001000 Other, Self-Insured Co.
9002000 Other, Unions
1000000 Self-Pay 4 Self-Pay
1000100 Self-Pay
1000200 Self-Pay, No Charge
-- -- 5 No charge
3060000 Minnesota Care 6 Other
3060100 Minnesota Care
4000000 Other Government
4000100 Title V
4000200 Worker's Comp
4000300 TRICARE/CHAMPUS
4000400 MN Comp. Health Care
4000500 General Assistance Medical Care (GAMC)/GA/Welfare
4000600 Aid to Families with Dependent Children (AFDC)
4000700 Children's Health Plan
4000800 PrimeWest, Cty Based Purchased
4000900 Itasca Medical Care, CBP
4001000 So. Country Hlth Alliance, CBP
4009900 Other Govt., Other
7000103 Medica - Choice, GAMC
7000104 Medica-Choice, MNCare
7000303 Ramsey Care, GAMC, etc.
7000404 Medica-Primary, MNCare
7000603 Ucare, GAMC, etc.
7000604 U-Care, MNCare
7000703 Blue Plus, GAMC, etc.
7000704 Blue Plus, MNCare
7000803 Metro. Health Plan, GAMC, etc.
7000804 Metro. Health Plan, MNCare
7000904 Blue Cross HMO, MNCare
7001003 Health Partners, GAMC, etc.
7001004 Health Partners, MNCare
7001304 First Plan HMO, MNCare
7001404 Altru Health Plan, MNCare
7001504 Sioux Valley, MNCare
7009903 Other HMO, GAMC/GA/Welfare
7009904 Other HMO, MNCare
8000404 Preferred One, MNCare
8000504 America's PPO, MNCare
8000604 Aetna PPO, MNCare
8000804 HealthEast Care, Inc. MNCare
8000904 Blue Cross PPO, MNCare
8001304 Private Hlth Care Sys MNCare
8001404 Prudential Plus, MNCare
8001504 LaborCare PPO MNCare
8009904 Other PPO, MNCare
9000000 Other
9009900 Other
Blank Missing . Missing
8888888 Missing/Unknown (or insurance master)
9999999 Missing/Unknown (not on insurance master)
Any values not documented by the data source .A Invalid


Missouri
Missouri
(Valid beginning in 1995)
PAY1_X and PAY2_X PAY1 and PAY2
Value Description Value Description
01 Medicare 1 Medicare
02 Medicaid 2 Medicaid
04 Blue Cross/Blue Shield 3 Private Insurance
07 Commercial/Private Insurance
06 Self-pay 4 Self-pay
08 No charge (charity) 5 No charge
03 Maternal and Child Health 6 Other
05 Worker's Compensation
09 Other government (CHAMPUS)
10 Other
99, Blank Unknown, Missing . Missing
Any values not documented by the data source .A Invalid

Separate information on HMO and PPO providers is not provided.



Nebraska
Nebraska
PAY1_X, PAY2_X and PAY3_X PAY1
Value Description Value Description
02 Medicare 1 Medicare
04 Medicaid 2 Medicaid
12 Medicaid
01 Commercial Insurance 3 Private Insurance
03 Commercial Insurance
08 Commercial Insurance
11 Commercial Insurance
13 Commercial Insurance
14 Commercial Insurance
09, 9 Self-pay 4 Self-pay
-- -- 5 No charge
05 Worker's Compensation 6 Other
06 Champus/Champva
07 Other Federal and State Programs
10 Other
Blank Missing . Missing
Any values not documented by the data source .A Invalid


Nevada
Nevada
(Valid Beginning in 2008)
PAY1_X and PAY2_X and PAY3_X PAY1 and PAY2
Value Description Value Description
10 Medicare 1 Medicare
27 Medicare HMO
16 Nevada Medicaid 2 Medicaid
17 Other Medicaid
28 Nevada Medicaid HMO
20 Commercial Insurer 3 Private insurance
21 Negotiated Discounts e.g. Preferred Provider Organization (PPO)
22 Health Maintenance Organization (HMO)
24 All Worker's Compensation Cases
25 Nevada Blue Cross / Blue Shield
26 Other Blue Cross / Blue Shield
18 Self Pay 4 Self-pay
12 Charity 5 No charge
11 Black Lung (beginning in 2006, Black Lung was coded as 11 instead of 6) 6 Other
13 Hill-Burton Free Care (HBFC)
14 CHAMPUS / CHAMPVA
19 Miscellaneous - does not fit any of the other categories. This field covers insurers that are not licensed to sell insurance in Nevada
23 County Indigent Referral (Patient has already been approved for County Coverage)
29 Section 1011 undocumented Aliens/unknown
99, Blank Missing . Missing
Any values not documented by the data source .A Invalid



Expected payer information from two hospitals in the 2006 Nevada source data was unreliable; consequently, PAY1 was set to "Invalid" (.A) for these two hospitals.

Nevada
(Valid Prior to 2008)
PAY1_X and PAY2_X and PAY3_X PAY1 and PAY2
Value Description Value Description
10 Medicare 1 Medicare
27 Medicare HMO
16 Nevada Medicaid 2 Medicaid
17 Other Medicaid
28 Medicaid HMO
20 Commercial Insurer 3 Private insurance
21 Negotiated Discounts e.g. Preferred Provider Organization (PPO)
22 Health Maintenance Organization (HMO)
24 State Industrial Insurance System (SIIS) (beginning in 2005)
25 Nevada Blue Cross/Blue Shield (BC)
26 Other Blue Cross/Blue Shield (BS)
18 Self Pay 4 Self-pay
12 Charity 5 No charge
11 Black Lung (beginning in 2006, Black Lung was coded as 11 instead of 6) 6 Other
13 Hill-Burton Free Care (HBFC)
14 CHAMPUS (or successor)
15 CHAMPVA (or successor)
19 Miscellaneous - does not fit any of the other categories. This field covers insurers that are not licensed to sell insurance in Nevada
23 County Indigent Referral (those already qualified for, or being referred to, the County Indigent program)
29 Section 1011 undocumented Aliens/unknown
99, Blank Missing . Missing
Any values not documented by the data source .A Invalid


New Hampshire
New Hampshire
PAY1_X PAY1
Value Description Value Description
3 Medicare 1 Medicare
10 Medicare Managed Care
4 Medicaid 2 Medicaid
11 Medicaid Managed Care
5 HMO 3 Private Insurance
7 Blue Cross
8 Commercial insurance
1 Self-Pay 4 Self-pay
--   5 No charge
2 Worker's Compensation 6 Other
6 Other government
9 Other
Blank Missing . Missing
Any values not documented by the data source .A Invalid


New Jersey
New Jersey
PAY1_X and PAY2_X and PAY3_X PAY1 and PAY2
Value Description Value Description
009 Medicare: Other 1 Medicare
011 Title XVII (Medicare) Part A
015 Title XVII (Medicare) Part B
017 Title XVII (Medicare) Part B - Physician Charges
082 Medicare HMO (Beginning in 2003)
012 Title XIX (Medicaid) 2 Medicaid
083 Medicaid HMO (Beginning in 2003)
010 Blue Cross Plan 3 Private Insurance
018 Other Government (Beginning in 1998)
020 Blue Cross Plan
022 Blue Cross Plan
025 Blue Cross Plan
026 Blue Cross Plan
029 Blue Cross Plan
030 Blue Cross Plan
040 Blue Cross Plan
041 Blue Cross Plan (1994 only)
042 Blue Cross Plan (1994 only)
050 Blue Cross Plan
060 Blue Cross Plan
070 Blue Cross Plan
080 Blue Cross Plan
090 Blue Cross Plan
100 Blue Cross Plan (1994 only)
101 Blue Cross Plan
110 Blue Cross Plan
121 Blue Cross Plan
130 Blue Cross Plan
140 Blue Cross Plan
141 Blue Cross Plan
150 Blue Cross Plan
160 Blue Cross Plan
170 Blue Cross Plan
180 Blue Cross Plan
190 Blue Cross Plan
200 Blue Cross Plan
210 Blue Cross Plan
220 Blue Cross Plan
230 Blue Cross Plan
240 Blue Cross Plan
241 Blue Cross Plan
250 Blue Cross Plan
260 Blue Cross Plan
265 Blue Cross Plan
270 Blue Cross Plan
280 Blue Cross Plan
281 Blue Cross Plan (valid beginning 1/93)
290 Blue Cross Plan
300 Blue Cross Plan (1994 only)
301 Blue Cross Plan
303 Blue Cross Plan
304 Blue Cross Plan
305 Blue Cross Plan
306 Blue Cross Plan
307 Blue Cross Plan (1994 only)
308 Blue Cross Plan (1994 only)
310 Blue Cross Plan
320 Blue Cross Plan
331 Blue Cross Plan (1994 only)
332 Blue Cross Plan
333 Blue Cross Plan
334 Blue Cross Plan (1994 only)
335 Blue Cross Plan (1994 only)
337 Blue Cross Plan (1994 only)
338 Blue Cross Plan (1994 only)
340 Blue Cross Plan
350 Blue Cross Plan
351 Blue Cross Plan
360 Blue Cross Plan (1994 only)
361 Blue Cross plan
362 Blue Cross Plan
363 Blue Cross plan
364 Blue Cross plan
370 Blue Cross plan
380 Blue Cross plan
390 Blue Cross Plan
392 Blue Cross Plan
400 Blue Cross plan
410 Blue Cross plan
415 Blue Cross plan
423 Blue Cross plan
424 Blue Cross Plan (1994 only)
430 Blue Cross Plan
441 Blue Cross Plan (1994 only)
443 Blue Cross Plan
444 Blue Cross Plan (1994 only)
450 Blue Cross Plan
460 Blue Cross Plan
470 Blue Cross Plan
471 Blue Cross Plan (effective beginning 1/93)
865 Blue Cross Plan (effective beginning 1/95)
932 Blue Cross Plan (1994 only)
936 Blue Cross Plan (1994 only)
971 Blue Cross Plan (1994 only)
105 Commercial
106 Commercial
107 Commercial (effective beginning 4/1/95)
115 Commercial
120 Commercial
125 Commercial
131 Commercial
135 Commercial
142 Commercial
145 Commercial
151 Commercial
155 Commercial
161 Commercial
165 Commercial
171 Commercial
175 Commercial
181 Commercial
185 Commercial
186 Commercial
187 Commercial
188 Commercial
189 Commercial
191 Commercial
192 Commercial
193 Commercial
194 Commercial
195 Commercial
196 Commercial
197 Commercial
198 Commercial
199 Commercial
032 HMO (effective 11/96)
033 HMO (effective 11/96)
034 HMO (effective 8/96)
035 HMO (effective 11/95)
036 HMO (effective 8/97)
037 HMO (effective 8/97)
043 HMO (1994 only)
044 HMO (1994 only)
045 HMO
046 HMO (1994 only)
047 HMO
048 HMO
049 HMO (1994 only)
051 HMO (1994 only)
052 HMO (1994 only)
053 HMO (discontinued 6/98)
054 HMO (1994 only)
055 HMO (1994 only)
056 HMO
057 HMO (1994 only)
058 HMO
059 HMO
061 HMO (discontinued 6/98)
062 HMO (discontinued 6/98)
063 HMO (1994 only)
064 HMO (1994 only)
065 HMO (1994 only)
066 HMO (discontinued 6/98)
067 HMO (discontinued 6/98)
068 HMO (discontinued 6/98)
069 HMO (discontinued 6/98)
071 HMO (discontinued 6/98)
072 HMO
073 HMO
074 HMO
075 HMO (1994 only)
077 HMO
078 HMO
081 HMO (effective 11/96)
082 HMO (discontinued 6/98)
083 HMO (discontinued 6/98)
084 HMO (effective 11/96)
085 HMO (discontinued 6/98)
086 HMO (discontinued 6/98)
087 HMO (effective 11/96)
088 HMO (effective 11/96)
089 HMO (discontinued 6/98)
094 HMO (effective 11/96)
097 HMO (effective 11/96)
076 Miscellaneous
091 Miscellaneous
093 Miscellaneous (effective 1/95)
096 Miscellaneous (effective 1/95)
309 No Fault
311 No Fault
315 No Fault
399 No Fault
095 Miscellaneous 4 Self-pay
031 Patient
039 Patient
098 Miscellaneous 5 No charge
014 Champus 6 Other
016 Other Government
092 Miscellaneous
099 Miscellaneous
018 Other Government (effective between 1988 and 1997)
019 Other Government
013 Title V (Material and Child Health)
205 Worker's Compensation
211 Worker's Compensation
215 Worker's Compensation
221 Worker's Compensation
225 Worker's Compensation
231 Worker's Compensation
299 Worker's Compensation
000, Blank Not Available, Missing . Missing
Any values not documented by the data source .A Invalid


New York
New York
(Valid Beginning in 2005)
PAY1_X, PAY2_X PAY1 and PAY2
Value Description Value Description
C Medicare 1 Medicare
D Medicaid 2 Medicaid
F Insurance Company, HMO, PHSP 3 Private Insurance*
G Blue Cross
A Self-pay 4 Self-pay
B Workers' Compensation 6 Other*
E Other Federal Program
H CHAMPUS
I Other Non-Federal Program
Blank Missing . Missing
Any values not documented by the data source .A Invalid

New York Note: New York reports source of payment on their ED records instead of expected payer. The coding scheme uses alphabetic characters A through I defined in the recode table. New York reports expected payer for ambulatory surgery data (coding scheme is numeric). If an ambulatory surgery record has evidence of ED services (either ED charge or an admission source), then the record is also included in the HCUP SEDD.



New York
New York
(Valid Beginning in 2005)
(PAY1 applies to IP/AS/ED; PAY2 applies to IP only)
PAY1_X, PAY2_X, and PAY3_X PAY1 and PAY2
Value Description Value Description
03 Medicare 1 Medicare
16 Medicare HMO
04 Medicaid 2 Medicaid
17 Medicaid HMO
06 Blue Cross 3 Private Insurance*
08 Commercial Insurance Company
11 HMO (Other)
13 No-fault
15 Self-insured, Self-administered plans
01 Self-pay 4 Self-pay
09 No charge 5 No charge
02 Worker's Compensation 6 Other*
07 Other Government
10 Other
12 CHAMPUS/VA
18 Corrections Federal
19 Corrections State
20 Corrections Local
Blank Missing . Missing
Any values not documented by the data source .A Invalid


New York
New York
(Valid for 1993-2004)
PAY1_X, PAY2_X, and PAY3_X PAY1 and PAY2
Value Description Value Description
03 Medicare 1 Medicare
16 Medicare HMO
04 Medicaid 2 Medicaid
17 Medicaid HMO
06 Blue Cross 3 Private Insurance
08 Commercial Insurance Company
11 HMO (Other)
13 No-fault
15 Self-insured, Self-administered plans
01 Self-pay 4 Self-pay
09 No charge 5 No charge
02 Worker's Compensation 6 Other
07 Other Government
10 Other
12 CHAMPUS/VA
14 Corrections (federal, state, or local) (1993-1995 only)
18 Corrections Federal (beginning in 1996)
19 Corrections State (beginning in 1996)
20 Corrections Local (beginning in 1996)
Blank Missing . Missing
Any values not documented by the data source .A Invalid



New York
(Valid for 1992)
PAY1_X, PAY2_X PAY1 and PAY2
Value Description Value Description
03 Medicare 1 Medicare
04 Medicaid 2 Medicaid
06 Blue Cross 3 Private Insurance
08, 13, 15 Commercial Insurance; no-fault; self-insured, self-administered plan
11 Other HMO
01 Self-pay 4 Self-pay
09 No charge 5 No charge
02 Workers' Compensation 6 Other
12 CHAMPUS/VA
07, 14 Other government; Corrections (state, county, or city)
10 Other
Blank Primary . Missing
Blank, 00 Secondary . Missing
Other Values   .A Invalid



New York
(Valid from 1988-1991)
PAY1_X, PAY2_X PAY1 and PAY2
Value Description Value Description
03 Medicare 1 Medicare
04 Medicaid 2 Medicaid
06 Blue Cross 3 Private Insurance
08 Commercial Insurance
11 Other HMO
01 Self-pay 4 Self-pay
09 No charge 5 No charge
02 Workers' Compensation 6 Other
07 Other government; Corrections (state, county, or city)
10 Other
Blank Primary: . Missing
Blank, 00 Secondary: . Missing
Other Values   .A Invalid


North Carolina

Beginning in Q4 2010, the payer data element was modified to two characters in length and the values changed.

North Carolina
Valid from October - December 2010
PAY1_X, PAY2_X, and PAY3_X PAY1 and PAY2
Value Description Value Description
MA Medicare 1 Medicare
MB Medicare Part B
MC Medicaid 2 Medicaid
BL Blue Cross 3 Private insurance
HM HMO - PPO
CI Other Insurance Companies
A Automobile Medical
14 Exclusive Provider Org
16 Health Maintenance Org
15 Indemnity Insurance
LI Liability
LM Liability Medical
13 Point of Service
12 Preferred Provider Org
09 Self-pay 4 Self-pay
--   5 No charge
CH Champus 6 Other
O Other
DS Disability
OF Other Federal Program
11 Other Non-Federal Program
TV Title V
VA Veteran Administration Plan
WC Workers' Compensation
ZZ, Blank Documented by source as unknown values . Missing
Any values not documented by the data source .A Invalid



North Carolina
Valid from January - September 2010
PAY1_X, PAY2_X, and PAY3_X PAY1 and PAY2
Value Description Value Description
M Medicare 1 Medicare
T Medicare Part B
D Medicaid 2 Medicaid
B Blue Cross 3 Private insurance
H HMO - PPO
I Other Insurance Companies
A Automobile Medical
J Exclusive Provider Org
K Health Maintenance Org
L Indemnity Insurance
Q Liability
R Liability Medical
Y Point of Service
Z Preferred Provider Org
P Self-pay 4 Self-pay
--   5 No charge
C Champus 6 Other
O Other
G Disability
V Other Federal Program
X Other Non-Federal Program
1 Title V
2 Veteran Administration Plan
W Workers' Compensation
U, Blank Documented by source as unknown values . Missing
Any values not documented by the data source .A Invalid


Ohio
Ohio
(Beginning in 2006)
PAY1_X PAY1
Value Description Value Description
C Medicare 1 Medicare
O Medicare HMO
D Medicaid 2 Medicaid
M Medicaid HMO
F Commercial Insurance 3 Private insurance
G Blue Cross Crossover
J Blue Cross
K HMO
L PPO
N Blue Cross HMO
A Self Pay 4 Self-pay
P Bad Debt - beginning with 2003 5 No charge
Q Charity - beginning with 2003
B Workers Compensation 6 Other
E Other Government
H Champus
I Other
R Hospital Care Assurance Program (HCAP) - beginning with 2003
Z International Payor
00, Blank Unknown, Missing . Missing
Any values not documented by the data source .A Invalid


Ohio
Ohio
(Prior to 2006)
PAY1_X PAY1
Value Description Value Description
03 Medicare 1 Medicare
15 Medicare HMO
04 Medicaid 2 Medicaid
13 Medicaid HMO
06 Commercial Insurance 3 Private insurance
07 Blue Cross Crossover
10 Blue Cross Primary
11 HMO
12 PPO
14 Blue Cross HMO
01 Self Pay 4 Self-pay
16 Bad Debt - beginning with 2003 5 No charge
17 Charity - beginning with 2003
02 Workers Compensation 6 Other
05 Other Federal
08 Champus
09 Other
18 Hospital Care Assurance Program (HCAP) - beginning with 2003
00, Blank Unknown, Missing . Missing
Any values not documented by the data source .A Invalid


Oklahoma
Oklahoma
PAY1_X PAY1
Value Description Value Description
2 Medicare, including HMO and insurance managed Medicare 1 Medicare
3 Medicaid, including Medicaid pending 2 Medicaid
1 Commercial (include HMO, PPO, POS, Indemnity) 3 Private Insurance
6 Uninsured / Self Pay 4 Self pay
--   5 No charge
4 Veterans affairs / Military 6 Other
5 Workers Compensation
7 Others - All payers not in any of the above groups and including charity, Indian Health, hospice, auto liability, DOC or correctional institution
Blank Missing . Missing
Any values not documented by the data source .A Invalid


Oklahoma

Due to an error in processing, 4,616 (0.89%) Workers Compensation records were coded to missing in the 2005 data file. These records can be identified by PAY1_X = 5.



Oregon
Oregon
(Valid Beginning in 2008 - SID only)
(Valid Beginning in 2010 - SASD only)
PAY1_X, PAY2_X, and PAY3_X PAY1 and PAY2
Value Description Value Description
11 Medicare (Managed Care) 1 Medicare
12 Medicare (Fee-For-Service)
21 Medicaid (Managed Care) 2 Medicaid
22 Medicaid (Fee-For-Service)
25 Medicaid - Out Of State
51 HMO/Managed Care 3 Private Insurance
511