Transformed - Medicaid Statistical Information System (T-MSIS)

Transformed - Medicaid Statistical Information System (T-MSIS) (CMS-R-284)

2a-TMSIS_V2.4.0_Valid_Value_List.xlsx

Transformed - Medicaid Statistical Information System (T-MSIS)

OMB: 0938-0345

Document [xlsx]
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Overview

Cover Sheet
Valid Value List

Sheet 1: Cover Sheet











































Centers for Medicaid and CHIP Services (CMCS)










Transformed Medicaid Statistical Information System (T-MSIS)










Data Dictionary Valid Value List










Version: v2.4.0










Last Modified: 12/04/2020























Sheet 2: Valid Value List
T-MSIS Valid Value List



VVL_ID VVL_Name VVL_Field VVL_Code VVL_Code_Description
VVL.001 1115A Demonstration Indicator List 1115A-DEMONSTRATION-IND 0 No
VVL.001 1115A Demonstration Indicator List 1115A-DEMONSTRATION-IND 1 Yes
VVL.002 Address Border State Indicator List ADDR-BORDER-STATE-IND 0 No
VVL.002 Address Border State Indicator List ADDR-BORDER-STATE-IND 1 Yes
VVL.002 Address Border State Indicator List ADDR-BORDER-STATE-IND 8 N/A - State does not distinguish border state providers.
VVL.003 Adjustment Indicator List ADJUSTMENT-IND / LINE-ADJUSTMENT-IND 0 Original Claim/Encounter/Payment - Indicates that this is the first (and, when applicable, only) fully adjudicated transaction in a claim family (one or more claims with the related ICN-ORIG and/or ICN-ADJ and typically the same MSIS ID and provider ID(s) also).
VVL.003 Adjustment Indicator List ADJUSTMENT-IND / LINE-ADJUSTMENT-IND 1 Void/Reversal/Cancel of a prior submission Use this code to convey that the purpose of the transaction is to void/reverse/cancel a previously paid/approved claim/encounter/payment where the claim/encounter/payment is not being replaced by a new paid/approved version of the claim/encounter/payment. Typically, this would be the last claim/encounter/payment that would ever be associated with a given claim family. These records must have the same ICN-ORIG or ICN-ADJ as the claim/encounter being voided. CMS expects a void transaction to also have the same MSIS ID and provider ID(s) as the claim/encounter/payment being voided/reversed/cancelled.
VVL.003 Adjustment Indicator List ADJUSTMENT-IND / LINE-ADJUSTMENT-IND 4 Replacement/Resubmission of a previously paid/approved claim/encounter/payment - Use when the purpose of the transaction is to replace a previously paid/approved claim/encounter/payment with a new paid/approved version of the claim/encounter/payment. These records must have the same ICN-ORIG or ICN-ADJ as the claim/encounter being replaced. CMS expects a replacement transaction to also have the same MSIS ID and provider ID(s) as the claim/encounter/payment being replaced/resubmitted.
VVL.003 Adjustment Indicator List ADJUSTMENT-IND / LINE-ADJUSTMENT-IND 5 Credit Gross Adjustment - Use this code to indicate an aggregate provider-level recoupment of payments (e.g., not attributable to a single beneficiary). Amounts on these claims should be expressed as negative numbers. If a credit gross adjustment is reported with an ICN that is related to an ICN(s) of another gross adjustment (credit or debit) then CMS will interpret this to mean that the credit gross adjustment with the more recent adjudication date should completely replace the preceding related gross adjustment. If the ICNs of a credit gross adjustment are not related to any other gross adjustments (credit or debit) then the credit gross adjustment will always be treated as a distinct financial transaction.
VVL.003 Adjustment Indicator List ADJUSTMENT-IND / LINE-ADJUSTMENT-IND 6 Debit Gross Adjustment - Use this code to indicate an aggregate provider-level payment to a provider (e.g., not attributable to a single beneficiary). Amounts on these claims should be expressed as positive numbers. If a debit gross adjustment is reported with an ICN that is related to an ICN(s) of another gross adjustment (credit or debit) then CMS will interpret this to mean that the credit gross adjustment with the more recent adjudication date should completely replace the preceding related gross adjustment. If the ICNs of a debit gross adjustment are not related to any other gross adjustments (credit or debit) then the debit gross adjustment will always be treated as a distinct financial transaction.
VVL.004 Affiliated Program Type List AFFILIATED-PROGRAM-TYPE 2 Health Plan (state-assigned health plan ID) - The value in the AFFILIATED-PROGRAM-ID data element contains the state-assigned health plan Identifier of health plan in which the provider is enrolled to provide services including through the state plan and a waiver.
VVL.004 Affiliated Program Type List AFFILIATED-PROGRAM-TYPE 3 Waiver - The value in the AFFILIATED-PROGRAM-ID data element contains an identifier for the waiver in which a provider is allowed to deliver services to eligible beneficiaries.
VVL.004 Affiliated Program Type List AFFILIATED-PROGRAM-TYPE 4 Health Home Entity - The value in the AFFILIATED-PROGRAM-ID data element contains the name of the health home in which a provider is participating. The health home entity is responsible for providing health home services to the patient in conformance with the Health Home SPA. This is the name that the state uses to uniquely identify the health home team. This entity can be a designated provider (e.g., physician, clinic, behavioral health organization), a health team which links to a designated provider, or a health team (physicians, nurses, behavioral health professionals).
VVL.004 Affiliated Program Type List AFFILIATED-PROGRAM-TYPE 5 Other - The value in the AFFILIATED-PROGRAM-ID data element contains an identifier for something other than a health plan, waiver, or health home entity.
VVL.005 Bed Type Code List BED-TYPE-CODE 1 Intermediate Care Facility for the Intellectually Disabled
VVL.005 Bed Type Code List BED-TYPE-CODE 2 Inpatient
VVL.005 Bed Type Code List BED-TYPE-CODE 3 Nursing Facility
VVL.005 Bed Type Code List BED-TYPE-CODE 4 Title 18 Skilled Nursing Facility (T18 SNF)
VVL.006 Coverage Type List COVERAGE-TYPE 01 Drug
VVL.006 Coverage Type List COVERAGE-TYPE 02 Professional (Physician) Visit - Office
VVL.006 Coverage Type List COVERAGE-TYPE 03 Dental Care
VVL.006 Coverage Type List COVERAGE-TYPE 04 Inpatient Hospital
VVL.006 Coverage Type List COVERAGE-TYPE 05 Outpatient Hospital
VVL.006 Coverage Type List COVERAGE-TYPE 06 Nursing Home
VVL.006 Coverage Type List COVERAGE-TYPE 07 Vision
VVL.006 Coverage Type List COVERAGE-TYPE 08 Durable Med Equip (rent)
VVL.006 Coverage Type List COVERAGE-TYPE 09 Durable Med Equip (purchase)
VVL.006 Coverage Type List COVERAGE-TYPE 10 Home Health
VVL.006 Coverage Type List COVERAGE-TYPE 11 Mental health - outpatient
VVL.006 Coverage Type List COVERAGE-TYPE 12 Mental health - inpatient
VVL.006 Coverage Type List COVERAGE-TYPE 13 Psychiatric care- outpatient
VVL.006 Coverage Type List COVERAGE-TYPE 14 Psychiatric care- inpatient
VVL.006 Coverage Type List COVERAGE-TYPE 15 Rehabilitation
VVL.006 Coverage Type List COVERAGE-TYPE 16 Cancer
VVL.006 Coverage Type List COVERAGE-TYPE 17 Emergency Services
VVL.006 Coverage Type List COVERAGE-TYPE 18 Chiropractic
VVL.006 Coverage Type List COVERAGE-TYPE 19 Surgical
VVL.006 Coverage Type List COVERAGE-TYPE 20 Diagnostic Medical, including X-ray and Lab Services
VVL.006 Coverage Type List COVERAGE-TYPE 21 PT/OT/ST
VVL.006 Coverage Type List COVERAGE-TYPE 22 Hospice
VVL.006 Coverage Type List COVERAGE-TYPE 23 Transportation
VVL.006 Coverage Type List COVERAGE-TYPE 98 Other
VVL.007 Eligible Address Type List ADDR-TYPE 01 Primary home address and contact information, used for the eligibility determination process
VVL.007 Eligible Address Type List ADDR-TYPE 02 Primary work address and contact information
VVL.007 Eligible Address Type List ADDR-TYPE 03 Secondary residence and contact information
VVL.007 Eligible Address Type List ADDR-TYPE 04 Secondary work address and contact information
VVL.007 Eligible Address Type List ADDR-TYPE 05 Other category of address and contact information
VVL.007 Eligible Address Type List ADDR-TYPE 06 Eligible persons official mailing address
VVL.008 Facility Group Individual Code List FACILITY-GROUP-INDIVIDUAL-CODE 01 Facility - The entity identified by the associated SUBMITTING-STATE-PROV-ID is a facility.
VVL.008 Facility Group Individual Code List FACILITY-GROUP-INDIVIDUAL-CODE 02 Group - The entity identified by the associated SUBMITTING-STATE-PROV-ID is a group of individual practitioners.
VVL.008 Facility Group Individual Code List FACILITY-GROUP-INDIVIDUAL-CODE 03 Individual - The entity identified by the associated SUBMITTING-STATE-PROV-ID is an individual practitioner.
VVL.009 Ownership Code List OWNERSHIP-CODE 01 Voluntary - Non-Profit - Religious Organizations
VVL.009 Ownership Code List OWNERSHIP-CODE 02 Voluntary - Non-Profit - Other
VVL.009 Ownership Code List OWNERSHIP-CODE 03 Voluntary - multiple owners
VVL.009 Ownership Code List OWNERSHIP-CODE 04 Proprietary - Individual
VVL.009 Ownership Code List OWNERSHIP-CODE 05 Proprietary - Corporation
VVL.009 Ownership Code List OWNERSHIP-CODE 06 Proprietary - Partnership
VVL.009 Ownership Code List OWNERSHIP-CODE 07 Proprietary - Other
VVL.009 Ownership Code List OWNERSHIP-CODE 08 Proprietary - multiple owners
VVL.009 Ownership Code List OWNERSHIP-CODE 09 Government - Federal
VVL.009 Ownership Code List OWNERSHIP-CODE 10 Government - State
VVL.009 Ownership Code List OWNERSHIP-CODE 11 Government - City
VVL.009 Ownership Code List OWNERSHIP-CODE 12 Government - County
VVL.009 Ownership Code List OWNERSHIP-CODE 13 Government - City-County
VVL.009 Ownership Code List OWNERSHIP-CODE 14 Government - Hospital District
VVL.009 Ownership Code List OWNERSHIP-CODE 15 Government - State and City/County
VVL.009 Ownership Code List OWNERSHIP-CODE 16 Government - other multiple owners
VVL.009 Ownership Code List OWNERSHIP-CODE 17 Voluntary /Proprietary
VVL.009 Ownership Code List OWNERSHIP-CODE 18 Proprietary/Government
VVL.009 Ownership Code List OWNERSHIP-CODE 19 Voluntary/Government
VVL.009 Ownership Code List OWNERSHIP-CODE 88 N/A - The individual only practices as part of a group, e.g., as an employee
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 01 General Practice
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 02 General Surgery
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 03 Allergy/Immunology
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 04 Otolaryngology
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 05 Anesthesiology C
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 06 Cardiology
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 07 Dermatology
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 08 Family Practice
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 09 Interventional Pain Management
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 10 Gastroenterology
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 11 Internal Medicine
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 12 Osteopathic Manipulative Therapy
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 13 Neurology
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 14 Neurosurgery
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 15 Speech Language Pathologist
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 16 Obstetrics/Gynecology
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 17 Hospice and Palliative Care
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 18 Ophthalmology
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 19 Oral Surgery (dentists only)
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 20 Orthopedic Surgery
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 21 Cardiac Electrophysiology
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 22 Pathology
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 23 Sports Medicine
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 24 Plastic and Reconstructive Surgery
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 25 Physical Medicine and Rehabilitation
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 26 Psychiatry
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 27 Geriatric Psychiatry
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 28 Colorectal Surgery (formerly proctology)
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 29 Pulmonary Disease
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 30 Diagnostic Radiology
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 31 Cardiac Rehabilitation & Intensive Cardiac Rehabilitation
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 32 Anesthesiologist Assistant
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 33 Thoracic Surgery
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 34 Urology
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 35 Chiropractic
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 36 Nuclear Medicine
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 37 Pediatric Medicine
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 38 Geriatric Medicine
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 39 Nephrology
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 40 Hand Surgery
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 41 Optometry
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 42 Certified Nurse Midwife
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 43 Certified Registered Nurse Anesthetist (CRNA)
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 44 Infectious Disease
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 45 Mammography Center
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 46 Endocrinology
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 47 Independent Diagnostic Testing Facility (IDTF)
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 48 Podiatry
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 49 Ambulatory Surgical Center
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 50 Nurse Practitioner
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 51 Medical Supply Company with Orthotist
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 52 Medical Supply Company with Prosthetist
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 53 Medical Supply Company with Orthotist-Prosthetist
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 54 Other Medical Supply Company
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 55 Individual Certified Orthotist
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 56 Individual Certified Prosthetist
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 57 Individual Certified Orthotist-Prosthetist
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 58 Medical Supply Company with Pharmacist
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 59 Ambulance Service Provider
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 60 Public Health or Welfare Agency
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 61 Voluntary Health or Charitable Agency
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 62 Psychologist (Billing Independently)
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 63 Portable X-Ray Supplier
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 64 Audiologist
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 65 Physical Therapist in Private Practice
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 66 Rheumatology
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 67 Occupational Therapist in Private Practice
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 68 Clinical Psychologist
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 69 Clinical Laboratory
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 70 Single or Multispecialty Clinic or Group Practice
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 71 Registered Dietitian or Nutrition Professional
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 72 Pain Management
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 73 Mass Immunization Roster Biller
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 74 Radiation Therapy Center
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 75 Slide Preparation Facility
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 76 Peripheral Vascular Disease
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 77 Vascular Surgery
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 78 Cardiac Surgery
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 79 Addiction Medicine
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 80 Licensed Clinical Social Worker
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 81 Critical Care (Intensivists)
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 82 Hematology
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 83 Hematology/Oncology
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 84 Preventive Medicine
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 85 Maxillofacial Surgery
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 86 Neuropsychiatry
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 87 All Other Suppliers
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 88 Unknown Supplier/Provider Specialty
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 89 Certified Clinical Nurse Specialist
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 90 Medical Oncology
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 91 Surgical Oncology
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 92 Radiation Oncology
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 93 Emergency Medicine
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 94 Interventional Radiology
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 95 Advance Diagnostic Imaging
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 96 Optician
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 97 Physician Assistant
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 98 Gynecological/Oncology
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) 99 Undefined physician type (provider is an MD)
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) A0 Hospital-General
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) A1 Skilled Nursing Facility
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) A2 Intermediate Care Nursing Facility
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) A3 Other Nursing Facility
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) A4 Home Health Agency
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) A5 Pharmacy
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) A6 Medical Supply Company with Respiratory Therapist
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) A7 Department Store
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) A8 Grocery Store
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) A9 Indian Health Service facility
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) B1 Oxygen supplier
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) B2 Pedorthic personnel
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) B3 Medical supply company with pedorthic personnel
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) B4 Rehabilitation Agency
VVL.010 Provider Specialty List PROV-CLASSIFICATION-TYPE = 2 (Provider Specialty Code) B5 Ocularist
VVL.011 Provider Classification Type List PROV-CLASSIFICATION-TYPE 1 Taxonomy code
VVL.011 Provider Classification Type List PROV-CLASSIFICATION-TYPE 2 Provider specialty code
VVL.011 Provider Classification Type List PROV-CLASSIFICATION-TYPE 3 Provider type code
VVL.011 Provider Classification Type List PROV-CLASSIFICATION-TYPE 4 Authorized category of service code
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 01 Physician
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 02 Speech Language Pathologist
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 03 Oral Surgery (Dentist only)
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 04 Cardiac Rehabilitation and Intensive Cardiac Rehabilitation
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 05 Anesthesiology Assistant
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 06 Chiropractic
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 07 Optometry
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 08 Certified Nurse Midwife
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 09 Certified Registered Nurse Anesthetist (CRNA)
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 10 Mammography Center
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 11 Independent Diagnostic Testing Facility (IDTF)
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 12 Podiatry
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 13 Ambulatory Surgical Center
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 14 Nurse Practitioner
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 15 Medical Supply Company with Orthotist
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 16 Medical Supply Company with Prosthetist
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 17 Medical Supply Company with Orthotist-Prosthetist
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 18 Other Medical Supply Company
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 19 Individual Certified Orthotist
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 20 Individual Certified Prosthetist
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 21 Individual Certified Prosthetist-Orthotist
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 22 Medical Supply Company with Pharmacist
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 23 Ambulance Service Provider
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 24 Public Health or Welfare Agency
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 25 Voluntary Health or Charitable Agency
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 26 Psychologist, Clinical
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 27 Portable X-Ray Supplier
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 28 Audiologist
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 29 Physical Therapist in Private Practice
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 30 Occupational Therapist in Private Practice
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 31 Clinical Laboratory
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 32 Clinic or Group Practice
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 33 Registered Dietitian or Nutrition Professional
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 34 Mass Immunizer Roster Biller
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 35 Radiation Therapy Center
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 36 Slide Preparation Facility
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 37 Licensed Clinical Social Worker
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 38 Certified Clinical Nurse Specialist
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 39 Advance Diagnostic Imaging
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 40 Optician
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 41 Physician Assistant
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 42 Hospital-General
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 43 Skilled Nursing Facility
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 44 Intermediate Care Nursing Facility
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 45 Other Nursing Facility
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 46 Home Health Agency
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 47 Pharmacy
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 48 Medical Supply Company with Respiratory Therapist
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 49 Department Store
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 50 Grocery Store
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 51 Indian Health Service facility
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 52 Oxygen supplier
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 53 Pedorthic personnel
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 54 Medical supply company with pedorthic personnel
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 55 Rehabilitation Agency
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 56 Ocularist
VVL.012 Provider Type Code List PROV-CLASSIFICATION-TYPE = 3 (Provider Type Code) 57 All Other
VVL.013 T-MSIS File Type List FILE-NAME CLAIM-IP Inpatient claims file
VVL.013 T-MSIS File Type List FILE-NAME CLAIM-LT Long term care claims file
VVL.013 T-MSIS File Type List FILE-NAME CLAIM-OT Other claims file
VVL.013 T-MSIS File Type List FILE-NAME CLAIM-RX Prescription claims file
VVL.013 T-MSIS File Type List FILE-NAME ELIGIBLE Eligible file
VVL.013 T-MSIS File Type List FILE-NAME MNGDCARE Managed care organization file
VVL.013 T-MSIS File Type List FILE-NAME PROVIDER Provider file
VVL.013 T-MSIS File Type List FILE-NAME TPL-FILE Third-party liability file
VVL.014 Record ID List RECORD-ID MCR00001 FILE-HEADER-RECORD-MANAGED-CARE
VVL.014 Record ID List RECORD-ID MCR00002 MANAGED-CARE-MAIN
VVL.014 Record ID List RECORD-ID MCR00003 MANAGED-CARE-LOCATION-AND-CONTACT-INFO
VVL.014 Record ID List RECORD-ID MCR00004 MANAGED-CARE-SERVICE-AREA
VVL.014 Record ID List RECORD-ID MCR00005 MANAGED-CARE-OPERATING-AUTHORITY
VVL.014 Record ID List RECORD-ID MCR00006 MANAGED-CARE-PLAN-POPULATION-ENROLLED
VVL.014 Record ID List RECORD-ID MCR00007 MANAGED-CARE-ACCREDITATION-ORGANIZATION
VVL.014 Record ID List RECORD-ID MCR00008 NATIONAL-HEALTH-CARE-ENTITY-ID-INFO
VVL.014 Record ID List RECORD-ID MCR00009 CHPID-SHPID-RELATIONSHIP
VVL.014 Record ID List RECORD-ID PRV00001 FILE-HEADER-RECORD-PROVIDER
VVL.014 Record ID List RECORD-ID PRV00002 PROV-ATTRIBUTES-MAIN
VVL.014 Record ID List RECORD-ID PRV00003 PROV-LOCATION-AND-CONTACT-INFO
VVL.014 Record ID List RECORD-ID PRV00004 PROV-LICENSING-INFO
VVL.014 Record ID List RECORD-ID PRV00005 PROV-IDENTIFIERS
VVL.014 Record ID List RECORD-ID PRV00006 PROV-TAXONOMY-CLASSIFICATION
VVL.014 Record ID List RECORD-ID PRV00007 PROV-MEDICAID-ENROLLMENT
VVL.014 Record ID List RECORD-ID PRV00008 PROV-AFFILIATED-GROUPS
VVL.014 Record ID List RECORD-ID PRV00009 PROV-AFFILIATED-PROGRAMS
VVL.014 Record ID List RECORD-ID PRV00010 PROV-BED-TYPE-INFO
VVL.014 Record ID List RECORD-ID ELG00001 FILE-HEADER-RECORD-ELIGIBILITY
VVL.014 Record ID List RECORD-ID ELG00002 PRIMARY-DEMOGRAPHICS-ELIGIBILITY
VVL.014 Record ID List RECORD-ID ELG00003 VARIABLE-DEMOGRAPHICS-ELIGIBILITY
VVL.014 Record ID List RECORD-ID ELG00004 ELIGIBLE-CONTACT-INFORMATION
VVL.014 Record ID List RECORD-ID ELG00005 ELIGIBILITY-DETERMINANTS
VVL.014 Record ID List RECORD-ID ELG00006 HEALTH-HOME-SPA-PARTICIPATION-INFORMATION
VVL.014 Record ID List RECORD-ID ELG00007 HEALTH-HOME-SPA-PROVIDERS
VVL.014 Record ID List RECORD-ID ELG00008 HEALTH-HOME-CHRONIC-CONDITIONS
VVL.014 Record ID List RECORD-ID ELG00009 LOCK-IN-INFORMATION
VVL.014 Record ID List RECORD-ID ELG00010 MFP-INFORMATION
VVL.014 Record ID List RECORD-ID ELG00011 STATE-PLAN-OPTION-PARTICIPATION
VVL.014 Record ID List RECORD-ID ELG00012 WAIVER-PARTICIPATION
VVL.014 Record ID List RECORD-ID ELG00013 LTSS-PARTICIPATION
VVL.014 Record ID List RECORD-ID ELG00014 MANAGED-CARE-PARTICIPATION
VVL.014 Record ID List RECORD-ID ELG00015 ETHNICITY-INFORMATION
VVL.014 Record ID List RECORD-ID ELG00016 RACE-INFORMATION
VVL.014 Record ID List RECORD-ID ELG00017 DISABILITY-INFORMATION
VVL.014 Record ID List RECORD-ID ELG00018 1115A-DEMONSTRATION-INFORMATION
VVL.014 Record ID List RECORD-ID ELG00020 HCBS-CHRONIC-CONDITIONS-NON-HEALTH-HOME
VVL.014 Record ID List RECORD-ID ELG00021 ENROLLMENT-TIME-SPAN
VVL.014 Record ID List RECORD-ID ELG00022 ELG-IDENTIFIERS
VVL.014 Record ID List RECORD-ID TPL00001 FILE-HEADER-RECORD-TPL
VVL.014 Record ID List RECORD-ID TPL00002 TPL-MEDICAID-ELIGIBLE-PERSON-MAIN
VVL.014 Record ID List RECORD-ID TPL00003 TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-INFO
VVL.014 Record ID List RECORD-ID TPL00004 TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-CATEGORIES
VVL.014 Record ID List RECORD-ID TPL00005 TPL-MEDICAID-ELIGIBLE-OTHER-THIRD-PARTY-COVERAGE-INFORMATION
VVL.014 Record ID List RECORD-ID TPL00006 TPL-ENTITY-CONTACT-INFORMATION
VVL.014 Record ID List RECORD-ID CIP00001 FILE-HEADER-RECORD-IP
VVL.014 Record ID List RECORD-ID CIP00002 CLAIM-HEADER-RECORD-IP
VVL.014 Record ID List RECORD-ID CIP00003 CLAIM-LINE-RECORD-IP
VVL.014 Record ID List RECORD-ID CLT00001 FILE-HEADER-RECORD-LT
VVL.014 Record ID List RECORD-ID CLT00002 CLAIM-HEADER-RECORD-LT
VVL.014 Record ID List RECORD-ID CLT00003 CLAIM-LINE-RECORD-LT
VVL.014 Record ID List RECORD-ID COT00001 FILE-HEADER-RECORD-OT
VVL.014 Record ID List RECORD-ID COT00002 CLAIM-HEADER-RECORD-OT
VVL.014 Record ID List RECORD-ID COT00003 CLAIM-LINE-RECORD-OT
VVL.014 Record ID List RECORD-ID CRX00001 FILE-HEADER-RECORD-RX
VVL.014 Record ID List RECORD-ID CRX00002 CLAIM-HEADER-RECORD-RX
VVL.014 Record ID List RECORD-ID CRX00003 CLAIM-LINE-RECORD-RX
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 01 Alabama
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 02 Alaska
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 04 Arizona
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 05 Arkansas
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 06 California
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 08 Colorado
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 09 Connecticut
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 10 Delaware
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 11 District of Columbia
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 12 Florida
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 13 Georgia
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 15 Hawaii
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 16 Idaho
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 17 Illinois
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 18 Indiana
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 19 Iowa
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 20 Kansas
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 21 Kentucky
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 22 Louisiana
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 23 Maine
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 24 Maryland
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 25 Massachusetts
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 26 Michigan
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 27 Minnesota
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 28 Mississippi
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 29 Missouri
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 30 Montana
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 31 Nebraska
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 32 Nevada
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 33 New Hampshire
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 34 New Jersey
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 35 New Mexico
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 36 New York
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 37 North Carolina
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 38 North Dakota
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 39 Ohio
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 40 Oklahoma
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 41 Oregon
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 42 Pennsylvania
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 44 Rhode Island
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 45 South Carolina
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 46 South Dakota
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 47 Tennessee
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 48 Texas
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 49 Utah
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 50 Vermont
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 51 Virginia
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 53 Washington
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 54 West Virginia
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 55 Wisconsin
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 56 Wyoming
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 60 American Samoa
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 66 Guam
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 72 Puerto Rico
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 78 U.S. Virgin Islands
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 93 Wyoming (CHIP) - W4
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 94 Montana (TPA) - M8
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 96 Iowa (CHIP) - I4
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE 97 Pennsylvania (CHIP) - P1
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE Not Applicable
 The list is based on ANSI state codes but in some cases have been modified to meet T-MSIS needs.
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE Not Applicable This URL will take the reader to the American National Standards Institute (ANSI) Website for the various geographical code sets:
VVL.015 State Code List SUBMITTING-STATE / MANAGED-CARE-STATE / ADDR-STATE / ELIGIBLE-STATE / INSURANCE-CARRIER-STATE / ORIGINATION-STATE / DESTINATION-STATE Not Applicable State Code List
VVL.016 Sex List SEX F Female
VVL.016 Sex List SEX M Male
VVL.016 Sex List SEX U Unknown
VVL.017 State Plan Enrollment List STATE-PLAN-ENROLLMENT 1 Medicaid
VVL.017 State Plan Enrollment List STATE-PLAN-ENROLLMENT 2 CHIP
VVL.017 State Plan Enrollment List STATE-PLAN-ENROLLMENT 3 Both Medicaid and CHIP
VVL.017 State Plan Enrollment List STATE-PLAN-ENROLLMENT 4 Not state plan affiliated
VVL.018 Submission Transaction Type List SUBMISSION-TRANSACTION-TYPE C Create File - a file that contains a complete set of transactions/changes processed since the last Create file submission. States may submit only one valid Create file per reporting period and data file type.
VVL.018 Submission Transaction Type List SUBMISSION-TRANSACTION-TYPE R Replacement File - a Replacement submission is a replacement of the months data. It will completely replace the immediate prior submission. If a later replacement entry is received, it will overwrite the previous replacement, as well as a prior Create or Update submission for the same data type and reporting period.
VVL.018 Submission Transaction Type List SUBMISSION-TRANSACTION-TYPE U Update File - a file that contains T-MSIS record segments created in response to business rule rejects. Note: The records in an Update file are not generated as a result of a change processed in the states Medicaid or Medicaid-related systems during the current reporting month. These Update file record segments may be unchanged from the ones submitted previously for various reasons (for example, the state may be unable to process a change record in their Medicaid / Medicaid-related systems to correct the issue because the state is simply passing through to T-MSIS data that originated outside of the states systems).[1] Conversely, the records may be different from those previously submitted, but the change is the result of a fix whose root cause problem was an issue in the T-MSIS file-creation or replacement process at CMS. Regardless, the record was not generated from a change that occurred in the states source data.
VVL.019 Teaching Indicator List TEACHING-IND 0 No
VVL.019 Teaching Indicator List TEACHING-IND 1 Yes
VVL.020 Accepting New Patients Indicator List ACCEPTING-NEW-PATIENTS-IND 0 No
VVL.020 Accepting New Patients Indicator List ACCEPTING-NEW-PATIENTS-IND 1 Yes
VVL.020 Accepting New Patients Indicator List ACCEPTING-NEW-PATIENTS-IND 8 N/A - The individual only practices as a member of a group.
VVL.021 Accreditation Organization List ACCREDITATION-ORGANIZATION 01 National committee for quality assurance - excellent
VVL.021 Accreditation Organization List ACCREDITATION-ORGANIZATION 02 National committee for quality assurance - commendable
VVL.021 Accreditation Organization List ACCREDITATION-ORGANIZATION 03 National committee for quality assurance - provisional
VVL.021 Accreditation Organization List ACCREDITATION-ORGANIZATION 04 National committee for quality assurance - new plan no longer a valid accreditation level
VVL.021 Accreditation Organization List ACCREDITATION-ORGANIZATION 05 URAC - full
VVL.021 Accreditation Organization List ACCREDITATION-ORGANIZATION 06 URAC - conditional
VVL.021 Accreditation Organization List ACCREDITATION-ORGANIZATION 07 URAC - provisional
VVL.021 Accreditation Organization List ACCREDITATION-ORGANIZATION 08 Accreditation Association for Ambulatory Health Care, Inc. (AAAHC) - 3 years
VVL.021 Accreditation Organization List ACCREDITATION-ORGANIZATION 09 Accreditation Association for Ambulatory Health Care, Inc. (AAAHC) - 1 year - no longer valid accreditation level
VVL.021 Accreditation Organization List ACCREDITATION-ORGANIZATION 10 Accreditation Association for Ambulatory Health Care, Inc. (AAAHC) - 6 months - no longer valid accreditation level
VVL.021 Accreditation Organization List ACCREDITATION-ORGANIZATION 11 Not accredited
VVL.021 Accreditation Organization List ACCREDITATION-ORGANIZATION 12 Other
VVL.021 Accreditation Organization List ACCREDITATION-ORGANIZATION 13 National committee for quality assurance -- accredited
VVL.021 Accreditation Organization List ACCREDITATION-ORGANIZATION 14 National committee for quality assurance - interim
VVL.021 Accreditation Organization List ACCREDITATION-ORGANIZATION 15 National committee for quality assurance - denied
VVL.021 Accreditation Organization List ACCREDITATION-ORGANIZATION Not Applicable Accreditation Organization List
VVL.021 Accreditation Organization List ACCREDITATION-ORGANIZATION Not Applicable Accreditation Organization List 2
VVL.022 Adjustment Reason Code List ADJUSTMENT-REASON-CODE Not Applicable Adjustment Reason Code List
VVL.023 CHIP Code List CHIP-CODE 0 Individual was not Medicaid eligible and not eligible for separate CHIP for the month *End Dated 20200214
VVL.023 CHIP Code List CHIP-CODE 1 Individual was Medicaid eligible, but was not included in either Medicaid-Expansion CHIP or a separate title XXI CHIP) program for the month. These include blind and disabled people and low-income families with dependent children.
VVL.023 CHIP Code List CHIP-CODE 2 Individual was included in the Medicaid-Expansion CHIP program and subject to enhanced Federal matching for the month. States with Medicaid-Expansion programs have built upon existing Medicaid programs to include low-income children whose family incomes are above Medicaid income eligibility thresholds.
VVL.023 CHIP Code List CHIP-CODE 3 Individual was not Medicaid-Expansion CHIP eligible but was included in a separate title XXI CHIP program for the month. States using Separate CHIP have used CHIP funds to create separate programs outside of their Medicaid programs.
VVL.024 Admission Type List ADMISSION-TYPE 1 EMERGENCY The patient requires immediate medical intervention as a result of severe, life threatening or potentially disabling conditions. Generally, the patient is admitted through the emergency room.
VVL.024 Admission Type List ADMISSION-TYPE 2 URGENT The patient requires immediate attention for the care and treatment of a physical or mental disorder. Generally, the patient is admitted to the first available and suitable accommodation.
VVL.024 Admission Type List ADMISSION-TYPE 3 ELECTIVE The patients condition permits adequate time to schedule the availability of a suitable accommodation.
VVL.024 Admission Type List ADMISSION-TYPE 4 NEWBORN The patient is a newborn delivered either inside the admitting hospital (UB04 FL 15 value 5 [A baby born inside the admitting hospital] or outside of the hospital (UB04 FL 15 value 6 [A baby born outside the admitting hospital]).
VVL.024 Admission Type List ADMISSION-TYPE 5 TRAUMA The patient visits a trauma center (A trauma center means a facility licensed or designated by the State or local government authority authorized to do so, or as verified by the American College of surgeons and involving a trauma activation.)
VVL.024 Admission Type List ADMISSION-TYPE 9 UNKNOWN Information not available.
VVL.025 Diagnosis Code Flag List DIAGNOSIS-CODE-FLAG-1 to DIAGNOSIS-CODE-FLAG-12 / ADMITTING-DIAGNOSIS-CODE-FLAG 1 ICD-9
VVL.025 Diagnosis Code Flag List DIAGNOSIS-CODE-FLAG-1 to DIAGNOSIS-CODE-FLAG-12 / ADMITTING-DIAGNOSIS-CODE-FLAG 2 ICD-10
VVL.026 Diagnosis Code List ADMITTING-DIAGNOSIS-CODE / DIAGNOSIS-CODE 1 thru DIAGNOSIS-CODE-12 Not Applicable Admitting Diagnosis Code List (ICD-9-CM Diagnosis and Procedure Codes)
VVL.026 Diagnosis Code List ADMITTING-DIAGNOSIS-CODE / DIAGNOSIS-CODE 1 thru DIAGNOSIS-CODE-12 Not Applicable Admitting Diagnosis Code List (ICD-10)
VVL.030 American Indian Alaskan Native Indicator List AMERICAN-INDIAN-ALASKAN-NATIVE-INDICATOR 0 Individual does not meet the definition of an American Indian/Alaskan Native.
VVL.030 American Indian Alaskan Native Indicator List AMERICAN-INDIAN-ALASKAN-NATIVE-INDICATOR 1 Individual meets the definition of an American Indian/Alaskan Native.
VVL.031 Billing Unit List BILLING-UNIT 01 Per Day
VVL.031 Billing Unit List BILLING-UNIT 02 Per Hour
VVL.031 Billing Unit List BILLING-UNIT 03 Per Case
VVL.031 Billing Unit List BILLING-UNIT 04 Per Encounter
VVL.031 Billing Unit List BILLING-UNIT 05 Per Week
VVL.031 Billing Unit List BILLING-UNIT 06 Per Month
VVL.031 Billing Unit List BILLING-UNIT 07 Other Arrangements
VVL.032 Brand Generic Indicator List BRAND-GENERIC-IND 0 Not a Drug
VVL.032 Brand Generic Indicator List BRAND-GENERIC-IND 1 Generic
VVL.032 Brand Generic Indicator List BRAND-GENERIC-IND 2 Brand
VVL.033 Citizenship Indicator List CITIZENSHIP-IND 0 No
VVL.033 Citizenship Indicator List CITIZENSHIP-IND 1 Yes
VVL.034 Citizenship Verification Flag List CITIZENSHIP-VERIFICATION-FLAG 0 Citizenship Verified
VVL.034 Citizenship Verification Flag List CITIZENSHIP-VERIFICATION-FLAG 1 Enrolled in Medicaid pending citizenship verification
VVL.035 Claim Denied Indicator List CLAIM-DENIED-INDICATOR 0 Denied: The payment of claim in its entirety was denied by the state.
VVL.035 Claim Denied Indicator List CLAIM-DENIED-INDICATOR 1 Not Denied: The state paid some or all of the claim.
VVL.036 CMS 64 Category for Federal Reimbursement List CMS-64-CATEGORY-FOR-FEDERAL-REIMBURSEMENT 01 Federal funding under Title XIX
VVL.036 CMS 64 Category for Federal Reimbursement List CMS-64-CATEGORY-FOR-FEDERAL-REIMBURSEMENT 02 Federal funding under Title XXI
VVL.036 CMS 64 Category for Federal Reimbursement List CMS-64-CATEGORY-FOR-FEDERAL-REIMBURSEMENT 03 Federal funding under ACA *Code end dated 20200920
VVL.036 CMS 64 Category for Federal Reimbursement List CMS-64-CATEGORY-FOR-FEDERAL-REIMBURSEMENT 04 Federal funding under other legislation
VVL.037 Compound Dosage Form List COMPOUND-DOSAGE-FORM 01 Capsule
VVL.037 Compound Dosage Form List COMPOUND-DOSAGE-FORM 02 Ointment
VVL.037 Compound Dosage Form List COMPOUND-DOSAGE-FORM 03 Cream
VVL.037 Compound Dosage Form List COMPOUND-DOSAGE-FORM 04 Suppository
VVL.037 Compound Dosage Form List COMPOUND-DOSAGE-FORM 05 Powder
VVL.037 Compound Dosage Form List COMPOUND-DOSAGE-FORM 06 Emulsion
VVL.037 Compound Dosage Form List COMPOUND-DOSAGE-FORM 07 Liquid
VVL.037 Compound Dosage Form List COMPOUND-DOSAGE-FORM 10 Tablet
VVL.037 Compound Dosage Form List COMPOUND-DOSAGE-FORM 11 Solution
VVL.037 Compound Dosage Form List COMPOUND-DOSAGE-FORM 12 Suspension
VVL.037 Compound Dosage Form List COMPOUND-DOSAGE-FORM 13 Lotion
VVL.037 Compound Dosage Form List COMPOUND-DOSAGE-FORM 14 Shampoo
VVL.037 Compound Dosage Form List COMPOUND-DOSAGE-FORM 15 Elixir
VVL.037 Compound Dosage Form List COMPOUND-DOSAGE-FORM 16 Syrup
VVL.037 Compound Dosage Form List COMPOUND-DOSAGE-FORM 17 Lozenge
VVL.037 Compound Dosage Form List COMPOUND-DOSAGE-FORM 18 Enema
VVL.038 Compound Drug Indicator List COMPOUND-DRUG-IND 0 Not Compound
VVL.038 Compound Drug Indicator List COMPOUND-DRUG-IND 1 Compound
VVL.039 Conception to Birth Indicator List CONCEPTION-TO-BIRTH-IND 0 No
VVL.039 Conception to Birth Indicator List CONCEPTION-TO-BIRTH-IND 1 Yes
VVL.040 Copay Waived Indicator List COPAY-WAIVED-IND 0 Not Waived: The provider did not waive the beneficiarys copayment,
VVL.040 Copay Waived Indicator List COPAY-WAIVED-IND 1 Waived: The provider waived the beneficiarys copayment.
VVL.041 Core Based Statistical Area Code List CORE-BASED-STATISTICAL-AREA-CODE 1 The MCOs service area falls partially or entirely inside one or more metropolitan areas.
VVL.041 Core Based Statistical Area Code List CORE-BASED-STATISTICAL-AREA-CODE 2 The MCOs service area falls partially or entirely inside one or more micropolitan areas, but not within any metropolitan areas.
VVL.041 Core Based Statistical Area Code List CORE-BASED-STATISTICAL-AREA-CODE 3 The MCOs service area falls entirely outside of all metropolitan and micropolitan areas.
VVL.042 Crossover Indicator List CROSSOVER-INDICATOR 0 Not Crossover Claim
VVL.042 Crossover Indicator List CROSSOVER-INDICATOR 1 Crossover Claim
VVL.043 Disability Type Code List DISABILITY-TYPE-CODE 01 Individual is deaf or has serious difficulty hearing.
VVL.043 Disability Type Code List DISABILITY-TYPE-CODE 02 Individual is blind or has serious difficulty seeing, even when wearing glasses.
VVL.043 Disability Type Code List DISABILITY-TYPE-CODE 03 Individual has serious difficulty concentrating, remembering, or making decisions because of a physical, mental, or emotional condition. (Applicable only to people who are 5 years old or older.)
VVL.043 Disability Type Code List DISABILITY-TYPE-CODE 04 Individual has serious difficulty walking or climbing stairs. (Applicable only to people who are 5 years old or older.)
VVL.043 Disability Type Code List DISABILITY-TYPE-CODE 05 Individual has difficulty dressing or bathing. (Applicable only to people who are 5 years old or older.)
VVL.043 Disability Type Code List DISABILITY-TYPE-CODE 06 Individual has difficulty doing errands alone such as visiting a doctor's office or shopping because of a physical, mental, or emotional condition. (Applicable only to people who are 15 years old or older.)
VVL.043 Disability Type Code List DISABILITY-TYPE-CODE 07 Other
VVL.043 Disability Type Code List DISABILITY-TYPE-CODE 08 None
VVL.044 Drug Utilization Professional Service Code List DRUG-UTILIZATION-CODE (44Ø-E5, Professional Service Code) 00 No intervention
VVL.044 Drug Utilization Professional Service Code List DRUG-UTILIZATION-CODE (44Ø-E5, Professional Service Code) AS Patient assessment
VVL.044 Drug Utilization Professional Service Code List DRUG-UTILIZATION-CODE (44Ø-E5, Professional Service Code) CC Coordination of care
VVL.044 Drug Utilization Professional Service Code List DRUG-UTILIZATION-CODE (44Ø-E5, Professional Service Code) DE Dosing evaluation/determination
VVL.044 Drug Utilization Professional Service Code List DRUG-UTILIZATION-CODE (44Ø-E5, Professional Service Code) FE Formulary enforcement
VVL.044 Drug Utilization Professional Service Code List DRUG-UTILIZATION-CODE (44Ø-E5, Professional Service Code) GP Generic product selection
VVL.044 Drug Utilization Professional Service Code List DRUG-UTILIZATION-CODE (44Ø-E5, Professional Service Code) MA Medication administration
VVL.044 Drug Utilization Professional Service Code List DRUG-UTILIZATION-CODE (44Ø-E5, Professional Service Code) M0 Prescriber consulted
VVL.044 Drug Utilization Professional Service Code List DRUG-UTILIZATION-CODE (44Ø-E5, Professional Service Code) MR Medication review
VVL.044 Drug Utilization Professional Service Code List DRUG-UTILIZATION-CODE (44Ø-E5, Professional Service Code) PE Patient education/instruction
VVL.044 Drug Utilization Professional Service Code List DRUG-UTILIZATION-CODE (44Ø-E5, Professional Service Code) PH Patient medication history
VVL.044 Drug Utilization Professional Service Code List DRUG-UTILIZATION-CODE (44Ø-E5, Professional Service Code) PM Patient monitoring
VVL.044 Drug Utilization Professional Service Code List DRUG-UTILIZATION-CODE (44Ø-E5, Professional Service Code) P0 Patient consulted
VVL.044 Drug Utilization Professional Service Code List DRUG-UTILIZATION-CODE (44Ø-E5, Professional Service Code) PT Perform laboratory test
VVL.044 Drug Utilization Professional Service Code List DRUG-UTILIZATION-CODE (44Ø-E5, Professional Service Code) R0 Pharmacist consulted other source
VVL.044 Drug Utilization Professional Service Code List DRUG-UTILIZATION-CODE (44Ø-E5, Professional Service Code) RT Recommend laboratory test
VVL.044 Drug Utilization Professional Service Code List DRUG-UTILIZATION-CODE (44Ø-E5, Professional Service Code) SC Self-care consultation
VVL.044 Drug Utilization Professional Service Code List DRUG-UTILIZATION-CODE (44Ø-E5, Professional Service Code) SW Literature search/review
VVL.044 Drug Utilization Professional Service Code List DRUG-UTILIZATION-CODE (44Ø-E5, Professional Service Code) TC Payer/processor consulted
VVL.044 Drug Utilization Professional Service Code List DRUG-UTILIZATION-CODE (44Ø-E5, Professional Service Code) TH Therapeutic product interchange
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) AD Additional Drug Needed
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) AN Prescription Authentication
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) AR Adverse Drug Reaction
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) AT Additive Toxicity
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) CD Chronic Disease Management
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) CH Call Help Desk
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) CS Patient Complaint/Symptom
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) DA Drug-Allergy
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) DC Drug-Disease (Inferred)
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) DD Drug-Drug Interaction
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) DF Drug-Food interaction
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) DI Drug Incompatibility
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) DL Drug-Lab Conflict
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) DM Apparent Drug Misuse
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) DS Tobacco Use
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) ED Patient Education/Instruction
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) ER Overuse
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) EX Excessive Quantity
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) HD High Dose
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) IC Iatrogenic Condition
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) ID Ingredient Duplication
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) LD Low Dose
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) LK Lock In Recipient
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) LR Underuse
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) MC Drug-Disease (Reported)
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) MN Insufficient Duration
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) MS Missing Information/Clarification
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) MX Excessive Duration
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) NA Drug Not Available
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) NC Non-covered Drug Purchase
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) ND New Disease/Diagnosis
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) NF Non-Formulary Drug
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) NN Unnecessary Drug
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) NP New Patient Processing
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) NR Lactation/Nursing Interaction
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) NS Insufficient Quantity
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) OH Alcohol Conflict
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) PA Drug-Age
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) PC Patient Question/Concern
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) PG Drug-Pregnancy
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) PH Preventive Health Care
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) PN Prescriber Consultation
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) PP Plan Protocol
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) PR Prior Adverse Reaction
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) PS Product Selection Opportunity
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) RE Suspected Environmental Risk
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) RF Health Provider Referral
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) SR Suboptimal Regimen
VVL.045 Drug Utilization Reason for Service Code List DRUG-UTILIZATION-CODE (439-E4, Reason for Service Code) TD Therapeutic
VVL.046 Drug Utilization Result of Service Code List DRUG-UTILIZATION-CODE (441-E6, Result of Service Code) 00 Not Specified
VVL.046 Drug Utilization Result of Service Code List DRUG-UTILIZATION-CODE (441-E6, Result of Service Code) 1A Filled As Is, False Positive
VVL.046 Drug Utilization Result of Service Code List DRUG-UTILIZATION-CODE (441-E6, Result of Service Code) 1B Filled Prescription As Is
VVL.046 Drug Utilization Result of Service Code List DRUG-UTILIZATION-CODE (441-E6, Result of Service Code) 1C Filled, With Different Dose
VVL.046 Drug Utilization Result of Service Code List DRUG-UTILIZATION-CODE (441-E6, Result of Service Code) 1D Filled, With Different Directions
VVL.046 Drug Utilization Result of Service Code List DRUG-UTILIZATION-CODE (441-E6, Result of Service Code) 1E Filled, With Different Drug
VVL.046 Drug Utilization Result of Service Code List DRUG-UTILIZATION-CODE (441-E6, Result of Service Code) 1F Filled, With Different Quantity
VVL.046 Drug Utilization Result of Service Code List DRUG-UTILIZATION-CODE (441-E6, Result of Service Code) 1G Filled, With Prescriber Approval
VVL.046 Drug Utilization Result of Service Code List DRUG-UTILIZATION-CODE (441-E6, Result of Service Code) 1H Brand-to-Generic Change
VVL.046 Drug Utilization Result of Service Code List DRUG-UTILIZATION-CODE (441-E6, Result of Service Code) 1J Rx-to-OTC Change
VVL.046 Drug Utilization Result of Service Code List DRUG-UTILIZATION-CODE (441-E6, Result of Service Code) 1K Filled with Different Dosage Form
VVL.046 Drug Utilization Result of Service Code List DRUG-UTILIZATION-CODE (441-E6, Result of Service Code) 2A Prescription Not Filled
VVL.046 Drug Utilization Result of Service Code List DRUG-UTILIZATION-CODE (441-E6, Result of Service Code) 2B Not Filled, Directions Clarified
VVL.046 Drug Utilization Result of Service Code List DRUG-UTILIZATION-CODE (441-E6, Result of Service Code) 3A Recommendation Accepted
VVL.046 Drug Utilization Result of Service Code List DRUG-UTILIZATION-CODE (441-E6, Result of Service Code) 3B Recommendation Not Accepted
VVL.046 Drug Utilization Result of Service Code List DRUG-UTILIZATION-CODE (441-E6, Result of Service Code) 3C Discontinued Drug
VVL.046 Drug Utilization Result of Service Code List DRUG-UTILIZATION-CODE (441-E6, Result of Service Code) 3D Regimen Changed
VVL.046 Drug Utilization Result of Service Code List DRUG-UTILIZATION-CODE (441-E6, Result of Service Code) 3E Therapy Changed
VVL.046 Drug Utilization Result of Service Code List DRUG-UTILIZATION-CODE (441-E6, Result of Service Code) 3F Therapy Changed-cost increased acknowledged
VVL.046 Drug Utilization Result of Service Code List DRUG-UTILIZATION-CODE (441-E6, Result of Service Code) 3G Drug Therapy Unchanged
VVL.046 Drug Utilization Result of Service Code List DRUG-UTILIZATION-CODE (441-E6, Result of Service Code) 3H Follow-Up/Report
VVL.046 Drug Utilization Result of Service Code List DRUG-UTILIZATION-CODE (441-E6, Result of Service Code) 3J Patient Referral
VVL.046 Drug Utilization Result of Service Code List DRUG-UTILIZATION-CODE (441-E6, Result of Service Code) 3K Instructions Understood
VVL.046 Drug Utilization Result of Service Code List DRUG-UTILIZATION-CODE (441-E6, Result of Service Code) 3M Compliance Aid Provided
VVL.046 Drug Utilization Result of Service Code List DRUG-UTILIZATION-CODE (441-E6, Result of Service Code) 3N Medication Administered
VVL.047 Dual Eligible Code List DUAL-ELIGIBLE-CODE 00 Eligible is not a Medicare beneficiary
VVL.047 Dual Eligible Code List DUAL-ELIGIBLE-CODE 01 Eligible is entitled to Medicare - QMB only
VVL.047 Dual Eligible Code List DUAL-ELIGIBLE-CODE 02 Eligible is entitled to Medicare - QMB AND Medicaid coverage
VVL.047 Dual Eligible Code List DUAL-ELIGIBLE-CODE 03 Eligible is entitled to Medicare - SLMB only
VVL.047 Dual Eligible Code List DUAL-ELIGIBLE-CODE 04 Eligible is entitled to Medicare - SLMB AND Medicaid coverage
VVL.047 Dual Eligible Code List DUAL-ELIGIBLE-CODE 05 Eligible is entitled to Medicare - QDWI
VVL.047 Dual Eligible Code List DUAL-ELIGIBLE-CODE 06 Eligible is entitled to Medicare - Qualifying individuals
VVL.047 Dual Eligible Code List DUAL-ELIGIBLE-CODE 08 Eligible is entitled to Medicare - Other Dual Eligibles (Non QMB, SLMB, QDWI or QI)
VVL.047 Dual Eligible Code List DUAL-ELIGIBLE-CODE 09 Eligible is entitled to Medicare - Other (This code is to be used only with specific CMS approval.)
VVL.047 Dual Eligible Code List DUAL-ELIGIBLE-CODE 10 Separate CHIP Eligible is entitled to Medicare
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 01 Parents and Other Caretaker Relatives
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 02 Transitional Medical Assistance
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 03 Extended Medicaid due to Earnings
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 04 Extended Medicaid due to Spousal Support Collections
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 05 Pregnant Women
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 06 Deemed Newborns
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 07 Infants and Children under Age 19
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 08 Children with Title IV-E Adoption Assistance, Foster Care or Guardianship Care
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 09 Former Foster Care Children
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 10 Individuals at or below 133% FPL Age 19 through 64|Non-pregnant individuals aged 19 through 64, not otherwise mandatorily eligible, with income at or below 133% FPL
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 11 Individuals Receiving SSI
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 12 Aged, Blind and Disabled Individuals in 209(b) States
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 13 Individuals Receiving Mandatory State Supplements
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 14 Individuals Who Are Essential Spouses
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 15 Institutionalized Individuals Continuously Eligible Since 1973
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 16 Blind or Disabled Individuals Eligible in 1973
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 17 Individuals Who Lost Eligibility for SSI/SSP Due to an Increase in OASDI Benefits in 1972
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 18 Individuals Who Would be Eligible for SSI/SSP but for OASDI COLA increases since April, 1977
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 19 Disabled Widows and Widowers Ineligible for SSI due to Increase in OASDI
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 20 Disabled Widows and Widowers Ineligible for SSI due to Early Receipt of Social Security
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 21 Working Disabled under 1619(b)
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 22 Disabled Adult Children
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 23 Qualified Medicare Beneficiaries
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 24 Qualified Disabled and Working Individuals
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 25 Specified Low Income Medicare Beneficiaries
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 26 Qualifying Individuals
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 27 Optional Coverage of Parents and Other Caretaker Relatives
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 28 Reasonable Classifications of Individuals under Age 21
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 29 Children with Non-IV-E Adoption Assistance
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 30 Independent Foster Care Adolescents
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 31 Optional Targeted Low Income Children
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 32 Individuals Electing COBRA Continuation Coverage
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 33 Individuals above 133% FPL under Age 65
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 34 Certain Individuals Needing Treatment for Breast or Cervical Cancer
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 35 Individuals Eligible for Family Planning Services
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 36 Individuals with Tuberculosis
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 37 Aged, Blind or Disabled Individuals Eligible for but Not Receiving Cash Assistance
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 38 Individuals Eligible for Cash Assistance except for Institutionalization
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 39 Individuals Receiving Home and Community Based Services under Institutional Rules
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 40 Optional State Supplement Recipients - 1634 States, and SSI Criteria States with 1616 Agreements
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 41 Optional State Supplement Recipients - 209(b) States, and SSI Criteria States without 1616 Agreements
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 42 Institutionalized Individuals Eligible under a Special Income Level
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 43 Individuals participating in a PACE Program under Institutional Rules
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 44 Individuals Receiving Hospice Care
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 45 Qualified Disabled Children under Age 19
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 46 Poverty Level Aged or Disabled
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 47 Work Incentives Eligibility Group
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 48 Ticket to Work Basic Group
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 49 Ticket to Work Medical Improvements Group
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 50 Family Opportunity Act Children with Disabilities
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 51 Individuals Eligible for Home and Community-Based Services
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 52 Individuals Eligible for Home and Community-Based Services - Special Income Level
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 53 Medically Needy Pregnant Women
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 54 Medically Needy Children under Age 18
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 55 Medically Needy Children Age 18 through 20
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 56 Medically Needy Parents and Other Caretakers
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 59 Medically Needy Aged, Blind or Disabled
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 60 Medically Needy Blind or Disabled Individuals Eligible in 1973
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 61 Targeted Low-Income Children
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 62 Deemed Newborn
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 63 Children Ineligible for Medicaid Due to Loss of Income Disregards
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 64 Coverage from Conception to Birth
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 65 Children with Access to Public Employee Coverage
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 66 Children Eligible for Dental Only Supplemental Coverage
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 67 Targeted Low-Income Pregnant Women
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 68 Pregnant Women with Access to Public Employee Coverage
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 69 Individuals with Mental Health Conditions (expansion group)
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 70 Family Planning Participants (expansion group)
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 71 Other expansion group
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 72 Adult Group - Individuals at or below 133% FPL Age 19 through 64 - newly eligible for all states
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 73 Adult Group - Individuals at or below 133% FPL Age 19 through 64 - not newly eligible for non 1905z(3) states
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 74 Adult Group - Individuals at or below 133% FPL Age 19 through 64 - not newly eligible parent/ caretaker-relative(s) in 1905z(3) states
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 75 Adult Group - Individuals at or below 133% FPL Age 19 through 64 - not newly eligible non-parent/ caretaker-relative(s) in 1905z(3) states
VVL.048 Eligibility Group List ELIGIBILITY-GROUP 76 Uninsured Individual eligible for COVID-19 testing
VVL.051 Eligibility Change Reason List ELIGIBILITY-CHANGE-REASON 01 Excess income
VVL.051 Eligibility Change Reason List ELIGIBILITY-CHANGE-REASON 02 Excess assets
VVL.051 Eligibility Change Reason List ELIGIBILITY-CHANGE-REASON 03 Income reduced
VVL.051 Eligibility Change Reason List ELIGIBILITY-CHANGE-REASON 04 Aged out of program
VVL.051 Eligibility Change Reason List ELIGIBILITY-CHANGE-REASON 05 No longer in the foster care system
VVL.051 Eligibility Change Reason List ELIGIBILITY-CHANGE-REASON 06 Death
VVL.051 Eligibility Change Reason List ELIGIBILITY-CHANGE-REASON 07 No longer disabled
VVL.051 Eligibility Change Reason List ELIGIBILITY-CHANGE-REASON 08 No longer institutionalized
VVL.051 Eligibility Change Reason List ELIGIBILITY-CHANGE-REASON 09 No longer in need of long-term care services resides
VVL.051 Eligibility Change Reason List ELIGIBILITY-CHANGE-REASON 10 Obtained employer sponsored insurance (ESI)
VVL.051 Eligibility Change Reason List ELIGIBILITY-CHANGE-REASON 11 Gained access to public employees health plan
VVL.051 Eligibility Change Reason List ELIGIBILITY-CHANGE-REASON 12 Obtained other coverage (not ESI or public employees health plan)
VVL.051 Eligibility Change Reason List ELIGIBILITY-CHANGE-REASON 13 Failure to respond
VVL.051 Eligibility Change Reason List ELIGIBILITY-CHANGE-REASON 14 Failure to pay premium or enrollment fees
VVL.051 Eligibility Change Reason List ELIGIBILITY-CHANGE-REASON 15 Moved to a different state
VVL.051 Eligibility Change Reason List ELIGIBILITY-CHANGE-REASON 16 Voluntary request for termination
VVL.051 Eligibility Change Reason List ELIGIBILITY-CHANGE-REASON 17 Lack of verifications
VVL.051 Eligibility Change Reason List ELIGIBILITY-CHANGE-REASON 18 Fraud
VVL.051 Eligibility Change Reason List ELIGIBILITY-CHANGE-REASON 19 Suspension due to incarceration
VVL.051 Eligibility Change Reason List ELIGIBILITY-CHANGE-REASON 20 Residence in an Institution for Mental Disease (IMD)
VVL.051 Eligibility Change Reason List ELIGIBILITY-CHANGE-REASON 21 Suspension/Termination with reason unknown
VVL.051 Eligibility Change Reason List ELIGIBILITY-CHANGE-REASON 22 Other
VVL.052 US County Code List ADDR-COUNTY / ELIGIBLE-COUNTY-CODE / MANAGED-CARE-COUNTY Not Applicable This URL will take the reader to the American National Standards Institute (ANSI) Website for the various geographical code sets:
VVL.052 US County Code List ADDR-COUNTY / ELIGIBLE-COUNTY-CODE / MANAGED-CARE-COUNTY Not Applicable US County Code List
VVL.052 US County Code List ADDR-COUNTY / ELIGIBLE-COUNTY-CODE / MANAGED-CARE-COUNTY Not Applicable Once at the Website, the reader should scroll down to the section entitled "State and State Equivalents" for the state codes, "FIPS Codes for Outlying Areas of the United States and the Freely Associated States" for the territory codes and "County Subdivision" for the county codes.
VVL.054 Enrollment Type List ENROLLMENT-TYPE 1 Medicaid or Medicaid Expansion CHIP
VVL.054 Enrollment Type List ENROLLMENT-TYPE 2 Separate Title XXI CHIP
VVL.055 Ethnicity Code List ETHNICITY-CODE 0 Not of Hispanic or, Latino/a, or Spanish origin
VVL.055 Ethnicity Code List ETHNICITY-CODE 1 Mexican, Mexican American, Chicano/a
VVL.055 Ethnicity Code List ETHNICITY-CODE 2 Puerto Rican
VVL.055 Ethnicity Code List ETHNICITY-CODE 3 Cuban
VVL.055 Ethnicity Code List ETHNICITY-CODE 4 Another Hispanic, Latino, or Spanish origin
VVL.055 Ethnicity Code List ETHNICITY-CODE 5 Hispanic or Latino Unknown
VVL.055 Ethnicity Code List ETHNICITY-CODE 6 Ethnicity Unspecified
VVL.056 File Encoding Specification List FILE-ENCODING-SPECIFICATION FLF The file follows a fixed length format
VVL.056 File Encoding Specification List FILE-ENCODING-SPECIFICATION PSV The file follows a pipe-delimited format
VVL.058 File Status Indicator List FILE-STATUS-INDICATOR P Production file
VVL.058 File Status Indicator List FILE-STATUS-INDICATOR T Test file
VVL.059 Fixed Payment Indicator List FIXED-PAYMENT-IND 0 Not Fixed Payment
VVL.059 Fixed Payment Indicator List FIXED-PAYMENT-IND 1 FFS Fixed Payment
VVL.060 Forced Claim Indicator List FORCED-CLAIM-IND 0 No
VVL.060 Forced Claim Indicator List FORCED-CLAIM-IND 1 Yes
VVL.061 Funding Code List FUNDING-CODE A Medicaid Agency
VVL.061 Funding Code List FUNDING-CODE B CHIP Agency
VVL.061 Funding Code List FUNDING-CODE C Mental Health Service Agency
VVL.061 Funding Code List FUNDING-CODE D Education Agency
VVL.061 Funding Code List FUNDING-CODE E Child and Family Services Agency
VVL.061 Funding Code List FUNDING-CODE F County
VVL.061 Funding Code List FUNDING-CODE G City
VVL.061 Funding Code List FUNDING-CODE H Providers
VVL.061 Funding Code List FUNDING-CODE I Other
VVL.062 Funding Source Non-Federal Share List FUNDING-SOURCE-NONFEDERAL-SHARE 01 State appropriations to the Medicaid agency
VVL.062 Funding Source Non-Federal Share List FUNDING-SOURCE-NONFEDERAL-SHARE 02 Intergovernmental transfers (IGT)
VVL.062 Funding Source Non-Federal Share List FUNDING-SOURCE-NONFEDERAL-SHARE 03 Certified public expenditures (CPE)
VVL.062 Funding Source Non-Federal Share List FUNDING-SOURCE-NONFEDERAL-SHARE 04 Provider taxes
VVL.062 Funding Source Non-Federal Share List FUNDING-SOURCE-NONFEDERAL-SHARE 05 Donations
VVL.062 Funding Source Non-Federal Share List FUNDING-SOURCE-NONFEDERAL-SHARE 06 State appropriations to the CHIP agency
VVL.063 Health Home Chronic Condition List HEALTH-HOME-CHRONIC-CONDITION A Mental health
VVL.063 Health Home Chronic Condition List HEALTH-HOME-CHRONIC-CONDITION B Substance abuse
VVL.063 Health Home Chronic Condition List HEALTH-HOME-CHRONIC-CONDITION C Asthma
VVL.063 Health Home Chronic Condition List HEALTH-HOME-CHRONIC-CONDITION D Diabetes
VVL.063 Health Home Chronic Condition List HEALTH-HOME-CHRONIC-CONDITION E Heart disease
VVL.063 Health Home Chronic Condition List HEALTH-HOME-CHRONIC-CONDITION F Overweight (BMI of >25)
VVL.063 Health Home Chronic Condition List HEALTH-HOME-CHRONIC-CONDITION G HIV/AIDS
VVL.063 Health Home Chronic Condition List HEALTH-HOME-CHRONIC-CONDITION H Other
VVL.064 HCBS Chronic Condition Non Health Home Code List HCBS-CHRONIC-CONDITION-NON-HEALTH-HOME-CODE 001 Aged
VVL.064 HCBS Chronic Condition Non Health Home Code List HCBS-CHRONIC-CONDITION-NON-HEALTH-HOME-CODE 002 Physical Disabilities
VVL.064 HCBS Chronic Condition Non Health Home Code List HCBS-CHRONIC-CONDITION-NON-HEALTH-HOME-CODE 003 Intellectual Disabilities
VVL.064 HCBS Chronic Condition Non Health Home Code List HCBS-CHRONIC-CONDITION-NON-HEALTH-HOME-CODE 004 Autism Spectrum Disorder
VVL.064 HCBS Chronic Condition Non Health Home Code List HCBS-CHRONIC-CONDITION-NON-HEALTH-HOME-CODE 005 Developmental Disabilities
VVL.064 HCBS Chronic Condition Non Health Home Code List HCBS-CHRONIC-CONDITION-NON-HEALTH-HOME-CODE 006 Mental Illness and/or Serious Emotional Disturbance
VVL.064 HCBS Chronic Condition Non Health Home Code List HCBS-CHRONIC-CONDITION-NON-HEALTH-HOME-CODE 007 Brain Injury
VVL.064 HCBS Chronic Condition Non Health Home Code List HCBS-CHRONIC-CONDITION-NON-HEALTH-HOME-CODE 008 HIV/AIDS
VVL.064 HCBS Chronic Condition Non Health Home Code List HCBS-CHRONIC-CONDITION-NON-HEALTH-HOME-CODE 009 Technology Dependent or Medically Fragile
VVL.064 HCBS Chronic Condition Non Health Home Code List HCBS-CHRONIC-CONDITION-NON-HEALTH-HOME-CODE 010 Disabled (other)
VVL.065 HCBS Service Code List HCBS-SERVICE-CODE 1 The HCBS service was provided under 1915(i)
VVL.065 HCBS Service Code List HCBS-SERVICE-CODE 2 The HCBS service was provided under 1915(j)
VVL.065 HCBS Service Code List HCBS-SERVICE-CODE 3 The HCBS service was provided under 1915(k)
VVL.065 HCBS Service Code List HCBS-SERVICE-CODE 4 The HCBS service was provided under a 1915(c) HCBS Waiver
VVL.065 HCBS Service Code List HCBS-SERVICE-CODE 5 The HCBS service was provided under an 1115 waiver
VVL.065 HCBS Service Code List HCBS-SERVICE-CODE 6 The HCBS service was not provided under the statutes identified above and was of an acute care nature
VVL.065 HCBS Service Code List HCBS-SERVICE-CODE 7 The HCBS service was not provided under the statutes identified above and was of a long term care nature
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 01010 Case Management
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 02011 Group Living, Residential Habilitation
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 02012 Group Living, Mental Health Services
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 02013 Group Living, Other
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 02021 Shared Living, Residential Habilitation
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 02022 Shared Living, Mental Health Services
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 02023 Shared Living, Other
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 02031 In-e Residential Habilitation
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 02032 In-Home Round-The-Clock Mental Health Services
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 02033 In-Home Round-The-Clock Services, Other
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 03010 Job Development
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 03021 Ongoing Supported Employment, Individual
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 03022 Ongoing Supported Employment, Group
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 03030 Career Planning
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 04010 Prevocational Services
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 04020 Day Habilitation
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 04030 Education Services
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 04040 Day Treatment/Partial Hospitalization
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 04050 Adult Day Health
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 04060 Adult Day Services (Social Model)
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 04070 Community Integration
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 04080 Medical Day Care for Children
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 05010 Private Duty Nursing
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 05020 Skilled Nursing
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 06010 Home Delivered Meals
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 07010 Rent and Food Expenses For Live-In Caregiver
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 08010 Home-Based Habilitation
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 08020 Home Health Aide
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 08030 Personal Care
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 08040 Companion
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 08050 Homemaker
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 08060 Chore
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 09011 Respite, Out-Of-Home
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 09012 Respite, In-Home
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 09020 Caregiver Counseling and/or Training
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 10010 Mental Health Assessment
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 10020 Assertive Community Treatment
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 10030 Crisis Intervention
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 10040 Behavior Support
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 10050 Peer Specialist
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 10060 Counseling
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 10070 Psychosocial Rehabilitation
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 10080 Clinic Services
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 10090 Other Mental Health and Behavioral Services
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 11010 Health Monitoring
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 11020 Health Assessment
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 11030 Medication Assessment and/or Management
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 11040 Nutrition Consultation
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 11050 Physician Services
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 11060 Prescription Drugs
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 11070 Dental Services
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 11080 Occupational Therapy
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 11090 Physical Therapy
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 11100 Speech, Hearing, And Language Therapy
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 11110 Respiratory Therapy
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 11120 Cognitive Rehabilitative Therapy
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 11130 Other Therapies
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 12010 Financial Management Services In Support Of Participant Direction
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 12020 Information and Assistance In Support Of Participant Direction
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 13010 Participant Training
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 14010 Personal Emergency Response System (Pers)
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 14020 Home and/or Vehicle Accessibility Adaptations
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 14031 Equipment and Technology
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 14032 Supplies
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 15010 Non-Medical Transportation
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 16010 Community Transition Services
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 17010 Goods and Services
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 17020 Interpreter
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 17030 Housing Consultation
VVL.066 HCBS Taxonomy Code List HCBS-TAXONOMY 17990 Other
VVL.067 Hour List ADMISSION-HOUR DISCHARGE-HOUR 00 0:00-0:59
VVL.067 Hour List ADMISSION-HOUR DISCHARGE-HOUR 01 1:00-1:59
VVL.067 Hour List ADMISSION-HOUR DISCHARGE-HOUR 02 2:00-2:59
VVL.067 Hour List ADMISSION-HOUR DISCHARGE-HOUR 03 3:00-3:59
VVL.067 Hour List ADMISSION-HOUR DISCHARGE-HOUR 04 4:00-4:59
VVL.067 Hour List ADMISSION-HOUR DISCHARGE-HOUR 05 5:00-5:59
VVL.067 Hour List ADMISSION-HOUR DISCHARGE-HOUR 06 6:00-6:59
VVL.067 Hour List ADMISSION-HOUR DISCHARGE-HOUR 07 7:00-7:59
VVL.067 Hour List ADMISSION-HOUR DISCHARGE-HOUR 08 8:00-8:59
VVL.067 Hour List ADMISSION-HOUR DISCHARGE-HOUR 09 9:00-9:59
VVL.067 Hour List ADMISSION-HOUR DISCHARGE-HOUR 10 10:00-10:59
VVL.067 Hour List ADMISSION-HOUR DISCHARGE-HOUR 11 11:00-11:59
VVL.067 Hour List ADMISSION-HOUR DISCHARGE-HOUR 12 12:00-12:59
VVL.067 Hour List ADMISSION-HOUR DISCHARGE-HOUR 13 13:00-13:59
VVL.067 Hour List ADMISSION-HOUR DISCHARGE-HOUR 14 14:00-14:59
VVL.067 Hour List ADMISSION-HOUR DISCHARGE-HOUR 15 15:00-15:59
VVL.067 Hour List ADMISSION-HOUR DISCHARGE-HOUR 16 16:00-16:59
VVL.067 Hour List ADMISSION-HOUR DISCHARGE-HOUR 17 17:00-17:59
VVL.067 Hour List ADMISSION-HOUR DISCHARGE-HOUR 18 18:00-18:59
VVL.067 Hour List ADMISSION-HOUR DISCHARGE-HOUR 19 19:00-19:59
VVL.067 Hour List ADMISSION-HOUR DISCHARGE-HOUR 20 20:00-20:59
VVL.067 Hour List ADMISSION-HOUR DISCHARGE-HOUR 21 21:00-21:59
VVL.067 Hour List ADMISSION-HOUR DISCHARGE-HOUR 22 22:00-22:59
VVL.067 Hour List ADMISSION-HOUR DISCHARGE-HOUR 23 23:00-23:59
VVL.068 Household Size List HOUSEHOLD-SIZE 01 1 person
VVL.068 Household Size List HOUSEHOLD-SIZE 02 2 people
VVL.068 Household Size List HOUSEHOLD-SIZE 03 3 people
VVL.068 Household Size List HOUSEHOLD-SIZE 04 4 people
VVL.068 Household Size List HOUSEHOLD-SIZE 05 5 people
VVL.068 Household Size List HOUSEHOLD-SIZE 06 6 people
VVL.068 Household Size List HOUSEHOLD-SIZE 07 7 people
VVL.068 Household Size List HOUSEHOLD-SIZE 08 8 or more people
VVL.069 Immigration Status List IMMIGRATION-STATUS 1 Qualified non-citizen
VVL.069 Immigration Status List IMMIGRATION-STATUS 2 Lawfully present under CHIPRA 214
VVL.069 Immigration Status List IMMIGRATION-STATUS 3 Eligible only for payment for emergency services
VVL.069 Immigration Status List IMMIGRATION-STATUS 8 U.S. citizen
VVL.070 Immigration Verification Flag List IMMIGRATION-VERIFICATION-FLAG 0 Immigration Status Verified
VVL.070 Immigration Verification Flag List IMMIGRATION-VERIFICATION-FLAG 1 Enrolled in Medicaid pending immigration verification
VVL.071 Income Code List INCOME-CODE 01 Individuals State-defined family income is from 0 to 100% of the FPL
VVL.071 Income Code List INCOME-CODE 02 Individuals State-defined family income is from 101 to 133% of the FPL
VVL.071 Income Code List INCOME-CODE 03 Individuals State-defined family income is from 134 to 150% of the FPL
VVL.071 Income Code List INCOME-CODE 04 Individuals State-defined family income is from 151 to 200% of the FPL
VVL.071 Income Code List INCOME-CODE 05 Individuals State-defined family income is from 201 to 255% of the FPL
VVL.071 Income Code List INCOME-CODE 06 Individuals State-defined family income is from 256 to 300% of the FPL
VVL.071 Income Code List INCOME-CODE 07 Individuals State-defined family income is from 301 to 400% of the FPL
VVL.071 Income Code List INCOME-CODE 08 Individuals State-defined family income is over 400% of the FPL
VVL.072 Type of Service (Inpatient Claim) List TYPE-OF-SERVICE 001 Inpatient hospital services, other than services in an institution for mental diseases
VVL.072 Type of Service (Inpatient Claim) List TYPE-OF-SERVICE 058 Services furnished in a religious nonmedical health care institution
VVL.072 Type of Service (Inpatient Claim) List TYPE-OF-SERVICE 060 Emergency hospital services
VVL.072 Type of Service (Inpatient Claim) List TYPE-OF-SERVICE 084 Sterilizations
VVL.072 Type of Service (Inpatient Claim) List TYPE-OF-SERVICE 086 Other Pregnancy-related Procedures
VVL.072 Type of Service (Inpatient Claim) List TYPE-OF-SERVICE 090 Critical access hospital services - IP
VVL.072 Type of Service (Inpatient Claim) List TYPE-OF-SERVICE 091 Skilled care - hospital residing
VVL.072 Type of Service (Inpatient Claim) List TYPE-OF-SERVICE 092 Exceptional care - hospital residing
VVL.072 Type of Service (Inpatient Claim) List TYPE-OF-SERVICE 093 Non-acute care - hospital residing
VVL.072 Type of Service (Inpatient Claim) List TYPE-OF-SERVICE 123 Disproportionate share hospital (DSH) payments
VVL.072 Type of Service (Inpatient Claim) List TYPE-OF-SERVICE 132 Supplemental payment - inpatient
VVL.072 Type of Service (Inpatient Claim) List TYPE-OF-SERVICE 135 EHR payments to provider
VVL.072 Type of Service (Inpatient Claim) List TYPE-OF-SERVICE 136 In vitro diagnostic products (as defined in section 809.3(a) of title 21, Code of Federal Regulations) administered during any portion of the emergency period defined in paragraph (1)(B) of section 1135(g) beginning on or after the date of the enactment of this subparagraph for the detection of SARSCoV2 or the diagnosis of the virus that causes COVID-19, and the administration of such in vitro diagnostic products
VVL.072 Type of Service (Inpatient Claim) List TYPE-OF-SERVICE 137 COVID-19 testing-related services
VVL.073 Insurance Plan Type List INSURANCE-PLAN-TYPE 01 Medical or comprehensive health insurance plan (e.g. HMO)
VVL.073 Insurance Plan Type List INSURANCE-PLAN-TYPE 02 Dental health insurance plan
VVL.073 Insurance Plan Type List INSURANCE-PLAN-TYPE 03 Vision health insurance plan
VVL.073 Insurance Plan Type List INSURANCE-PLAN-TYPE 04 Prenatal/delivery health insurance plan
VVL.073 Insurance Plan Type List INSURANCE-PLAN-TYPE 05 Long term care health insurance plan (Long Term PIHP)
VVL.073 Insurance Plan Type List INSURANCE-PLAN-TYPE 06 Transportation health insurance plan (Transportation PAHP)
VVL.073 Insurance Plan Type List INSURANCE-PLAN-TYPE 07 A managed care plan
VVL.073 Insurance Plan Type List INSURANCE-PLAN-TYPE 08 Disease management health insurance plan (Disease Management PAHP)
VVL.073 Insurance Plan Type List INSURANCE-PLAN-TYPE 09 PAHP (Medical only)
VVL.073 Insurance Plan Type List INSURANCE-PLAN-TYPE 10 Comprehensive health insurance and Long Term Care (hybrid)
VVL.073 Insurance Plan Type List INSURANCE-PLAN-TYPE 11 Other health insurance plan
VVL.073 Insurance Plan Type List INSURANCE-PLAN-TYPE 12 Veterans Administration health benefits
VVL.073 Insurance Plan Type List INSURANCE-PLAN-TYPE 13 Indian Health Service Program health benefits
VVL.073 Insurance Plan Type List INSURANCE-PLAN-TYPE 14 TRICARE health benefits
VVL.073 Insurance Plan Type List INSURANCE-PLAN-TYPE 15 Eligible enrolled in private LTC insurance
VVL.073 Insurance Plan Type List INSURANCE-PLAN-TYPE 16 Fee-for-Service insurance
VVL.074 Level of Care Status List LEVEL-OF-CARE-STATUS 001 Hospital as defined in 42 CFR 440.10
VVL.074 Level of Care Status List LEVEL-OF-CARE-STATUS 002 Inpatient psychiatric facility for individuals under age 21 as provided in 42 CFR 440.160
VVL.074 Level of Care Status List LEVEL-OF-CARE-STATUS 003 Nursing Facility
VVL.074 Level of Care Status List LEVEL-OF-CARE-STATUS 004 ICF/IDD
VVL.074 Level of Care Status List LEVEL-OF-CARE-STATUS 005 Other Type of Facility
VVL.074 Level of Care Status List LEVEL-OF-CARE-STATUS 888 Not Applicable (Not in LTSS program)
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 01 Physician
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 02 Speech Language Pathologist
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 03 Oral Surgery (Dentist only)
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 04 Cardiac Rehabilitation and Intensive Cardiac Rehabilitation
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 05 Anesthesiology Assistant
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 06 Chiropractic
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 07 Optometry
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 08 Certified Nurse Midwife
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 09 Certified Registered Nurse Anesthetist (CRNA)
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 10 Mammography Center
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 11 Independent Diagnostic Testing Facility (IDTF)
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 12 Podiatry
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 13 Ambulatory Surgical Center
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 14 Nurse Practitioner
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 15 Medical Supply Company with Orthotist
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 16 Medical Supply Company with Prosthetist
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 17 Medical Supply Company with Orthotist-Prosthetist
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 18 Other Medical Supply Company
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 19 Individual Certified Orthotist
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 20 Individual Certified Prosthetist
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 21 Individual Certified Prosthetist-Orthotist
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 22 Medical Supply Company with Pharmacist
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 23 Ambulance Service Provider
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 24 Public Health or Welfare Agency
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 25 Voluntary Health or Charitable Agency
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 26 Psychologist, Clinical
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 27 Portable X-Ray Supplier
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 28 Audiologist
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 29 Physical Therapist in Private Practice
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 30 Occupational Therapist in Private Practice
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 31 Clinical Laboratory
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 32 Clinic or Group Practice
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 33 Registered Dietitian or Nutrition Professional
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 34 Mass Immunizer Roster Biller
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 35 Radiation Therapy Center
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 36 Slide Preparation Facility
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 37 Licensed Clinical Social Worker
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 38 Certified Clinical Nurse Specialist
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 39 Advance Diagnostic Imaging
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 40 Optician
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 41 Physician Assistant
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 42 Hospital-General
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 43 Skilled Nursing Facility
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 44 Intermediate Care Nursing Facility
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 45 Other Nursing Facility
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 46 Home Health Agency
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 47 Pharmacy
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 48 Medical Supply Company with Respiratory Therapist
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 49 Department Store
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 50 Grocery Store
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 51 Indian Health Service facility
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 52 Oxygen supplier
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 53 Pedorthic personnel
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 54 Medical supply company with pedorthic personnel
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 55 Rehabilitation Agency
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 56 Ocularist
VVL.075 Lockin Provider Type List LOCKIN-PROV-TYPE 57 All Other
VVL.076 Type of Service (Long Term Claim) List TYPE-OF-SERVICE 009 Nursing facility services for individuals age 21 or older (other than services in an institution for mental disease)
VVL.076 Type of Service (Long Term Claim) List TYPE-OF-SERVICE 044 Inpatient hospital services for individuals age 65 or older in institutions for mental diseases
VVL.076 Type of Service (Long Term Claim) List TYPE-OF-SERVICE 045 Nursing facility services for individuals age 65 or older in institutions for mental diseases
VVL.076 Type of Service (Long Term Claim) List TYPE-OF-SERVICE 046 Intermediate care facility (ICF/IID) services
VVL.076 Type of Service (Long Term Claim) List TYPE-OF-SERVICE 047 Nursing facility services, other than in institutions for mental diseases
VVL.076 Type of Service (Long Term Claim) List TYPE-OF-SERVICE 048 Inpatient psychiatric services for individuals under age 21
VVL.076 Type of Service (Long Term Claim) List TYPE-OF-SERVICE 050 Inpatient substance abuse treatment services and residential substance abuse treatment services.
VVL.076 Type of Service (Long Term Claim) List TYPE-OF-SERVICE 059 Skilled nursing facility services for individuals under age 21
VVL.076 Type of Service (Long Term Claim) List TYPE-OF-SERVICE 133 Supplemental payment - nursing
VVL.076 Type of Service (Long Term Claim) List TYPE-OF-SERVICE 136 In vitro diagnostic products (as defined in section 809.3(a) of title 21, Code of Federal Regulations) administered during any portion of the emergency period defined in paragraph (1)(B) of section 1135(g) beginning on or after the date of the enactment of this subparagraph for the detection of SARS-CoV-2 or the diagnosis of the virus that causes COVID-19, and the administration of such in vitro diagnostic products
VVL.076 Type of Service (Long Term Claim) List TYPE-OF-SERVICE 137 COVID-19 testing-related services
VVL.077 LTSS Level of Care List LTSS-LEVEL-CARE 1 Skilled Care
VVL.077 LTSS Level of Care List LTSS-LEVEL-CARE 2 Intermediate Care
VVL.077 LTSS Level of Care List LTSS-LEVEL-CARE 3 Custodial Care
VVL.079 Managed Care Address Type List MANAGED-CARE-ADDR-TYPE 1 MCOs corporate address and contact information
VVL.079 Managed Care Address Type List MANAGED-CARE-ADDR-TYPE 2 MCOs mailing address
VVL.079 Managed Care Address Type List MANAGED-CARE-ADDR-TYPE 3 MCOs service location address
VVL.079 Managed Care Address Type List MANAGED-CARE-ADDR-TYPE 4 MCOs Billing address and contact information
VVL.079 Managed Care Address Type List MANAGED-CARE-ADDR-TYPE 5 CEOs address and contact information
VVL.079 Managed Care Address Type List MANAGED-CARE-ADDR-TYPE 6 CFOs address and contact information
VVL.079 Managed Care Address Type List MANAGED-CARE-ADDR-TYPE 7 Other
VVL.080 Maintenance Assistance Status List MAINTENANCE-ASSISTANCE-STATUS 0 Eligible for Separate CHIP only
VVL.080 Maintenance Assistance Status List MAINTENANCE-ASSISTANCE-STATUS 1 Receiving Cash or eligible under section 1931 of the Act
VVL.080 Maintenance Assistance Status List MAINTENANCE-ASSISTANCE-STATUS 2 Medically Needy
VVL.080 Maintenance Assistance Status List MAINTENANCE-ASSISTANCE-STATUS 3 Poverty Related
VVL.080 Maintenance Assistance Status List MAINTENANCE-ASSISTANCE-STATUS 4 Other
VVL.080 Maintenance Assistance Status List MAINTENANCE-ASSISTANCE-STATUS 5 1115 - Demonstration expansion eligible
VVL.078 Provider Enrollment Method PROV-ENROLLMENT-METHOD 1 Enrolled through use of Medicare enrollment system (State did not require that provider submit application. Rather Provider is active Medicare provider and state Medicaid program accepted these credentials as sufficient to participate as state Medicaid provider.)
VVL.078 Provider Enrollment Method PROV-ENROLLMENT-METHOD 2 Enrolled through use of state-based provider application
VVL.078 Provider Enrollment Method PROV-ENROLLMENT-METHOD 3 Other 
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 01 Parents and Other Caretaker Relatives
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 02 Transitional Medical Assistance
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 03 Extended Medicaid due to Earnings
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 04 Extended Medicaid due to Spousal Support Collections
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 05 Pregnant Women
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 06 Deemed Newborns
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 07 Infants and Children under Age 19
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 08 Children with Title IV-E Adoption Assistance, Foster Care or Guardianship Care
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 09 Former Foster Care Children
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 10 Individuals at or below 133% FPL Age 19 through 64|Non-pregnant individuals aged 19 through 64, not otherwise mandatorily eligible, with income at or below 133% FPL
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 11 Individuals Receiving SSI
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 12 Aged, Blind and Disabled Individuals in 209(b) States
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 13 Individuals Receiving Mandatory State Supplements
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 14 Individuals Who Are Essential Spouses
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 15 Institutionalized Individuals Continuously Eligible Since 1973
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 16 Blind or Disabled Individuals Eligible in 1973
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 17 Individuals Who Lost Eligibility for SSI/SSP Due to an Increase in OASDI Benefits in 1972
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 18 Individuals Who Would be Eligible for SSI/SSP but for OASDI COLA increases since April, 1977
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 19 Disabled Widows and Widowers Ineligible for SSI due to Increase in OASDI
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 20 Disabled Widows and Widowers Ineligible for SSI due to Early Receipt of Social Security
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 21 Working Disabled under 1619(b)
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 22 Disabled Adult Children
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 23 Qualified Medicare Beneficiaries
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 24 Qualified Disabled and Working Individuals
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 25 Specified Low Income Medicare Beneficiaries
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 26 Qualifying Individuals
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 27 Optional Coverage of Parents and Other Caretaker Relatives
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 28 Reasonable Classifications of Individuals under Age 21
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 29 Children with Non-IV-E Adoption Assistance
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 30 Independent Foster Care Adolescents
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 31 Optional Targeted Low Income Children
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 32 Individuals Electing COBRA Continuation Coverage
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 33 Individuals above 133% FPL under Age 65
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 34 Certain Individuals Needing Treatment for Breast or Cervical Cancer
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 35 Individuals Eligible for Family Planning Services
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 36 Individuals with Tuberculosis
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 37 Aged, Blind or Disabled Individuals Eligible for but Not Receiving Cash Assistance
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 38 Individuals Eligible for Cash Assistance except for Institutionalization
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 39 Individuals Receiving Home and Community Based Services under Institutional Rules
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 40 Optional State Supplement Recipients - 1634 States, and SSI Criteria States with 1616 Agreements
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 41 Optional State Supplement Recipients - 209(b) States, and SSI Criteria States without 1616 Agreements
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 42 Institutionalized Individuals Eligible under a Special Income Level
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 43 Individuals participating in a PACE Program under Institutional Rules
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 44 Individuals Receiving Hospice Care
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 45 Qualified Disabled Children under Age 19
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 46 Poverty Level Aged or Disabled
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 47 Work Incentives Eligibility Group
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 48 Ticket to Work Basic Group
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 49 Ticket to Work Medical Improvements Group
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 50 Family Opportunity Act Children with Disabilities
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 51 Individuals Eligible for Home and Community-Based Services
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 52 Individuals Eligible for Home and Community-Based Services - Special Income Level
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 72 Adult Group - Individuals at or below 133% FPL Age 19 through 64 - newly eligible for all states
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 73 Adult Group - Individuals at or below 133% FPL Age 19 through 64- not newly eligible for non 1905z(3) states
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 74 Adult Group - Individuals at or below 133% FPL Age 19 through 64 not newly eligible parent/ caretaker-relative(s) in 1905z(3) states
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 75 Adult Group - Individuals at or below 133% FPL Age 19 through 64- not newly eligible non-parent/ caretaker-relative(s) in 1905z(3) states
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 53 Medically Needy Pregnant Women
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 54 Medically Needy Children under Age 18
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 55 Medically Needy Children Age 18 through 20
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 56 Medically Needy Parents and Other Caretakers
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 59 Medically Needy Aged, Blind or Disabled
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 60 Medically Needy Blind or Disabled Individuals Eligible in 1973
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 61 Targeted Low-Income Children
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 62 Deemed Newborn
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 63 Children Ineligible for Medicaid Due to Loss of Income Disregards
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 64 Coverage from Conception to Birth
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 65 Children with Access to Public Employee Coverage
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 66 Children Eligible for Dental Only Supplemental Coverage
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 67 Targeted Low-Income Pregnant Women
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 68 Pregnant Women with Access to Public Employee Coverage
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 69 Individuals with Mental Health Conditions (expansion group)
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 70 Family Planning Participants (expansion group)
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 71 Other expansion group
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 72 Adult Group - Individuals at or below 133% FPL Age 19 through 64 - newly eligible for all states
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 73 Adult Group - Individuals at or below 133% FPL Age 19 through 64- not newly eligible for non 1905z(3) states
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 74 Adult Group - Individuals at or below 133% FPL Age 19 through 64 not newly eligible parent/ caretaker-relative(s) in 1905z(3) states
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 75 Adult Group - Individuals at or below 133% FPL Age 19 through 64- not newly eligible non-parent/ caretaker-relative(s) in 1905z(3) states
VVL.081 Managed Care Plan Pop List MANAGED-CARE-PLAN-POP 76 Uninsured Individual eligible for COVID-19 testing
VVL.082 Managed Care Plan Type List MANAGED-CARE-PLAN-TYPE 01 Comprehensive MCO
VVL.082 Managed Care Plan Type List MANAGED-CARE-PLAN-TYPE 02 Traditional PCCM Provider arrangement
VVL.082 Managed Care Plan Type List MANAGED-CARE-PLAN-TYPE 03 Enhanced PCCM Provider arrangement
VVL.082 Managed Care Plan Type List MANAGED-CARE-PLAN-TYPE 04 Health Insuring Organization (HIO)
VVL.082 Managed Care Plan Type List MANAGED-CARE-PLAN-TYPE 05 Medical-only PIHP (risk or non-risk/non-comprehensive/with inpatient hospital or institutional services)
VVL.082 Managed Care Plan Type List MANAGED-CARE-PLAN-TYPE 06 Medical-only PAHP (risk or non-risk/non-comprehensive/no inpatient hospital or institutional services)
VVL.082 Managed Care Plan Type List MANAGED-CARE-PLAN-TYPE 07 Long Term Care (LTC) PIHP
VVL.082 Managed Care Plan Type List MANAGED-CARE-PLAN-TYPE 08 Mental Health (MH) PIHP
VVL.082 Managed Care Plan Type List MANAGED-CARE-PLAN-TYPE 09 Mental Health (MH) PAHP
VVL.082 Managed Care Plan Type List MANAGED-CARE-PLAN-TYPE 10 Substance Use Disorders (SUD) PIHP
VVL.082 Managed Care Plan Type List MANAGED-CARE-PLAN-TYPE 11 Substance Use Disorders (SUD) PAHP
VVL.082 Managed Care Plan Type List MANAGED-CARE-PLAN-TYPE 12 Mental Health (MH) and Substance Use Disorders (SUD) PIHP
VVL.082 Managed Care Plan Type List MANAGED-CARE-PLAN-TYPE 13 Mental Health (MH) and Substance Use Disorders (SUD) PAHP
VVL.082 Managed Care Plan Type List MANAGED-CARE-PLAN-TYPE 14 Dental PAHP
VVL.082 Managed Care Plan Type List MANAGED-CARE-PLAN-TYPE 15 Transportation PAHP
VVL.082 Managed Care Plan Type List MANAGED-CARE-PLAN-TYPE 16 Disease Management PAHP
VVL.082 Managed Care Plan Type List MANAGED-CARE-PLAN-TYPE 17 Program for All-Inclusive Care for the Elderly (PACE)
VVL.082 Managed Care Plan Type List MANAGED-CARE-PLAN-TYPE 18 Pharmacy PAHP
VVL.082 Managed Care Plan Type List MANAGED-CARE-PLAN-TYPE 19 Individual is enrolled in Long-Term Services & Supports (LTSS) and Mental Health (MH) PIHP
VVL.082 Managed Care Plan Type List MANAGED-CARE-PLAN-TYPE 20 Other
VVL.082 Managed Care Plan Type List MANAGED-CARE-PLAN-TYPE 60 Accountable Care Organization
VVL.082 Managed Care Plan Type List MANAGED-CARE-PLAN-TYPE 70 Health/Medical Home
VVL.082 Managed Care Plan Type List MANAGED-CARE-PLAN-TYPE 80 Integrated Care For Dual Eligibles
VVL.083 Managed Care Profit Status List MANAGED-CARE-PROFIT-STATUS 01 501(C)(3) NON-PROFIT
VVL.083 Managed Care Profit Status List MANAGED-CARE-PROFIT-STATUS 02 FOR-PROFIT, CLOSELY HELD
VVL.083 Managed Care Profit Status List MANAGED-CARE-PROFIT-STATUS 03 FOR-PROFIT, PUBLICLY TRADED
VVL.083 Managed Care Profit Status List MANAGED-CARE-PROFIT-STATUS 04 OTHER
VVL.084 Managed Care Program List MANAGED-CARE-PROGRAM 1 Medicaid State Plan
VVL.084 Managed Care Program List MANAGED-CARE-PROGRAM 2 CHIP State Plan
VVL.084 Managed Care Program List MANAGED-CARE-PROGRAM 3 Both Medicaid and CHIP
VVL.085 Managed Care Service Area List MANAGED-CARE-SERVICE-AREA 1 Statewide - The managed care entity provides services to beneficiaries throughout the entire state.
VVL.085 Managed Care Service Area List MANAGED-CARE-SERVICE-AREA 2 County - The managed care entity provides services to beneficiaries in specified counties.
VVL.085 Managed Care Service Area List MANAGED-CARE-SERVICE-AREA 3 City - The managed care entity provides services to beneficiaries in specified cities.
VVL.085 Managed Care Service Area List MANAGED-CARE-SERVICE-AREA 4 Region - The managed care entity provides services to beneficiaries in specified regions, not defined by individual counties within the state (region is state-defined).
VVL.085 Managed Care Service Area List MANAGED-CARE-SERVICE-AREA 5 Zip Code - The managed care entity program provides services to beneficiaries in specified zip codes.
VVL.085 Managed Care Service Area List MANAGED-CARE-SERVICE-AREA 6 Other - The managed care entity provides services to beneficiaries in "other" area(s), not Statewide, County, City, or Region.
VVL.086 Managed Care Service Area Name List MANAGED-CARE-SERVICE-AREA-NAME Not Applicable This URL will take the reader to the American National Standards Institute (ANSI) Website for the various geographical code sets:
VVL.086 Managed Care Service Area Name List MANAGED-CARE-SERVICE-AREA-NAME Not Applicable Managed Care Service Area Name List
VVL.086 Managed Care Service Area Name List MANAGED-CARE-SERVICE-AREA-NAME Not Applicable Once at the Website, the reader should scroll down to the section entitled "State and State Equivalents" for the state codes, "FIPS Codes for Outlying Areas of the United States and the Freely Associated States" for the territory codes and "County Subdivision" for the county codes.
VVL.088 Marital Status List MARITAL-STATUS 01 Legally Married (to opposite sex), spouse present
VVL.088 Marital Status List MARITAL-STATUS 02 Legally Married (to opposite sex), spouse absent
VVL.088 Marital Status List MARITAL-STATUS 03 Legally Married (to same sex), spouse present
VVL.088 Marital Status List MARITAL-STATUS 04 Legally Married (to same sex), spouse absent
VVL.088 Marital Status List MARITAL-STATUS 05 Partnered or in Civil Union (to opposite sex), spouse present
VVL.088 Marital Status List MARITAL-STATUS 06 Partnered or in Civil Union (to opposite sex), spouse absent
VVL.088 Marital Status List MARITAL-STATUS 07 Partnered or in Civil Union (to same sex), spouse present
VVL.088 Marital Status List MARITAL-STATUS 08 Partnered or in Civil Union (to same sex), spouse absent
VVL.088 Marital Status List MARITAL-STATUS 09 Legally separated (and not married or partnered)
VVL.088 Marital Status List MARITAL-STATUS 10 Divorced (and not currently married or partnered)
VVL.088 Marital Status List MARITAL-STATUS 11 Separated (and not currently married or partnered)
VVL.088 Marital Status List MARITAL-STATUS 12 Widower/Widow (and not currently married or partnered)
VVL.088 Marital Status List MARITAL-STATUS 13 Never married/partnered
VVL.088 Marital Status List MARITAL-STATUS 14 Other
VVL.089 Medicaid Basis of Eligibility List MEDICAID-BASIS-OF-ELIGIBILITY 00 Eligible for Separate CHIP only
VVL.089 Medicaid Basis of Eligibility List MEDICAID-BASIS-OF-ELIGIBILITY 01 Aged Individual
VVL.089 Medicaid Basis of Eligibility List MEDICAID-BASIS-OF-ELIGIBILITY 02 Blind/Disabled Individual
VVL.089 Medicaid Basis of Eligibility List MEDICAID-BASIS-OF-ELIGIBILITY 03 Not used
VVL.089 Medicaid Basis of Eligibility List MEDICAID-BASIS-OF-ELIGIBILITY 04 Child (not Child of Unemployed Adult, not Foster Care Child)
VVL.089 Medicaid Basis of Eligibility List MEDICAID-BASIS-OF-ELIGIBILITY 05 Adult (not based on unemployed status)
VVL.089 Medicaid Basis of Eligibility List MEDICAID-BASIS-OF-ELIGIBILITY 06 Child of Unemployed Adult (optional)
VVL.089 Medicaid Basis of Eligibility List MEDICAID-BASIS-OF-ELIGIBILITY 07 Unemployed Adult (optional)
VVL.089 Medicaid Basis of Eligibility List MEDICAID-BASIS-OF-ELIGIBILITY 08 Foster Care Child
VVL.089 Medicaid Basis of Eligibility List MEDICAID-BASIS-OF-ELIGIBILITY 10 Refugee Medical Assistance (45 CFR Sub-part G)
VVL.089 Medicaid Basis of Eligibility List MEDICAID-BASIS-OF-ELIGIBILITY 11 Individual covered under the Breast and Cervical Cancer Prevention and Treatment Act of 2000
VVL.090 MFP Lives with Family List MFP-LIVES-WITH-FAMILY 0 No
VVL.090 MFP Lives with Family List MFP-LIVES-WITH-FAMILY 1 Yes
VVL.090 MFP Lives with Family List MFP-LIVES-WITH-FAMILY 2 No MFP Participation
VVL.091 MFP Qualified Institution List MFP-QUALIFIED-INSTITUTION 00 Default- No MFP Participation
VVL.091 MFP Qualified Institution List MFP-QUALIFIED-INSTITUTION 01 Nursing Facility
VVL.091 MFP Qualified Institution List MFP-QUALIFIED-INSTITUTION 02 ICF/IID (Intermediate Care Facilities for individuals with Intellectual Disabilities)
VVL.091 MFP Qualified Institution List MFP-QUALIFIED-INSTITUTION 03 IMD (Institution for Mental Diseases)
VVL.091 MFP Qualified Institution List MFP-QUALIFIED-INSTITUTION 04 Hospital
VVL.091 MFP Qualified Institution List MFP-QUALIFIED-INSTITUTION 05 Other
VVL.092 MFP Qualified Residence List MFP-QUALIFIED-RESIDENCE 00 Default - No MFP Participation
VVL.092 MFP Qualified Residence List MFP-QUALIFIED-RESIDENCE 01 Home owned by participant
VVL.092 MFP Qualified Residence List MFP-QUALIFIED-RESIDENCE 02 Home owned by family member
VVL.092 MFP Qualified Residence List MFP-QUALIFIED-RESIDENCE 03 Apartment leased by participant, not assisted living
VVL.092 MFP Qualified Residence List MFP-QUALIFIED-RESIDENCE 04 Apartment leased by participant, assisted living
VVL.092 MFP Qualified Residence List MFP-QUALIFIED-RESIDENCE 05 Group home of no more than 4 people
VVL.093 MFP Reason Participation Ended List MFP-REASON-PARTICIPATION-ENDED 00 Default - No MFP Participation
VVL.093 MFP Reason Participation Ended List MFP-REASON-PARTICIPATION-ENDED 01 Completed 365 days of participation
VVL.093 MFP Reason Participation Ended List MFP-REASON-PARTICIPATION-ENDED 02 Suspended eligibility
VVL.093 MFP Reason Participation Ended List MFP-REASON-PARTICIPATION-ENDED 03 Re-institutionalized
VVL.093 MFP Reason Participation Ended List MFP-REASON-PARTICIPATION-ENDED 04 Died
VVL.093 MFP Reason Participation Ended List MFP-REASON-PARTICIPATION-ENDED 05 Moved
VVL.093 MFP Reason Participation Ended List MFP-REASON-PARTICIPATION-ENDED 06 No longer needed services
VVL.093 MFP Reason Participation Ended List MFP-REASON-PARTICIPATION-ENDED 07 Other
VVL.094 MFP Reinstitutionalized Reason List MFP-REINSTITUTIONALIZED-REASON 00 Default- No MFP Participation
VVL.094 MFP Reinstitutionalized Reason List MFP-REINSTITUTIONALIZED-REASON 01 Acute care hospitalization followed by long term rehabilitation
VVL.094 MFP Reinstitutionalized Reason List MFP-REINSTITUTIONALIZED-REASON 02 Deterioration in cognitive functioning
VVL.094 MFP Reinstitutionalized Reason List MFP-REINSTITUTIONALIZED-REASON 03 Deterioration in health
VVL.094 MFP Reinstitutionalized Reason List MFP-REINSTITUTIONALIZED-REASON 04 Deterioration in mental health
VVL.094 MFP Reinstitutionalized Reason List MFP-REINSTITUTIONALIZED-REASON 05 Loss of housing
VVL.094 MFP Reinstitutionalized Reason List MFP-REINSTITUTIONALIZED-REASON 06 Loss of personal care giver
VVL.094 MFP Reinstitutionalized Reason List MFP-REINSTITUTIONALIZED-REASON 07 By request of participant or guardian
VVL.094 MFP Reinstitutionalized Reason List MFP-REINSTITUTIONALIZED-REASON 08 Lack of sufficient community services
VVL.095 National Health Care Entity ID Type List NATIONAL-HEALTH-CARE-ENTITY-ID-TYPE 1 Controlling Health Plan (CHP) ID - the national health plan identifier of a health plan that either controls its own business activities, actions, or policies, or is controlled by an entity that is not a health plan and exercises sufficient control over the subhealth plan(s) under it so as to direct its own business activities, actions, or policies, as well as those of any subhealth plans under it.
VVL.095 National Health Care Entity ID Type List NATIONAL-HEALTH-CARE-ENTITY-ID-TYPE 2 Subhealth Plan (SHP) ID - the national health plan identifier of a health plan whose business activities, actions, or policies are directed by a controlling health plan. All subhealth HPIDs should be reported.
VVL.095 National Health Care Entity ID Type List NATIONAL-HEALTH-CARE-ENTITY-ID-TYPE 3 Other Entity Identifier (OEID) - a national identifier for entities that are not health plans, health care providers, or individuals (as defined in 45 CFR 160.103), but that need to be identified in standard transactions (including, for example, third party administrators, transaction vendors, clearinghouses, and other payers). Other entities are not required to obtain an OEID, but they could obtain and use one if they need to be identified in covered transactions.
VVL.096 Operating Authority List OPERATING-AUTHORITY 01 1115 demonstration waiver program - demonstration projects under which most provisions of Section 1902 of the Social Security Act are waived and/or expenditures that would not otherwise be eligible for FFP are authorized. States use these to expand eligibility, restructure Medicaid coverage and secure programmatic flexibility.
VVL.096 Operating Authority List OPERATING-AUTHORITY 02 1915(b) waiver program - waivers of most provisions of Section 1902 of the Social Security Act in order to limit beneficiaries freedom of choice of provider; selectively contract with providers; or provide additional services to beneficiaries (State may include BBA special populations)
VVL.096 Operating Authority List OPERATING-AUTHORITY 03 1932(a) state plan option to use managed care for MCO and PCCM programs - mandatory managed care programs implemented through the state plan (State must exclude or permit voluntary enrollment of specific populations)
VVL.096 Operating Authority List OPERATING-AUTHORITY 04 1915(a) voluntary managed care program - an MCO managed care program in which enrollment is voluntary and therefore does not require a waiver.
VVL.096 Operating Authority List OPERATING-AUTHORITY 05 Concurrent 1915(b)/1915(c) waivers - programs, or portions thereof, operating under both 1915(b) managed care and 1915(c) home and community-based services waivers.
VVL.096 Operating Authority List OPERATING-AUTHORITY 06 Concurrent 1915(a)/1915(c) waivers - programs, or portions thereof, operating under both 1915(a) voluntary managed care and 1915(c) home and community-based services waiver
VVL.096 Operating Authority List OPERATING-AUTHORITY 07 Concurrent 1932(a)/1915(c) waivers - programs, or portions thereof, operating under both 1932(a) managed care and 1915(c) home and community-based services waiver.
VVL.096 Operating Authority List OPERATING-AUTHORITY 08 PACE program that provides pre-paid, capitated comprehensive, health care services to the frail elderly.
VVL.096 Operating Authority List OPERATING-AUTHORITY 09 1905(t) voluntary PCCM program - A PCCM managed care program in which enrollment is voluntary and therefore does not require a waiver.
VVL.096 Operating Authority List OPERATING-AUTHORITY 10 1937benchmark benefit program - programs to provide benefits that differ from Medicaid state plan benefits using managed care and implemented through the state plan.
VVL.096 Operating Authority List OPERATING-AUTHORITY 11 1902(a)(70) non-emergency medical transportation program non-emergency medical transportation brokerage programs implemented through the state plan which can vary scope of services, operate on a less-than-statewide basis, and limit freedom of choice
VVL.096 Operating Authority List OPERATING-AUTHORITY 12 Concurrent 1915(b)/1915(i) HCBS state plan services - the optional 1915(i) state plan Home and Community-Based Services (HCBS) benefit operated in conjunction with a 1915(b) managed care waiver program.
VVL.096 Operating Authority List OPERATING-AUTHORITY 13 Concurrent 1915(a)/ 1915(i) HCBS state plan services - the optional 1915(i) state plan Home and Community-Based Services (HCBS) benefit operated in conjunction with a 1915(a) voluntary managed care program.
VVL.096 Operating Authority List OPERATING-AUTHORITY 14 Concurrent 1932(a)/ 1915(i) HCBS state plan services - the optional 1915(i) state plan Home and Community-Based Services (HCBS) benefit operated in conjunction with a 1932(a) managed care state plan option.
VVL.096 Operating Authority List OPERATING-AUTHORITY 15 1945 Health Homes.
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 002 Outpatient hospital services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 003 Rural health clinic services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 004 Other ambulatory services furnished by a rural health clinic
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 005 Professional laboratory services, Technical laboratory services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 006 Technical laboratory services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 007 Professional radiological services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 008 Technical radiological services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 010 Early and periodic screening and diagnosis and treatment (EPSDT) services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 011 Family planning services and supplies for individuals of child-bearing age
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 012 Physicians' services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 013 Medical and surgical services of a dentist
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 014 Outpatient substance abuse treatment services.
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 015 Medical or other remedial care or services, other than physicians' services, provided by licensed practitioners within the scope of practice as defined under State law
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 016 Home health services - Nursing services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 017 Home health services - Home health aide services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 018 Home health services - Medical supplies, equipment, and appliances suitable for use in the home
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 019 Home health services - Physical therapy provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 020 Home health services - Occupational therapy provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 021 Home health services - Speech pathology and audiology services provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 022 Private duty nursing services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 023 Advanced practice nurse services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 024 Pediatric nurse
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 025 Nurse-midwife service
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 026 Nurse practitioner services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 027 Respiratory care for ventilator-dependent individuals
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 028 Clinic services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 029 Dental services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 030 Physical therapy services (when not provided under home health services)
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 031 Occupational therapy services (when not provided under home health services)
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 032 Speech, hearing, and language disorders services (when not provided under home health services)
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 035 Dentures
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 036 Medical equipment/prosthetic devices
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 037 Eyeglasses
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 038 Hearing Aids
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 039 Diagnostic services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 040 Screening services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 041 Preventive services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 042 Well-baby and well-child care services as defined by the State.
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 043 Rehabilitative services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 049 Outpatient mental health services, other than Outpatient substance abuse treatment services. This TOS includes services furnished in a State-operated mental hospital and including community-based services.
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 050 Inpatient substance abuse treatment services and residential substance abuse treatment services.
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 051 Personal care services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 052 Primary care case management services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 053 Targeted case management services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 054 Case Management services other than those that meet the definition of primary care case management services or targeted case management services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 055 Care coordination services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 056 Transportation services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 057 Enabling services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 060 Emergency hospital services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 061 Critical access hospital services - OT
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 062 HCBS - Case management services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 063 HCBS - Homemaker services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 064 HCBS - Home health aide services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 065 HCBS - Personal care services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 066 HCBS - Adult day health services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 067 HCBS - Habilitation services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 068 HCBS - Respite care services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 069 HCBS - Day treatment or other partial hospitalization services, psychosocial rehabilitation services and clinic services (whether or not furnished in a facility) for individuals with chronic mental illness
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 070 HCBS - Day Care
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 071 HCBS - Training for family members
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 072 HCBS - Minor modification to the home
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 073 HCBS - Other services requested by the agency and approved by CMS as cost effective and necessary to avoid institutionalization
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 074 HCBS - Expanded habilitation services - Prevocational services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 075 HCBS - Expanded habilitation services - Educational services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 076 HCBS - Expanded habilitation services - Supported employment services, which facilitate paid employment
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 077 HCBS-65-plus - Case management services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 078 HCBS-65-plus - Homemaker services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 079 HCBS-65-plus - Home health aide services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 080 HCBS-65-plus - Personal care services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 081 HCBS-65-plus - Adult day health services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 082 HCBS-65-plus - Respite care services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 083 HCBS-65-plus - Other medical and social services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 084 Sterilizations
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 085 Prenatal care and pre-pregnancy family planning services and supplies.
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 086 Other Pregnancy-related Procedures
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 087 Hospice services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 088 Any other health care services or items specified by the Secretary and not excluded under regulations.
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 089 Disposable medical supplies.
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 115 Residential care
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 119 Capitated payments to HMOs, HIOs, or PACE plans
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 120 Capitated payments for primary care case management (PCCM)
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 121 Premium payments for private health insurance
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 122 Capitated payments to prepaid health plans (PHPs)
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 123 Disproportionate share hospital (DSH) payments
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 127 Indian Health Service (IHS) - Family Plan
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 131 Drug Rebates
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 134 Supplemental payment outpatient
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 135 EHR payments to provider
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 136 In vitro diagnostic products (as defined in section 809.3(a) of title 21, Code of Federal Regulations) administered during any portion of the emergency period defined in paragraph (1)(B) of section 1135(g) beginning on or after the date of the enactment of this subparagraph for the detection of SARSCoV2 or the diagnosis of the virus that causes COVID19, and the administration of such in vitro diagnostic products
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 137 COVID-19 testing-related services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 138 Per member per month (PMPM) payments for health home services
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 139 Per member per month (PMPM) payments for Medicare Part A premiums
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 140 Per member per month (PMPM) payments for Medicare Part B premiums
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 141 Per member per month (PMPM) payments for Medicare Advantage Dual Special Needs Plans (D-SNP) Medicare Part C
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 142 Per member per month (PMPM) payments for Medicare Part D premiums
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 143 Per member per month (PMPM) payments for other payments
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 144 Payments to individuals for personal assistance services under 1915(j)
VVL.097 Type of Service (Other Claim) List TYPE-OF-SERVICE 145 Medication Assisted Treatment (MAT) services and drugs for evidenced-based treatment of Opioid Use Disorder (OUD)
VVL.098 Patient Status List PATIENT-STATUS Not Applicable A valid list of Patient Status codes can be purchased at https://www.nubc.org/license
VVL.099 Policy Owner Code List POLICY-OWNER-CODE 01 Self
VVL.099 Policy Owner Code List POLICY-OWNER-CODE 02 Spouse
VVL.099 Policy Owner Code List POLICY-OWNER-CODE 03 Custodial Parent
VVL.099 Policy Owner Code List POLICY-OWNER-CODE 04 Noncustodial Parent (Child Support Enforcement in effect)
VVL.099 Policy Owner Code List POLICY-OWNER-CODE 05 Noncustodial Parent without child support enforcement in effect
VVL.099 Policy Owner Code List POLICY-OWNER-CODE 06 Grandparent
VVL.099 Policy Owner Code List POLICY-OWNER-CODE 07 Guardian
VVL.099 Policy Owner Code List POLICY-OWNER-CODE 08 Domestic Partner
VVL.099 Policy Owner Code List POLICY-OWNER-CODE 09 Other
VVL.100 Pregnancy Indicator List PREGNANCY-IND 0 No
VVL.100 Pregnancy Indicator List PREGNANCY-IND 1 Yes
VVL.101 Primary Language Engl Prof List PRIMARY-LANGUAGE-ENGL-PROF-CODE 0 Very Well
VVL.101 Primary Language Engl Prof List PRIMARY-LANGUAGE-ENGL-PROF-CODE 1 Well
VVL.101 Primary Language Engl Prof List PRIMARY-LANGUAGE-ENGL-PROF-CODE 2 Not well
VVL.101 Primary Language Engl Prof List PRIMARY-LANGUAGE-ENGL-PROF-CODE 3 No spoken proficiency
VVL.102 Provider Address Type List ADDR-TYPE 1 Provider Billing
VVL.102 Provider Address Type List ADDR-TYPE 2 Provider Mailing
VVL.102 Provider Address Type List ADDR-TYPE 3 Provider Practice
VVL.102 Provider Address Type List ADDR-TYPE 4 Provider Service Location
VVL.104 Provider Profit Status List PROV-PROFIT-STATUS 01 501(C)(3) NON-PROFIT
VVL.104 Provider Profit Status List PROV-PROFIT-STATUS 02 FOR-PROFIT, CLOSELY HELD
VVL.104 Provider Profit Status List PROV-PROFIT-STATUS 03 FOR-PROFIT, PUBLICLY TRADED
VVL.104 Provider Profit Status List PROV-PROFIT-STATUS 04 OTHER
VVL.104 Provider Profit Status List PROV-PROFIT-STATUS 88 N/A - The individual only practices as part of a group
VVL.104 Provider Profit Status List PROV-PROFIT-STATUS 99 Unknown
VVL.106 Provider Taxonomy List PROV-CLASSIFICATION-TYPE = 1 (Provider Taxonomy) Not Applicable The key values pairs for this list is incorporated by reference and can be found at the following URL:
VVL.106 Provider Taxonomy List PROV-CLASSIFICATION-TYPE = 1 (Provider Taxonomy) Not Applicable Link to Provider Taxonomy Code List
VVL.107 Race List RACE 001 White
VVL.107 Race List RACE 002 Black or African American
VVL.107 Race List RACE 003 American Indian or Alaskan Native
VVL.107 Race List RACE 004 Asian Indian
VVL.107 Race List RACE 005 Chinese
VVL.107 Race List RACE 006 Filipino
VVL.107 Race List RACE 007 Japanese
VVL.107 Race List RACE 008 Korean
VVL.107 Race List RACE 009 Vietnamese
VVL.107 Race List RACE 010 Other Asian
VVL.107 Race List RACE 011 Asian Unknown
VVL.107 Race List RACE 012 Native Hawaiian
VVL.107 Race List RACE 013 Guamanian or Chamorro
VVL.107 Race List RACE 014 Samoan
VVL.107 Race List RACE 015 Other Pacific Islander
VVL.107 Race List RACE 016 Native Hawaiian or Other Pacific Islander Unknown
VVL.107 Race List RACE 017 Unspecified
VVL.108 Reimbursement Arrangement List REIMBURSEMENT-ARRANGEMENT 01 Risk-based Capitation, no incentives or risk-sharing
VVL.108 Reimbursement Arrangement List REIMBURSEMENT-ARRANGEMENT 02 Risk-based Capitation with Incentive Arrangements
VVL.108 Reimbursement Arrangement List REIMBURSEMENT-ARRANGEMENT 03 Risk-based Capitation with other risk-sharing Arrangements
VVL.108 Reimbursement Arrangement List REIMBURSEMENT-ARRANGEMENT 04 Non-Risk Capitation
VVL.108 Reimbursement Arrangement List REIMBURSEMENT-ARRANGEMENT 05 Fee-For-Service
VVL.108 Reimbursement Arrangement List REIMBURSEMENT-ARRANGEMENT 06 Primary Care Case Management Payment
VVL.108 Reimbursement Arrangement List REIMBURSEMENT-ARRANGEMENT 07 Other
VVL.108 Reimbursement Arrangement List REIMBURSEMENT-ARRANGEMENT 08 Primary Care Case Management Payment plus Fee-For-Service
VVL.109 Restricted Benefits Code List RESTRICTED-BENEFITS-CODE 0 Individual is not eligible for Medicaid or CHIP during the month.
VVL.109 Restricted Benefits Code List RESTRICTED-BENEFITS-CODE 1 Individual is eligible for Medicaid or CHIP and entitled to the full scope of Medicaid or CHIP benefits.
VVL.109 Restricted Benefits Code List RESTRICTED-BENEFITS-CODE 2 Individual is eligible for Medicaid or Medicaid-Expansion CHIP, but only entitled to restricted benefits based on alien status.
VVL.109 Restricted Benefits Code List RESTRICTED-BENEFITS-CODE 3 Individual is eligible for Medicaid but only entitled to restricted benefits based on Medicare dual-eligibility status (e.g., QMB, SLMB, QDWI, QI).
VVL.109 Restricted Benefits Code List RESTRICTED-BENEFITS-CODE 4 Individual is eligible for Medicaid or CHIP but is only entitled to restricted benefits for pregnancy-related services, including services that do and those that do not meet the Minimum Essential Coverage standard.
VVL.109 Restricted Benefits Code List RESTRICTED-BENEFITS-CODE 5 Individual is eligible for Medicaid or Medicaid-Expansion CHIP, but for reasons other than alien, dual-eligibility, or pregnancy-related status, is only entitled to restricted benefits (e.g., restricted benefits based upon substance abuse, medically needy, or other criteria) that meet the standard for Minimum Essential Coverage.
VVL.109 Restricted Benefits Code List RESTRICTED-BENEFITS-CODE 6 Individual is eligible for Medicaid or Medicaid-Expansion CHIP but only entitled to restricted benefits for family planning services.
VVL.109 Restricted Benefits Code List RESTRICTED-BENEFITS-CODE 7 Individual is eligible for Medicaid and entitled to Medicaid benefits under an alternative package of benchmark-equivalent coverage, as enacted by the Deficit Reduction Act of 2005.
VVL.109 Restricted Benefits Code List RESTRICTED-BENEFITS-CODE A Individual is eligible for Medicaid and entitled to benefits under the Psychiatric Residential Treatment Facilities Demonstration Grant Program (PRTF), as enacted by the Deficit Reduction Act of 2005.
VVL.109 Restricted Benefits Code List RESTRICTED-BENEFITS-CODE B Individual is eligible for Medicaid and entitled to Medicaid benefits using a Health Opportunity Account (HOA)
VVL.109 Restricted Benefits Code List RESTRICTED-BENEFITS-CODE C Individual is eligible for S-separate CHIP dental coverage (supplemental dental wraparound benefit to employer-sponsored insurance)
VVL.109 Restricted Benefits Code List RESTRICTED-BENEFITS-CODE D Individual is eligible for Medicaid and entitled to benefits under a Money Follows the Person (MFP) rebalancing demonstration, as enacted by the Deficit Reduction Act of 2005, to allow States to develop community based long term care opportunities.
VVL.109 Restricted Benefits Code List RESTRICTED-BENEFITS-CODE E Individual is eligible for Medicaid or Medicaid-Expansion CHIP, but for reasons other than alien, dual-eligibility, or pregnancy-related status, is only entitled to restricted benefits (e.g., restricted benefits based on substance abuse, medically needy, or other criteria) that do not meet the standard for Minimum Essential Coverage.
VVL.109 Restricted Benefits Code List RESTRICTED-BENEFITS-CODE F Individual is eligible for Medicaid but is only entitled to restricted benefits for medical assistance for COVID-19 diagnostic products and any visit described as a COVID-19 testing-related service for which payment may be made under the State plan during any portion of the public health emergency period, beginning March 18, 2020, as described in Sections 1902(a)(10)(A)(ii)(XXIII), 1902(ss) and clause XVIII in the matter following 1902(a)(10)(G) of the Social Security Act.
VVL.110 Type of Service (RX Claim) List TYPE-OF-SERVICE 011 Family planning services and supplies for individuals of child-bearing age
VVL.110 Type of Service (RX Claim) List TYPE-OF-SERVICE 018 Home health services - Medical supplies, equipment, and appliances suitable for use in the home
VVL.110 Type of Service (RX Claim) List TYPE-OF-SERVICE 033 Prescribed drugs
VVL.110 Type of Service (RX Claim) List TYPE-OF-SERVICE 034 Over-the-counter medications.
VVL.110 Type of Service (RX Claim) List TYPE-OF-SERVICE 036 Medical equipment/prosthetic devices
VVL.110 Type of Service (RX Claim) List TYPE-OF-SERVICE 085 Prenatal care and pre-pregnancy family planning services and supplies.
VVL.110 Type of Service (RX Claim) List TYPE-OF-SERVICE 089 Disposable medical supplies.
VVL.110 Type of Service (RX Claim) List TYPE-OF-SERVICE 127 Indian Health Service (IHS) - Family Plan
VVL.110 Type of Service (RX Claim) List TYPE-OF-SERVICE 131 Drug Rebates
VVL.110 Type of Service (RX Claim) List TYPE-OF-SERVICE 136 In vitro diagnostic products (as defined in section 809.3(a) of title 21, Code of Federal Regulations) administered during any portion of the emergency period defined in paragraph (1)(B) of section 1135(g) beginning on or after the date of the enactment of this subparagraph for the detection of SARS-CoV-2 or the diagnosis of the virus that causes COVID-19, and the administration of such in vitro diagnostic products
VVL.110 Type of Service (RX Claim) List TYPE-OF-SERVICE 137 COVID-19 testing-related services
VVL.110 Type of Service (RX Claim) List TYPE-OF-SERVICE 145 Medication Assisted Treatment (MAT) services and drugs for evidenced-based treatment of Opioid Use Disorder (OUD)
VVL.111 SSDI Indicator List SSDI-IND 0 No
VVL.111 SSDI Indicator List SSDI-IND 1 Yes
VVL.112 SSI Indicator List SSI-IND 0 No
VVL.112 SSI Indicator List SSI-IND 1 Yes
VVL.113 SSN Indicator List SSN-INDICATOR 0 State does not use SSN as MSIS-IDENTIFICATION-NUMBER
VVL.113 SSN Indicator List SSN-INDICATOR 1 State uses SSN as MSIS-IDENTIFICATION-NUMBE
VVL.114 SSN Verification Flag List SSN-VERIFICATION-FLAG 0 SSN not verified
VVL.114 SSN Verification Flag List SSN-VERIFICATION-FLAG 1 SSN successfully verified by SSA
VVL.114 SSN Verification Flag List SSN-VERIFICATION-FLAG 2 SSN is pending SSA verification
VVL.117 State Plan Option Type List STATE-PLAN-OPTION-TYPE 01 Community First Choice
VVL.117 State Plan Option Type List STATE-PLAN-OPTION-TYPE 02 1915(i)
VVL.117 State Plan Option Type List STATE-PLAN-OPTION-TYPE 03 1915(j)
VVL.117 State Plan Option Type List STATE-PLAN-OPTION-TYPE 04 1932(a)
VVL.117 State Plan Option Type List STATE-PLAN-OPTION-TYPE 05 1915(a)
VVL.117 State Plan Option Type List STATE-PLAN-OPTION-TYPE 06 1937 (Alternative Benefit Plans)
VVL.119 TANF Cash Code List TANF-CASH-CODE 0 Individual was not eligible for medicaid
VVL.119 TANF Cash Code List TANF-CASH-CODE 1 Individual did not receive TANF benefits
VVL.119 TANF Cash Code List TANF-CASH-CODE 2 Individual did receive TANF benefits (States should only use this value if they can accurately separate eligible receiving TANF benefits from other 1931 eligible)
VVL.120 Tooth Surface Code List TOOTH-SURFACE-CODE B Buccal - The surface of the tooth which is closest to the cheek.
VVL.120 Tooth Surface Code List TOOTH-SURFACE-CODE D Distal - The surface of the tooth facing away from an invisible line drawn vertically through the center of the face.
VVL.120 Tooth Surface Code List TOOTH-SURFACE-CODE F Facial - The surface of a tooth that is directed towards the face.
VVL.120 Tooth Surface Code List TOOTH-SURFACE-CODE I Incisal - The cutting edges of the anterior teeth.
VVL.120 Tooth Surface Code List TOOTH-SURFACE-CODE L Lingual - The surface of the tooth that is directed towards the tongue.
VVL.120 Tooth Surface Code List TOOTH-SURFACE-CODE M Mesial - The surface of a tooth which faces toward an invisible line drawn vertically through the center of the face.
VVL.120 Tooth Surface Code List TOOTH-SURFACE-CODE O Occlusa - The surfaces of the posterior (back) teeth which provides the chewing function.
VVL.121 TPL Entity Address Type List TPL-ENTITY-ADDR-TYPE 06 TPL-Entity Corporate Location
VVL.121 TPL Entity Address Type List TPL-ENTITY-ADDR-TYPE 07 TPL-Entity Mailing
VVL.121 TPL Entity Address Type List TPL-ENTITY-ADDR-TYPE 08 TPL-Entity Satellite Location
VVL.121 TPL Entity Address Type List TPL-ENTITY-ADDR-TYPE 09 TPL-Entity Billing
VVL.121 TPL Entity Address Type List TPL-ENTITY-ADDR-TYPE 10 TPL-Entity Correspondence
VVL.121 TPL Entity Address Type List TPL-ENTITY-ADDR-TYPE 11 TPL-Other
VVL.122 TPL Health Insurance Coverage Indicator List TPL-HEALTH-INSURANCE-COVERAGE-IND 0 Medicaid/CHIP eligible individual has no TPL insurance coverage.
VVL.122 TPL Health Insurance Coverage Indicator List TPL-HEALTH-INSURANCE-COVERAGE-IND 1 Medicaid/CHIP eligible individual does have TPL insurance coverage.
VVL.123 TPL Other Coverage Indicator List TPL-OTHER-COVERAGE-IND 0 Medicaid/CHIP eligible individual has no other TPL funding available.
VVL.123 TPL Other Coverage Indicator List TPL-OTHER-COVERAGE-IND 1 Medicaid/CHIP eligible individual does have other TPL funding available.
VVL.124 Type of Bill List TYPE-OF-BILL Not Applicable 1st Digit must always be a zero ('0')
VVL.124 Type of Bill List TYPE-OF-BILL Not Applicable 2nd Digit-Type of Facility
VVL.124 Type of Bill List TYPE-OF-BILL 1 Hospital
VVL.124 Type of Bill List TYPE-OF-BILL 2 Skilled Nursing
VVL.124 Type of Bill List TYPE-OF-BILL 3 Home Health
VVL.124 Type of Bill List TYPE-OF-BILL 4 Religious Nonmedical (Hospital)
VVL.124 Type of Bill List TYPE-OF-BILL 5 Reserved for national assignment (discontinued effective 10/1/05).
VVL.124 Type of Bill List TYPE-OF-BILL 6 Intermediate Care
VVL.124 Type of Bill List TYPE-OF-BILL 7 Clinic or Hospital Based Renal Dialysis Facility (requires special information in second digit below).
VVL.124 Type of Bill List TYPE-OF-BILL 8 Special facility or hospital ASC surgery (requires special information in second digit below).
VVL.124 Type of Bill List TYPE-OF-BILL 9 Reserved for National Assignment
VVL.124 Type of Bill List TYPE-OF-BILL Not Applicable 3rd Digit-Bill Classification (Except Clinics and Special Facilities)
VVL.124 Type of Bill List TYPE-OF-BILL 1 Inpatient
VVL.124 Type of Bill List TYPE-OF-BILL 2 Inpatient
VVL.124 Type of Bill List TYPE-OF-BILL 3 Outpatient
VVL.124 Type of Bill List TYPE-OF-BILL 4 Other
VVL.124 Type of Bill List TYPE-OF-BILL 5 Intermediate Care - Level I
VVL.124 Type of Bill List TYPE-OF-BILL 6 Intermediate Care - Level II
VVL.124 Type of Bill List TYPE-OF-BILL 7 Reserved for national assignment (discontinued effective 10/1/05).
VVL.124 Type of Bill List TYPE-OF-BILL 8 Swing Bed (may be used to indicate billing for SNF level of care in a hospital with an approved swing bed agreement).
VVL.124 Type of Bill List TYPE-OF-BILL 9 Reserved for National Assignment
VVL.124 Type of Bill List TYPE-OF-BILL Not Applicable 3rd Digit-Classification (Clinics Only)
VVL.124 Type of Bill List TYPE-OF-BILL 1 Rural Health Clinic (RHC)
VVL.124 Type of Bill List TYPE-OF-BILL 2 Hospital Based or Independent Renal Dialysis Facility
VVL.124 Type of Bill List TYPE-OF-BILL 3 Free Standing Provider-Based Federally Qualified Health Center (FQHC)
VVL.124 Type of Bill List TYPE-OF-BILL 4 Other Rehabilitation Facility (ORF)
VVL.124 Type of Bill List TYPE-OF-BILL 5 Comprehensive Outpatient Rehabilitation Facility (CORF)
VVL.124 Type of Bill List TYPE-OF-BILL 6 Community Mental Health Center (CMHC)
VVL.124 Type of Bill List TYPE-OF-BILL 7 Reserved for national assignment (discontinued effective 10/1/05)
VVL.125 Type of Bill List TYPE-OF-BILL 8 Licensed Freestanding Emergency Medical Facility (Effective 4/1/12)
VVL.124 Type of Bill List TYPE-OF-BILL 9 OTHER
VVL.124 Type of Bill List TYPE-OF-BILL Not Applicable 3rd Digit-Classification (Special Facilities Only)
VVL.124 Type of Bill List TYPE-OF-BILL 1 Hospice (Nonhospital Based)
VVL.124 Type of Bill List TYPE-OF-BILL 2 Hospice (Hospital Based)
VVL.124 Type of Bill List TYPE-OF-BILL 3 Ambulatory Surgical Center Services to Hospital Outpatients
VVL.124 Type of Bill List TYPE-OF-BILL 4 Free Standing Birthing Center
VVL.124 Type of Bill List TYPE-OF-BILL 5 Critical Access Hospital
VVL.125 Type of Bill List TYPE-OF-BILL 6 Residential Facility
VVL.126 Type of Bill List TYPE-OF-BILL 7 Freestanding Non-residential Opioid Treatment Program (Effective 1/1/21)
VVL.125 Type of Bill List TYPE-OF-BILL 8 Reserved for National Assignment
VVL.124 Type of Bill List TYPE-OF-BILL 9 OTHER
VVL.124 Type of Bill List TYPE-OF-BILL Not Applicable 4th Digit-Frequency
VVL.124 Type of Bill List TYPE-OF-BILL A Admission/Election Notice
VVL.124 Type of Bill List TYPE-OF-BILL B Hospice/Medicare Coordinated Care Demonstration/Religious Nonmedical Health Care Institution Termination/Revocation Notice
VVL.124 Type of Bill List TYPE-OF-BILL C Hospice Change of Provider Notice
VVL.124 Type of Bill List TYPE-OF-BILL D Hospice/Medicare Coordinated Care Demonstration/Religious Nonmedical Health Care Institution Void/Cancel
VVL.124 Type of Bill List TYPE-OF-BILL E Hospice Change of Ownership
VVL.124 Type of Bill List TYPE-OF-BILL F Beneficiary Initiated Adjustment Claim
VVL.124 Type of Bill List TYPE-OF-BILL G CWF Initiated Adjustment Claim
VVL.124 Type of Bill List TYPE-OF-BILL H CMS Initiated Adjustment Claim
VVL.124 Type of Bill List TYPE-OF-BILL I FI Adjustment Claim (Other than QIO or Provider
VVL.124 Type of Bill List TYPE-OF-BILL J Initiated Adjustment Claim-Other
VVL.124 Type of Bill List TYPE-OF-BILL K OIG Initiated Adjustment Claim
VVL.124 Type of Bill List TYPE-OF-BILL M MSP Initiated Adjustment Claim
VVL.124 Type of Bill List TYPE-OF-BILL P QIO Adjustment Claim
VVL.124 Type of Bill List TYPE-OF-BILL 0 Nonpayment/Zero Claims
VVL.124 Type of Bill List TYPE-OF-BILL 1 Admit Through Discharge Claim
VVL.124 Type of Bill List TYPE-OF-BILL 2 Interim-First Claim
VVL.124 Type of Bill List TYPE-OF-BILL 3 Interim-Continuing Claims (Not valid for PPS Bills)
VVL.124 Type of Bill List TYPE-OF-BILL 4 Interim-Last Claim (Not valid for PPS Bills)
VVL.124 Type of Bill List TYPE-OF-BILL 5 Late Charge Only
VVL.124 Type of Bill List TYPE-OF-BILL 7 Replacement of Prior Claim
VVL.124 Type of Bill List TYPE-OF-BILL 8 Void/Cancel of a Prior Claim
VVL.124 Type of Bill List TYPE-OF-BILL 9 Final Claim for a Home Health PPS Episode
VVL.125 Type of Claim List TYPE-OF-CLAIM 1 A Fee-For-Service Medicaid or Medicaid-expansion CHIP Claim
VVL.125 Type of Claim List TYPE-OF-CLAIM 2 Medicaid or Medicaid-expansion CHIP Capitated Payment
VVL.125 Type of Claim List TYPE-OF-CLAIM 3 Medicaid or Medicaid-expansion CHIP Managed Care Encounter record that simulates a bill for a service rendered to a patient covered under some form of Capitation Plan. This includes billing records submitted by providers to non-state entities (e.g., MCOs, health plans) for which the State has no financial liability since the risk entity has already received a capitated payment from the State.
VVL.125 Type of Claim List TYPE-OF-CLAIM 4 Medicaid or Medicaid-expansion CHIP Service Tracking Claim
VVL.125 Type of Claim List TYPE-OF-CLAIM 5 Medicaid or Medicaid-expansion CHIP Supplemental Payment (above capitation fee or above negotiated rate) (e.g., FQHC additional reimbursement)
VVL.125 Type of Claim List TYPE-OF-CLAIM A Separate CHIP (Title XXI) claim: A Fee-for-Service Claim
VVL.125 Type of Claim List TYPE-OF-CLAIM B Separate CHIP (Title XXI) claim: Capitated Payment
VVL.125 Type of Claim List TYPE-OF-CLAIM C Separate CHIP (Title XXI) managed care encounter record that simulates a bill for a service or items rendered to a patient covered under some form of Capitation Plan. This includes billing records submitted by providers to non-State entities (e.g., MCOs, health plans) for which a state has no financial liability as the at-risk entity has already received a capitated payment from the state
VVL.125 Type of Claim List TYPE-OF-CLAIM D Separate CHIP (Title XXI) Service Tracking Claim
VVL.125 Type of Claim List TYPE-OF-CLAIM E Separate CHIP (Title XXI) claim for a supplemental payment (above capitation fee or above negotiated rate) (e.g., FQHC additional reimbursement)
VVL.125 Type of Claim List TYPE-OF-CLAIM U Other FFS claim
VVL.125 Type of Claim List TYPE-OF-CLAIM V Other Capitated Payment
VVL.125 Type of Claim List TYPE-OF-CLAIM W Other Managed Care Encounter
VVL.125 Type of Claim List TYPE-OF-CLAIM X Non-Medicaid/CHIP service tracking claims
VVL.125 Type of Claim List TYPE-OF-CLAIM Y Other Supplemental Payment
VVL.125 Type of Claim List TYPE-OF-CLAIM Z Denied claims
VVL.126 Type of Hospital List TYPE-OF-HOSPITAL 00 Not a hospital
VVL.126 Type of Hospital List TYPE-OF-HOSPITAL 01 Inpatient Hospital
VVL.126 Type of Hospital List TYPE-OF-HOSPITAL 02 Outpatient Hospital
VVL.126 Type of Hospital List TYPE-OF-HOSPITAL 03 Critical Access Hospital
VVL.126 Type of Hospital List TYPE-OF-HOSPITAL 04 Swing Bed Hospital
VVL.126 Type of Hospital List TYPE-OF-HOSPITAL 05 Inpatient Psychiatric Hospital
VVL.126 Type of Hospital List TYPE-OF-HOSPITAL 06 IHS Hospital
VVL.126 Type of Hospital List TYPE-OF-HOSPITAL 07 Childrens Hospital
VVL.126 Type of Hospital List TYPE-OF-HOSPITAL 08 Other
VVL.127 Type of Other Third-Party Liability List TYPE-OF-OTHER-THIRD-PARTY-LIABILITY 1 Tort/Casualty Claim
VVL.127 Type of Other Third-Party Liability List TYPE-OF-OTHER-THIRD-PARTY-LIABILITY 2 Medical Malpractice
VVL.127 Type of Other Third-Party Liability List TYPE-OF-OTHER-THIRD-PARTY-LIABILITY 3 Estate (an estate, annuity or designated trust)
VVL.127 Type of Other Third-Party Liability List TYPE-OF-OTHER-THIRD-PARTY-LIABILITY 4 Liens
VVL.127 Type of Other Third-Party Liability List TYPE-OF-OTHER-THIRD-PARTY-LIABILITY 5 Workers Compensation
VVL.127 Type of Other Third-Party Liability List TYPE-OF-OTHER-THIRD-PARTY-LIABILITY 6 Payments from an individual or group who has either voluntarily or been assigned legal responsibility for the health care of one or more Medicaid recipients; fraternal groups; unions
VVL.127 Type of Other Third-Party Liability List TYPE-OF-OTHER-THIRD-PARTY-LIABILITY 7 Other - unidentified
VVL.129 Veteran Indicator List VETERAN-IND 0 No
VVL.129 Veteran Indicator List VETERAN-IND 1 Yes
VVL.130 Waiver Type List WAIVER-TYPE 01 1115 Other demonstration
VVL.130 Waiver Type List WAIVER-TYPE 02 1915(b)(1) - These waivers permit freedom-of-choice or mandatory managed care with some voluntary managed care.
VVL.130 Waiver Type List WAIVER-TYPE 03 1915(b)(2) - These waivers allow states to use enrollment brokers.
VVL.130 Waiver Type List WAIVER-TYPE 04 1915(b)(3) - These waivers allow states to use savings to provide additional services that are not in the State Plan.
VVL.130 Waiver Type List WAIVER-TYPE 05 1915(b)(4) - These waivers allow fee for service selective contracting.
VVL.130 Waiver Type List WAIVER-TYPE 06 1915(c) - Aged and Disabled
VVL.130 Waiver Type List WAIVER-TYPE 07 1915(c) - Aged
VVL.130 Waiver Type List WAIVER-TYPE 08 1915(c) - Physical Disabilities
VVL.130 Waiver Type List WAIVER-TYPE 09 1915(c) - Intellectual Disabilities
VVL.130 Waiver Type List WAIVER-TYPE 10 1915(c) - Intellectual and Developmental Disabilities
VVL.130 Waiver Type List WAIVER-TYPE 11 1915(c) - Brain Injury
VVL.130 Waiver Type List WAIVER-TYPE 12 1915(c) - HIV/AIDS
VVL.130 Waiver Type List WAIVER-TYPE 13 1915(c) - Technology Dependent or Medically Fragile
VVL.130 Waiver Type List WAIVER-TYPE 14 1915(c) - Disabled (other)
VVL.130 Waiver Type List WAIVER-TYPE 15 1915(c) - Enrolled in 1915(c) waiver for unspecified or unknown populations
VVL.130 Waiver Type List WAIVER-TYPE 16 1915(c) - Autism/Autism spectrum disorder
VVL.130 Waiver Type List WAIVER-TYPE 17 1915(c) - Developmental Disabilities
VVL.130 Waiver Type List WAIVER-TYPE 18 1915(c) - Mental Illness-Age 18 or Older
VVL.130 Waiver Type List WAIVER-TYPE 19 1915(c) - Mental Illness-Under Age 18
VVL.130 Waiver Type List WAIVER-TYPE 20 1915(c) waiver concurrent with an 1115 or 1915(b) managed care authority
VVL.130 Waiver Type List WAIVER-TYPE 21 1115 HIFA Waiver - Health Insurance Flexibility and Accountability (HIFA) demonstration
VVL.130 Waiver Type List WAIVER-TYPE 22 1115 Pharmacy demonstration
VVL.130 Waiver Type List WAIVER-TYPE 23 1115 Disaster-related demonstration
VVL.130 Waiver Type List WAIVER-TYPE 24 1115 Family planning demonstration
VVL.130 Waiver Type List WAIVER-TYPE 25 1115 Substance use demonstration
VVL.130 Waiver Type List WAIVER-TYPE 26 1115 Premium Assistance demonstration
VVL.130 Waiver Type List WAIVER-TYPE 27 1115 Beneficiary engagement demonstration
VVL.130 Waiver Type List WAIVER-TYPE 28 1115 Former foster care youth from another state
VVL.130 Waiver Type List WAIVER-TYPE 29 1115 Managed long term services and support
VVL.130 Waiver Type List WAIVER-TYPE 30 1115 Delivery system reform
VVL.130 Waiver Type List WAIVER-TYPE 31 1332 Demonstration
VVL.130 Waiver Type List WAIVER-TYPE 32 1915(b) waiver
VVL.130 Waiver Type List WAIVER-TYPE 33 1915(c) waiver
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 1A Inpatient Hospital - Reg. Payments
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 1B Inpatient Hospital - DSH
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 1C Inpatient Hospital - Sup. Payments
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 1D Inpatient Hospital - GME Payments
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 2A Mental Health Facility Services - Reg. Payments
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 2B Mental Health Facility - DSH
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 3A Nursing Facility Services - Reg. Payments
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 3B Nursing Facility Services - Sup. Payments
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 4A Intermediate Care Facility Services Individuals with Intellectual Disabilities: Public Providers
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 4B Intermediate Care Facility Services - Individuals with Intellectual Disabilities: Private Providers
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 4C Intermediate Care Facility Services Individuals with Intellectual Disabilities: Supplemental Payments
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 5A Physician & Surgical Services - Reg. Payments
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 5B Physician & Surgical Services - Sup. Payments
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 5C Physician & Surgical Services - Evaluation and Management
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 5D Physician & Surgical Services - Vaccine codes
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 6A Outpatient Hospital Services - Reg. Payments
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 6B Outpatient Hospital Services - Sup. Payments
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 7 Prescribed Drugs
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 7A1 Drug Rebate Offset - National
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 7A2 Drug Rebate Offset - State Sidebar Agreement
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 7A3 MCO - National Agreement
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 7A4 MCO - State Sidebar Agreement
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 7A5 Increased ACA OFFSET - Fee for Service - 100%
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 7A6 Increased ACA OFFSET - MCO - 100%
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 8 Dental Services
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 9A Other Practitioners Services - Reg. Payments
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 9B Other Practitioners Services - Sup. Payments
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 10 Clinic Services
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 11 Laboratory/Radiological
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 12 Home Health Services
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 13 Sterilizations
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 14 Other Pregnancy-related Procedures
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 15 EPSDT Screening
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 16 Rural Health
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 17A Medicare - Part A
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 17B Medicare - Part B
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 17C1 120% - 134% Of Poverty
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 17D Coinsurance
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 18A Medicaid - MCO
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 18A1 Medicaid MCO - Evaluation and Management
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 18A2 Medicaid MCO - Vaccine codes
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 18A3 Medicaid MCO - Community First Choice
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 18A4 Medicaid MCO - Preventive Services Grade A OR B, ACIP Vaccines and their Admin
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 18B1 Prepaid Ambulatory Health Plan
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 18B1a MCO PAHP - Evaluation and Management
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 18B1b MCO PAHP - Vaccine codes
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 18B1c MCO PAHP - Community First Choice
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 18B1d MCO PAHP - Preventive Services Grade A OR B, ACIP Vaccines and their Admin
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 18B2 Prepaid Inpatient Health Plan
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 18B2a MCO PIHP - Evaluation and Management
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 18B2b MCO PIHP - Vaccine codes
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 18B2c MCO PIHP - Community First Choice
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 18B2d MCO PIHP - Preventive Services Grade A OR B, ACIP Vaccines and their Admin
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 18C Medicaid - Group Health
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 18D Medicaid - Coinsurance
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 18E Medicaid - Other
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 19A Home & Community-Based Services - Reg. Pay. (Waiv)
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 19B Home & Community-Based Services - St. Plan 1915(i) Only Pay.
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 19C Home & Community-Based Services - St. Plan 1915(j) Only Pay.
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 19D Home & Community Based Services State Plan 1915(k) Community First Choice
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 22 All-Inclusive Care Elderly
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 23A Personal Care Services - Reg. Payments
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 23B Personal Care Services - SDS 1915(j)
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 24A Targeted Case Management Services - Com. Case-Man.
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 24B Case Management - State Wide
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 25 Primary Care Case Management
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 26 Hospice Benefits
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 27 Emergency Services for Undocumented Aliens
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 28 Federally-Qualified Health Center
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 29 Non-Emergency Medical Transportation
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 30 Physical Therapy
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 31 Occupational Therapy
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 32 Services for Speech, Hearing & Language
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 33 Prosthetic Devices, Dentures, Eyeglasses
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 34 Diagnostic Screening & Preventive Services
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 34A Preventive Services Grade A OR B, ACIP Vaccines and their Admin
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 35 Nurse Mid-Wife
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 36 Emergency Hospital Services
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 37 Critical Access Hospitals
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 38 Nurse Practitioner Services
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 39 School Based Services
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 40 Rehabilitative Services (non-school-based)
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 41 Private Duty Nursing
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 42 Freestanding Birth Center
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 43 Health Home for Enrollees w Chronic Conditions
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 44 Tobacco Cessation for Pregnant Women
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 45 Health Homes for Substance-Use-Disorder Enrollees per section 1006 of the SUPPORT for Patients and Communities Act
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 49 Other Care Services
VVL.131 XIX MBESCBES Category of Service List XIX-MBESCBES-CATEGORY-OF-SERVICE 50 Total
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 1A Premiums - Up To 150%: Gross Premiums Paid
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 1B Premiums - Up To 150%: Cost Sharing Offset
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 1C Premiums - Over 150%: Gross Premiums Paid
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 1D Premiums - Over 150%: Cost Sharing Offset
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 2 Inpatient Hospital
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 3 Inpatient Mental Health
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 4 Nursing Care Services
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 5 Physician/Surgical
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 6 Outpatient Hospital
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 7 Outpatient Mental Health
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 8 Prescribed Drugs
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 8A Drug Rebate
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 9 Dental Services
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 10 Vision Services
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 11 Other Practitioners
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 12 Clinic Services
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 13 Therapy Services
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 14 Laboratory/Radiological
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 15 Medical Equipment
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 16 Family Planning
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 17 Other Pregnancy-related Procedures
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 18 Screening Services
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 19 Home Health
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 20 Health Services Initiatives
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 21 Home and Community
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 22 Hospice
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 23 Medical Transportation
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 24 Case Management
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 25 Translation and Interpretation
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 31 Other Services
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 32 Outreach
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 32A Increased Outreach and Enrollment of Indians
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 32B Increase outreach and enrollment of children through premium subsidies
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 33 Administration
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 34 PERM Administration
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 35 Citizenship Verification Technology CHIPRA
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 35A CVT Development
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 35B CVT Operation
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 48 Balance
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 49 Less: Collections
VVL.132 XXI MBESCBES Category of Service List XXI-MBESCBES-CATEGORY-OF-SERVICE 50 Total
VVL.133 Other TPL Collection List OTHER-TPL-COLLECTION 000 Not Applicable
VVL.133 Other TPL Collection List OTHER-TPL-COLLECTION 001 Third Party Resource is Casualty/Tort
VVL.133 Other TPL Collection List OTHER-TPL-COLLECTION 002 Third Party Resource is Estate
VVL.133 Other TPL Collection List OTHER-TPL-COLLECTION 003 Third Party Resource is Lien (TEFRA)
VVL.133 Other TPL Collection List OTHER-TPL-COLLECTION 004 Third Party Resource is Lien (Other)
VVL.133 Other TPL Collection List OTHER-TPL-COLLECTION 005 Third Party Resource is Workers Compensation
VVL.133 Other TPL Collection List OTHER-TPL-COLLECTION 006 Third Party Resource is Medical Malpractice
VVL.133 Other TPL Collection List OTHER-TPL-COLLECTION 007 Third Party Resource is Other
VVL.134 Health Home Provider Indicator List HEALTH-HOME-PROV-IND 0 No
VVL.134 Health Home Provider Indicator List HEALTH-HOME-PROV-IND 1 Yes
VVL.136 Medicare Combined Deductible Indicator List MEDICARE-COMB-DED-IND 0 Amount not combined with coinsurance amount
VVL.136 Medicare Combined Deductible Indicator List MEDICARE-COMB-DED-IND 1 Amount combined with coinsurance amount
VVL.137 Immunization Type List IMMUNIZATION-TYPE 00 None
VVL.137 Immunization Type List IMMUNIZATION-TYPE 01 Anthrax
VVL.137 Immunization Type List IMMUNIZATION-TYPE 02 Cervical Cancer)
VVL.137 Immunization Type List IMMUNIZATION-TYPE 03 Diphtheria
VVL.137 Immunization Type List IMMUNIZATION-TYPE 04 Hepatitis A
VVL.137 Immunization Type List IMMUNIZATION-TYPE 05 Hepatitis B
VVL.137 Immunization Type List IMMUNIZATION-TYPE 06 Haemophilus influenza type b (Hib)
VVL.137 Immunization Type List IMMUNIZATION-TYPE 07 Human Papillomavirus (HPV)
VVL.137 Immunization Type List IMMUNIZATION-TYPE 08 H1N1 Flu
VVL.137 Immunization Type List IMMUNIZATION-TYPE 09 Seasonal Flu
VVL.137 Immunization Type List IMMUNIZATION-TYPE 10 Japanese Encephalitis
VVL.137 Immunization Type List IMMUNIZATION-TYPE 11 Lyme Disease
VVL.137 Immunization Type List IMMUNIZATION-TYPE 12 Measles
VVL.137 Immunization Type List IMMUNIZATION-TYPE 13 Meningococcal
VVL.137 Immunization Type List IMMUNIZATION-TYPE 14 Monkey pox
VVL.137 Immunization Type List IMMUNIZATION-TYPE 15 Mumps
VVL.137 Immunization Type List IMMUNIZATION-TYPE 16 Pertussis
VVL.137 Immunization Type List IMMUNIZATION-TYPE 17 Pneumococcal
VVL.137 Immunization Type List IMMUNIZATION-TYPE 18 Poliomyelitis
VVL.137 Immunization Type List IMMUNIZATION-TYPE 19 Rabies
VVL.137 Immunization Type List IMMUNIZATION-TYPE 20 Rotavirus
VVL.137 Immunization Type List IMMUNIZATION-TYPE 21 Rubella
VVL.137 Immunization Type List IMMUNIZATION-TYPE 22 Shingles
VVL.137 Immunization Type List IMMUNIZATION-TYPE 23 Smallpox
VVL.137 Immunization Type List IMMUNIZATION-TYPE 24 Tetanus
VVL.137 Immunization Type List IMMUNIZATION-TYPE 25 Tuberculosis
VVL.137 Immunization Type List IMMUNIZATION-TYPE 26 Typhoid Fever
VVL.137 Immunization Type List IMMUNIZATION-TYPE 27 Varicella
VVL.137 Immunization Type List IMMUNIZATION-TYPE 28 Yellow Fever
VVL.137 Immunization Type List IMMUNIZATION-TYPE 29 Other
VVL.138 Medicare Reimbursement Type List MEDICARE-REIM-TYPE 01 IPPS - Acute Inpatient PPS
VVL.138 Medicare Reimbursement Type List MEDICARE-REIM-TYPE 02 LTCHPPS - Long-term Care Hospital PPS
VVL.138 Medicare Reimbursement Type List MEDICARE-REIM-TYPE 03 SNFPPS - Skilled Nursing Facility PPS
VVL.138 Medicare Reimbursement Type List MEDICARE-REIM-TYPE 04 HHPPS - Home Health PPS
VVL.138 Medicare Reimbursement Type List MEDICARE-REIM-TYPE 05 IRFPPS - Inpatient Rehabilitation Facility PPS
VVL.138 Medicare Reimbursement Type List MEDICARE-REIM-TYPE 06 IPFPPS - Inpatient Psychiatric Facility PPS
VVL.138 Medicare Reimbursement Type List MEDICARE-REIM-TYPE 07 OPPS - Outpatient PPS
VVL.138 Medicare Reimbursement Type List MEDICARE-REIM-TYPE 08 Fee Schedules (for physicians, DME, ambulance, and clinical lab)
VVL.138 Medicare Reimbursement Type List MEDICARE-REIM-TYPE 09 Part C Hierarchical Condition Category Risk Assessment (CMS-HCC RA) Capitation Payment Model
VVL.139 Program Type List PROGRAM-TYPE 00 No Special Program
VVL.139 Program Type List PROGRAM-TYPE 01 EPSDT
VVL.139 Program Type List PROGRAM-TYPE 02 Family Planning
VVL.139 Program Type List PROGRAM-TYPE 03 Rural Health Clinic
VVL.139 Program Type List PROGRAM-TYPE 04 Federally Qualified Health Centers (FQHC)
VVL.139 Program Type List PROGRAM-TYPE 05 Indian Health Services
VVL.139 Program Type List PROGRAM-TYPE 07 Home and Community Based Care Waiver Services
VVL.139 Program Type List PROGRAM-TYPE 08 Money Follows the Person (MFP)
VVL.139 Program Type List PROGRAM-TYPE 10 BIP - Balancing Incentive Payment
VVL.139 Program Type List PROGRAM-TYPE 11 Community First Choice (1915(k))
VVL.139 Program Type List PROGRAM-TYPE 12 Medicaid Emergency Psychiatric Demonstration
VVL.139 Program Type List PROGRAM-TYPE 13 Home and Community Based Services (HCBS) State Plan Option (1915(i))
VVL.139 Program Type List PROGRAM-TYPE 14 State Plan CHIP
VVL.139 Program Type List PROGRAM-TYPE 15 Psychiatric Residential Treatment Facilities Demonstration Grant Program (PRTF)
VVL.139 Program Type List PROGRAM-TYPE 16 1915(j) (Self- directed personal assistance services/personal care under State Plan or 1915(c) waiver)
VVL.139 Program Type List PROGRAM-TYPE 17 COVID-19 Testing and Testing-Related Services (1905(a)(3) and 2103(c))
VVL.140 Split Claim Indicator List SPLIT-CLAIM-IND 0 No
VVL.140 Split Claim Indicator List SPLIT-CLAIM-IND 1 Yes
VVL.141 Service Tracking Type List SERVICE-TRACKING-TYPE 00 Not a Service Tracking Claim
VVL.141 Service Tracking Type List SERVICE-TRACKING-TYPE 01 Drug Rebate
VVL.141 Service Tracking Type List SERVICE-TRACKING-TYPE 02 DSH Payment
VVL.141 Service Tracking Type List SERVICE-TRACKING-TYPE 03 Lump Sum Payment
VVL.141 Service Tracking Type List SERVICE-TRACKING-TYPE 04 Cost Settlement
VVL.141 Service Tracking Type List SERVICE-TRACKING-TYPE 05 Supplemental
VVL.141 Service Tracking Type List SERVICE-TRACKING-TYPE 06 Other
VVL.142 Other Insurance Indicator List OTHER-INSURANCE-IND 0 No
VVL.142 Other Insurance Indicator List OTHER-INSURANCE-IND 1 Yes
VVL.143 Payment Level Indicator List PAYMENT-LEVEL-IND 1 Claim payment is determined at the header
VVL.143 Payment Level Indicator List PAYMENT-LEVEL-IND 2 Claim payment is determined at the individual lines
VVL.144 License Type List LICENSE-TYPE 1 State, county, or municipality professional or business license
VVL.144 License Type List LICENSE-TYPE 2 DEA license
VVL.144 License Type List LICENSE-TYPE 3 Professional society accreditation
VVL.144 License Type List LICENSE-TYPE 4 CLIA accreditation
VVL.144 License Type List LICENSE-TYPE 5 Other
VVL.146 Provider Identifier Type List PROV-IDENTIFIER-TYPE 1 State-specific Medicaid Provider ID
VVL.146 Provider Identifier Type List PROV-IDENTIFIER-TYPE 2 NPI
VVL.146 Provider Identifier Type List PROV-IDENTIFIER-TYPE 3 Medicare ID
VVL.146 Provider Identifier Type List PROV-IDENTIFIER-TYPE 4 NCPDP ID
VVL.146 Provider Identifier Type List PROV-IDENTIFIER-TYPE 5 Federal Tax ID
VVL.146 Provider Identifier Type List PROV-IDENTIFIER-TYPE 6 State Tax ID
VVL.146 Provider Identifier Type List PROV-IDENTIFIER-TYPE 7 SSN
VVL.146 Provider Identifier Type List PROV-IDENTIFIER-TYPE 8 Other
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 01 Active - Active Do Not Pay
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 02 Active - Active Reinstated
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 03 Active - Active
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 04 Active - Eligibility Verification
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 05 Active - Encounter Only
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 06 Active - Financial Trans Only
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 20 Denied - Denied Two Provider Numbers
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 21 Denied - For Other Reasons
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 22 Denied - Invalid License
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 23 Denied - Not Eligible
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 24 Denied - Same Number Assigned
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 40 Pending - Enrollment
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 41 Pending - License/Cert Verification
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 42 Pending - Missing Documentation
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 43 Pending - No License/Temp License
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 44 Pending - NPI Invalid
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 45 Pending - Rate Determination
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 46 Pending - Signed Agreement
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 47 Pending - Status Approval
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 48 Pending - W9 Missing or Incomplete
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 60 Term - Abuse of billing privileges
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 61 Term - Action Taken by Medicaid/CHIP
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 62 Term - Action Taken by Medicare
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 63 Term - Change of Ownership
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 64 Term - Failure to report a change of address/ownership
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 65 Term - False or misleading information
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 66 Term - Federal exclusion/ debarment, etc.
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 67 Term - Felony conviction
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 68 Term - Involuntary Termination
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 69 Term - License Expired
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 70 Term - License Revoked
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 71 Term - Loss of license or other State action
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 72 Term - Medicare/Medicaid Exclusion
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 73 Term - Medicaid Authority
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 74 Term - Medicare Termination
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 75 Term - Misuse of billing number
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 76 Term - No Claims Activity
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 77 Term - Non-Compliance
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 78 Term - Onsite review/ Provider is no longer operational
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 79 Term - Other
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 80 Term - Provider Deceased
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 81 Term - State exclusion/ debarment, etc.
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 82 Term - Unknown
VVL.147 Provider Medicaid Enrollment Status Code List PROV-MEDICAID-ENROLLMENT-STATUS-CODE 83 Term - Voluntary Termination
VVL.148 Diagnosis POA Flag List DIAGNOSIS-POA-FLAG-1 to DIAGNOSIS-POA-FLAG-12 Y Diagnosis was present at time of inpatient admission
VVL.148 Diagnosis POA Flag List DIAGNOSIS-POA-FLAG-1 to DIAGNOSIS-POA-FLAG-12 N Diagnosis was not present at time of inpatient admission
VVL.148 Diagnosis POA Flag List DIAGNOSIS-POA-FLAG-1 to DIAGNOSIS-POA-FLAG-12 U Documentation insufficient to determine if condition was present at the time of inpatient admission
VVL.148 Diagnosis POA Flag List DIAGNOSIS-POA-FLAG-1 to DIAGNOSIS-POA-FLAG-12 W Clinically undetermined. Provider unable to clinically determine whether the condition was present at the time of inpatient admission.
VVL.148 Diagnosis POA Flag List DIAGNOSIS-POA-FLAG-1 to DIAGNOSIS-POA-FLAG-12 1 Exempt from POA reporting.
VVL.149 Claim Payment Remittance Code List CLAIM-PYMT-REM-CODE-1 to CLAIM-PYMT-REM-CODE-4 Not Applicable Claim Payment Remittance Code List
VVL.150 Source Location List SOURCE-LOCATION 01 MMIS
VVL.150 Source Location List SOURCE-LOCATION 02 Non-MMIS CHIP Payment System
VVL.150 Source Location List SOURCE-LOCATION 03 Pharmacy Benefits Manager (PBM) Vendor
VVL.150 Source Location List SOURCE-LOCATION 04 Dental Benefits Manager Vendor
VVL.150 Source Location List SOURCE-LOCATION 05 Transportation Provider System
VVL.150 Source Location List SOURCE-LOCATION 06 Mental Health Claims Payment System
VVL.150 Source Location List SOURCE-LOCATION 07 Financial Transaction/Accounting System
VVL.150 Source Location List SOURCE-LOCATION 08 Other State Agency Claims Payment System
VVL.150 Source Location List SOURCE-LOCATION 09 County/Local Government Claims Payment System
VVL.150 Source Location List SOURCE-LOCATION 10 Other Vendor/Other Claims Payment System
VVL.150 Source Location List SOURCE-LOCATION 20 Managed Care Organization (MCO)
VVL.151 Benefit Type Code List BENEFIT-TYPE 001 Inpatient Hospital Services
VVL.151 Benefit Type Code List BENEFIT-TYPE 002 Outpatient Hospital Services
VVL.151 Benefit Type Code List BENEFIT-TYPE 003 Rural health clinic services
VVL.151 Benefit Type Code List BENEFIT-TYPE 004 FQHC services
VVL.151 Benefit Type Code List BENEFIT-TYPE 005 Other Laboratory and X-Ray Services
VVL.151 Benefit Type Code List BENEFIT-TYPE 006 Nursing Facility Services for 21 and over
VVL.151 Benefit Type Code List BENEFIT-TYPE 007 EPSDT
VVL.151 Benefit Type Code List BENEFIT-TYPE 008 Family Planning Services
VVL.151 Benefit Type Code List BENEFIT-TYPE 009 Mandatory tobacco cessation counseling for pregnant women under 1905(a)(4)(D)
VVL.151 Benefit Type Code List BENEFIT-TYPE 010 Physicians' Services
VVL.151 Benefit Type Code List BENEFIT-TYPE 011 Medical and Surgical Services Furnished by a Dentist
VVL.151 Benefit Type Code List BENEFIT-TYPE 012 Nurse-midwife services
VVL.151 Benefit Type Code List BENEFIT-TYPE 013 Certified pediatric or family nurse practitioners' services
VVL.151 Benefit Type Code List BENEFIT-TYPE 014 Free Standing Birth Center Services
VVL.151 Benefit Type Code List BENEFIT-TYPE 015 Home Health Services - Intermittent or part-time nursing services provided by a home health agency
VVL.151 Benefit Type Code List BENEFIT-TYPE 016 Home Health Services - Home Health Aide Services Provided by a Home Health Agency
VVL.151 Benefit Type Code List BENEFIT-TYPE 017 Home Health Services - Medical supplies, equipment, and appliances suitable for use in the home
VVL.151 Benefit Type Code List BENEFIT-TYPE 018 Medical care and any type of remedial care recognized under State law - Podiatrists' Services
VVL.151 Benefit Type Code List BENEFIT-TYPE 019 Medical care and any type of remedial care recognized under State law - Optometrists' Services
VVL.151 Benefit Type Code List BENEFIT-TYPE 020 Medical care and any type of remedial care recognized under State law - Chiropractors' Services
VVL.151 Benefit Type Code List BENEFIT-TYPE 021 Medical care and any type of remedial care recognized under State law - Other Practitioners' Services within scope of practice as defined by State law
VVL.151 Benefit Type Code List BENEFIT-TYPE 022 Home Health Services - Physical therapy; occupational therapy; speech pathology; audiology provided by a home health agency
VVL.151 Benefit Type Code List BENEFIT-TYPE 023 Private Duty Nursing
VVL.151 Benefit Type Code List BENEFIT-TYPE 024 Clinic Services
VVL.151 Benefit Type Code List BENEFIT-TYPE 025 Dental Services
VVL.151 Benefit Type Code List BENEFIT-TYPE 026 Physical Therapy and Related Services - Physical Therapy
VVL.151 Benefit Type Code List BENEFIT-TYPE 027 Physical Therapy and Related Services - Occupational Therapy
VVL.151 Benefit Type Code List BENEFIT-TYPE 028 Physical Therapy and Related Services - Services for individuals with speech, hearing and language disorders
VVL.151 Benefit Type Code List BENEFIT-TYPE 029 Prescription drugs, dentures, and prosthetic devices; and eyeglasses - Prescribed Drugs
VVL.151 Benefit Type Code List BENEFIT-TYPE 030 Prescription drugs, dentures, and prosthetic devices; and eyeglasses - Dentures
VVL.151 Benefit Type Code List BENEFIT-TYPE 031 Prescription drugs, dentures, and prosthetic devices; and eyeglasses - Prosthetic Devices
VVL.151 Benefit Type Code List BENEFIT-TYPE 032 Prescription drugs, dentures, and prosthetic devices; and eyeglasses - Eyeglasses
VVL.151 Benefit Type Code List BENEFIT-TYPE 033 Other diagnostic, screening, preventive, and rehabilitative services - Diagnostic Services
VVL.151 Benefit Type Code List BENEFIT-TYPE 034 Other diagnostic, screening, preventive, and rehabilitative services - Screening Services
VVL.151 Benefit Type Code List BENEFIT-TYPE 035 Other diagnostic, screening, preventive, and rehabilitative services - Preventive Services
VVL.151 Benefit Type Code List BENEFIT-TYPE 036 Other diagnostic, screening, preventive, and rehabilitative services - Rehabilitative Services
VVL.151 Benefit Type Code List BENEFIT-TYPE 037 Services for individuals over age 65 in IMDs - Inpatient hospital services
VVL.151 Benefit Type Code List BENEFIT-TYPE 038 Services for individuals over age 65 in IMDs - Nursing facility services
VVL.151 Benefit Type Code List BENEFIT-TYPE 039 Intermediate Care Facility Services for individuals with intellectual disabilities or persons with related conditions
VVL.151 Benefit Type Code List BENEFIT-TYPE 040 Inpatient psychiatric facility services for under 21
VVL.151 Benefit Type Code List BENEFIT-TYPE 041 Hospice Care
VVL.151 Benefit Type Code List BENEFIT-TYPE 042 Case Management Services and TB related services - Case management services as defined in the State Plan in accordance with section 1905(a)(19) or 1915(g)
VVL.151 Benefit Type Code List BENEFIT-TYPE 043 Case Management Services and TB related services - Special TB related services under section 1902(z)(2)
VVL.151 Benefit Type Code List BENEFIT-TYPE 044 Respiratory care services under 1902(e)9)(A) through (C)
VVL.151 Benefit Type Code List BENEFIT-TYPE 045 Personal care services
VVL.151 Benefit Type Code List BENEFIT-TYPE 046 Primary care case management services
VVL.151 Benefit Type Code List BENEFIT-TYPE 047 Special sickle-cell anemia-related services
VVL.151 Benefit Type Code List BENEFIT-TYPE 048 Any other medical care and any other type of remedial care recognized under State law, specified by the Secretary - Transportation
VVL.151 Benefit Type Code List BENEFIT-TYPE 049 Any other medical care and any other type of remedial care recognized under State law, specified by the Secretary - Services provided in religious non-medical health care facilities
VVL.151 Benefit Type Code List BENEFIT-TYPE 050 Any other medical care and any other type of remedial care recognized under State law, specified by the Secretary - Nursing facility services for patients under 21
VVL.151 Benefit Type Code List BENEFIT-TYPE 051 Any other medical care and any other type of remedial care recognized under State law, specified by the Secretary - Emergency hospital services
VVL.151 Benefit Type Code List BENEFIT-TYPE 052 Any other medical care and any other type of remedial care recognized under State law, specified by the Secretary - Critical Access Hospitals
VVL.151 Benefit Type Code List BENEFIT-TYPE 053 Extended services for pregnant women - Additional Services for any other medical conditions that may complicate pregnancy
VVL.151 Benefit Type Code List BENEFIT-TYPE 054 Community First Choice
VVL.151 Benefit Type Code List BENEFIT-TYPE 055 Health Home Services
VVL.151 Benefit Type Code List BENEFIT-TYPE 056 Limited Pregnancy-Related Services for Pregnant Women with Income Above the Applicable Income Limit
VVL.151 Benefit Type Code List BENEFIT-TYPE 057 Ambulatory prenatal care for pregnant women furnished during a presumptive eligibility period
VVL.151 Benefit Type Code List BENEFIT-TYPE 058 Benefits for Families Receiving Transitional Medical Assistance
VVL.151 Benefit Type Code List BENEFIT-TYPE 059 Standards for Coverage of Transplant Services
VVL.151 Benefit Type Code List BENEFIT-TYPE 060 School-Based Services Payment Methodologies
VVL.151 Benefit Type Code List BENEFIT-TYPE 061 Indian Health Services and Tribal Health Facilities
VVL.151 Benefit Type Code List BENEFIT-TYPE 062 Methods and Standards to Assure High Quality Care
VVL.151 Benefit Type Code List BENEFIT-TYPE 063 Medicare Premium Payments
VVL.151 Benefit Type Code List BENEFIT-TYPE 064 Medicare Coinsurance and Deductibles
VVL.151 Benefit Type Code List BENEFIT-TYPE 065 Other Medical Insurance Premium Payments
VVL.151 Benefit Type Code List BENEFIT-TYPE 066 Programs for Distribution of Pediatric Vaccines
VVL.151 Benefit Type Code List BENEFIT-TYPE 067 Laboratory and x-ray services
VVL.151 Benefit Type Code List BENEFIT-TYPE 068 Home Health Services - Home health aide services provided by a home health agency
VVL.151 Benefit Type Code List BENEFIT-TYPE 069 Private duty nursing services
VVL.151 Benefit Type Code List BENEFIT-TYPE 070 Physical Therapy and Related Services - Audiology services
VVL.151 Benefit Type Code List BENEFIT-TYPE 071 Extended services for pregnant women - Additional Pregnancy-related and postpartum services for a 60-day period after the pregnancy ends and any remaining days in the month in which the 60th day falls.
VVL.151 Benefit Type Code List BENEFIT-TYPE 072 Home and Community Care for Functionally Disabled Elderly individuals as defined and described in the State Plan
VVL.151 Benefit Type Code List BENEFIT-TYPE 073 Emergency services for certain legalized aliens and undocumented aliens
VVL.151 Benefit Type Code List BENEFIT-TYPE 074 Licensed or Otherwise State-Approved Free-Standing Birthing Center and other ambulatory services that are offered by a freestanding birth center
VVL.151 Benefit Type Code List BENEFIT-TYPE 075 Homemaker
VVL.151 Benefit Type Code List BENEFIT-TYPE 076 Home Health Aide
VVL.151 Benefit Type Code List BENEFIT-TYPE 077 Adult Day Health services
VVL.151 Benefit Type Code List BENEFIT-TYPE 078 Habilitation
VVL.151 Benefit Type Code List BENEFIT-TYPE 079 Habilitation: Residential Habilitation
VVL.151 Benefit Type Code List BENEFIT-TYPE 080 Habilitation: Supported Employment
VVL.151 Benefit Type Code List BENEFIT-TYPE 081 Habilitation: Education (non IDEA available)
VVL.151 Benefit Type Code List BENEFIT-TYPE 082 Habilitation: Day Habilitation
VVL.151 Benefit Type Code List BENEFIT-TYPE 083 Habilitation: Pre-Vocational
VVL.151 Benefit Type Code List BENEFIT-TYPE 084 Habilitation: Other Habilitative Services
VVL.151 Benefit Type Code List BENEFIT-TYPE 085 Respite
VVL.151 Benefit Type Code List BENEFIT-TYPE 086 Day Treatment (mental health service)
VVL.151 Benefit Type Code List BENEFIT-TYPE 087 Psychosocial rehabilitation
VVL.151 Benefit Type Code List BENEFIT-TYPE 088 Environmental Modifications (Home Accessibility Adaptations)
VVL.151 Benefit Type Code List BENEFIT-TYPE 089 Vehicle Modifications
VVL.151 Benefit Type Code List BENEFIT-TYPE 090 Non-Medical Transportation
VVL.151 Benefit Type Code List BENEFIT-TYPE 091 Special Medical Equipment (minor assistive Devices)
VVL.151 Benefit Type Code List BENEFIT-TYPE 092 Home Delivered meals
VVL.151 Benefit Type Code List BENEFIT-TYPE 093 Assistive Technology (i.e., communication devices)
VVL.151 Benefit Type Code List BENEFIT-TYPE 094 Personal Emergency Response (PERS)
VVL.151 Benefit Type Code List BENEFIT-TYPE 095 Nursing Services
VVL.151 Benefit Type Code List BENEFIT-TYPE 096 Community Transition Services
VVL.151 Benefit Type Code List BENEFIT-TYPE 097 Adult Foster Care
VVL.151 Benefit Type Code List BENEFIT-TYPE 098 Day Supports (non-habilitative)
VVL.151 Benefit Type Code List BENEFIT-TYPE 099 Supported Employment
VVL.151 Benefit Type Code List BENEFIT-TYPE 100 Supported Living Arrangements
VVL.151 Benefit Type Code List BENEFIT-TYPE 101 Supports for Consumer Direction (Supports Facilitation)
VVL.151 Benefit Type Code List BENEFIT-TYPE 102 Participant Directed Goods and Services
VVL.151 Benefit Type Code List BENEFIT-TYPE 103 Senior Companion (Adult Companion Services)
VVL.151 Benefit Type Code List BENEFIT-TYPE 104 Assisted Living
VVL.151 Benefit Type Code List BENEFIT-TYPE 105 Program for All-inclusive Care for the Elderly (PACE) Services
VVL.151 Benefit Type Code List BENEFIT-TYPE 106 Self-directed Personal Assistance Services under 1915(j)
VVL.151 Benefit Type Code List BENEFIT-TYPE 107 In vitro diagnostic products (as defined in section 809.3(a) of title 21, Code of Federal Regulations) administered during any portion of the emergency period defined in paragraph (1)(B) of section 1135(g) beginning on or after the date of the enactment of this subparagraph for the detection of SARSCoV2 or the diagnosis of the virus that causes COVID19, and the administration of such in vitro diagnostic products
VVL.151 Benefit Type Code List BENEFIT-TYPE 108 COVID19 testing-related services
VVL.152 Claim Status List CLAIM-LINE-STATUS / CLAIM-STATUS Not Applicable Link to Claim Status List
VVL.153 Claim Status Category List CLAIM-STATUS-CATEGORY Not Applicable Link to Claim Status Category List
VVL.154 Line Adjustment Reason Code List LINE-ADJUSTMENT-REASON-CODE Not Applicable Link to Line Adjustment Reason Code List
VVL.156 Healthcare Acquired Condition Indicator List HEALTH-CARE-ACQUIRED-CONDITION-IND 0 No
VVL.156 Healthcare Acquired Condition Indicator List HEALTH-CARE-ACQUIRED-CONDITION-IND 1 Yes
VVL.157 NDC Unit of Measure List NDC-UNIT-OF-MEASURE/UNIT-OF-MEASURE EA Each
VVL.157 NDC Unit of Measure List NDC-UNIT-OF-MEASURE/UNIT-OF-MEASURE F2 International Unit
VVL.157 NDC Unit of Measure List NDC-UNIT-OF-MEASURE/UNIT-OF-MEASURE ML Milliliter
VVL.157 NDC Unit of Measure List NDC-UNIT-OF-MEASURE/UNIT-OF-MEASURE ME Milligram
VVL.157 NDC Unit of Measure List NDC-UNIT-OF-MEASURE/UNIT-OF-MEASURE GR Gram
VVL.157 NDC Unit of Measure List NDC-UNIT-OF-MEASURE/UNIT-OF-MEASURE GM Grams
VVL.157 NDC Unit of Measure List NDC-UNIT-OF-MEASURE/UNIT-OF-MEASURE UN Unit
VVL.158 Revenue Code List REVENUE-CODE Not Applicable Revenue Code List
VVL.159 Self Direction Type List SELF-DIRECTION-TYPE 000 Not Applicable
VVL.159 Self Direction Type List SELF-DIRECTION-TYPE 001 Hiring Authority
VVL.159 Self Direction Type List SELF-DIRECTION-TYPE 002 Budget Authority
VVL.159 Self Direction Type List SELF-DIRECTION-TYPE 003 Hiring and Budget Authority
VVL.164 Rebate Eligible Indicator List REBATE-ELIGIBLE-INDICATOR 0 NDC is not eligible for drug rebate program. (Manufacturer does not have a rebate agreement.)
VVL.164 Rebate Eligible Indicator List REBATE-ELIGIBLE-INDICATOR 1 NDC is eligible for drug rebate program
VVL.164 Rebate Eligible Indicator List REBATE-ELIGIBLE-INDICATOR 2 NDC is exempt from the drug rebate program (biological and medical devices)
VVL.165 Allowed Charge Source List ALLOWED-CHARGE-SRC 1 Priced using QMB Pricing
VVL.165 Allowed Charge Source List ALLOWED-CHARGE-SRC 2 Lab panel bundled
VVL.165 Allowed Charge Source List ALLOWED-CHARGE-SRC 4 Priced using RBRVS
VVL.165 Allowed Charge Source List ALLOWED-CHARGE-SRC 5 Anesthesia pricing
VVL.165 Allowed Charge Source List ALLOWED-CHARGE-SRC 7 APC priced
VVL.165 Allowed Charge Source List ALLOWED-CHARGE-SRC A Manually priced
VVL.165 Allowed Charge Source List ALLOWED-CHARGE-SRC B By report
VVL.165 Allowed Charge Source List ALLOWED-CHARGE-SRC C Maximum fee
VVL.165 Allowed Charge Source List ALLOWED-CHARGE-SRC D Percent of charges
VVL.165 Allowed Charge Source List ALLOWED-CHARGE-SRC E Reimbursement Rate
VVL.165 Allowed Charge Source List ALLOWED-CHARGE-SRC F Lower level screening fee
VVL.165 Allowed Charge Source List ALLOWED-CHARGE-SRC G Billed Charges
VVL.165 Allowed Charge Source List ALLOWED-CHARGE-SRC H Denied
VVL.165 Allowed Charge Source List ALLOWED-CHARGE-SRC I Medicare Coins and deductible
VVL.165 Allowed Charge Source List ALLOWED-CHARGE-SRC J Daily Per Diem Rate
VVL.165 Allowed Charge Source List ALLOWED-CHARGE-SRC K Medicare allowed amount
VVL.165 Allowed Charge Source List ALLOWED-CHARGE-SRC L First 20 days stay
VVL.165 Allowed Charge Source List ALLOWED-CHARGE-SRC M Medicare prevailing
VVL.165 Allowed Charge Source List ALLOWED-CHARGE-SRC O APRDRG pricing
VVL.165 Allowed Charge Source List ALLOWED-CHARGE-SRC P DRG
VVL.165 Allowed Charge Source List ALLOWED-CHARGE-SRC R DRG w/cost outlier
VVL.165 Allowed Charge Source List ALLOWED-CHARGE-SRC U DRG priced by proration
VVL.165 Allowed Charge Source List ALLOWED-CHARGE-SRC V Mid-level priced
VVL.165 Allowed Charge Source List ALLOWED-CHARGE-SRC Z ATP Bundled
VVL.166 Occurrence Code List OCCURRENCE-CODE-01 to OCCURRENCE-CODE-10 Not Applicable Occurrence Codes
VVL.166 Occurrence Code List OCCURRENCE-CODE-01 to OCCURRENCE-CODE-10 Not Applicable Occurrence Span Codes
VVL.167 Provider Facility Type PROV-FACILITY-TYPE 100000000 Individuals or Groups (of Individuals)
VVL.167 Provider Facility Type PROV-FACILITY-TYPE 170000000 Non-Individual - Other Service Providers
VVL.167 Provider Facility Type PROV-FACILITY-TYPE 250000000 Non-Individual - Agencies
VVL.167 Provider Facility Type PROV-FACILITY-TYPE 260000000 Non-Individual - Ambulatory Health Care Facilities
VVL.167 Provider Facility Type PROV-FACILITY-TYPE 270000000 Non-Individual - Hospital Units
VVL.167 Provider Facility Type PROV-FACILITY-TYPE 280000000 Non-Individual - Hospitals
VVL.167 Provider Facility Type PROV-FACILITY-TYPE 290000000 Non-Individual - Laboratories
VVL.167 Provider Facility Type PROV-FACILITY-TYPE 300000000 Non-Individual - Managed Care Organizations
VVL.167 Provider Facility Type PROV-FACILITY-TYPE 310000000 Non-Individual - Nursing & Custodial Care Facilities
VVL.167 Provider Facility Type PROV-FACILITY-TYPE 320000000 Non-Individual - Residential Treatment Facilities
VVL.167 Provider Facility Type PROV-FACILITY-TYPE 330000000 Non-Individual - Suppliers
VVL.167 Provider Facility Type PROV-FACILITY-TYPE 340000000 Non-Individual - Transportation Services
VVL.167 Provider Facility Type PROV-FACILITY-TYPE 380000000 Non-Individual - Respite Care Facility
VVL.167 Provider Facility Type PROV-FACILITY-TYPE Not Applicable Note: Appendix L takes the WPC taxonomy codes and relates each one to its provider facility type code
VVL.168 Primary Eligibility Group Indicator List PRIMARY-ELIGIBILITY-GROUP-IND 0 No
VVL.168 Primary Eligibility Group Indicator List PRIMARY-ELIGIBILITY-GROUP-IND 1 Yes
VVL.169 SSI State Supplement Code List SSI-STATE-SUPPLEMENT-STATUS-CODE 000 Not Applicable
VVL.169 SSI State Supplement Code List SSI-STATE-SUPPLEMENT-STATUS-CODE 001 Mandatory
VVL.169 SSI State Supplement Code List SSI-STATE-SUPPLEMENT-STATUS-CODE 002 Optional
VVL.170 Tooth Designation System List TOOTH-DESIGNATION-SYSTEM JO ANSI/ADA/ISO Specification No. 3950
VVL.170 Tooth Designation System List TOOTH-DESIGNATION-SYSTEM JP ADAs Universal/National Tooth Designation system
VVL.171 Tooth Number List TOOTH-NUM 1 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 2 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 3 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 4 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 5 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 6 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 7 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 8 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 9 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 10 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 11 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 12 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 13 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 14 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 15 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 16 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 17 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 18 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 19 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 20 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 21 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 22 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 23 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 24 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 25 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 26 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 27 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 28 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 29 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 30 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 31 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 32 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 51 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 52 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 53 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 54 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 55 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 56 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 57 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 58 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 59 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 60 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 61 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 62 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 63 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 64 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 65 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 66 Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 67 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 68 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 69 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 70 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 71 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 72 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 73 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 74 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 75 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 76 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 77 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 78 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 79 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 80 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 81 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM 82 Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM A Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM B Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM C Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM D Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM E Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM F Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM G Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM H Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM I Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM J Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM K Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM L Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM M Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM N Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM O Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM P Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM Q Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM R Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM S Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM T Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM AS Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM BS Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM CS Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM DS Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM ES Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM FS Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM GS Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM HS Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM IS Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM JS Upper Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM KS Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM LS Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM MS Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM NS Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM OS Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM PS Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM QS Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM RS Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM SS Lower Arch, Upper right quadrant
VVL.171 Tooth Number List TOOTH-NUM TS Lower Arch, Upper right quadrant
VVL.172 Tooth Quad Code List TOOTH-QUAD-CODE 00 Entire Oral Cavity
VVL.172 Tooth Quad Code List TOOTH-QUAD-CODE 01 Maxillary Area
VVL.172 Tooth Quad Code List TOOTH-QUAD-CODE 02 Mandibular Area
VVL.172 Tooth Quad Code List TOOTH-QUAD-CODE 03 Upper Right Sextant
VVL.172 Tooth Quad Code List TOOTH-QUAD-CODE 04 Upper Anterior Sextant
VVL.172 Tooth Quad Code List TOOTH-QUAD-CODE 05 Upper Left Sextant
VVL.172 Tooth Quad Code List TOOTH-QUAD-CODE 06 Lower Left Sextant
VVL.172 Tooth Quad Code List TOOTH-QUAD-CODE 07 Lower Anterior Sextant
VVL.172 Tooth Quad Code List TOOTH-QUAD-CODE 08 Lower Right Sextant
VVL.172 Tooth Quad Code List TOOTH-QUAD-CODE 09 Other Area of Oral Cavity (An area specified in an annexed document or further explanation available.)
VVL.172 Tooth Quad Code List TOOTH-QUAD-CODE 10 Upper Right Quadrant (Right Refers to the oral and skeletal structures on the right side.)
VVL.172 Tooth Quad Code List TOOTH-QUAD-CODE 20 Upper Left Quadrant (Left Refers to the oral and skeletal structures on the left side.)
VVL.172 Tooth Quad Code List TOOTH-QUAD-CODE 30 Lower Left Quadrant
VVL.172 Tooth Quad Code List TOOTH-QUAD-CODE 40 Lower Right Quadrant
VVL.174 New Refill Indicator List NEW-REFILL-IND 00 New Prescription
VVL.174 New Refill Indicator List NEW-REFILL-IND 01-99 Number of Refill(s)
VVL.175 Procedure Code Flag List PROCEDURE-CODE-FLAG 1 thru PROCEDURE-CODE-FLAG 6 01 CPT 4
VVL.175 Procedure Code Flag List PROCEDURE-CODE-FLAG 1 thru PROCEDURE-CODE-FLAG 6 02 ICD-9 CM
VVL.175 Procedure Code Flag List PROCEDURE-CODE-FLAG 1 thru PROCEDURE-CODE-FLAG 6 06 HCPCS (Both National and Regional HCPCS)
VVL.175 Procedure Code Flag List PROCEDURE-CODE-FLAG 1 thru PROCEDURE-CODE-FLAG 6 07 ICD-10 - CM PCS
VVL.175 Procedure Code Flag List PROCEDURE-CODE-FLAG 1 thru PROCEDURE-CODE-FLAG 6 10-87 Other Systems
VVL.176 SSI Status List SSI-STATUS 000 Not Applicable
VVL.176 SSI Status List SSI-STATUS 001 SSI
VVL.176 SSI Status List SSI-STATUS 002 SSI Eligible Spouse
VVL.176 SSI Status List SSI-STATUS 003 SSI Pending a Final Determination of Disposal of Resources Exceeding SSI Dollar Limits
VVL.177 Outlier Code List OUTLIER-CODE 00 No Outlier
VVL.177 Outlier Code List OUTLIER-CODE 01 Day Outlier
VVL.177 Outlier Code List OUTLIER-CODE 02 Cost Outlier
VVL.177 Outlier Code List OUTLIER-CODE 06 Valid DRG Received from the intermediary
VVL.177 Outlier Code List OUTLIER-CODE 07 CMS Developed DRG
VVL.177 Outlier Code List OUTLIER-CODE 08 CMS Developed DRG Using Patient Status Code
VVL.177 Outlier Code List OUTLIER-CODE 09 Not Group able
VVL.177 Outlier Code List OUTLIER-CODE 10 Composite of cost outliers
VVL.178 Place of Service Code List PLACE-OF-SERVICE Not Applicable Place of Service Code List
VVL.179 Primary Language Code List PRIMARY-LANGUAGE-CODE Not Applicable See language codes in the Data Dictionary Appendix G: ISO 639-2 Language Codes Reference for a list of all valid language codes
VVL.179 Primary Language Code List PRIMARY-LANGUAGE-CODE Not Applicable Language Codes List
VVL.180 HCPCS Rate List HCPCS-RATE Not Applicable HCPCS Codes
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 001 Inpatient hospital services, other than services in an institution for mental diseases
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 002 Outpatient hospital services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 003 Rural health clinic services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 004 Other ambulatory services furnished by a rural health clinic
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 005 Professional laboratory services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 006 Technical laboratory services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 007 Professional radiological services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 008 Technical radiological services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 009 Nursing facility services for individuals age 21 or older (other than services in an institution for mental disease)
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 010 Early and periodic screening and diagnosis and treatment (EPSDT) services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 011 Family planning services and supplies for individuals of child-bearing age
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 012 Physicians' services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 013 Medical and surgical services of a dentist
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 014 Outpatient substance abuse treatment services.
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 015 Medical or other remedial care or services, other than physicians' services, provided by licensed practitioners within the scope of practice as defined under State law
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 016 Home health services - Nursing services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 017 Home health services - Home health aide services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 018 Home health services - Medical supplies, equipment, and appliances suitable for use in the home
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 019 Home health services - Physical therapy provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 020 Home health services - Occupational therapy provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 021 Home health services - Speech pathology and audiology services provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 022 Private duty nursing services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 023 Advanced practice nurse services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 024 Pediatric nurse
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 025 Nurse-midwife service
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 026 Nurse practitioner services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 027 Respiratory care for ventilator-dependent individuals
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 028 Clinic services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 029 Dental services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 030 Physical therapy services (when not provided under home health services)
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 031 Occupational therapy services (when not provided under home health services)
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 032 Speech, hearing, and language disorders services (when not provided under home health services)
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 033 Prescribed drugs
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 034 Over-the-counter medications.
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 035 Dentures
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 036 Prosthetic devices
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 037 Eyeglasses
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 038 Hearing Aids
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 039 Diagnostic services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 040 Screening services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 041 Preventive services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 042 Well-baby and well-child care services as defined by the State.
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 043 Rehabilitative services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 044 Inpatient hospital services for individuals age 65 or older in institutions for mental diseases
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 045 Nursing facility services for individuals age 65 or older in institutions for mental diseases
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 046 Intermediate care facility (ICF/IIDICF/IID) services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 047 Nursing facility services, other than in institutions for mental diseases
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 048 Inpatient psychiatric services for individuals under age 21
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 049 Outpatient mental health services, other than Outpatient substance abuse treatment services. This TOS includes services furnished in a State-operated mental hospital and including community-based services.
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 050 Inpatient substance abuse treatment services and residential substance abuse treatment services.
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 051 Personal care services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 052 Primary care case management services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 053 Targeted case management services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 054 Case Management services other than those that meet the definition of primary care case management services or targeted case management services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 055 Care coordination services.
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 056 Transportation services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 057 Enabling services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 058 Services furnished in a religious nonmedical health care institution
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 059 Skilled nursing facility services for individuals under age 21
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 060 Emergency hospital services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 061 Critical access hospital services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 062 HCBS - Case management services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 063 HCBS - Homemaker services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 064 HCBS - Home health aide services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 065 HCBS - Personal care services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 066 HCBS - Adult day health services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 067 HCBS - Habilitation services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 068 HCBS - Respite care services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 069 HCBS - Day treatment or other partial hospitalization services, psychosocial rehabilitation services and clinic services (whether or not furnished in a facility) for individuals with chronic mental illness
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 070 HCBS - Day Care
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 071 HCBS - Training for family members
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 072 HCBS - Minor modification to the home
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 073 HCBS - Other services requested by the agency and approved by CMS as cost effective and necessary to avoid institutionalization
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 074 HCBS - Expanded habilitation services - Prevocational services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 075 HCBS - Expanded habilitation services - Educational services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 076 HCBS - Expanded habilitation services - Supported employment services, which facilitate paid employment
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 077 HCBS-65-plus - Case management services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 078 HCBS-65-plus - Homemaker services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 079 HCBS-65-plus - Home health aide services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 080 HCBS-65-plus - Personal care services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 081 HCBS-65-plus - Adult day health services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 082 HCBS-65-plus - Respite care services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 083 HCBS-65-plus - Other medical and social services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 084 Sterilizations
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 085 Prenatal care and pre-pregnancy family planning services and supplies.
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 086 Other Pregnancy-related Procedures
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 087 Hospice services
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 088 Any other health care services or items specified by the Secretary and not excluded under regulations.
VVL.181 Provider Authorized Category of Service Code List PROV-CLASSIFICATION-TYPE = 4 (Authorized Category of Service Code) 115 Residential care
VVL.182 Eligible Identifier Type List ELG-IDENTIFIER-TYPE 1 Medicaid Card ID (State MMIS)
VVL.182 Eligible Identifier Type List ELG-IDENTIFIER-TYPE 2 Old MSIS Identification Number (State MMIS)
VVL.183 Reason for Change List REASON-FOR-CHANGE MERGE Merge Beneficiaries
VVL.183 Reason for Change List REASON-FOR-CHANGE UNMERGE Unmerge Beneficiaries
VVL.183 Reason for Change List REASON-FOR-CHANGE LSE Large System Enhancement
VVL.183 Reason for Change List REASON-FOR-CHANGE TCAM Transition between CHIP and Medicaid
VVL.184 Border State Indicator List BORDER-STATE-IND 0 No
VVL.184 Border State Indicator List BORDER-STATE-IND 1 Yes
VVL.186 Procedure Code List PROCEDURE-CODE-1 thru PROCEDURE-CODE-6 Not Applicable Procedure Code List
VVL.186 Procedure Code List PROCEDURE-CODE-1 thru PROCEDURE-CODE-6 Not Applicable Procedure Code List 2
VVL.186 Procedure Code List PROCEDURE-CODE-1 thru PROCEDURE-CODE-6 Not Applicable Procedure Code List 3
End of table



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