| Code | Display | Definition |
| after-deductible | After Deductible | The consumer first pays the deductible, and after the deductible is met, the consumer is responsible only for the cost-share amount (this indicates that this benefit is subject to the deductible). |
| before-deductible | Before Deductible | The consumer first pays the cost share amount, and any net remaining allowed charges accrue to the deductible (this indicates that this benefit is subject to the deductible). |
| no-charge | No Charge | No cost sharing is charged (this indicates that this benefit is not subject to the deductible). |
| no-charge-after-deductible | No Charge After Deductible | The consumer first pays the deductible, and after the deductible is met, no cost share amount is charged (this indicates that this benefit is subject to the deductible). |
| charge | Charge | The consumer always pays just the cost share amount and the issuer pays the remainder of allowed charges (this indicates that this benefit is not subject to the deductible). |
| coinsurance-not-applicable | Coinsurance Not Applicable | The consumer pays only a copay. Note: When using Not Applicable for coinsurance, Not Applicable cannot also be used for copay (unless the drug tier type is Medical Service Drugs). |
| copay-not-applicable | Copay Not Applicable | Deductible is not applicable: Zero-deductible cost sharing represented by a co-pay value of 'Not applicable' and co-insurance value of 'No charge'. |
| deductible-waived | Deductible Waived | The consumer pays the cost share amount with deductible requirement waived. |