| Code | Display | Definition |
| coinsurance | Co-insurance | The amount the insured individual pays, as a set percentage of the cost of covered medical services, as an out-of-pocket payment to the provider. Example: Insured pays 20% and the insurer pays 80%. |
| noncovered | Noncovered | The portion of the cost of this service that was deemed not eligible by the insurer because the service or member was not covered by the subscriber contract. |
| priorpayerpaid | Prior payer paid | The reduction in the payment amount to reflect the carrier as a secondary payer. |
| paidbypatient | Paid by patient | The total amount paid by the patient without specifying the source. |
| paidbypatientcash | Paid by patient - cash | The amount paid by the patient using cash, check, or other personal account. |
| paidbypatientother | Paid by patient - other | The amount paid by the patient using a method different than cash (cash, check, or personal account) or health account. |
| paidbypatienthealthaccount | Paid by patient - health account | The amount paid by the patient using another method like HSA, HRA, FSA or other type of health account. |
| paidtoprovider | Paid to provider | The amount paid to the provider. |
| paidtopatient | Paid to patient | paid to patient |
| memberliability | Member liability | The amount of the member's liability. |
| discount | Discount | The amount of the discount |
| drugcost | Drug cost | Price paid for the drug excluding mfr or other discounts. It typically is the sum of the following components: ingredient cost, dispensing fee, sales tax, and vaccine administration |