01A = Premiums — Up To 150%: Gross Premiums Paid
01C = Premiums — Over 150%: Gross Premiums Paid
01D = Premiums — Over 150%: Cost Sharing Offset
002 = Inpatient Hospital
02A = Inpatient Hospital Services — DSH
003 = Inpatient Mental Health
03A = Inpatient Mental Health — DSH
03B = Certified Community Behavior Health Clinic Payments
004 = Nursing Care Services
005 = Physician/Surgical
006 = Outpatient Hospital
007 = Outpatient Mental Health
008 = Prescribed Drugs
08A = Drug Rebate
8A2 = Drug Rebate — State
8A3 = MCO — National Agreement
8A4 = MCO — State Sidebar Agreement
8A5 = Increased ACA OFFSET — Fee for Service — 100%
8A6 = Increased ACA OFFSET — MCO — 100%
009 = Dental Services
010 = Vision Services
011 = Other Practitioners
012 = Clinic Services
013 = Therapy Services
014 = Laboratory/Radiological
015 = Medical Equipment
016 = Family Planning
017 = Other Pregnancy-related Procedures
018 = Screening Services
019 = Home Health
020 = Health Services Initiatives
021 = Home and Community
21A = Home and Community-Based Services — Regular Payment (WAIVER)
022 = Hospice
023 = Medical Transportation
024 = Case Management
025 = Translation and Interpretation
026 = American Rescue Plan Act of 2021 (ARP) Section 9821 COVID Vaccine/Vaccine Administration
031 = Other Services
032 = Outreach
033 = Administration (costs incurred by State to administer plan)
034 = PERM Administration
035 = Citizenship Verification Technology CHIPRA
048 = Balance
049 = Less: Collections; total computable amount of refunds or collections attributable to the CHIP program
050 = Total
Null/missing = source value is missing or unknown