Healthcare Financial Services IG Edition 1
0.3.0 - ci-build Saudi Arabia flag

Healthcare Financial Services IG Edition 1 - Local Development build (v0.3.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

ValueSet: Benefit Category

Official URL: http://nphies.sa/terminology/ValueSet/benefit-category Version: 0.3.0
Active as of 2024-08-11 Computable Name: BenefitCategory

Copyright/Legal: nphies 2020+ (https://nphies.sa)

Codes for the categories of benefits.

References

Logical Definition (CLD)

Generated Narrative: ValueSet benefit-category

version: 16; Last updated: 2024-08-11 18:26:55+0300

 

Expansion

ValueSet

Expansion performed internally based on codesystem Benefit Category v0.3.0 (CodeSystem)

This value set contains 84 concepts

CodeSystemDisplay (en-US)Definition
  14http://nphies.sa/terminology/CodeSystem/benefit-categoryDental Care

Dental Care.

  15http://nphies.sa/terminology/CodeSystem/benefit-categoryDental Crowns

Dental Crowns.

  19http://nphies.sa/terminology/CodeSystem/benefit-categoryMedically Related Transportation

Medically Related Transportation.

  4http://nphies.sa/terminology/CodeSystem/benefit-categoryDiagnostic XRay

Diagnostic XRay.

  3http://nphies.sa/terminology/CodeSystem/benefit-categoryConsultation

Consultation.

  28http://nphies.sa/terminology/CodeSystem/benefit-categoryVision Coverage

Vision Coverage.

  27http://nphies.sa/terminology/CodeSystem/benefit-categoryHearing Coverage

Hearing Coverage.

  17http://nphies.sa/terminology/CodeSystem/benefit-categoryHospital Room and Board

Hospital Room and Board.

  9http://nphies.sa/terminology/CodeSystem/benefit-categoryRestorative

Restorative.

  5http://nphies.sa/terminology/CodeSystem/benefit-categoryDiagnostic Lab

Diagnostic Lab.

  2http://nphies.sa/terminology/CodeSystem/benefit-categorySurgical

Surgical.

  25http://nphies.sa/terminology/CodeSystem/benefit-categoryMedical Coverage

Medical Coverage.

  13http://nphies.sa/terminology/CodeSystem/benefit-categoryHealth Benefit Plan Coverage

Health Benefit Plan Coverage.

  18http://nphies.sa/terminology/CodeSystem/benefit-categoryMajor Medical

Major Medical.

  10http://nphies.sa/terminology/CodeSystem/benefit-categoryEndodontics

Endodontics.

  12http://nphies.sa/terminology/CodeSystem/benefit-categoryAdjunctive Dental Services

Adjunctive Dental Services.

  24http://nphies.sa/terminology/CodeSystem/benefit-categoryRenal Dialysis

Renal dialysis.

  16http://nphies.sa/terminology/CodeSystem/benefit-categoryDental Accident

Dental Accident.

  11http://nphies.sa/terminology/CodeSystem/benefit-categoryMaxillofacial Prosthetics

Maxillofacial Prosthetics.

  23http://nphies.sa/terminology/CodeSystem/benefit-categoryMaternity

Maternity.

  22http://nphies.sa/terminology/CodeSystem/benefit-categoryDonor Procedures

Donor Procedures such as organ harvest.

  20http://nphies.sa/terminology/CodeSystem/benefit-categoryIn-vitro Fertilization

In-vitro Fertilization.

  7http://nphies.sa/terminology/CodeSystem/benefit-categoryDiagnostic Dental

Diagnostic Dental.

  6http://nphies.sa/terminology/CodeSystem/benefit-categoryRenal Supplies

Renal Supplies excluding Dialysis.

  1http://nphies.sa/terminology/CodeSystem/benefit-categoryMedical Care

Medical Care.

  26http://nphies.sa/terminology/CodeSystem/benefit-categoryDental Coverage

Dental Coverage.

  21http://nphies.sa/terminology/CodeSystem/benefit-categoryMRI Scan

MRI Scan.

  8http://nphies.sa/terminology/CodeSystem/benefit-categoryPeriodontics

Periodontics.

  30http://nphies.sa/terminology/CodeSystem/benefit-categoryOP Medical

OP Medical

  31http://nphies.sa/terminology/CodeSystem/benefit-categoryMax Copay

Max Copay

  29http://nphies.sa/terminology/CodeSystem/benefit-categoryMental Health

Mental Health

  40http://nphies.sa/terminology/CodeSystem/benefit-categoryEar Piercing of female newborn

Ear Piercing of female newborn

  39http://nphies.sa/terminology/CodeSystem/benefit-categoryCircumcision of male newborn

Circumcision of male newborn

  55http://nphies.sa/terminology/CodeSystem/benefit-categoryRehabilitation

Rehabilitation

  48http://nphies.sa/terminology/CodeSystem/benefit-categoryAcquired valvular heart disease

Acquired valvular heart disease

  56http://nphies.sa/terminology/CodeSystem/benefit-categoryPharmacy

Pharmacy

  35http://nphies.sa/terminology/CodeSystem/benefit-categoryAlzheimer's Disease

Alzheimer's Disease

  44http://nphies.sa/terminology/CodeSystem/benefit-categoryOutpatient Treatment expenses-for hospital out of the minimum unified network

Outpatient Treatment expenses-for hospital out of the minimum unified network

  49http://nphies.sa/terminology/CodeSystem/benefit-categoryAutism Management

Autism Management

  41http://nphies.sa/terminology/CodeSystem/benefit-categoryDental Prosthesis

Dental Prosthesis

  54http://nphies.sa/terminology/CodeSystem/benefit-categoryLong term care

Long term care

  45http://nphies.sa/terminology/CodeSystem/benefit-categoryOutpatient Treatment expenses-for non-hospital out of the minimum unified network

Outpatient Treatment expenses-for non-hospital out of the minimum unified network

  34http://nphies.sa/terminology/CodeSystem/benefit-categoryChronic Psychiatric Cases

Chronic Psychiatric Cases

  50http://nphies.sa/terminology/CodeSystem/benefit-categoryDisability Compensations

Disability Compensations

  52http://nphies.sa/terminology/CodeSystem/benefit-categoryNewborn Screening Programs for Hearing Impairment & critical congenital heart disease

Newborn Screening Programs for Hearing Impairment & critical congenital heart disease

  36http://nphies.sa/terminology/CodeSystem/benefit-categoryInfertility & Related Procedures

Infertility & Related Procedures

  46http://nphies.sa/terminology/CodeSystem/benefit-categoryCompanion Room and Board

Companion Room and Board

  42http://nphies.sa/terminology/CodeSystem/benefit-categoryVision Surgery

Vision Surgery

  47http://nphies.sa/terminology/CodeSystem/benefit-categoryRepatriation of Mortal Remains

Repatriation of Mortal Remains

  51http://nphies.sa/terminology/CodeSystem/benefit-categoryObesity Surgery

Obesity Surgery

  37http://nphies.sa/terminology/CodeSystem/benefit-categoryOrthodontic Treatment

Orthodontic Treatment

  53http://nphies.sa/terminology/CodeSystem/benefit-categoryHome Healthcare

Home Healthcare

  32http://nphies.sa/terminology/CodeSystem/benefit-categoryMedical Equipment

Medical Equipment

  43http://nphies.sa/terminology/CodeSystem/benefit-categoryOutpatient Treatment expenses-within minimum unified network

Outpatient Treatment expenses-within minimum unified network

  33http://nphies.sa/terminology/CodeSystem/benefit-categoryAcute Psychiatric Cases

Acute Psychiatric Cases

  38http://nphies.sa/terminology/CodeSystem/benefit-categoryCheck ups

Check ups

  62http://nphies.sa/terminology/CodeSystem/benefit-categoryBasic Homecare coverage

Basic Homecare coverage

  64http://nphies.sa/terminology/CodeSystem/benefit-categoryHip and Knee Replacement

Hip and Knee Replacement

  67http://nphies.sa/terminology/CodeSystem/benefit-categoryOutpatient Treatment expenses - Primary clinic

Outpatient Treatment expenses - Primary clinic

  79http://nphies.sa/terminology/CodeSystem/benefit-categoryGenetic diseases

Genetic diseases

  74http://nphies.sa/terminology/CodeSystem/benefit-categoryComplications arising from treatment of a covered benefit

Complications arising from treatment of a covered benefit

  80http://nphies.sa/terminology/CodeSystem/benefit-categoryInpatient Medical Coverage

Inpatient Medical Coverage

  82http://nphies.sa/terminology/CodeSystem/benefit-categoryMaternity Complications Coverage

Maternity Complications Coverage

  77http://nphies.sa/terminology/CodeSystem/benefit-categoryDelivery of premature babies

Delivery of premature babies

  65http://nphies.sa/terminology/CodeSystem/benefit-categoryImpairment medical management

Impairment medical management

  71http://nphies.sa/terminology/CodeSystem/benefit-categoryPsychiatry coverage

Psychiatry coverage

  60http://nphies.sa/terminology/CodeSystem/benefit-categoryAdvanced Obesity Medical Management

Advanced Obesity Medical Management

  68http://nphies.sa/terminology/CodeSystem/benefit-categoryOutpatient Treatment expenses - specialized clinic with referral

Outpatient Treatment expenses - specialized clinic with referral

  84http://nphies.sa/terminology/CodeSystem/benefit-categoryTelemedicine

Telemedicine

  58http://nphies.sa/terminology/CodeSystem/benefit-categoryAdvanced Dental Coverage

Advanced Dental Coverage

  61http://nphies.sa/terminology/CodeSystem/benefit-categoryBasic and Preventive Dental Coverage

Basic and Preventive Dental Coverage

  69http://nphies.sa/terminology/CodeSystem/benefit-categoryOutpatient Treatment expenses - specialized clinic without referral

Outpatient Treatment expenses - specialized clinic without referral

  72http://nphies.sa/terminology/CodeSystem/benefit-categoryRenal transplant

Renal transplant

  75http://nphies.sa/terminology/CodeSystem/benefit-categoryCongenital anomalies

Congenital anomalies

  78http://nphies.sa/terminology/CodeSystem/benefit-categoryEmergency Service coverage

Emergency Service coverage

  59http://nphies.sa/terminology/CodeSystem/benefit-categoryAdvanced Homecare coverage

Advanced Homecare coverage

  83http://nphies.sa/terminology/CodeSystem/benefit-categoryNew-born coverage

New-born coverage

  63http://nphies.sa/terminology/CodeSystem/benefit-categoryContraception Coverage (Birth Control)

Contraception Coverage (Birth Control)

  66http://nphies.sa/terminology/CodeSystem/benefit-categoryOP Prescribed Generic and Invented Medicines - with no generic alternative available

OP Prescribed Generic and Invented Medicines - with no generic alternative available

  73http://nphies.sa/terminology/CodeSystem/benefit-categoryRoot canal dental coverage

Root canal dental coverage

  57http://nphies.sa/terminology/CodeSystem/benefit-categoryOP Prescribed Invented Medicines - with generic alternative

OP Prescribed Invented Medicines - with generic alternative

  76http://nphies.sa/terminology/CodeSystem/benefit-categoryCosts of national program for the early examination of newborn to limit impairment

Costs of national program for the early examination of newborn to limit impairment

  70http://nphies.sa/terminology/CodeSystem/benefit-categoryPediatric vision coverage

Pediatric vision coverage

  81http://nphies.sa/terminology/CodeSystem/benefit-categoryLife sustaining and interventions altering medical outcomes

Life sustaining and interventions altering medical outcomes


Explanation of the columns that may appear on this page:

Level A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
System The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code The code (used as the code in the resource instance)
Display The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition An explanation of the meaning of the concept
Comments Additional notes about how to use the code