| 1 | Medical Care | 74 | Private Duty Nursing |
| 2 | Surgical | 75 | Prosthetic Device |
| 3 | Consultation | 76 | Dialysis |
| 4 | Diagnostic X-Ray | 77 | Otological Exam |
| 5 | Diagnostic Lab | 78 | Chemotherapy |
| 5 | Radiation Therapy | 79 | Allergy Testing |
| 7 | Anesthesia | 80 | Immunizations |
| 8 | Surgical Assistance | 81 | Routine Physical |
| 9 | Other Medical | 82 | Family Planning |
| 10 | Blood Charges | 83 | Infertility |
| 11 | Used Durable Medical Equipment | 84 | Abortion |
| 12 | Durable Medical Equipment Purchase | 85 | AIDS |
| 13 | Ambulatory Service Center Facility | 86 | Emergency Services |
| 14 | Renal Supplies in the Home | 87 | Cancer |
| 15 | Alternate Method Dialysis | 88 | Pharmacy |
| 16 | Chronic Renal Disease (CRD) Equipment | 89 | Free Standing Prescription Drug |
| 17 | Pre-Admission Testing | 90 | Mail Order Prescription Drug |
| 18 | Durable Medical Equipment Rental | 91 | Brand Name Prescription Drug |
| 19 | Pneumonia Vaccine | 92 | Generic Prescription Drug |
| 20 | Second Surgical Opinion | 93 | Podiatry |
| 21 | Third Surgical Opinion | 94 | Podiatry – Office Visits |
| 22 | Social Work | 95 | Podiatry – Nursing Home Visits |
| 23 | Diagnostic Dental | 96 | Professional ( Physician ) |
| 24 | Periodontics | 97 | Anesthesiologist |
| 25 | Restorative | 98 | Professional ( Physician ) Visit – Office |
| 26 | Endodontics | 99 | Professional ( Physician ) Visit – Inpatient |
| 27 | Maxillofacial Prosthetics | A0 | Professional ( Physician ) Visit – Outpatient |
| 28 | Adjunctive Dental Services | A1 | Professional ( Physician ) Visit – Nursing Home |
| 30 | Health Benefit Plan Coverage If Only a Single Category of Inquiry Can Be Supported, Use This Code | A2 | Professional ( Physician ) Visit – Skilled Nursing Facility |
| 32 | Plan Waiting Period | A3 | Professional ( Physician ) Visit – Home |
| 33 | Chiropractic | A4 | Psychiatric |
| 34 | Chiropractic Office Visits | A5 | Psychiatric – Room and Board |
| 35 | Dental Care | A6 | Psychotherapy |
| 36 | Dental Crowns | A7 | Psychiatric – Inpatient |
| 37 | Dental Accident | A8 | Psychiatric – Outpatient |
| 38 | Orthodontics | A9 | Rehabilitation |
| 39 | Prosthodontics | AA | Rehabilitation – Room and Board |
| 40 | Oral Surgery | AB | Rehabilitation – Inpatient |
| 41 | Routine (Preventive) Dental | AC | Rehabilitation – Outpatient |
| 42 | Home Health Care | AD | Occupational Therapy |
| 43 | Home Health Prescriptions | AE | Physical Medicine |
| 44 | Home Health Visits | AF | Speech Therapy |
| 45 | Hospice | AG | Skilled Nursing Care |
| 46 | Respite Care | AH | Skilled Nursing Care – Room and Board |
| 47 | Hospital | AI | Substance Abuse |
| 48 | Hospital – Inpatient | AJ | Alcoholism |
| 49 | Hospital – Room and Board | AK | Drug Addiction |
| 50 | Hospital – Outpatient | AL | Vision ( Optometry ) |
| 51 | Hospital – Emergency Accident | AM | Frames |
| 52 | Hospital – Emergency Medical | AN | Routine Exam |
| 53 | Hospital – Ambulatory Surgical | AO | Lenses |
| 54 | Long Term Care | AQ | Nonmedically Necessary Physical |
| 55 | Major Medical | AR | Experimental Drug Therapy |
| 56 | Medically Related Transportation | BA | Independent Medical Evaluation |
| 57 | Air Transportation | BB | Partial Hospitalization ( Psychiatric ) |
| 58 | Ambulance | BC | Day Care ( Psychiatric ) |
| 59 | Licensed Ambulance | BD | Cognitive Therapy |
| 60 | General Benefits | BE | Massage Therapy |
| 61 | In-Vitro Fertilization | BF | Pulmonary Rehabilitation |
| 62 | MRI/CAT Scan | BG | Cardiac Rehabilitation |
| 63 | Donor Procedures | BH | Pediatric |
| 64 | Acupuncture | BI | Nursery |
| 65 | Newborn Care | BJ | Skin |
| 66 | Pathology | BK | Orthopedic |
| 67 | Smoking Cessation | BL | Cardiac |
| 68 | Well Baby Care | BM | Lymphatic |
| 69 | Maternity | BN | Gastrointestinal |
| 70 | Transplants | BP | Endocrine |
| 71 | Audiology Exam | BQ | Neurology |
| 72 | Inhalation Therapy | BR | Eye |
| 73 | Diagnostic Medical | BS | Invasive Procedures |