| Code | Description |
|---|---|
| 99 | Quantity Used |
| CA | Covered – Actual |
| CE | Covered – Estimated |
| DB | Deductible Blood Units |
| DY | Days |
| HS | Hours |
| LA | Lifetime Reserve – Actual |
| LE | Lifetime Reserve – Estimated |
| MN | Month |
| P6 | Number of Services or Procedures |
| QA | Quantity Approved |
| S7 | Age, High Value: Use this code when a benefit is based on a maximum age for patient |
| S8 | Age, Low Value: Use this code when a benefit is based on a minimum age for the patient |
| VS | Visits |
| YY | Years |