Coverage Codes Coverage Type Coverage Description 1 Hospital Inpatient Services 2 Hospital Outpatient Services 3 Hospital Inpatient / Outpatient Services 4 Physician Services 5 Physician Inpatient / Outpatient Services 6 Physician Inpatient / Outpatient Services & Major Medical 7 Dental Coverage 8 Vision Coverage 9 Drug Coverage 10 Physician Inpatient / Outpatient Services, Major Medical, & Dental 11 Physician Inpatient / Outpatient Services, Major Medical, & Vision 12 Physician Inpatient / Outpatient Services, Major Medical, & Drug (System 13 Medicare Supplement A & B 14 Indemnity Coverage (Payment To Client) 15 Major Medical 16 Major Medical / Physician 17 Major Medical / Physician / Dental 18 Major Medical / Physician / Vision 19 Major Medical / Physician / Drug 20 Major Medical / Physician / Dental / Vision/ Drug 21 Inpatient / Outpatient / Physician / Dental / Major Medical / Drug / Vision 22 Medicare Supplement Part A 23 Medicare Supplement Part B 24 Specialty Coverage (Cancer) 25 HMO 26 Nursing Home 27 Veterans Home 28 Worker's Compensation 29 Transplant Rider 30 Drug Script/Reg 40 DME 45 CHAMPUS Coverage 50 Absent Parent (4D) 60 HMO/Dental 61 HMO/Vision 62 HMO/Drug 63 HMO/Dental/Vision 64 HMO/Dental/Drug 65 HMO/Vision/Drug 66 HMO/Dental/Vision/Drug 70 Phys/Inpatient/Outpatient/Dental 71 Phys/Inpatient/Outpatient/Vision 72 Phys/Inpatient/Outpatient/Drug 73 Phys/Inpatient/Outpatient/Dental/Vision 74 Phys/Inpatient/Outpatient/Dental/Drug 75 Phys/Inpatient/Outpatient/Vision/Drug 76 Phys/Inpatient/Outpatient/Dental/Vision/Drug 77 Phys/Inpatient/Outpatient/Maj Med/Dental/Drug 78 Phys/Inpatient/Outpatient/Maj Med/Vision/Drug 90 Medicare Supplement A & B/Dental 91 Medicare Supplement A & B/Vision 92 Medicare Supplement A & B/Drug 93 Medicare Supplement A & B/Major Medical 99 Unknown A1 Medicare A A2 Medicare A HMO B1 Medicare B B2 Medicare B HMO B3 Medicare B HMO/Dental B4 Medicare B HMO/Vision B5 Medicare B HMO/Drug B6 Medicare B HMO/Dental/Vision B7 Medicare B HMO/Dental/Drug B8 Medicare B HMO/Vision/Drug B9 Medicare B HMO/Dental/Vision/Drug