ND Health Enterprise MMIS - s 001 General Practice 002 General Surgery 003 Allergy & Immunology 004 Otology, Laryngology, Rhinology 005 Anesthesiology 006 Cardiovascular Disease 007 Dermatology 010 Gastroenterology 011 Internal Medicine 012 Phlebology 013 Neurology 014 Neurological Surgery 015 Family Planning Non-Surgical 016 OB/GYN 017 Addiction Medicine 018 Ophthalmology 019 Dentists 020 Orthopedic Surgery 021 Clinical Pathology 022 Pathology 023 Peripheral Vascular Disease 024 Plastic Surgery 025 Physical Medicine and Rehabilitation 026 Adolescent and Children Mental Health 027 Cardiology 028 Proctology 029 Pulmonary Diseases 030 Radiology 031 Roentgenology, Radiology 032 Radiation Oncology Therapy 033 Thoracic Surgery 034 Urology 035 Case Management 036 Clinical Nurse Specialist 040 Community Health Centers 045 Day Treatment Services 047 Chiropractor 048 Podiatric 049 Pediatrics 050 Psychologist 053 Adolescent Medicine 054 Clinical Medical Lab 055 Nurse Practitioner -Advanced Practice 056 Licensed Registered Dietician Page 1 of 10
ND Health Enterprise MMIS - s 057 Speech Therapy 058 Adult Medicine 060 Early Intervention Agency 062 Endodontics 063 Pedodontics 064 Orthodontics 065 Periodontics 066 Prosthodontics 067 Oral Pathology 069 Mental Health Services 070 Adult Mental Health 071 Augmentative Communication 072 Child Health 073 Day Habilitation 074 Clinical Neuropsychologist 075 Bariatric Medicine 076 Clinical & Laboratory Immunology 077 Certified Diabetic Educator 078 Clinical & Lab Dermatological Immunology 079 Basic Care 080 Advanced Registered Nurse Practitioner 081 Respite Care (QSP) 082 Home Health Agency 083 Clinical Biochemical Genetics 084 Clinical Cardiac Electrophysiology 085 Clinical Cytogenetic 086 Respite Care 087 Audiologist 088 Optometrist 089 Ambulatory Surgical Center 091 General Acute Care Hospital 093 Emergency Medical Services 099 OTHER 101 Colon and Rectal Surgery 102 Pulmonary Medicine 103 Nuclear Medicine 104 Geriatric Medicine 105 Nephrology 106 Hand Surgery 107 Oncology 108 Pediatric Allergy 109 Clinical Genetics (MD) 110 Physical Therapy 111 Critical Access: Hospital Page 2 of 10
ND Health Enterprise MMIS - s 112 Family Personal Care (QSP) 113 DME & Medical Suppliers 114 Orthotists 115 Prosthetist 116 Portable X-Ray Supplier 117 Independent Laboratory 118 Clinical Molecular Genetics 120 Podiatrist 121 Psychiatry 122 Transportation 123 Physical Therapist 124 Residential Modification Service 125 Specialized Equipment (QSP) 126 Occupational Therapy 127 Licensed Vocational Nurse 128 Pharmacy 129 Registered Nurse 130 Licensed Practical Nurse 131 Psychiatric Hospital 132 Ambulance 133 Clinical Pharmacology 134 Dialysis; Professional 135 Dialysis; Technical 136 Clinical Pathology/Laboratory Medicine 137 Eye, Ear, Nose, Throat 138 Orthodontic Prosthetics; Non A 140 Pediatric Otolaryngology 141 Psychiatric Facility; Inpatient 142 Psychiatry; Child/Adolescent 143 Respite Care; In Home 144 Respite Care; Out of Home 145 Alcohol Rehab / Treatment Center 146 Attendant Care (QSP) 147 Audiologist/Hearing Aid Fitter 148 Behavioral Management 150 Cardiovascular Surgery 151 Certified Nurse Aide (CNA) 152 Counselor 153 Core Emergency Response System Comp (QSP) 154 Installation ERS (QSP) 155 Counselor, Addiction 156 Chronic Disease Hospital 158 CBRT Facility, Mental Illness 159 CBRT Facility, Mental Retardation and/or Developmental Disability Page 3 of 10
ND Health Enterprise MMIS - s 161 Day Training (DD Services) 163 Dental Hygienist 164 Dental Laboratory Technician 165 Dental Laboratory 166 Diagnostic Laboratory 167 Diagnostic Radiology 168 Endocrinology, Diabetes & Metabolism 169 Epidemiology 171 EPSDT 173 Family Medicine 175 Geriatric Psychiatry 177 Counselor, Licensed Associate Professional (LAPC) 178 Hematology 179 Hematology/Oncology 180 Homemaker (QSP) 181 Hospice, Inpatient 183 Immunopathology 184 Indian Health Services (I/U/T) Pharmacy 185 Infectious Diseases 186 Infusion Therapy 188 Interventional Cardiology 189 Vascular and Interventional Radiology 190 Counselor, Licensed Prof Clinical(LPCC) 191 Licensed Independent Clinical Social Worker 192 Long Term Care Hospital 193 Medical Microbiology 194 Counselor, Professional 195 Medical Toxicology 196 Swing Bed 197 Midwife 198 Certified Nurse Midwife 199 Midwife; Lay 200 Neonatology 201 Neoplastic Oncology 202 Neuro-Ophthalmology 203 Neuropathology 204 Neuroradiology 205 Non-Medical Transportation (Carrier-bus, taxi) (QSP) 206 Critical Care Medicine 207 Nurse Delegated Care (QSP) 208 Nurse Delegation (QSP) 209 Nurse Management (QSP) 210 Nursing Home / Domiciliary Facility 211 Obstetrics Page 4 of 10
ND Health Enterprise MMIS - s 212 Oral Maxillofacial Surgery 213 Orofacial Pain / TMJ Disorders 214 Orthopedic Hand Surgery 215 Orthotics/Prosthetics Fitter 216 Osteopathy 217 Otolaryngology 218 Pain Management 219 Pain Medicine 220 Pediatric Interventional Radiology 221 Pediatric Cardiology 222 Pediatric Dermatology 223 Pediatric Developmental & Behavioral 224 Pediatric Diagnostic Lab Immunology 225 Pediatric Emergency Medicine 226 Pediatric Endocrinology 227 Pediatric Gastroenterology 228 Pediatric Hematology-Oncology 229 Pediatric Infectious Disease 231 Pediatric Medical Toxicology 232 Pediatric Nephrology 233 Pediatric Neurodevelopment 234 Pediatric Neurology 235 Pediatric Neurosurgery 236 Pediatric Ophthalmology 237 Pediatric Orthopedics 238 Pediatric Pathology 240 Pediatric Pulmonology 241 Pediatric Radiology 242 Pediatric Rehabilitation Medicine 243 Pediatric Rheumatology 244 Pediatric Sports Medicine 245 Pediatric Surgery 246 Pediatric Urology 247 Perinatology 248 Personal Care Medicaid State Plan (QSP) 249 Personal Care (QSP) 250 Personal Care-Attendant Services (QSP) 251 Personal Care Daily Rate (QSP) 252 Personal Support Services/Self 253 Pharmacist 254 Pharmacy Supplies 255 Physician Assistant 256 Plastic Surgery Hand Surgery 257 Preventive Medicine/Occupational-Environ Medicine Page 5 of 10
ND Health Enterprise MMIS - s 258 Psychiatric Residential Treatment Facility 259 Anatomic / Clinical Pathology 260 Dermatopathology 261 Public Health or Welfare 262 Renal Dialysis Center 263 Reproductive Endocrinology 264 Residential Treatment Facility, Emotionally Disturbed Children 265 Residential Treatment Facility, Mental Retardation and/or DD 266 Residential Treatment Facility, Physical Disabilities 267 Rheumatology 268 Rural Health Clinic 269 Skilled Nursing Facility 270 Emergency Medicine 271 Emergency Care 272 Speech-Language Pathologist 273 Sports Medicine 274 Substance Abuse Disorder Rehabilitation Facility 275 Surgery 276 Surgical Oncology 277 Targeted Case Management 278 Therapeutic Radiology 279 Transplant Surgery 280 Transportation Non-Medical carrier, Bus, Taxi (QSP) 284 Traumatic Brain Injury (TBI) 285 TBI Case Management Other (QSP) 286 TBI Case Management Team Meeting (QSP) 287 TBI Supportive Employment (QSP) 288 Urgent Care Center 289 Vascular Surgery 290 Neopathology 298 End Stage Renal Dialysis (ESRD) 299 Endoscopy 300 ESRD Treatment 301 Facial Plastic Surgery 302 Foot and Ankle Surgery 303 Dental Assistant 304 Optometry Technician/Technologist 306 Respite Care, Institutional (QSP) 307 Gynecologic Oncology 308 Chore Snow Removal (QSP) 309 Chore-Labor (QSP) 310 Installation ERS 311 Emergency Response System Companies 312 Case Management Assessment (QSP) Page 6 of 10
ND Health Enterprise MMIS - s 313 Case Management Other (QSP) 314 Tech Dependent Case Mgmt. Other (QSP) 315 Tech Dependent Case Management - Assessment (QSP) 316 Higher Level Case Management Other (QSP) 317 Higher Level Case Management Assessment (QSP) 318 Adult Family Foster Care (QSP) 319 Family Home Care (QSP) 320 Personal Care Assisted Living (QSP) 321 Environmental Modifications (QSP) 323 Adult Day Care (QSP) 324 Residential Service (QSP) 325 Non-Med Transportation ( Out of Town) (QSP) 326 Non-Med Transportation (local-round trip) (QSP) 327 Non-Medical Transportation (Escort) (QSP) 328 Supported Employment 329 Transitional Living (QSP) 330 Home Delivered Meals (QSP) 332 Hearing and Speech 333 Nurse's Aide 334 Driver 335 Case Manager/Care Coordinator 336 Contractor 337 Community Health Worker 339 Lodging 340 Hepatology 341 Certified Registered Nurse Anesthetist 342 Anesthesiologist Assistant 343 Psychiatric & Neurology 344 Hospitalist 345 Hospice and Palliative Medicine 347 Prosthetic/Orthotic Supplier 348 Voluntary or Charitable 349 Respiratory Therapist, Certified 352 Technician/Technologist 353 Independent Medical Examiner (IME) 357 Community Behavior Health 358 PACE 359 Clinic/Center 360 Mental Health (Includes Community Mental Health) 361 Federally Qualified Health Center 362 Psychiatric Unit:;Hospital Unit 363 Rehabilitation Unit; Hospital Unit 364 Rehab, Substance Use Disorder Unit 366 Physiological Lab (Independent Physiological Lab) Page 7 of 10
ND Health Enterprise MMIS - s 367 Health Maintenance Organization 368 Intermediate Care FAC-Mental Illness 369 Nursing Facility/Interim Care Facility 371 Alzheimer/Dementia/Demential Care Unit 372 Infant Development (DD) 373 Extended Services (DD) 374 Day Supports (DD) 375 Legal Medicine 376 Transitional Community Living Facility (DD) 377 Independent Supplemental Living Arrangement (DD) 379 Family Support Services (DD) 380 Congregate Care (DD) 381 Minimally Supervised Living Arrangement (DD) 382 Supported Living Arrangement (DD) 383 Hearing Aid Equipment 384 Eyewear Supplier 385 Bus 386 Non-Emergency Medical Transport (Van) 387 Private Vehicle 388 Secured Medical Transport (Van) 389 Taxi 390 Train 393 Provide Meals 394 Extended Personal Care (QSP) 395 Magnetic Resonance Imaging (MRI) 396 Nurse Education Care (QSP) 397 Local Education Agency/Special Education 399 Personal Care Unit Rate 401 Indian Health Services 403 Marriage & Family Therapist 404 Maternal & Fetal Medicine 405 Clinical Genetics 406 Migrant Health 407 Molecular Genetic Pathology 408 Occupational Medicine 409 Oncology, Radiation 410 Ophthalmologic Surgery 411 Optician 412 Pediatric Anesthesiology 413 Primary Care 414 Procedural Dermatology 415 Public Health, Federal 416 Public Health, State or Local 417 Radiology, Mammography Page 8 of 10
ND Health Enterprise MMIS - s 418 Radiology, Mobile 419 Radiology, Mobile Mammography 420 Rehabilitation 421 Rehabilitation Hospital 422 Rehabilitation, Comp Outpatient Rehab Facility (CORF) 423 Rehabilitation: Cardiac Facilities 424 Sleep Disorder Diagnostic 425 Social Worker (LSW, LCSW) 426 Student Health 427 Substance Abuse Treatment, Children 429 Undersea & Hyperbaric Medicine 430 Respiratory Therapist, Registered 431 Nurse Practitioner Adult Health 432 Nurse Practitioner Family 433 Nurse Practitioner General 434 Nurse Practitioner OB/GYN 435 Nurse Practitioner Pediatrics 436 Anatomic Pathology 437 Dental Clinic 438 Gerontology Psych Nursing Home 439 Non-Gerontology Psych Nursing Home 450 Skilled Nursing Facility-IMD 451 Psychiatric Residential Treatment Facility (RTF) - IMD 452 Basic Care - IMD 453 Human Service Center 454 Hospice 460 Clinical Nurse Specialist Psychiatric/Mental Health 461 Clinical Nurse Specialist Psychiatric/Mental Health Adult 462 Clinical Nurse Specialist Psychiatric/Mental Health Clinical Family 463 Clinical Nurse Specialist Psychiatric/Mental Health Chronically Ill 464 Clinical Nurse Specialist Psychiatric/Mental Health Community 465 Clinical Nurse Specialist Psychiatric/Mental Health Gerontology Psych 466 Nurse Practitioner- Neonatal-Critical Care 467 Nurse Practitioner- Psychiatric/Mental Health 468 County Social Service Office 469 Nurse Practitioner- Primary Care 470 Nurse Practitioner- Women's Health 471 Independent Medical Examiner 472 Clinic Pharmacy 473 Community/Retail Pharmacy 474 Compounding Pharmacy 475 Home Infusion Therapy Pharmacy 476 Institutional Pharmacy 477 Long Term Care Pharmacy Page 9 of 10
ND Health Enterprise MMIS - s 478 Mail Order Pharmacy 479 Managed Care Organization Pharmacy 480 Non-Pharmacy Dispensing Site 481 Nuclear Pharmacy 482 Specialty Pharmacy 483 Air Carrier 484 Transportation Broker 485 Advanced Practice Midwife 486 Indian Health Service (HIS)/Tribal/Urban Indian Health (I/T/U) Pharmacy 488 Behavior Modification Specialist 489 Case Aide 490 Forensic Psychiatry 491 Human Relations Counselor 492 Mental Health Technician 493 Pharmacy Technician 495 Nuclear Radiology 497 Oncology, Radiation - Physician 498 Dental Public Health 499 Nursing Care 500 Special Hospital 501 Self-Directed Services 502 Neonatal-Perinatal Medicine 503 Single Specialty 504 Multi-Specialty 505 Assistive Technology 506 Program Design & Monitoring 507 Skills Training 508 Service Management 509 Methadone 510 Ambulance- Air Transport 511 Ambulance- Land Transport 512 Hearing Services Specialist 513 Supervision Page 10 of 10