Other Part B Carrier Primary Payer Amount

This variable is contained in the following files:

Master Beneficiary Summary File (MBSF): Cost and Use Segment

SAS Name

OTHC_PRMRY_PMT

This variable indicates the total amount paid for Part B Carrier and DME claims which appear in settings other than the 10 specific categories which are part of this file by a primary payer other than Medicare for a given year. Claims for other carrier/DME claims are a subset of the claims in the Part B Carrier and DME data files. Types of services which may have been summarized in this other carrier category (OTHC) include ambulance, chiropractor, chemotherapy, vision, hearing and speech services, etc.

The total Primary Payer Payments are calculated as the sum of the LINE_BENE_PRMRY_PYR_PD_AMT.

Comments

There are 11 cost/use categories from the Carrier Part B and DME data files – the ASC, Anesthesia, Part B Drug, Physician, E & M, dialysis, imaging, tests, other procedures, DME and other carrier claims.

Source: CCW (derived)