Other Procedures Primary Payer Amount

SAS Name
OPROC_PRMRY_PMT

This variable indicates the total amount paid for services considered part B other procedures (i.e., not anesthesia or dialysis) by a primary payer other than Medicare for a given year. Claims for other procedures are a subset of the claims, and a subset of procedures in the Part B Carrier data file.

These other procedure claims are defined as those with a line BETOS code (BETOS_CD) where the first 2 digits are ('P1','P2','P3','P4','P5','P6','P7', or 'P8'). 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.