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This variable is contained in the following files: Master Beneficiary Summary File (MBSF): Cost and Utilization Segment
SAS Name
PHYS_PRMRY_PMT

This variable indicates the total amount paid for part B physician office services (PHYS) by a primary payer other than Medicare for a given year. Physician office claims are a subset of the claims in the Part B Carrier and DME data files, and a subset of physician evaluation and management claims (note that E&M are tabulated separately in this data file).

The PHYS claims are defined as those with a line BETOS code (BETOS_CD) where the first three digits =M1A or M1B (the remainder of physician services which occur in different settings appear in EM_MDCR_PMT). 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.