Hospital Outpatient Primary Payer Amount

SAS Name

This variable indicates the total amount paid for hospital outpatient (HOP) visits by a primary payer other than Medicare. It is the sum of all the primary payer amounts (NCH_PRMRY_PYR_CLM_PD_AMT from each claim) in the HOP setting for the year.


This variable was new in 2010; it will always be null/missing in earlier files.

Medicare payments are described in detail in a series of Medicare Payment Advisory Commission (MedPAC) documents called “Payment Basics” (see:

Also in the Medicare Learning Network (MLN) “Payment System Fact Sheet Series” (see the list of MLN publications at: Publications.html)

Source: CCW (derived)