Part B Drug Primary Payer Amount

Updated research request forms and data security approval requirement effective 4/24/23

This variable is contained in the following files:

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

SAS Name

PTB_DRUG_PRMRY_PMT

This variable indicates the total amount paid for Part B drugs by a primary payer other than Medicare for a given year. Part B drug claims are a subset of the claims in the Part B Carrier and DME data files.

The Part B drug claims are identified by BETOS codes (CCW variable BETOS_CD with values of 'D1G','O1D','O1E','O1G','I1E', or 'I1F'). Total Part B drug payments from a Primary Payer 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.