MC_PRICER_SUMMARY

Description:

This table contains pricing summary output returned by the Epic Pricer.

Primary Key

Column Name	Ordinal Position
PRICER_MSG_ID	1

Column Information

	Name	Type	Discontinued?
1	PRICER_MSG_ID	NUMERIC	No
	The unique identifier for the Pricer Message record.
2	PRICE_SUM_ALLOW	NUMERIC	No
	Returned allowed amount from pricing summary data.
3	PRICE_SUM_PMT	NUMERIC	No
	Returned payment amount from pricing summary data. This is a calculation of the allowed amount minus coinsurance/deductible.
4	PRICE_SUM_DEDUCT	NUMERIC	No
	Returned deductible amount from pricing summary data.
5	PRICE_SUM_COINS	NUMERIC	No
	Returned coinsurance amount from pricing summary data.
6	PRICE_SUM_OUTLIER	NUMERIC	No
	Returned outlier amount from pricing summary data.
7	PRICE_SUM_HCPCS_RTN_C_NAME	VARCHAR	No
	The returned HCPCS Pricer return code from pricing summary data. May contain organization-specific values: No Category Entries: Priced Normally Review Needed for Co-Surgeon Review Needed for Assistant At Surgery Not Covered Paid in Other Services Missing HCPCS Code Fee Schedule Amount is 0 Priced by Percentage of Billed Priced by Percentage of Cost Reporting Purposes HCPCS Code Not Found in Fee Schedule HCPCS and POS Type Do Not Match Missing Required Modifier Missing Ambulance Pickup Zipcode Missing Anesthesia Time in Minutes Service Date Prior to HCPCS Effective Date Team Surgeon Distribution Required More Than 5 Surgeries Missing Physician Invalid Units for Bilateral Codes Invalid Modifiers CBSA Not Found Wage Index Not Found NOC Not Found for NDC Price by Medicare Contractor Review Generic bad request
8	PRICE_SUM_FSC_AMT	NUMERIC	No
	Returned fee schedule amount from pricing summary data.
9	IS_NON_FACILITY_RATE_YN	VARCHAR	No
	Indicator for whether the service is paid using the non-facility rate in the Medicare Physician Fee Schedule. May contain organization-specific values: No Category Entries: No Yes
10	ALLOWED_AMT_BEFORE_ADJ	NUMERIC	No
	Medicare fee schedule allowed amount before any pricing adjustments.
11	UNITS_APPLIED	NUMERIC	No
	Number of units applied to the base fee schedule rate to determine the Medicare allowed amount.
12	PRICE_SUM_CLAIM_DRG	VARCHAR	No
	The DRG code used by the Epic Pricer to price a claim.