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 for Medicare
Paid in Other Services
Missing HCPCS Code
Fee Schedule Amount is 0
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
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.