NAME              TYPE   LENGTH
 -------------------------------------   ------
 56.  MEDPAR Medicare             PACK   4
      Payment Amount
  
 Amount of payment made from the Medicare trust fund for the
 services covered by the claim record.  Generally, the amount
 is calculated by the fi; and represents what was paid to the
 institutional provider, with the exceptions noted below.
 **Note:  in some situations, a negative claim payment amount
 May be present; e.g., (1) when a beneficiary is charged the
 full deductible during a short stay and the deductible
 exceeded the amount Medicare pays; or (2) when a beneficiary
 is charged a coinsurance amount during a long stay and the
 coinsurance amount exceeds the amount Medicare pays (most
 prevalent situation involves psych hospitals who are paid a
 daily per diem rate no matter what the charges are.)
  
 Under ip PPS, Inpatient hospital services are paid based on
 a predetermined rate per discharge, using the DRG patient
 classification system and the pricer program.   On the ip
 PPS claim, the payment amount includes the DRG outlier
 approved payment amount, disproportionate share (since
 5/1/86), in- direct medical education (since 10/1/88), total
 PPS capital (since 10/1/91).  It does not include the pass
 thru amounts (i.e., capital-related costs, direct medical
 education costs, kidney acquisition costs, bad debts); or
 any beneficiary-paid amounts (i.e., deductibles and
 coinsurance); or any other payer remibursement.
  
 Under SNF PPS, SNFs will classify beneficiaries using the
 patient classification system known as rugs III.  For the
 SNF PPS claim, the SNF pricer will calculate/return the rate
 for each revenue center line item with revenue center code =
 '0022'; multiply the rate times the units count; and then
 sum the amount payable for all lines with revenue center
 code '0022' to determine the total claim payment amount.
  
 Exceptions:  For claims involving demos and bba encounter
 data, the amount reported in this field May not just
 represent the actual provider payment.
  
 For demo ids '01','02','03','04' -- claims contain
 amount paid to the provider, except that special
 'differentials' paid outside the normal payment system
 are not included.
  
 For demo ids '05','15' -- encounter data 'claims'
 contain amount Medicare would have paid under ffs,
 instead of the actual pay- ment to the MCO.
  
 For demo ids '06','07','08' -- claims contain actual
 provider payment but represent a special negotiated
 bundled payment for both part a and part B services.
 To identify what the conventional provider part a
 payment would have been, check value code = 'y4'.
  
 For bba encounter data (non-demo) -- 'claims' contain
 amount Medicare would have paid under ffs, instead of
 the actual payment to the bba plan.
  
 DB2      ALIAS : UNDEFINED
 SAS      ALIAS : PMT_AMT
 STANDARD ALIAS : MEDPAR_MDCR_PMT_AMT
  
 LENGTH         : 7    SIGNED : Y
  
 DERIVATIONS :
 This field is derived by accumulating the payment amount
 that is present on all of the claim records included in
 the stay (i.e, the sum of payment (reimbursement)
 reported on the claims that comprise the stay).
  
 SOURCE         : NCH
  
 EDIT RULES :
 +$$$$$$$
 ROUNDED; ON-SIZE (OVERFLOW) SITUATION = ALL NINES