Department of Human Services Variables Checklist for
Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS)Data
Please complete this checklist to indicate which variables in the Department of Human Services (formerly Medicare) records held by the Sax Institute you need for your research questions - listed in C4 of the applicationform - and provide a brief written justification for each variable selected.
SECTION Alists variablesof the Medicare Benefits Schedule (MBS).
SECTION Blistsvariables of the Pharmaceutical Benefits Scheme (PBS).
For both the MBS and PBS lists there are some variables which are classified asrestricted accessbecause they may contain information that is arisk to participant privacy. Requests for restricted access variables will be given more rigorous review for approval.
Please submit this checklist with the 45 and Up Study Project Application Form(required for Stage 2 applications) or the Application to Amend Approved Research Project Form.
Only complete this checklist if you are proposing to link the 45 and Up Study data to Department of Human Services records.The MBS and PBS data do not form part of any participant record stored in the 45 and Up Study questionnaire data collection.
NOTES:
- Please consult the data dictionary for more information about the MBS and PBS items (available from our website);
- For approved requests, access to variables in the Department of Human Services records will be given only via the SURE. For more information about the SURE facility to access data or if you wish to use the SURE facility, please contact the SURE team for information about costs and project setup requirements: ().
SECTION A – MEDICARE BENEFITS SCHEDULE (MBS)
GENERAL PBS ITEMS / BRIEF WRITTEN JUSTIFICATION FOR REQUEST
Date of Service
Date of Processing
Item Description
Medicare Item Number
Provider Charge
Schedule Fee
Benefit Paid
Patient Out of Pocket
Bill Type
Scrambled Ordering Provider Number
Scrambled Rendering Provider Number
Date of Referral
Hospital Indicator
Provider Speciality
Item Category
RESTRICTED ACCESS FOR MBS / WRITTEN JUSTIFICATION FOR RESTRICTED ACCESS REQUEST
Rendering Provider Postcode
Ordering Provider Postcode
SECTION B – PHARMACEUTICAL BENEFITS SCHEME (PBS)
GENERAL PBS ITEMS / BRIEF WRITTEN JUSTIFICATION FOR REQUEST
Date of Supply
Date of Prescribing
PBS Item Code
Item Description
Patient Category
Patient Contribution
Net Benefit
Scrambled Prescriber Number
Form Category
ATC Code*
ATC Name*
*(Anatomical Therapeutic Chemical Classification System)
RESTRICTED ACCESS FOR PBS / WRITTEN JUSTIFICATION FOR RESTRICTED ACCESS REQUEST
Pharmacy Postcode
Medicare Variable Checklist | v. January 2013 – Page 1