Table 3 Data collected through Medicare and Pharmaceutical Benefit scheme
Variables from medicare data | Description |
|---|---|
Date of service | Date on which the provider performed the service |
Date of processing | Date on which Medicare processed the payment of a claim for the service |
Medicare benefits Item description | Describes the service provided by the provider as per Medicare Benefits Schedule |
Medicare item number | A number that identifies the service provided by the provider as per Medicare Benefits Schedule |
Provider charge | The amount the provider charged for the service |
Schedule fee | The fee listed in the Medicare Benefits Schedule |
Benefit paid | The Medicare benefit paid to the claimant |
Patient out of pocket | The amount the patient is out of pocket i.e. provider charge minus benefit paid Bill |
Type | Method by which the Medicare benefit was claimed i.e. cash, bulk bill, cheque to claimant, cheque to provider via claimant, PCE (Easy claim patient claim), simplified bill and EFT |
Scrambled ordering provider number | A scrambled provider number identifying the doctor who referred the service scrambled |
Rendering provider number | A scrambled provider number identifying the doctor who provided the service |
Date of referral | The date of referral or request for a service by a provider |
Rendering provider postcode | Postcode of servicing provider’s practice location |
Ordering provider postcode | Postcode of referring provider's practice location |
Hospital indicator | An indicator of whether the service was performed in hospital |
Provider speciality | Speciality of the provider as at time of service |
Item category | From the hierarchical system of the Medicare Benefits Schedule |
Variables from Pharmaceutical Benefits Scheme (PBS) claims data | |
Date of supply | The date on which the PBS item was supplied |
Date of prescribing | The date on which the prescription was written PBS |
Item code | Number which indicates item prescribed as per Schedule of |
Pharmaceutical benefits item description | Item name description as it appears in the Schedule of PBS |
Pharmaceutical benefits patient category | Refers to the patient's concessional status at the time of supply of the benefit of the item |
Patient contribution | The contribution actually paid by the patient |
Net benefit | Benefit that Medicare paid to the Pharmacy |
Scrambled prescriber number | A scrambled prescriber number identifying the doctor who prescribed the PBS item |
Pharmacy postcode | Postcode of Pharmacy where the prescription was dispensed |
Form category | Description of script type, e.g. OR: Original, RE: Repeat, DS, Deferred Script, AU: Authority, AR: Authority Repeat |
Code | Code allocated by the WHO Collaborating Centre for Drug Statistics |
ATC name | According to the Anatomical Therapeutic Chemical (ATC) classification system |
Prescriber derived major speciality | Speciality of prescribing doctor |