The Texas Department of Insurance, Division of Workers' Compensation (DWC) maintains a database of professional medical billing services (SV1). It contains charges, payments, and treatments billed on a CMS-1500 form by doctors and other health care professionals who treat injured employees, including ambulatory surgical centers, with dates of service for the last five years. For datasets going back to 2010, see <a href="https://data.texas.gov/dataset/Professional-Medical-Billing-Services-SV1-Header-I/gh5j-28a7" target="_blank"><u>professional medical billing services (SV1) header information – historical</u></a>.
The header identifies insurance carriers, injured employees, employers, place of service, and diagnostic information. The bill header information groups individual line items reported in the detail section. The bill selection date and bill ID must be used to group individual line items into a single bill. Find more information in our <a href="https://www.tdi.texas.gov/wc/information/documents/pudfdictionary2.xlsx" target="_blank"><u>professional medical billing services (SV1) header data dictionary</u></a>.
See <a href="https://data.texas.gov/dataset/Professional-Medical-Billing-Services-SV1-Detail-I/c7b4-gune" target="_blank"><u>professional medical billing services (SV1) detail information</u></a> for the corresponding detail records related to this dataset.
Go to our page on <a href="https://www.tdi.texas.gov/wc/information/pudfpricelist.html" target="_blank"><u>DWC medical state reporting public use data file (PUDF)</u></a> to learn more about using this information.
Splitgraph serves as an HTTP API that lets you run SQL queries directly on this data to power Web applications. For example:
curl https://data.splitgraph.com/sql/query/ddn \ -H "Content-Type: application/json" \ -d@-<<EOF {"sql": " SELECT * FROM \"texas-gov/professional-medical-billing-services-sv1-header-pvi6-huub\".\"professional_medical_billing_services_sv1_header\" LIMIT 100 "} EOF
See the Splitgraph documentation for more information.
