The Texas Department of Insurance, Division of Workers' Compensation (DWC) maintains a database of institutional medical billing services (SV2). It contains charges, payments, and treatments billed on a CMS-1450 form (UB-92, UB-04) by hospitals and medical facilities that treat injured employees, excluding ambulatory surgical centers, with dates of service for the last five years. For datasets going back to 2010, see institutional medical billing services (SV2) header information – historical. 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 institutional medical billing services (SV2) header data dictionary. See institutional medical billing services (SV2) detail information for the corresponding detail records related to this dataset. Go to our page on DWC medical state reporting public use data file (PUDF) to learn more about using this information.

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 professional medical billing services (SV1) detail information – historical. The detail contains information to identify insurance carriers, injured employees, employers, place of service, and diagnostic information. The bill details are individual line items that are grouped in the header section of a single bill. The bill selection date and bill ID must be used to group individual line items into a single bill. Find more information in our professional medical billing services (SV1) detail data dictionary. See professional medical billing services (SV1) header information for the corresponding header records related to this dataset. Go to our page on DWC medical state reporting public use data file (PUDF) to learn more about using this information.

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 professional medical billing services (SV1) header information – historical. 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 professional medical billing services (SV1) header data dictionary. See professional medical billing services (SV1) detail information for the corresponding detail records related to this dataset. Go to our page on DWC medical state reporting public use data file (PUDF) to learn more about using this information.

The Texas Department of Insurance, Division of Workers’ Compensation (DWC) maintains a database of pharmacy medical billing services (SV4). It contains charges, payments, and prescriptions billed on a DWC Form-066, Statement of Pharmacy Services by pharmacies with dates of service for the last five years. For datasets going back to 2010, see pharmacy medical billing services (SV4) detail information – historical. The detail section contains information to identify insurance carriers, injured employees, employers, place of service, and diagnostic information. The bill details are individual line items that are grouped in the header section of a single bill. The bill selection date and bill ID must be used to group individual line items into a single bill. Find more information in our pharmacy medical billing services (SV4) detail data dictionary. See pharmacy medical billing services (SV4) header information for the corresponding header records related this dataset. Go to our page on DWC medical state reporting public use data file (PUDF) to learn more about using this information.

The Texas Department of Insurance, Division of Workers’ Compensation (DWC) maintains a database of pharmacy medical billing services (SV4). It contains charges, payments, and prescriptions billed on a DWC Form-066, Statement of Pharmacy Services by pharmacies with dates of service for the last five years. For datasets going back to 2010, see pharmacy medical billing services (SV4) header information – historical. 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 pharmacy medical billing services (SV4) header data dictionary. See pharmacy medical billing services (SV4) detail information for the corresponding detail records related to this dataset. Go to our page on DWC medical state reporting public use data file (PUDF) to learn more about using this information.

고객이 가입하고 있는 장기간병요양진단비 보험의 계약정보

o 내용: 일차의료 만성질환관리 시범사업 수가코드 중 환자관리료(IB021~22) 산정 기초 정보 o 대상: 참여 환자 중 케어플랜 1주기 이상 수립 및 환자 관리를 받은 환자 o 환자관리료(IB021, IB022) 산정 기준 구분 / 환자관리료1 (IB021) / 환자관리료2 (IB022) 대상자 / 등록된 고혈압, 당뇨병 환자 / 등록된 고혈압, 당뇨병 환자 중 집중관리가 필요한 환자 제공수단 / 전화 또는 문자 등 다양한 방법 / 전화 실시횟수 / 월 1회 이상, 분기별 6회 이상 / 월 2회 이상, 분기별 12회 이상 산정기준 / 주기적으로 임상수치 확인 필수 - 주 3일 이상 환자가 자가측정한 임상수치 확인 필수 - 연간 2회(2분기) 이내 산정 수가(분기당) / 30,920원 / 48,730원 o 최초케어플랜등록일자: 케어플랜 1주기 수립 일자 o 분기 구분 코드: 케어플랜 1주기 수립 일자에 따른 분기별 구분 코드 o 환자관리수가구분코드: IB021, IB022 구분 코드

1. 진료일기준(한의분류 제외, 약국 제외), 연령(연말기준)2. 건강보험 급여실적(의료급여 제외)이며, 비급여는 제외- 2023년 6월 지급분까지 반영3. 아래 질병통계 자료는 요양기관에서 환자진료 중 진단명이 확정되지 않은 상태에서의 호소, 증세 등에 따라 일차진단명을 부여하고 청구한 내역 중 주진단명 및 제1부상병 기준으로 발췌한 것이므로 최종 확정된 질병과는 다를 수 있음<주상병코드 및 제1부상병코드는 KOICD 질병분류정보센터(https://www.koicd.kr) 참조>※ 2023.12.5. 발췌 데이터로서, 민원인의 제공 신청에 따른 제공 건