Texas Pharmacy Billing Details for Workers' Compensation

Five years of detailed pharmacy billing line items for workers' compensation claims in Texas. The Texas Department of Insurance, Division of Workers’ Compensation (DWC) maintains this database of charges, payments, and prescriptions submitted on DWC Form-066. Individual line items can be grouped into complete bills using the Bill ID and Bill Selection Date.

Use Cases

• Analyze payment patterns by calculating the ratio of Total Amount Paid Per Line to Drugs/Supplies Billed Amount across different NDC Billed Codes.
• Model prescription volume trends over time using Service Line From Date, Service Line To Date, and Drugs/Supplies Number of Days.
• Identify common billing adjustments by analyzing Service Adjustment Reason Code and Service Adjustment Amount fields across claims.
• Link provider-level data by aggregating line items using the Rendering Line Provider National Provider ID.
• Examine cost basis variability by grouping claims by Basis of Cost Determination Code and Drug Name.

Strengths

• Covers five years of recent billing data for temporal analysis.
• Contains over 30 specific columns detailing charges, adjustments, and prescriptions.
• Designed to be linked to a separate header dataset for complete bill context.
• Supported by a published data dictionary for column definitions.

Limitations

• Exact row count and total data size are unknown.
• Limited to Texas workers' compensation claims, not nationally representative.
• Requires joining on Bill ID and Bill Selection Date to reconstruct full bills, which adds complexity.

Provenance

Source

Texas Department of Insurance, Division of Workers’ Compensation (DWC).

Collection Method

Collected from pharmacy medical billing services (SV4) submitted on DWC Form-066.

Time Range

Last five years (relative to dataset update). Historical data back to 2010 is available in a separate dataset.

Freshness

Last updated March 2026, suggesting regular maintenance.

Geography

Texas, United States.