2011 Independent Medical Review Annual Report

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Consumers Overview / Health Related Insurance Information / 2011 Independent Medical Review Annual Report

The Department of Insurance manages the Independent Medical Review Program outlined in California Insurance Code Section 10169. The information provided on this web page provides statistical information.

Total Number IMR: 462
Experimental/Investigational-Overturned: 63
Experimental/Investigational-Upheld: 102
Medical Necessity Overturned: 111
Medical Necessity Upheld: 181
Withdrawn: 5

Independent Medical Reviews (IMR) Annual Report- January through December 2011

Reference #	Diagnosis	Treatment	Experimental / Investigational- Overturned	Experimental / Investigational- Upheld	Medical Necessity Overturned	Medical Necessity Upheld	Withdrawn
11-2001	Earache	Emergency Services			X
11-2000	Migraine Headache	Botox Injections	X
11-2002	Substance Use Disorder	Residential Treatment Center			Partial
11-2003	Sleep Apnea	Uvulopalatoplasty			X
11-2004	Brain Cancer	Perscription: Avastin					X
11-2015	Cystic Fibrosis	Synagis		X
11-2016	Heart Attack	Real-Time Remote Heart Monitor		X
11-2017	Migraine Headache	Botox Injections	X
11-2018	Focal Osteochandral Lesion	Osteochondral Allograft		X
11-2019	Multiple Sclerosis	Walk Aide Functional Electrical Stimulator		X
11-2020	Cervical Radiculopathy & Myelopathy	Cervical Disc Replacement Surgery With Prodisc-C		X
11-2021	Preventive Care	Anesthesia During Colonoscopy				X
11-2022	Depression, Psychosis, Gilbert Syndrome	Inpatient Psychiatric Care			X
11-2023	Calcinosis Cutis	Facial Laser Surgery			X
11-2029	Clear Cell Renal Carcinoma	Perscription: Procrit			X
11-2044	Bipolar 2 Disorder	Psychiatric Residential Treatment				X
11-2045	Depression	Outpatient Psychotherapy			X
11-2046	Anxiety Disorder	Outpatient Family Therapy			Partial
11-2048	Degenerative Disc Disease	Spinal Fusion				X
11-2053	Impaired Visual Field (Droopy Eye Lids)	Blepharosplasty			X
11-2006	Autism	Speech & Occupational Therapy			X
11-2007	Autism	ABA			X
11-2005	Mood Disorder	Perscription: Lexapro				X
11-2008	Diabetes Type II	Perscription: Victoza			X
11-2009	Alzheimer	Perispinal Administration				X
11-2010	Unknown	Cervical Spine Intervertebral Disc Replacement		X
11-2011	ADHD. Drug Addiction. Mental Health	Residential Treatment Center				X
11-2012	Autism	Speech & Occupational Therapy			X
11-2013	Sleep Apnea	Tongue Suspension				X
11-2014	Depression & Anxiety	Transcranial Magnetic Stimulation	X
11-2051	Ovarian Cancer	Perscription: Neulasta	X
11-2049	Normal Pressure Hydrocephalus (NPH)	Inpatient Hospital Services				X
11-2038	Viral Conjunctivitis	Lab Tests	X
11-2055	Cervical Discectomy/ Discectomy Infusion	Physical Therapy				X
11-2056	Autism	ABA			X
11-2030	Prostate Cancer	IMRT With HDR Brachytherapy	X
11-2047	Avascular Necrosis With Collapse Of The Femoral Head Superiorly	Computer Navigation During Surgery		X
11-2054	Global Development Delay	Genetic Array Genome Testing	X
11-2050	Depression	Transcranial Magnetic Stimulation	X
11-2052	Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)	Intravenous Immunoglobulin (IVIG)	X
11-2041	Poor Biomechanics	Walk-Aide		X
11-2042	Diabetes Type I	Glucose Monitoring	X
11-2028	Lower Back Pain	Spinal Decompression Therapy		X
11-2040	Mental Health	Inpatient				X
11-2043	Low Back & Bilateral Lower Extremity Pain.	Spinal Fusion				X
11-2037	Pre-Operative Diagnoses Of Gastroesophage al Reflux	Anesthesia				X
11-2025	Endoscopic	Anesthesia				X
11-2035	Unresectable Intrahepatic Cholangiocarcino ma (Cancer Of The Liver) With Lymph Node Involvement	Radioactive Beads (SIRT)	X
11-2034	Risk Of Coronary Artery Disease	Diagnostic Testing Including C- Reactive Protein; High Sensitivity (Hs- CRP) And Fibrinogen.		X
11-2031	Osteoarthritis	Synvisc One Injection				X
11-2024	Eating Disorder	Partial Hospitalization Program			X
11-2027	Neuromonitoring	Spinal Muscular Atrophy Type III And Neuromuscular Scoliosis.				X
11-2033	Microsurgical Repair Of The Radial Digital Artery & Nerve Of Left Ring Finger.	Assistant Surgeon			Partial
11-2039	Depression	Neurostar Transcranial Magnetic Stimulation Therapy			X
11-2026	Polyarthralgias	Rheumatologic Lab				X
11-2036	Bulimia, Anorexia	Inpatient Treatment			X
11-2057	Lumbar Radiculapathy	Discectomy	X
11-2032	Back Pain	Chiropractic Care				X
11-2087	Shoulder Injury	Physical Therapy			X
11-2088	Bilateral Temporomadibul ar Disorder	Upper Jaw Surgery				X
11-2094	Incompetent Vein For Varicose Veins	Endovenous Ablation Therapy				X
11-2093	Pituitary Dwarfism	Somatropin Growth Hormone (GH) Injections				X
11-2092	Varicose Veins	Endovenous Ablation Therapy & Stabphlebectomy			X
11-2090	Depression	Inpatient Mental Services				X
11-2091	Growth Hormone Deficiency	Growth Hormone Injections				X
11-2089	Bi-Polar, Anxiety, Pervasive Developmental Disorder	Inpatient Psychiatric Treatment			X
11-2079	Lumbar Herniated Disc	Lumbar Fusion With Cougar Cages & Synthes Plates				X
11-2067	Anorexia Nervosa	Inpatient Hospitalization			X
11-2076	Degenerative Disc Disease	Lumbar Spine Fusion				X
11-2074	Obsessive Compulsive Disorder; Anxiety Disorder, Post Traumatic Stress Disorder; Depressive Disorder; And Eating Disorder.	Residential Treatment				X
11-2075	Facial Nerve Damage	Nerve Damage Treatment				X
11-2063	Anterior Hip Tendinopathy	Platelet Rich Plasma Transfusion/Injectio n		X
11-2066	Vitiligo	Monochromatic Light Therapy / A&B Excimer Laser Treatment	X
11-2068	Anxiety Disorder, Post-Traumatic Stress Disorder & Dissociative Identity Disorder	Outpatient Mental Health Services				X
11-2065	Degenerative Disc Disease	Percutaneous Decompression Of Disc		X
11-2058	Barrett's Esophagus, GERD And IBS	Endoscopy & Ablation		X
11-2072	Sleep Apnea	Intraoral Splint			X
11-2062	Breast Cancer History W/ Detection Of Mass In Breast	MRI		X
11-2073	Bipolar Disorder	Hospitalization				X
11-2071	AIDS	Perscription: Provigil			X
11-2070	Gastrointestinal Bleeding	Anesthesia For An Endoscopy				X
11-2078	Back Pain	Discectomy				X
11-2077	Disc Degeneration	Prodisc C (TDR) Procedure		X
11-2061	Degenerative Disc Disease With Sciatic Pain	Perispinal Etanercept (Enbrel)		X
11-2064	Major Depressive Disorder	Transcranial Magnetic Stimulation (TMS)	X
11-2059	Glaucoma	Canaloplasty	X
11-2080	Eating Disorder, Substance Abuse	Residential Treatment				X
11-2060	Intractable Epilepsy	PET Scan		X
11-2069	Post-Surgical Re	Continuous Passive hMotion (CPM)				X
11-2084	Epilepsy	Perscription: Keppra XR			X
11-2081	Lumbar Spondylosis	Radiofrequency Neurotomy		X
11-2086	Cervical Degenerative Disease	Spinal Injections				X
11-2083	Obstructive Sleep Apnea	Ct Colonoscopy (Virtual)			X
11-2082	Brain Tumors	Perscription: Vorinostat & Zolinza				X
11-2085	Meniscal Tear Of Left Knee	Custom Knee Brace				X
11-2095	Autism	Speech & Occupational Treatment	X
11-2096	Mood Disorder; Anxiety Disorder; Borderline Personality Disorder, Bipolar Disorder	Inpatient Psychiatric Services; Electroconvulsive Therapy (ECT)				X
11-2097	Cranial Misshapen	Cranial Arthotic			X
11-2099	Severe Emotional Disturbance	Behavioral Therapy				X
11-2098	Parsonage Syndrome	IVIG		X
11-2101	Cervical Spondylosis	Chiropractic			X
11-2104	Depressive Disorder	Transcranial Magnetic Stimulation		X
11-2103	Herniated/Displa ced Disc	Lumbar Decompression & Spinal Fusion				X
11-2102	Alcohol/Drug Dependence	Residential Treatment				X
11-2100	Ovarian Cancer	Lab Test: HE4 Test	X
11-2120	Osteoarthritis	Lumbar Fusion				X
11-2109	Depression	Transcranial Magnetic Stimulation		X
11-2108	Congenital Deformity	Subtalar Joint Arthroereisis	X
11-2112	Blood/Bone Cancer	Interferon	X
11-2129	Spinal Stenosis & Spondylolisthesis	Spinal Fusion				X
11-2119	Suicidal	Inpatient Hospitalization				X
11-2126	Varicose Veins	Venous Ablation			X
11-2111	Cervical Spondylosis	Botox Injection		X
11-2110	Degenerative Disc Disease	Artificial Disc Replacement		X
11-2107	Attention Deficit Hyperactivity Disorder	Biofeedback		X
11-2121	Alcohol/Drug Dependence	Drug Rehabilitation Program				X
11-2114	Herniated/Displa ced Disc	Stimulator			X
11-2130	Contracture Of Joint - Upper Limb	Dynasplint				X
11-2118	Bulimia	Partial Hospitalization			X
11-2117	Degenerative Disc Disease	Fusion				X
11-2116	Degenerative Disc Disease	Fusion				X
11-2115	Foot Problem	Inpatient Hospitalization				X
11-2124	Spinal Stenosis & Spondylolisthesis	Fusion				X
11-2123	Developmental Delays	Speech Therapy			X
11-2105	Coronary Artery Disease	Angiography		X
11-2125	Ulcerative Colitis	CT Scan				X
11-2106	Rheumatoid Arthritis, Lyme Disease	Long Term Antibiotic Therapy - Rocephin		X
11-2128	Chronic Venous Disease Class V	Vein Ultrasound	X
11-2113	Wrist Pain	MRI Of Both Hands			X
11-2127	Anorexia Nervosa	Residential Treatment				X
11-2131	Disc Herniation C3-4	Cervical Spinal Stenosis		X
11-2122	Disc Herniation Of Back	Back Fusion				X
11-2135	Degenerative Disc Disease	MRI			X
11-2133	Post Brain Hemorrhage	Cognitive Rehabilitation	X
11-2132	Eye Disorders	Vision Therapy		X
11-2136	Idopathic Short Stature	Growth Hormone				X
11-2134	Degenerative Disc Disease	Artificial Cervical Disc Replacement		X
11-2137	Osteopenia (Low Bone Mineral Density)	Dual Energy X-Ray Absorptiometry (DEXA) Scan			X
11-2147	Autism	ABA	X
11-2143	ADHD / Drug Addiction / Mental Health	Residential Treatment			X
11-2141	Major Depressive Disorder	Transcranial Magnetic Stimulation	X
11-2139	Bilateral Occipital Neuralgia	Occipital Nerve Stimulator	X
11-2138	Osteoarthritis Of Right Hip	Hip Replacement Surgery				X
11-2144	Oxycontin Dependence	Residential Rehabilitation & Day Treatment				X
11-2145	Alcohol Dependence	Emergency Services				X
11-2146	Diabetes, Diabetic Polyneuropathy, Chronic Pain.	Pain Medication			Partial
11-2140	Bilateral Pulmonary Embolism	Inpatient Services				X
11-2142	Autism	ABA			X
11-2148	Hip Impingement Syndrome	Femoro-Acetabular Surgery	X
11-2154	Post Right Knee Medial Meniscus Allograft Replacement	Physical Therapy			X
11-2150	Metastatic Urothelial Cancer	Prolia Injection	X
11-2152	Left Eye Lesion	Slit Lamp Photo	X
11-2153	Ovarian Cancer	Lipoprotein Testing		X
11-2149	Upper Respiratory Infection	Emergency Services				X
11-2151	Crohn's Disease	Pharmacy- Prescription Drugs		X
11-2159	Tachyarrhythmia	Remote Real Time Cardiac Monitor		X
11-2162	Bulimia	Residential Treatment				X
11-2171	Bulimia	Psychiatric Treatment				X
11-2175	Lumbar Disc Herniation And L2-L3 Disc Bulge	Physical Therapy			X
11-2163	Acute Papilledema	MRI			X
11-2166	Major Depressive Disorder	Inpatient Psychiatric Hospitalization				X
11-2158	Ligaments - Post Hip Surgery	CPM Machine		X
11-2164	Derangement Of Medial Meniscus	ACL Reconstruction & Meniscus Allograft				X
11-2172	Drug Induced Disorders	Residential Rehabilitation				X
11-2165	Major Depressive Disorder	Psychotherapy				X
11-2173	Major Depressive Disorder	Acute Inpatient Hospitalization				X
11-2174	Post Right Hallux Rigidus Correction & Partial Excision Of B158 Plantar Fascia Mass Operation	Toe Dynasplint System				X
11-2157	Congenital Heart Defect	Genetic Testing	X
11-2155	Congenital Heart Defect	Genetic Testing	X
11-2156	Congenital Heart Defect	Genetic Testing	X
11-2168	Psychotic Disorder	Acute Inpatient Psychiatric Hospital			X
11-2167	Anorexia Nervosa	Residential Treatment			X
11-2160	Left Foot, Plantar Faciitis	Dynasplint	X
11-2169	Drug Dependency	Hospitalization				X
11-2170	Polysubstance Dependence	Residential Substance Abuse Rehabilitation				X
11-2161	Anorexia Nervousa	Psychiatric Treatment			X
11-2176	Bulimia	Behavioral Therapy			X
11-2182	Concussion	Neuropsychological Testing			X
11-2183	Growth Hormone Deficiency	Perscription: Saizen			X
11-2181	Crohn's Disease	Remicade Injections				X
11-2179	Multiple Sclerosis	Perscription: Acthar Gel			X
11-2177	Lung Cancer	Perscription: Avastin		X
11-2180	Demyelinating Disease Of CNS	IVIG Therapy			X
11-2178	Autism	ABA			X
11-2185	Major Depressive Disorder	Transcranial Magnetic Stimulation		X
11-2184	Lung Cancer	SBRT - Radiation Therapy	X
11-2186	Chronic Tonsillitis, Chronic Pharyngitis	Tonsillectomy, Adenoidectomy, Pharyngolasty			Partial
11-2187	Inpingement Syndrome	Arthroscopic Femoral Neck Resection				X
11-2189	Anorexia Nervosa	Residential Treatment			X
11-2188	Substance Abuse	Residential Treatment				X
11-2190	Major Depressive Disorder	Transcranial Magnetic Stimulation		X
11-2192	Autism	ABA	X
11-2191	Autism	ABA	X
11-2197	Varicose Veins	Venous Ablation				X
11-2196	Herniated / Displaced Disc	Laminectomy		X
11-2195	Barrett's Esophagus	Radiofrequency Ablation		X
11-2194	Inflammatory Bowel Disease	Immunofluorescent Antibody Study		X
11-2198	Migraine Headaches	Botox Injection			X
11-2193	Major Depressive Disorder	Residential Treatment				X
11-2201	Paraplegic	Easty Standing Frame		X
11-2217	Degenerative Disc Disease	Spinal Fusion				X
11-2214	Bipolar. Depression	Inpatient Treatment			X
11-2209	Right Ankle Contracture	Ankle Dynasplint	X
11-2207	Rotator Cuff	Platelet Rich Plasma Injection		X
11-2208	Breast Carcinoma	Intensity Modulated Radiation Therapy		X
11-2222	Spinal Stenosis & Spondylolisthesis	Spinal Fusion			X
11-2211	Lyme's Disease	Antibiotics		X
11-2206	Distal Radius Fracture	Joint Manipulation Under Anesthesia		X
11-2200	Barrett's Esophagus	Radiofrequency Ablation		X
11-2202	Cervicalgia with Cervicalgia Radiculitis	Water Circulating Head Pad with Pump		X
11-2204	Menopausal Symptoms	Testosterone Pellet Insertion		X
11-2212	High Risk Pregnancy	Hospitalization			Partial
11-2220	Varicose Veins	Ablation				X
11-2219	Herniated / Displaced Disc	Physical Therapy				X
11-2205	Frontal Sinus	Endoscopic Frontal Sinusplasty And Balloon Frontal Sinusplasty		X
11-2221	Heart Palpitations After Chemotherapy For Breast Carcinoma	Mobile Outpatient Cardiac Telemetry		X
11-2199	Severe Intracranial & Facial Abnormalities On Prenatal Ultrasound	3-D Surface Ultrasound	X
11-2210	Degenerative Disc Disease	Radiofrequency Neurolysis	X
11-2203	Herniated / Displaced Disc	Radiofrequency Ablation		X
11-2213	Leg Fracture	Acute Inpatient Rehabilitation				X
11-2216	Behavioral Problem	Residential Treatment			X
11-2218	Right Shoulder Pain. Bursitis	MRI			X
11-2215	Depression And Chronic Pain	Psychiatric Residential Treatment				X
11-2229	Prostate Cancer	Intensity Modulated Radiation Therapy			X
11-2228	Myelodysplasia	Perscription: Aranesp. Infusion. Injection Therapy				X
11-2226	Right Knee Osteoarthritis	Synvisc Injections				X
11-2223	Tinnitus	Neuromonics Device		X
11-2225	Short Stature	Perscription: Trevtropin			X
11-2224	Lyme's Disease	Neurospychological Testing			X
11-2227	Prostate Cancer	Intensity Modulated Radiation Therapy			X
11-2231	Autism	ABA	X
11-2230	Degenerative Disc Disease	Fusion				X
11-2232	Autism	Speech and Occupational Therapy			X
11-2236	Osteoarthritis	Game Ready Cold Therapy				X
11-2234	Ascending Thoracic Aneurysm	CT Angiography Of The Chest				X
11-2233	Adenocarcinoma Of The Uterus	CT Scan Of Chest				X
11-2235	Psychotic Disorder	Inpatient Rehabilitation			X
11-2237	Scleroderma	Perscription: Tevatio	X
11-2238	Osteoarthrosis / Osteoarthritis	Hip Surgery	X
11-2239	Cervical Cancer	Diagnostic Testing		X
11-2240	Drug Dependency	Inpatient Treatment				X
11-2241	Herniated Discs	Artificial Disc Replacement				X
11-2242	Arthralgia Of Shoulder	MRI				X
11-2243	Radiculopathy	Physical Therapy				X
11-2244	Burn To Foot	Gamma Graft	X
11-2245	Testicular Cancer	Pet Scan	X
11-2246	Chronic Low Back Pain / Right Posterior Superior Iliac Spine	Radio Frequency Ablation	X
11-2247	Chronic Low Back Pain With Radiculopathy	Percutaneous Discectomy/Nucleo plasty Surgery		X
11-2248	Mastodynia	MRI	X
11-2249	Left Knee Pain	Autologous Chondrocyte Implantation Surgery	X
11-2250	Anorexia Nervosa	Inpatient Eating Disorder Treatment			X
11-2251	Mood Disorder/Depres sion	Inpatient Residential Treatment			X
11-2252	Toenail Fungus / Onychomycosis	Perscription: Penlac					X
11-2253	Anorexia Nervosa	Hospitalization				X
11-2254	Depression	Psychotherapy			X
11-2255	Compulsive And Obsessive Behavior	Psychotherapy			X
11-2256	Breast Cancer	Color Doppler Evaluation / Doppler Flow Study / Ultrasound			X
11-2257	Anxiety Disorder	Inpatient Treatment				X
11-2258	Special Screening For Malignant Neoplasmas Colon	Anesthesia			X
11-2259	Chronic Low Back Pain / Degenerative Disc Disease	Spinal Fusion L5-S1				X
11-2260	Chronic Lumbar Pain	Lumbar Fusion				X
11-2261	Degenerative Disc Disease	Fusion				X
11-2262	Peyronie's Disease	Intron-A Injections				X
11-2263	Severe Migraines	IG Allergens Bloodwork	X
11-2264	Post Left Knee Arthroscopy & Partial Lateral Meniscectomy	Continuous Passive Motion Machine				X
11-2265	Bipolar Disorder. Drug Abuse	Inpatient Care				X
11-2266	Mental Disorder	Biofeed Back		X
11-2267	Osteoporosis	Diagnostic Testing		X
11-2268	Kerataconus	Corneal Ring Implants	X (Partial)
11-2269	Spinal Stenosis, Lumbar Region	Facet Injections And Facet Blocks			X
11-2270	Major Depressive Disorder	Transcranial Magnetic Stimulation		X
11-2271	Knee Meniscal Tear	MRI			X
11-2272	Autism, Asperger Syndrome, And Attention Deficit Disorder	Physical Therapy			X
11-2273	Depression	Transcranial Magnetic		X
11-2274	Autism	ABA Treatment	X
11-2275	Anorexia Nervosa	Inpatient Treatment				X
11-2276	Drug Dependency	Substance Abuse Residential Treatment/Detoxific ation				X
11-2277	Substance Abuse	Residential Treatment Center				X
11-2278	Colon Cancer	Chemotherapy. FX Assay Test		X
11-2279	Progressive Tumor	Magnetic Resonance Spectroscopy	X
11-2281	Osteoporosis	Collagen Crosslink				X
11-2282	Vitiligo	Prescription Drugs			X
11-2283	Dysfunctional Lt Scapula	Physical Therapy				X
11-2280	Osteoarthritis Bilateral Knees	Physical Therapy				X
11-2293	Endometrial Stromal Sarcoma Recurring	Prescription Drugs	X
11-2294	Multiple Superficial Venous Unsufficiencies	Endo-Venous Ablation	X
11-2295	Ductal Carcinoma In Situ	MRI		X
11-2296	Degenerative Disc Disease	Artificial Disc - Prodisc		X
11-2297	Cervical Spondylosis	Artificial Disc Replacement		X
11-2304	Anorexia Nervosa	Residential Treatment				X
11-2298	Bi-Polar Disorder	Residential Treatment				X
11-2299	Alcohol Dependence	Inpatient Treatment				X
11-2300	Colonoscopy And Endoscopy	General Anesthesia				X
11-2301	Left Side Shoulder Pain	Chiropractic PT				X
11-2302	Ulcerative Colitis	Functional Electric Stimulator	X
11-2303	Depressive Disorder	Transcranial Stimulation		X
11-2288	Alcohol Dependence	Residential Treatment				X
11-2289	Aggressive Breast Cancer	Pet Scan			X
11-2290	Intervertebral Disc Disease	MRI Of The Lumbar Spine				X
11-2291	Major Depressive Disorder And Chronic Fatigue Syndrome	Provigil		X
11-2305	Drug And Alcohol Dependence	Inpatient Treatment					X
11-2292	Ovarian Cancer	Diagnostic Imaging		X
11-2284	Anxiety	Prescription Drugs				X
11-2285	Degenerative Joint Disease	Facet Injections				X
11-2286	Major Depressive Disorder & Chronic Fatigue Syndrome	Prescription Drugs				X
11-2287	Gynecomastia	Prescription Drugs				X
11-2306	Cleft Lip	Dental And Orthodontic Services				X
11-2307	Herniated Nucleus Pulposus At L4-5.	Acute Inpatient Level Of Care			X
11-2308	Autism	Speech Therapy			X
11-2309	Prostrate Cancer	Image Guided Radiation (IMRT- IGRT) And Cyberknife Stereotactic Body Radiosurgery Therapy (SBRT)		X
11-2310	Coats' Syndrome	Avastin	X
11-2311	Major Depression	Transcranial Magnetic Stimulation		X
11-2312	Degenerative Disc Disease	Artificial Disc Replacement		X
11-2313	Polymorphic Ventricular Tachycardia	Genetic Testing	X
11-2314	Moderate To Severe Traumatic Brain Injury Secondary To Motor Vehicle Accident	Inpatient Services			X
11-2315	Nasal Obstruction	Ablation Of The Nasal Turbinates			X
11-2316	Stroke	Skilled Nursing Facility				X
11-2317	Opioid Type Dependence	Inpatient Substance Abuse Treatment				X
11-2318	Bulimia, Depression	Inpatient Behavioral Health Treatment				X
11-2319	Status Post Prostatectomy	Viagra				X
11-2320	History Of Gastroesophage al Reflux Disease And Gastric Ulcer	Anesthesia For Esophagogastroduo denoscopy				X
11-2322	Left Knee Pain	MRI			X
11-2321	Temporomandib ular Joint Disorder	Expenses Related To Treatment TMJ				X
11-2327	Bilateral Shoulder Adhesive Capsulitis	Physical Therapy				X
11-2328	Alcoholism	Naltrexone Pellet		X
11-2329	Colorectal Cancer State IV	Colorectal Cancer State IV	X
11-2330	Breast Cancer / Langerhans Cell Histiocytosis (LCH) -AP	Pet Scan			X
11-2331	Acute Sigmoid Colon Diverticulitis With Abscess	Inpatient Care			X
11-2334	Degenerative Disc Disease	Artificial Disc Replacement		X
11-2323	Left Knee Replacement	Computer Assisted Navigation (CAS)		X
11-2324	Immunodeficienc y And Rheumatologic Disorder Along With Pre-Existing Juvenile Arthritis.	Immune Globulin Infusion			X
11-2325	Osteoarthritis	Hyaluronic Acid Injections				X
11-2326	Obesity	Laparoscopic Roux- En-Y Gastric Bypass			X
11-2332	Major Depressive Disorder	Residential Treatment			X
11-2333	Preconception And Prenatal Screening	Gynecologic Services			X (Partial)
11-2336	Diagnosis: Right Lateral Epicondylitis And Right Frozen Shoulder	Physical Therapy		X
11-2337	Varicose Veins With Inflammation	Venous Duplex			X
11-2355	Prostrate Cancer	Imrt-Igrt		X
11-2356	Headaches	Botox		X
11-2357	Major Depressive Disorder	Transcranial Magnetic Stimulation		X
11-2358	Bunion/Bunionec tomy	Dynasplint Low- Load Prolonged Duration Stretch		X
11-2359	Lumbar Degenerative Disc Disease, Scoliosis And Lumbar Spondylosis	Radiofrequency Facet Rhizotomy	X
11-2360	Spect Scan	Moyamoya Disease		X
11-2361	Disc Degeneration, Lumbar	Vertebral Axial Decompression		X
11-2362	Alcohol / Drug Dependence	Inpatient Detoxification Program				X
11-2363	Schizophrenia, Drug Dependence	Residential Care				X
11-2364	Alcohol / Drug Dependence	Inpatient Drug Rehabilitation				X
11-2365	Left Knee Arthroscopic Surgery With Partial Medial Meniscectomy	Physical Therapy				X
11-2366	Colonscopy	Anesthesia				X
11-2367	Bipolar	Out Patient Therapy				X
11-2368	Colon Cancer	Chemo FX Lab Testing				X
11-2369	Brain Metastases	Radiosurgery				X
11-2370	Cocaine Abuse	Residential Rehabilitation				X
11-2371	Substance/Alcoh ol Dependence	Residential Treatment				X
11-2372	Short Stature	Growth Hormone Treatment				X
11-2373	Major Depression And Panic Disorder With Agoraphobia	Intensive Outpatient Services				X
11-2346	Spinal Muscular Atrophy Type I	Synagis			X
11-2347	Lipodystrophy - HIV Related	Egrifta-- Perscription			X
11-2348	Talipes Valgus Of The Feet, Bilaterally	Subtalar Arthroereisis	X
11-2349	Chronic Neck Pain	Total Disc Replacement		X
11-2350	Spinal Stenosis	Cervical Artificial Discectomy		X
11-2351	Multiple Sclerosis	IVIG Infusion			X
11-2352	Cervicogenic Headaches	Multilevel Cervical Fusion			X
11-2353	Bilateral Knee Osteoarthritis	Supartz Injections				X
11-2354	ACL Reconstruction	CPM Machine				X
11-2338	Speech Delay Following Head Injury Due To Accident At 7 Months	Speech Therapy			X
11-2339	Substance Abuse, Major Depressive Disorder With History Of ADHD	Psychiatric Partial Hospitalization Program Treatment			X
11-2340	Bilateral -Severe To Profound Sensorineural Hearing Loss	Nucleus 5 Processor Implant				X
11-2341	Major Depressive Disorder, Bipolar Disorder And ADD	Transcranial Magnetic Stimulation		X
11-2342	Alcohol Dependence	Residential Treatment				X
11-2343	Bipolar Disorder, Type II, Post- Traumatic Stress Disorder, Major Depressive Disorder, Generalized Anxiety Disorder And Benzodiazephine Dependency	Inpatient Mental Health Services				X
11-2344	Hypomania And Insomnia Secondary To Medical Therapy For Treatment Of Bipolar Disorder	Seroquel 25 Mg			X
11-2345	Obsessive Compulsive Behavior/Aggres sion	Inpatient Mental Health				X
11-2379	Spinal Stenosis & Spondylolisthesis	X-Stop Intraspinal Distraction Device		X
11-2380	Vaginal Hemorrhage	Emergency Services			X
11-2381	Tourette's Syndrome	Drug, Xenazine			X
11-2382	Otitis Media	Emergency Services			X
11-2383	Severe Systemic Mysthenia Gravis	Ivig	X
11-2384	Depression	TMS - Transcranial Magnetic Stimulation	X
11-2385	Major Depressive Disorder	TMS - Transcranial Magnetic Stimulation	X
11-2386	Rheumatoid Arthritis	Munoassay Antibody Diagnostic Tests	X
11-2388	Pericardium	Cellular Tissue Grafts		X
11-2387	Alcohol Dependence	Residential Mental Health Care				X
11-2389	Chronic Neck Pain - Cervicalgia	Spine Nerve Treatment (Radiofrequency Neurolysis)		X
11-2390	Degenerative Disc Disease	Artificial Disc Replacement		X
11-2391	Deviated Septum - Nasal Obstruction	Septoplasty - Radiofrequency Or Laser Ablation Of Nasal Tubinates		X
11-2392	Monitor The Heart Rate, Fainting Spells	External Mobile Cardiovascular Telemetry With EEG		X
11-2393	Deviated Septum - Nasal Obstruction, Sleep Apnea	Nasal & Throat Surgery, Septoplasty		X
11-2394	Derangement Of Medial Meniscus Left Knee Pain	Artiledge Cells Tranplant And Meniscal Transplant Surgery - Allograft / Osteochondral		X
11-2395	Displacement Of Intervertebral - Neck Pain And Left Upper Extremity Pain And Weakness	Cervical Artificial Disc Replacement.		X
11-2396	Deviated Septum - Nasal Obstruction	Radiofrequency / Laser Ablation (Reduction Of Tissue Volume)		X
11-2397	Alcohol Dependence	Residential Treatment				X
11-2398	Schizophrenia	Res Psych Ward					X
11-2399	Degenerative Disc Disease	Fusion Surgery			X
11-2400	Alcohol Dependence	Sub Acute Residential Treatment Services				X
11-2401	Anxiety, Major Depression, Benzodiazepine Dependence, Alcohol Abuse & Substance Abuse	Residential Treatment				X
11-2402	Gastritis & Duodenitis	Anesthesia Services, Endoscopy				X
11-2403	Traumatic Amputation	Microprocessor Controlled Lower Limb Prosthesis				X
11-2404	Obesity	Gastric Bypass				X
11-2405	Anxiety, Suicidal, Cutting	Hospitalization, Residential Treatment Center					X
11-2406	Obesity	Gastric Bypass				X
11-2407	Obesity	Gastric Sleeve Procedure				X
11-2408	Knee Instability, Post Surgery	Knee Brace				X
11-2409	Coronary Artery Disease	C-Reactive Protein Testing	X
11-2410	Prostate Cancer	IMRT - Radiation Therapy			X
11-2375	Alcohol Dependence	Residential Treatment				X
11-2376	Major Depressive Disorder	Tms - Transcranial Magnetic Stimulation		X
11-2377	Shoulder Pain, Tendonitis	MRI				X
11-2378	Degenerative Disc Disease	Cervical Total Disc Replacement Therapy		X
11-2374	Bipolar	Residential Mental Health Treatment				X
11-2414	Injury - Muscular/Skeleta l	ER Room Treatment				X
11-2412	Exudative Tonsils W/ Probable Acute Pharanitis	Zithromax And An Opioid Pain Medication			X
11-2413	Chronic Pain Syndrome	Actiq LOZ 1600 Mcg Every 8 Hours As Needed			X
11-2414	Knee Pain, Neck Pain And Back Pain	Physical Therapy				X
11-2415	Neck Pain, Cervical Strain, Lumbosacral A Strain, Sciatic Nerve Lesion	Physical Therapy				X
11-2416	Mastocytosis	Laser Skin Tag Removal				X
11-2417	Panhypopituitaris m	Growth Hormone Therapy				X
11-2418	Hip Pain, Hiking Injury	Physical Therapy				X
11-2419	Breast Cancer	Med (Sprycel) Designed To Treat Bone Tumors		X
11-2420	Osteoarthrosis	Synvisc Injection		X
11-2421	Foot Drop Resulting From CVA (Stroke)	Functional Electrical Stimulator Walk Aide	X
11-2422	Breast Cancer	Mammaprint Testing - Gene Expressing Profile		X
11-2423	Chronic Sinusitis	Balloon Sinuplasty		X
11-2424	Major Depressive Disorder	Transcranial Magnetic Stimulation		X
11-2425	Degenerative Disc Disease	Spinal Fusion				X
11-2426	Major Depressive Disorder With Psychotic Features, Paranoid Schizophrenia, Suicidal Idealization	Inpatient Psych Hospitalization			X
11-2427	Depression And Suicidal Ideation	Psychiatric Residential Treatment			X
11-2428	Hypothyroidism	MRI				X
11-2429	Autism	Outpatient Mental Health Services			X
11-2430	Major Depressive Disorder	Therapy, 4x Week				X
11-2431	Chemical Dependency	In Patient Substance Abuse Sub Acute Residential Treatment Services				X
11-2432	Anorexia Nervosa	Residential Treatment				X
11-2438	Bipolar, Severe Emotional Disturbances	Inpatient & Residential Treatment			X
11-2439	Degenerative Disc Disease	Lower Lumbar Vertebrae Fusion / Low Back Fusion Surgery				X
11-2440	Painful Degenerative Disc L4-5	Surgical Intervention Lumbar Fusion At L4-5 Or Total Disc Replacement At L4- 5.				X
11-2441	Bi-Polar	Inpatient Psychiatric Care				X
11-2433	Psycohotic Disorder	Acute Inpatient Psychiatric Services			Partial
11-2434	Hepatitis C	Prescription For Humira				X
11-2435	Lower Back Pain, Radiculopathy	Lumbar Spinal Fusion				X
11-2436	Unknown Etiology	Ct Scan			X
11-2437	Anorexia Nervosa	Residential Treatment				X
11-2442	Surgical Repair Of Right Knee	Custom Knee Brace				X
11-2443	Hypertriglyceride mia (High Triglycerides)	Lovaza				X
11-2444	Degenerative Disc Disease	Artificial Disc		X
11-2445	Breast Cancer (Invasive Ductal Carcinoma)	Low Dose Chemotherapy		X
11-2446	Degenerative Disc Disease	Artificial Disc		X
11-2447	Low Back Pain - Degenerative Disc Disease	Lumbar Artificial Disc Arthroplasty		X
11-2448	Piriformosis Syndrome	MRI - Magnetic Resonance Imaging			Partial
11-2449	Low Back Pain - Chronic Low Back Pain And Left Leg Pain	Facet Joint Injections - Lumbar Epidural And Steroid Injections				X
11-2450	Schizophrenia	Hospitalization				X
11-2451	Genetic Predisposition To Hypertrophic Cardiomyopathy	External Mobile Cardiovascular Telemetry (MCOT)				X
11-2452	Alcohol / Drug Dependence	Residential Treatment				X
11-2453	Alcohol / Drug Dependence	Residential Treatment				X
11-2454	Necrotizing Fasciitis & Toxic Affect Of Unspecified Metal	Hyperbaric Oxygen Therapy				X
11-2455	Left Thigh Contusion & Hematoma	Physical Therapy				X
11-2456	Herniated / Displaced Disc	Artificial Disc Replacement		X
11-2457	Bilateral Nasal Obstruction	Septoplasty / Rhinoplasty			X
11-2458	Lumbago, Spinal Stenosis, Disorder Of Bone And Cartilage	Lumbar Spinal Fusion				X
11-2462	Depression	Weekly Outpatient Mental Health Treatment			Partial
11-2459	Drug/Alcohol Dependence, Major Depressive Disorder, Attention Deficit/Hyperacti vity Disorder	Residential Mental Health Treatment				X
11-2460	Anorexia Nervosa	Residential Treatment			X
11-2461	Bulimia	Partial Hospitalization Program				X
Totals			63	102	111	181	5