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2010 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: 428
  • Experimental/Investigational-Overturned: 58
  • Experimental/Investigational-Upheld: 86
  • Medical Necessity Overturned: 147
  • Medical Necessity Upheld: 128
  • Withdrawn: 9

Independent Medical Reviews (IMR) Annual Report- January through December 2010


Reference # Diagnosis Treatment Experimental / Investigational- Overturned  Experimental / Investigational- Upheld Medical Necessity Overturned Medical Necessity Upheld Withdrawn
10-1512 Narcolepsy Rx: Xyrem     x    
10-1513 Invasive Breast Cancer PET Scan     x    
10-1514 Autism ABA therapy     x    
10-1515 Renal cancer PET and CT scan   x      
10-1516 Left knee injury Physical Therapy       x  
10-1517 Migraine headaches.  Botox treatments x        
10-1518 Multiple Sclerosis Rituximab injections x        
10-1519 Back injury Back surgery         X
10-1520 Stomach pain - acid reflux Rx: Zegerid 40mg         X
10-1521 Low back pain Physical Therapy       x  
10-1522 Morbid Obesity Duodenal Switch Bariactic Surgery     x    
10-1523 Substance abuse Sub-acute residential tx       x  
10-1524 Fibroid Tumors of Uterus Unterine Fibroid Embolization     x    
10-1525 Breast Hyperthrophy Breast Reduction     x    
10-1526 morbid obesity Removal of lap band. Gastroplasty revision.       x  
10-1527 Substance abuse Sub-acute residential tx       x  
10-1528 Hypogonadism Rx: AndroGel      x    
10-1529 Acute Psychosis Residential TX Center     x    
10-1530 Extremity lymphedema & recurrent cellulites Flexxitouch pneumatic compression device     x    
10-1531 Cervical facet arthritis & Degenerative joint dx Radiofrequency lesioning of the facet nerves   x      
10-1532 Sleep disorder Neurofeedback therapy   x      
10-1533 Neck pain Cervical/thoracic discography and CT of cervical spine   x      
10-1534 ADHD Speech therapy     x    
10-1535 Recalcitrant scalp psoriasis Rx: Enbrel 50mg     x    
10-1536 Left knee arthroscopy with partial medial & lateral meniscectomy Continuous Passive Motion (CPM)     x    
10-1537 Chronic Auto Immune Uticaria Rx: Xolair       x  
10-1538 Lower back pain, sciatica MRI       x  
10-1539 RSV Rx: Synagis      x    
10-1540 Chronic low back pain Artificial Intervertebral Disc Replacement   x      
10-1541 Short stature Diagnostic test     x    
10-1542 Esophogeal Cancer Rx: Nexium     x    
10-1543 Cervicalgia. Lumbago. Sciatica Rx: Celebrex 200mg, twice daily       x  
10-1544 Plantar fascitis Orthotics     x    
10-1545 Post total knee arthroplasty Continous Passive Motion Device (CPM)       x  
10-1546 Spastic cerebral palsy Wheelchair     x    
10-1547 Degenerative disc disease Low back fusion surgery       x  
10-1548 Psychiatric Inpatient care       x  
10-1549 Psychiatric Inpatient care         X
10-1550 Back pain Hemilaminotomy - back surgery       x  
10-1551 Anorexia Nervousa. Syncope episodes. Obstipation. Suicidal. Residential Tx     x    
10-1552 Substance abuse.  Mental disorder. Inpatient care     x    
10-1553 Bleeding hemorroids Inpatient hospital & surgery         X
10-1554 Paresthesias MRI of brain   x      
10-1555 Degenerative disc disease Discectomy & Artificial disc replacement   x      
10-1556 Spinal stenosis & spondylolisthesis X-STOP interspinous distraction device   x      
10-1557 Morbid obesity Sleeve gastrectomy x        
10-1558 Severe wrist pain MRI of wrist x        
10-1559 Endometrial carcinoma Intensity Modulated Radiation Therapy     x    
10-1560 Post ACL knee surgery Knee brace     x    
10-1561 Post ACL knee surgery Custom knee brace       x  
10-1562 Bilateral knee osteoarthritis Supartz injections     x    
10-1563 Post ACL knee surgery & Medical meniscal tear Custom knee brace & femoral length sock     x    
10-1564 Chronic migraine headaches Botox injections     x    
10-1565 Transfemoral amputation secondary to osteosarcoma Microprocessor-controlled prosthesis (C-Leg)     x    
10-1566 Post ACL replacement surgery Continous Passive Motion Device (CPM)       x  
10-1567 Hx of psychotic depression.  Malaise and decreased activity level. Inpatient adult psychiatric services     x    
10-1568 Nasal deformity Nasal Reconstruction       x  
10-1569 Acute Renal Failure/Congestive Heart Failure Skilled nursing care     x    
10-1570 Hx of left breast cancer MRI of breast       x  
10-1571 Candida /yeast/ thrush
Rx: Diflucan
Rx: Celebrex
10-1572 Neck pain Theraputic selective nerve root blocks     x    
10-1573 Cyclic Dysmenorrhea Rx: Leuprolide x        
10-1574 Degenerative disc disease Two-level artificial disc replacement   x      
10-1575 Mood disorder NOS, polysubstance abuse (alcohol, opiates, marijuana). Inpatient residential tx       x  
10-1576 Schizophrenia Psychiatric residential treatment       x  
10-1577 Multiple sclerosis Rx: Rixtuxan         X
10-1578 Dementia, paralysis from several strokes, heart attacks, diabetes. Skilled nursing facility care       x  
10-1579 Autism Applied Behavior Analysis     x    
10-1580 Major Depression(suicidal) Residential Treatment       x  
10-1581 Eating disorder Inpatient care        x  
10-1582 Bipolar disorder. Bulimia. Mixed personality traits w/anti-social behavior. Cocaine dependence. Psychiatric residential tx       x  
10-1583 Low back pain MRI       x  
10-1584 Left patellar tendon rupture Physical therapy     x    
10-1585 Unknown Anesthesiology during endoscopy     x    
10-1586 Alcohol dependence & major depression Residential treatment       x  
10-1587 Back pain posterior lumbar interbody fusion     x    
10-1588 Binocular dysfunction, defective stereopsis, saccadic dysfunction, accomodative dysfunction. Vision therapy       x  
10-1589 Heart disease / heart attack Real-Time Remote Heart Monitor   x      
10-1590 Chest pains / shortness of breath Coronary CT angiography   x      
10-1591 Ruptured rotator cuff Rotator cuff graft x        
10-1592 Idiopathic short stature Growth hormone therapy (Nutropin)       x  
10-1593 Pre-breast cancer Rx: Arimidex     x    
10-1594 Liposarcoma of the Spermatic Cord and agressive tumor with metastisis. PET Scan x        
10-1595 Myocardial Infarction Enhance External Counterpulsation (EECP) and Thoracic Bioimendance (TEB) & Inert Gas Rebreathing. x        
10-1596 Kidney cancer PET Scan   x      
10-1597 Neck and upper back pain Physical therapy       x  
10-1598 Recurrent metastatic endometrial cancer PET Scan x        
10-1599 Disassociation and Deralization w/photophobia and phonophobia. Video imaging (EEG)       x  
10-1600 Fractured and sprained ankle Emergency treatment     x    
10-1601 Hx of breast cancer. Post mastectomy. Oncotype DX       x  
10-1602 Drug abuse Residential treatment center       x  
10-1603 Acne Rx: Benzaclin gel       x  
10-1604 Post spine surgery Physical therapy       x  
10-1605 Major depressive disorder Inpatient hospitalization       x  
10-1606 Lymphedema Multi-chamber programmable lymphedema pump     x    
10-1607 Back pain MRI       x  
10-1608 Esophagitis.    Esophago-gastroduo-denoscopy(EGD) Anesthesia        x  
10-1609 Pancreatic cyst Tumor cell assay   x      
10-1610 Lumbar radiculopathy (L3-4 and L4-5) Percutaneous laser discectomy   x      
10-1611 Chest pain & discomfort Cardiac computed omography angiography with 3-dimensional imaging   x      
10-1612 Rt knee & ligaments Vasopneumatic device   x      
10-1613 Degenerative disc disease Two-level cervical disc arthroplasty   x      
10-1614 Post ligament reconstruction Left knee autologous chondrocyte implantation   x      
10-1615 Right anterior scalene muscle block Botox injections   x      
10-1616 Pancreatic cancer PET scan - full body   x      
10-1617 Post acute myocardian infarction Skilled nursing facility       x  
10-1618 IGF deficiency (insulin-like growth factor) IGF Tx       x  
10-1619 Osteoarthritis Synvisc One injection     x    
10-1620 Hypertriglyceridemia Rx: Lovaza 8mg     x    
10-1621 Lumbago, lumbar segmental dysfunction and myalgia Physical therapy. Chiropractic services.       x  
10-1622 ADD.   Mood Disorder. Polysubstance abuse Residential treatment       x  
10-1623 Pelvic pain and dyspareunia Physical therapy       x  
10-1624 Attention Deficit Hyperactivity Disorder (ADHD) Bio-feedback   x      
10-1625 Elevated Liver Enzyme CT of abdomen & pelvis     x    
10-1626 Right leg pain Physical therapy     x    
10-1627 Rt knee & ligaments Physical therapy     x    
10-1628 Substance Abuse/Dependence Sub-acute residential detoxification & rehabilitation       x  
10-1629 Mental health Inpatient hospitalization       x  
10-1630 Unknown Rx: Butorphanol Tartrate 10mg/ml     x    
10-1631 Substance abuse Residential treatment     x    
10-1632 Alcohol, opiate and sedative withdrawal Inpatient detox services     x    
10-1633 Lower back pain Back surgery       x  
10-1634 Drug/Alcohol abuse Residential treatment for inpatient detox       x  
10-1635 Arthroscopy shoulder sx & torn labrum Physical therapy     x    
10-1636 Hallux rigidus Custom functional orthotic     x    
10-1637 Major depression w/severe impairment Psychiatric hospitalization     x    
10-1638 Hypogonadism with low testosterone levels.  Elevated levels of prolactin MRI of brain and pitutary     x    
10-1639 Lesions on head (causing bald spots) Hair Transplant       x  
10-1640 Severe mental disorder Inpatient psychiatric services     x    
10-1641 Erichiosis Antibotic treatment   x      
10-1642 Degenerative disc disease Artificial lumbar disc surgery.  Artificial intervertebral discs   x      
10-1643 Papillary thyroid cancer Stereotactic radiation therapy   x      
10-1644 Metastatic carcinoma MRI   x      
10-1645 Peripheral neuropathy Rx: Lyrica     x    
10-1646 Sciatica Lumbar discogram (spine fusion surgery)       x  
10-1647 Lumbar disc displacement Disectomy   x      
10-1648 Autism Speech, occupational, physical therapy, and ABA treatment.     x    
10-1649 Attention Deficit Hyperactivity Disorder (ADHD) Rx: Vyvanese 100mg/day       x  
10-1650 Growth Hormone Deficiency Growth Hormone Supplements       x  
10-1651 Liver cancer Selective internal radiation therapy x        
10-1652 Breast cancer Oncotype DX testing       x  
10-1653 Crohn's Disease Rx: Remicade (Infliximab)     x    
10-1654 Fractured foot Delayed ultrasonic bone stimulation       x  
10-1655 Mental health (ADHD, bipolar, etc.) Inpatient care       x  
10-1656 Post Stroke Transcatheterembolization procedure   x      
10-1657 Sarcoidosis CT scan       x  
10-1658 Intrparenchymal hemorrhage Hospitalization       x  
10-1659 Autism ABA     x    
10-1660 Substance Abuse Prometa   x      
10-1661 Alcohol addiction Inpatient treatment for substance abuse       x  
10-1662 Ankle and Mid-thoracic pain Physical therapy     partial    
10-1663 Glaucoma Canaloplasty x        
10-1664 Chronic Migranes Botox   x      
10-1665 Uterine fibroids  MRI guided focused ultasound   x      
10-1666 Flu like symptoms Emergency room service       x  
10-1667 Social anxiety disorder with obsessive compulsive disorder Inpatient mental health residential treatment     x    
10-1668 Incomplete bladder emptying Diagnostic MRI       x  
10-1669 Sleep disorder, insomnia & narcolepsy Rx: Provigil     x    
10-1670 Alcohol addiction Subacute detoxification treatment       x  
10-1671 Depression Inpatient hospitalization       x  
10-1672 Substance abuse with physiological dependence Sub-acute residential substance abuse rehabilitation     x    
10-1673 Short stature Rx: Tev-Tropin     x    
10-1674 Deg disc disease Spinal fusion surgery     x    
10-1675 Keloid scarring tissue Surgery       x  
10-1676 Bulimia Nervosa Intensive outpatient treatment       x  
10-1677 Behavioral health Residential Tx Center       x  
10-1678 Anxiety, bipolar disorder & major depression Inpatient psychiatric hospitalization     Partial    
10-1679 Multiple sclerosis Upper & lower surface electromyography & surface electrodiagnostic testing   x      
10-1680 Irritable bowel syndrome Gastroenterology procedure--SmartPill GI Monitoring System   x      
10-1681 Left-sided lower extremity hemiplegia post stroke WalkAide functional electrical stimulator device   x      
10-1682 Recurrent syncopal episodes Real time remote cardiac monitoring x        
10-1683 Varicose veins Endovenous Laser Closure (EVIC) and Ultrasound Guided Sclerotherapy (UGS) partial        
10-1684 Hypercholesterolemia Coronary computed tomography angiography   x      
10-1685 Meniere's Disease Meniett device   x      
10-1686 hepatitits C genotype 1 SPECT scan x        
10-1687 Acne vulgaris Rx: Duac CS Kit       x  
10-1688 Major depression Inpatient treatment       x  
10-1689 Obesity Rx: Meridia     x    
10-1690 Short stature Saizen growth hormone therapy       x  
10-1691 Bilateral profound sensorineural hearing loss Bilateral cochlear implants     x    
10-1692 Breast cancer IMRT (Intensity Modulated Radiation Therapy) x        
10-1693 Combined hyperlipidemia Homocysteine & lipoprotein tests   x      
10-1694 Tumors in lungs. Rx: Gleevec x        
10-1695 Right renal lesion PathFinder TG testing x        
10-1696 Alcohol/Drug addiction Inpatient addiction treatment       x  
10-1697 Behavioral issues - polysubstance dependency Psychological care, residential tx     partial    
10-1698 Chronic cough CT Scan     x    
10-1699 Suspected metastatic breast cancer CT scans of the chest, abdomen and pelvis     x    
10-1700 Prostate cancer  IMRT x        
10-1701 Polysubstance abuse Hospital services     x    
10-1702 CIPD IVIG therapy     x    
10-1703 Hidradenitis suppurativa Rx: Remicade x        
10-1704 Right Shoulder Sprain/Inpingement Physical therapy       x  
10-1705 Lower back pain associated with radicular symptoms during pregnancy. Physical therapy     x    
10-1706 Transverse discrepancy Jaw Multi-segment Lefort I oesteotomy w/bone grafting     x    
10-1707 Adult Growth Hormone Deficiency.  Benign Neoplasm of Pituitary. Genotropin therapy     x    
10-1708 History of lumbar spinal stenosis & post-laminectomy syndrome in lumbar region Interspinous Process Decompression System (X-STOP).   x      
10-1709 Sore throat & fever Emergency services     x    
10-1710 Back pain Enbrel therapy   x      
10-1711 Speech and learning disability Speech therapy         X
10-1712 Substance abuse & depression Residential treatment       x  
10-1713 Lumbar degenarative disc disease Posterior fusion       x  
10-1714 Bulging disc in neck & severe arthritis MRI of the cervical spine       x  
10-1715 Bipolar I disorder Acute inpatient psychiatric hosp       x  
10-1716 Mood disorder, anxiety, bulimia nervosa, attention deficit hyperactivity disorder. Residential treatment        x  
10-1717 History of right renal tumor Radiofrequency ablation   x      
10-1718 Osteoporosis Bone mineral density scan x        
10-1719 Morbid obesity Laparoscopic sleeve gastrectomy x        
10-1720 Reconstruction of the anterior cruciate ligament of the left knee. Cooling device/pneumatic compression device   x      
10-1721 Short stature Growth hormone tx   x      
10-1722 History of gastric adenocarcinoma PET scan   x      
10-1723 Lung cancer metastic to the brain PET scan x        
10-1724 Syncope due to cardiac arrhythmia Real-time cardiac monitor x        
10-1725 Back pain Discography       x  
10-1726 Cardiovascular Disease Laboratory blood test       x  
10-1727 Hypogammaglobulinemia IVIG therapy     x    
10-1728 Right knee chondromalacia Synvisc injections     x    
10-1729 Severe dermatochalasia.  Symmetry & obstruction of vision. Bilateral blepharoplasty         X
10-1730 Epilepsy Steriotactic computer assisted volumetric x        
10-1731 Cancer PET/CAT scan x        
10-1732 Cardiovascular Disease C-reactive protein; high sensitivity partial        
10-1733 Acute menopausal symptoms, at risk for cardiac disease. VAP test partial        
10-1734 High risk breast cancer MRI (Diagnostic)     x    
10-1735 Sleep apnea along with depression and anxiety. CPAP machine     x    
10-1736 Severe back & flank pain CT Urogram     x    
10-1737 Brain aneurism 3-D Echocardiogram x        
10-1738 Autism ABA therapy       x  
10-1739 Autism ABA, speech and occupational therapy     x    
10-1740 Depression, obsessive-compulsive disorder and anxiety. Partial hospitalization program       x  
10-1741 Metastatic bladder cancer Papillary urothelial carcinoma cell therapy   x      
10-1742 Psoriasis Excimer Laser   x      
10-1743 Lyme's disease Lab test   x      
10-1744 Hyperlipdemia Various blood tests: Homocysteine, lipoprotein quantification, lipoprotein, fibrinogen and apolipoprotein.   x      
10-1745 Ocular Melanoma metastases to liver  Chemoembolization (CE), selective catheter placement, arterial system. x        
10-1746 Post surgery- recurring patella dislocation Physical therapy     partial    
10-1747 Cough, congestion, fever Emergency service       x  
10-1748 Foot pain and insomnia Rx: Ambien       x  
10-1749 Pelvic floor dysfunction Physical therapy       x  
10-1750 Superior semicircular canal dehiscence syndrome (SCDS) Post surgery ICU stay     x    
10-1751 Post surgery - Anterior cruciate ligament Allogrant Transplant x        
10-1752 Hx of ovarian cancer & status post hysterectomy. Human epididymis protein 4 (HE4) diagnostic test. x        
10-1753 Pancreatic cancer  PET/CT Scan x        
10-1754 Prostrate cancer stage IV Proton Treatment   x      
10-1755 Post hip surgery Game Ready System   x      
10-1756 Chronic migraine headache Botox injections x        
10-1757 Tinnitus Neuromonics Tinnitus Treatment (device)    x      
10-1758 Vitiligo Ultraviolet light therapy x        
10-1759 Rheumatoid arthritis MRI of the hand   x      
10-1760 Basal & squamous cell carcinoma Photodynamic light therapy   x      
10-1761 Cancer of fallopian tube MRI   x      
10-1762 Sacroiliac joint and left lower gluteal pain Physical therapy       x  
10-1763 Suicidal / Depression Hospitalization     x    
10-1764 Autism Speech, Occupational and Applied Behavioral Analysis (ABA)       x  
10-1765 Herniated disc at L3-4 & foraminal stenosis at L2-3 with nerve root impingement (post surgical)
Rx: Pregabalin (Lyrica)     x    
10-1766 Anxiety attacks Residential treatment center services       x  
10-1767 Diagnostic procedure Colonoscopy     x    
10-1768 Eating disorder Residential treatment center services     x    
10-1769 Post temporomandibular joint arthroplasty (TMJ) CT Scan     x    
10-1770 Acute Depressive disorder (bereavement issues) Inpatient hospitalization       x  
10-1771 Bipolar disorder; Attention deficit hyperactivity disorder;
Eating disorder.
Inpatient psychiatric residential care     x    
10-1772 Ribroadenoma of breast Cryoablation of fibroadenoma x        
10-1773 Stuttering Comfort Fit SpeechEasy device   x      
10-1774 Morbid obesity Vertical sleeve gastrectomy   x      
10-1775 Tibial Plateau Fx Continous Passive Motion Device       x  
10-1776 ADHD / Drug addiction / Mental health Residential treatment center services     x    
10-1777 Autism Speech, Occupational, and ABA Tx     partial    
10-1778 Oppositional defiant disorder, depressive disorder, cannabis dependence, cocaine abuse. Residential treatment       x  
10-1779 Posttraumatic multilevel degenerative herniated lumbar discs. Microendoscopic Discectomy   x      
10-1780 Unknown Epidural injections of anesthetic agent x        
10-1781 Cervicalgia & lumbago Physical therapy       x  
10-1782 Mesothelioma Interferon   x      
10-1783 Lung cancer Stereostactic Radiosurgery   x      
10-1784 Chest pain CTA Coronaries. CAL scoring x        
10-1785 Major depression Transcranial Magnetic Stimulation Therapy.   x      
10-1786 Breast cancer history IMR x        
10-1787 Depression & attention deficit hyperactivity. Neurofeedback (EEG biofeedback)   x      
10-1788 Post fusion C5-6 with adjacent degeneration above & below. Cervical anterior interbody fusion   x      
10-1789 Diabetic Retinopathy Intravitreal injection of Avastin. x        
10-1790 Obesity AP Sleeve Gastrectomy x        
10-1791 Migraine headaches Botox injection x        
10-1792 Brachycephaly Cranial remolding orthesis x        
10-1793 Chronic migraine headaches Botox injections x        
10-1794 Progressive memory & cognitive dysfunction. PET scan   x      
10-1795 Learning disabilities Speech therapy & Occupational therapy     x    
10-1796 Symtomatic Macromastia Breast Reduction       x  
10-1797 Cerebral Palsy Occupational therapy     x    
10-1798 Polysubstance dependence Inpatient psychiatric residential tx       x  
10-1799 Neck & shoulder pain Physical therapy     x    
10-1800 Post status rotator cuff repair Physical therapy       x  
10-1801 Drug addiction Rx: Subutex     x    
10-1802 Weakness, fatigue & paresthesias of unclear etiology. Acute hospital services      x    
10-1803 Blepharochalasia Bilateral upper eyelid blepharoplasty     x    
10-1804 Depression, anorexia Inpatient hospitalization       x  
10-1805 Dysfluency Speech therapy       x  
10-1806 Shoulder pain MRI of right shoulder       x  
10-1807 Major depressive disorder Residential tx      x    
10-1808 Osteoporsis of hip & spine Duel Energy X-ray absorptimetry (DEXA)       x  
10-1809 Cirrhosis & hepatocellular carcinoma Selective internal radiation therapy (SIRT) x        
10-1810 History of Hypercholesterolemia CT Antgiography   x      
10-1811 Obesity Laproscopic restrictive vertical sleeve surgery.     x    
10-1812 Obstructive Sleep Apnea Mandibular repositioning device     x    
10-1813 Metastatic colon cancer Rx: Avastin     x    
10-1814 Post injury left knee Knee brace        x  
10-1815 Chronic tics Rx: Xenazine     x    
10-1816 Growth failure/short stature Growth hormone therapy (Humatrope)     x    
10-1817 TMJ vs TMD (temporomandibular disorders) Orthotics removable      x    
10-1818 Left hip impingement Femoroacetabular hip arthroscopic   x      
10-1819 Rectal cancer IMRT  x        
10-1820 Intractable seizures Magnetoencephalogram (MEG) x        
10-1821 Liver mass MRI of lumbar spine.   Computerized tomography of the abdomen & pelvis     partial    
10-1822 Ovarian cancer.  Hx of 2 primary tumors w/possibility of metastasis to the lungs in each instances. CT scan of the chest     x    
10-1823 Breast cancer Diagnositic imaging     x    
10-1824 Asymptomatic cancer patient MRI x        
10-1825 Substance-abuse disorder, depression w/ sucidical ideation & possible overdose. Acute psychiatric inpatient services     x    
10-1826 Pancreatic Cancer Stereotactic body TX     x    
10-1827 Depression TMS - Transcranial Magnetic Stimulation   x      
10-1828 Gynomastia Surgery     x    
10-1829 Post right knee medial meniscectomy Physical therapy     x    
10-1830 Progressive liver disease Selective Internal Radiation Therapy (SIRT) x        
10-1831 Esophaeal cancer with brain metastasis Stereotactic radiosurgery   x      
10-1832 Degenerative Disc Disease Artificial Disc Replacement Surgery   x      
10-1833 Coronary artery disease Computed Tomography (CT) angiography of the heart   x      
10-1834 Depression Transcranial Magnetic Stimulation x        
10-1835 Right hip Arthroscopy GameReady Ice Machine   x      
10-1836 Autism Partial Inpatient Psychiatric Hospitalization     x    
10-1837 Autism Partial Inpatient Psychiatric Hospitalization     x    
10-1838 Asperger's syndrome Psychiatric residential treatment     x    
10-1839 Degenerative Disc Disease Spinal Fusion       x  
10-1840 Allergies Intradermal testing       x  
10-1841 Addiction & eating disorder Inpatient stay     x    
10-1842 Anxiety. Developmental coordination disorder/Hypotonia Occupational treatment     x    
10-1843 Multiple Sclerosis IVIG treatment     x    
10-1844 Diagnostic testing Anesthesia during colonoscopy       x  
10-1845 Post exploratory laparotomy & umbilical hernia repair Hospital services     x    
10-1846 Sleep Apnea Sleep Apnea retest       x  
10-1847 Biopolar Residential treatment     x    
10-1848 Depressive disorder In-patient psychiatric hospitalization     x    
10-1849 Back injury MRI of spince       x  
10-1850 Degenerative spine disease Lower back fusion surgery       x  
10-1851 Cerebrovascular accident (CVA), hypertension, sleep apnea, COPD, morbid obesity Physical & occupational therapy     x    
10-1852 Drug addiction Inpatient detox       x  
10-1853 Degenerative disc disease X-Ray of lower spine disc       x  
10-1854 Esophago gastro doudenoscopy Anesthesia         X
10-1855 GERD Lipoprotein-associated phospholipase A2   x      
10-1856 Metastatic Breast Cancer Rx: Avastin     x    
10-1857 Metastatic neuroendocrine tumor with liver involvement. Transcatheter embolization     x    
10-1858 Sleep apnea Average Volume Assured Pressure support (AVAP)     x    
10-1859 Status post total knee arthroplasty Continuous passive motion device       x  
10-1860 Post knee surgery Knee brace       x  
10-1861 Osteoarthritis of the right knee Supartz Injections       x  
10-1862 Multiple Sclerosis w/systemic sjogrens syndrome overlap. IVIG     x    
10-1863 Bipolar disorder Residential treatment     x    
10-1864 Rectal cancer IMRT (intensity modulated radiation therapy)       x  
10-1865 Adhesive capsulitis (status-post fracture) Physical therapy     x    
10-1866 3mm C6-C7 disc protrusion & C5-C6 degenerative disc w/ spinal stenosis.       x    
10-1867 Colorectal cancer state IV Rx: Gemcitabine   x      
10-1868 Unknown MRI of breast   x      
10-1869 Autism ABA therapy x        
10-1870 Right piriformis syndrome; Right pelvic neurologic symptoms. Complex imaging interpretation & surgical services.   x      
10-1871 Bilateral hip pain Bilateral arthroscopic hip surgery   x      
10-1872 Migraine headaches Botox therapy     x    
10-1873 Left knee injury MRI of knee     x    
10-1874 Hyper-mobility of left shoulder Physical therapy     x    
10-1875 Autism Speech therapy     x    
10-1876 Nasal congestion Intradermal allegery testing   x      
10-1877 Lyme disease Non-oral medication   x      
10-1878 Post-traumatic ostechondral lesion of the talus. Autograft transplantation   x      
10-1879 Lung Cancer Rx: Avastin x        
10-1880 Vitiligo Excimer laser tx x        
10-1881 Crohn's disease Allergen testing   x      
10-1882 Degenerative disc disease Laminotomy       x  
10-1883 Chronic lumbar pain Spine surgery       x  
10-1884 Alcohol Dependence Residential Treatment       x  
10-1885 Disc disease Lumbar fusion, spinal fixation, lamina removal, shaving of disc.       x  
10-1886 Breast Cancer PET scan       x  
10-1887 Herniated disc Spinal fusion surgery       x  
10-1888 Bipolar affective disorder; Current episode depressed Inpatient treatment for overdose     x    
10-1889 Degenerative disc disease and bilateral lower extremity radiculopathy. Spinal fusion followed by posterior fusion & decompression.       x  
10-1890 Bipolar Disorder Inpatient treatment     x    
10-1891 Severe depression Transcranial Magnetic Stimulation   x      
10-1892 Post right ACL repair (knee) Knee brace        x  
10-1893 Autism Speech therapy     x    
10-1894 Autism ABA therapy x        
10-1895 Endometrial Cancer CT scan     partial    
10-1896 Multiple Sclerosis Antologous hematopoietic stem cell transplant x        
10-1897 Autism Inpatient tx     x    
10-1898 Diarrhea C DIFF Toxin testing x        
10-1899 Right ankle arthritis Ankle arthroplasty with implant (total knee)   x      
10-1900 Mild degenerative interspace narrowing, L2-3 diffuse bulge Anterior spine fusion       x  
10-1901 Alcohol Dependence Detoxification       x  
10-1902 Severe depression Residential mental health service     x    
10-1903 Bi-lateral breast reduction Migraines. Severe back & shoulder pain       x  
10-1904 Facial pain Botox injections       x  
10-1905 Post auto accident injuries Physical therapy       x  
10-1906 Liver cancer / Unresectable Intrahepatic Cholangiocarcinoma Stereotactic body radiotherapy x        
10-1907 Loss of medial meniscus Paste grafting procedure - articular cartilage   x      
10-1908 Migraine headaches Botox injections x        
10-1909 Myocardial ischemia CT scan   x      
10-1910 Severe fatigue & pain related to posterior trapezial & neck region w/intermittent pain radiating to central proximal thoracic spine. Complete discectomy   x      
10-1911 Multiple sclerosis WalkAide Functional Electrical Stimulator   x      
10-1912 Schizophrenia disorder Partial hospitalization program       x  
10-1913 Back pain. Degenerative disc disease. Fusion surgery       x  
10-1914 Autism ABA treatment     x    
10-1915 Post rotator cuff repair Physical therapy       x  
10-1916 Precocious puberty Rx: Supprelin LA     x    
10-1917 Sleep apnea C-pap device / Intraoral splint     x    
10-1918 Type 1 diabetes Portable insulin pump     x    
10-1919 Eating Disorder Intensive outpatient services     x    
10-1920 Paraplegic Ultra lightweight wheelchair     x    
10-1921 Alcohol abuse Residential treatment     x    
10-1922 Depression, attention deficit hyperactivity disorder, obsessive compulsive disorder, anxiety disorder, substance abuse, suicidal ideation & self injurious behaviors Residential treatment     x    
10-1923 Major depressive dorder w/ psychotic features & boderline personality disorder Residential treatment     x    
10-1924 Ovarian Cancer Human tumor cell assay       x  
10-1925 Neck & back Pain; Multilevel degenerative disc disease w/facet arthrosis Percutaneous neurolysis     x    
10-1926 Severe Headaches & visual disturbance MR angiography       x  
10-1927 Acute Myeloid Leukemia w/unrelated Stem-cell transplant PET with CT x        
10-1928 Metastatic ampullary carcinoma Nanoparticle pacilitaxel (Abraxane) in combination w/gemcitabine.       x  
10-1929 Limited Flexion to thirty degrees Continuous passive motion device       x  
10-1930 B-cell lymphoma Intensity modulated radiation therapy (IMRT)       x  
10-1931 Infection secondary to ganegrenous toe amputation Intravenous Immune Globulin therapy (IVIG)     x    
10-1932 Small intestinal bacterial overgrowth Rx: Xifaxan 200mg      x    
10-1933 Pervasive development disorder Psychiatric visits       x  
10-1934 Depression Transcranial Magnetic Stimulation tx   x      
10-1935 Spinal cord injury Bilateral shoulder Dynasplints     x    
10-1936 Unknown Inpatient hospitalization         X
10-1937 Atopic dermatitis IVG   x      
10-1938 Sleep apnea / Insomnia Yongue based suspension, permanent suture technique.   x      
10-1939 Short stature Growth hormone Nutropin AQ     x    
    TOTALS 58 86 147 128 9


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