{ "@context": "https://schema.org", "@type": "Dataset", "name": "Apellica Appeal Outcomes Library (California IMR aggregates)", "description": "Overturn rates by treatment and diagnosis from every California Independent Medical Review decision published by the Department of Managed Health Care, with keyword tags on reviewer findings.", "url": "https://apellica.com/appeal-outcomes", "license": "https://creativecommons.org/licenses/by/4.0/", "isAccessibleForFree": true, "isBasedOn": "https://data.chhs.ca.gov/dataset/independent-medical-review-imr-determinations-trend", "creator": { "@type": "Organization", "name": "Apellica", "url": "https://apellica.com" }, "temporalCoverage": "2001/2026", "spatialCoverage": "California", "dateModified": "2026-09-11T18:04:09.201Z", "distribution": [ { "@type": "DataDownload", "encodingFormat": "text/csv", "contentUrl": "https://apellica.com/appeal-outcomes/california-imr/data" } ], "caveats": [ "California only: these are decisions by independent reviewers under California's IMR program (plans regulated by the Department of Managed Health Care). Other states and self-funded employer plans use different reviewers and rules.", "Selection: only denials that a member took all the way to IMR appear. Most denials are never appealed, and the ones that reach an external reviewer are not a random sample.", "Overturned means the reviewer disagreed with the plan; it does not mean the treatment worked or that a similar request will be approved.", "Argument tags are keyword matches on the reviewer's findings. They describe what the findings mention, not why the case was decided.", "Categories are DMHC's own labels (treatment sub-category and diagnosis category); 'Other' is a catch-all and is excluded from rankings." ], "summary": { "decisions": 42710, "overturned": 22431, "year_min": 2001, "year_max": 2026, "downloaded_at": "2026-09-11T18:04:09.201Z" }, "treatments": [ { "tx_sub_slug": "weight-control", "tx_sub": "Weight Control", "tx_cat": "Pharmacy", "n": 1581, "overturned": 1365, "year_min": 2001, "year_max": 2026 }, { "tx_sub_slug": "rtc", "tx_sub": "RTC", "tx_cat": "Mental Health", "n": 1390, "overturned": 1119, "year_min": 2019, "year_max": 2026 }, { "tx_sub_slug": "anti-virals", "tx_sub": "Anti-virals", "tx_cat": "Pharmacy", "n": 1351, "overturned": 1100, "year_min": 2003, "year_max": 2026 }, { "tx_sub_slug": "mri", "tx_sub": "MRI", "tx_cat": "Diag Imag & Screen", "n": 1068, "overturned": 457, "year_min": 2001, "year_max": 2026 }, { "tx_sub_slug": "rtc-admit", "tx_sub": "RTC/ Admit", "tx_cat": "Mental Health", "n": 1061, "overturned": 440, "year_min": 2002, "year_max": 2020 }, { "tx_sub_slug": "lab-work", "tx_sub": "Lab Work", "tx_cat": "Diag Imag & Screen", "n": 1015, "overturned": 321, "year_min": 2005, "year_max": 2026 }, { "tx_sub_slug": "speech-therapy", "tx_sub": "Speech Therapy", "tx_cat": "Autism Related Tx", "n": 972, "overturned": 718, "year_min": 2002, "year_max": 2026 }, { "tx_sub_slug": "hormones", "tx_sub": "Hormones", "tx_cat": "Pharmacy", "n": 971, "overturned": 418, "year_min": 2001, "year_max": 2026 }, { "tx_sub_slug": "viscosupp-injection", "tx_sub": "Viscosupp Injection", "tx_cat": "Pain Management", "n": 844, "overturned": 792, "year_min": 2018, "year_max": 2026 }, { "tx_sub_slug": "mammography", "tx_sub": "Mammography", "tx_cat": "Diag Imag & Screen", "n": 784, "overturned": 731, "year_min": 2006, "year_max": 2021 }, { "tx_sub_slug": "genetic-genomic-test", "tx_sub": "Genetic/Genomic Test", "tx_cat": "Diag Imag & Screen", "n": 582, "overturned": 301, "year_min": 2018, "year_max": 2026 }, { "tx_sub_slug": "biologics", "tx_sub": "Biologics", "tx_cat": "Pharmacy", "n": 527, "overturned": 412, "year_min": 2006, "year_max": 2026 }, { "tx_sub_slug": "skin-treatment", "tx_sub": "Skin Treatment", "tx_cat": "Pharmacy", "n": 519, "overturned": 358, "year_min": 2002, "year_max": 2026 }, { "tx_sub_slug": "botox-injection", "tx_sub": "Botox Injection", "tx_cat": "Pharmacy", "n": 517, "overturned": 300, "year_min": 2001, "year_max": 2026 }, { "tx_sub_slug": "appld-behav-analysis", "tx_sub": "Appld Behav Analysis", "tx_cat": "Autism Related Tx", "n": 481, "overturned": 334, "year_min": 2006, "year_max": 2025 }, { "tx_sub_slug": "emergency-room", "tx_sub": "Emergency Room", "tx_cat": "Emergency/Urg Care", "n": 471, "overturned": 219, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "pain-medication", "tx_sub": "Pain Medication", "tx_cat": "Pain Management", "n": 459, "overturned": 148, "year_min": 2017, "year_max": 2026 }, { "tx_sub_slug": "ct-scan", "tx_sub": "CT Scan", "tx_cat": "Diag Imag & Screen", "n": 433, "overturned": 131, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "pet-scan", "tx_sub": "Pet Scan", "tx_cat": "Diag Imag & Screen", "n": 429, "overturned": 255, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "physical-therapy", "tx_sub": "Physical Therapy", "tx_cat": "Autism Related Tx", "n": 416, "overturned": 144, "year_min": 2001, "year_max": 2025 }, { "tx_sub_slug": "arthritis-rx", "tx_sub": "Arthritis Rx", "tx_cat": "Pharmacy", "n": 400, "overturned": 224, "year_min": 2001, "year_max": 2026 }, { "tx_sub_slug": "partial-hospital", "tx_sub": "Partial Hospital", "tx_cat": "Autism Related Tx", "n": 386, "overturned": 242, "year_min": 2002, "year_max": 2026 }, { "tx_sub_slug": "ivig-therapy", "tx_sub": "IVIG Therapy", "tx_cat": "Pharmacy", "n": 385, "overturned": 189, "year_min": 2002, "year_max": 2026 }, { "tx_sub_slug": "non-fda-approved-use", "tx_sub": "Non-FDA Approved Use", "tx_cat": "Pharmacy", "n": 383, "overturned": 167, "year_min": 2002, "year_max": 2011 }, { "tx_sub_slug": "acute-psych-admit", "tx_sub": "Acute Psych/ Admit", "tx_cat": "Mental Health", "n": 362, "overturned": 203, "year_min": 2002, "year_max": 2020 }, { "tx_sub_slug": "scp-consult-refer", "tx_sub": "SCP Consult Refer", "tx_cat": "Diag/ MD Eval", "n": 348, "overturned": 206, "year_min": 2001, "year_max": 2025 }, { "tx_sub_slug": "tms", "tx_sub": "TMS", "tx_cat": "Elect/Therm/Radfreq", "n": 321, "overturned": 182, "year_min": 2010, "year_max": 2025 }, { "tx_sub_slug": "radiofreq-ablat", "tx_sub": "Radiofreq Ablat", "tx_cat": "Elect/Therm/Radfreq", "n": 317, "overturned": 136, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "proton-beam", "tx_sub": "Proton Beam", "tx_cat": "Cancer Care", "n": 315, "overturned": 107, "year_min": 2005, "year_max": 2025 }, { "tx_sub_slug": "intensive-outpt-prog", "tx_sub": "Intensive Outpt Prog", "tx_cat": "Mental Health", "n": 309, "overturned": 221, "year_min": 2017, "year_max": 2025 }, { "tx_sub_slug": "inpt-admission", "tx_sub": "Inpt Admission", "tx_cat": "Rehab/Svcs SNF Inpt", "n": 301, "overturned": 77, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "rtc-discharge", "tx_sub": "RTC/Discharge", "tx_cat": "Mental Health", "n": 289, "overturned": 117, "year_min": 2006, "year_max": 2020 }, { "tx_sub_slug": "diabetic-medication", "tx_sub": "Diabetic Medication", "tx_cat": "Pharmacy", "n": 288, "overturned": 215, "year_min": 2017, "year_max": 2026 }, { "tx_sub_slug": "occupational-therapy", "tx_sub": "Occupational Therapy", "tx_cat": "Autism Related Tx", "n": 276, "overturned": 177, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "anti-inflammatories", "tx_sub": "Anti-inflammatories", "tx_cat": "Pharmacy", "n": 266, "overturned": 140, "year_min": 2003, "year_max": 2026 }, { "tx_sub_slug": "chemotherapy", "tx_sub": "Chemotherapy", "tx_cat": "Cancer Care", "n": 263, "overturned": 109, "year_min": 2002, "year_max": 2021 }, { "tx_sub_slug": "nerve-block", "tx_sub": "Nerve Block", "tx_cat": "Pain Management", "n": 247, "overturned": 146, "year_min": 2003, "year_max": 2026 }, { "tx_sub_slug": "fusion", "tx_sub": "Fusion", "tx_cat": "Neurosurgery Proc", "n": 246, "overturned": 69, "year_min": 2003, "year_max": 2025 }, { "tx_sub_slug": "artificial-disc-repl", "tx_sub": "Artificial Disc Repl", "tx_cat": "Orthopedic Proc", "n": 244, "overturned": 24, "year_min": 2005, "year_max": 2025 }, { "tx_sub_slug": "digestion-gi-rx", "tx_sub": "Digestion/GI Rx", "tx_cat": "Pharmacy", "n": 229, "overturned": 182, "year_min": 2019, "year_max": 2026 }, { "tx_sub_slug": "admission", "tx_sub": "Admission", "tx_cat": "Acute Med Svc Inpt", "n": 211, "overturned": 109, "year_min": 2002, "year_max": 2026 }, { "tx_sub_slug": "gastric-bypass", "tx_sub": "Gastric Bypass", "tx_cat": "Gen Surg proc", "n": 210, "overturned": 124, "year_min": 2001, "year_max": 2005 }, { "tx_sub_slug": "acupuncture", "tx_sub": "Acupuncture", "tx_cat": "Alternative Tx", "n": 205, "overturned": 81, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "antibiotics", "tx_sub": "Antibiotics", "tx_cat": "Pharmacy", "n": 202, "overturned": 84, "year_min": 2001, "year_max": 2026 }, { "tx_sub_slug": "formulary-v-non-form", "tx_sub": "Formulary v Non Form", "tx_cat": "Pharmacy", "n": 197, "overturned": 78, "year_min": 2003, "year_max": 2011 }, { "tx_sub_slug": "oon-referral", "tx_sub": "OON Referral", "tx_cat": "Diag/ MD Eval", "n": 183, "overturned": 50, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "cardiac-rx", "tx_sub": "Cardiac Rx", "tx_cat": "Pharmacy", "n": 180, "overturned": 70, "year_min": 2002, "year_max": 2026 }, { "tx_sub_slug": "analgesics", "tx_sub": "Analgesics", "tx_cat": "Pharmacy", "n": 179, "overturned": 36, "year_min": 2002, "year_max": 2017 }, { "tx_sub_slug": "radiation-therapy", "tx_sub": "Radiation Therapy", "tx_cat": "Cancer Care", "n": 178, "overturned": 101, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "panniculectomy", "tx_sub": "Panniculectomy", "tx_cat": "Reconstr/Plast Proc", "n": 178, "overturned": 59, "year_min": 2001, "year_max": 2026 }, { "tx_sub_slug": "bariatric-other", "tx_sub": "Bariatric Other", "tx_cat": "Gen Surg Proc", "n": 174, "overturned": 89, "year_min": 2002, "year_max": 2019 }, { "tx_sub_slug": "migraine-rx", "tx_sub": "Migraine Rx", "tx_cat": "Pharmacy", "n": 172, "overturned": 143, "year_min": 2018, "year_max": 2026 }, { "tx_sub_slug": "epidural-injection", "tx_sub": "Epidural Injection", "tx_cat": "Pain Management", "n": 169, "overturned": 76, "year_min": 2002, "year_max": 2026 }, { "tx_sub_slug": "psychotherapy", "tx_sub": "Psychotherapy", "tx_cat": "Autism Related Tx", "n": 168, "overturned": 88, "year_min": 2008, "year_max": 2025 }, { "tx_sub_slug": "surgery", "tx_sub": "Surgery", "tx_cat": "Cancer Care", "n": 168, "overturned": 88, "year_min": 2002, "year_max": 2026 }, { "tx_sub_slug": "breast-reduction", "tx_sub": "Breast reduction", "tx_cat": "Reconstr/Plast Proc", "n": 165, "overturned": 93, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "electric-wheelchair", "tx_sub": "Electric Wheelchair", "tx_cat": "DME", "n": 160, "overturned": 37, "year_min": 2001, "year_max": 2025 }, { "tx_sub_slug": "sinus-surgery", "tx_sub": "Sinus Surgery", "tx_cat": "Ear-Nose-Thro Proc", "n": 155, "overturned": 99, "year_min": 2009, "year_max": 2026 }, { "tx_sub_slug": "radiation-oncology", "tx_sub": "Radiation Oncology", "tx_cat": "Cancer Care", "n": 149, "overturned": 58, "year_min": 2003, "year_max": 2015 }, { "tx_sub_slug": "general-anesthesia", "tx_sub": "General Anesthesia", "tx_cat": "Special Proc", "n": 148, "overturned": 38, "year_min": 2006, "year_max": 2025 }, { "tx_sub_slug": "investigational-tx", "tx_sub": "Investigational Tx", "tx_cat": "Cancer Care", "n": 145, "overturned": 64, "year_min": 2001, "year_max": 2019 }, { "tx_sub_slug": "cancer-rx", "tx_sub": "Cancer Rx", "tx_cat": "Cancer Care", "n": 145, "overturned": 67, "year_min": 2021, "year_max": 2026 }, { "tx_sub_slug": "wheelchair", "tx_sub": "Wheelchair", "tx_cat": "DME", "n": 141, "overturned": 38, "year_min": 2002, "year_max": 2026 }, { "tx_sub_slug": "orthotics", "tx_sub": "Orthotics", "tx_cat": "DME", "n": 133, "overturned": 92, "year_min": 2003, "year_max": 2025 }, { "tx_sub_slug": "individ-counsel", "tx_sub": "Individ Counsel", "tx_cat": "Mental Health", "n": 130, "overturned": 87, "year_min": 2003, "year_max": 2025 }, { "tx_sub_slug": "ultrasound", "tx_sub": "Ultrasound", "tx_cat": "Diag Imag & Screen", "n": 127, "overturned": 52, "year_min": 2003, "year_max": 2025 }, { "tx_sub_slug": "bariatric-lap-band", "tx_sub": "Bariatric Lap Band", "tx_cat": "Gen Surg Proc", "n": 126, "overturned": 56, "year_min": 2005, "year_max": 2018 }, { "tx_sub_slug": "neuromuscular-rx", "tx_sub": "Neuromuscular RX", "tx_cat": "Pharmacy", "n": 111, "overturned": 90, "year_min": 2019, "year_max": 2026 }, { "tx_sub_slug": "cpm-machine", "tx_sub": "CPM Machine", "tx_cat": "DME", "n": 108, "overturned": 43, "year_min": 2003, "year_max": 2026 }, { "tx_sub_slug": "hip-replacement", "tx_sub": "Hip Replacement", "tx_cat": "Orthopedic Proc", "n": 107, "overturned": 35, "year_min": 2001, "year_max": 2025 }, { "tx_sub_slug": "drug-rehab-program", "tx_sub": "Drug Rehab Program", "tx_cat": "Mental Health", "n": 106, "overturned": 29, "year_min": 2003, "year_max": 2019 }, { "tx_sub_slug": "tx-for-migraine", "tx_sub": "Tx for Migraine", "tx_cat": "Pharmacy", "n": 104, "overturned": 46, "year_min": 2002, "year_max": 2019 }, { "tx_sub_slug": "anti-depressants", "tx_sub": "Anti-Depressants", "tx_cat": "Pharmacy", "n": 103, "overturned": 53, "year_min": 2007, "year_max": 2026 }, { "tx_sub_slug": "colonoscopy-sigmoid", "tx_sub": "Colonoscopy/Sigmoid", "tx_cat": "Diag Imag & Screen", "n": 102, "overturned": 40, "year_min": 2005, "year_max": 2025 }, { "tx_sub_slug": "anti-fungal", "tx_sub": "Anti-Fungal", "tx_cat": "Pharmacy", "n": 102, "overturned": 43, "year_min": 2002, "year_max": 2026 }, { "tx_sub_slug": "electric-scooter", "tx_sub": "Electric Scooter", "tx_cat": "DME", "n": 100, "overturned": 9, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "glucose-monitor", "tx_sub": "Glucose Monitor", "tx_cat": "DME", "n": 100, "overturned": 76, "year_min": 2020, "year_max": 2025 }, { "tx_sub_slug": "arthroscopy", "tx_sub": "Arthroscopy", "tx_cat": "Orthopedic Proc", "n": 97, "overturned": 42, "year_min": 2002, "year_max": 2026 }, { "tx_sub_slug": "prosthesis", "tx_sub": "Prosthesis", "tx_cat": "DME", "n": 94, "overturned": 48, "year_min": 2005, "year_max": 2025 }, { "tx_sub_slug": "knee-replacement", "tx_sub": "Knee Replacement", "tx_cat": "Orthopedic Proc", "n": 93, "overturned": 25, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "bariatric-duod-swtch", "tx_sub": "Bariatric Duod Swtch", "tx_cat": "Gen Surg Proc", "n": 91, "overturned": 67, "year_min": 2005, "year_max": 2018 }, { "tx_sub_slug": "skill-nsg-vsts", "tx_sub": "Skill Nsg Vsts", "tx_cat": "Home Health Care", "n": 90, "overturned": 44, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "special-bed", "tx_sub": "Special Bed", "tx_cat": "DME", "n": 88, "overturned": 40, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "liposuction", "tx_sub": "Liposuction", "tx_cat": "Reconstr/Plast Proc", "n": 87, "overturned": 34, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "steroid-injection", "tx_sub": "Steroid Injection", "tx_cat": "Pain Management", "n": 86, "overturned": 57, "year_min": 2001, "year_max": 2025 }, { "tx_sub_slug": "insulin-pump", "tx_sub": "Insulin Pump", "tx_cat": "DME", "n": 84, "overturned": 60, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "hysterectomy", "tx_sub": "Hysterectomy", "tx_cat": "Ob-Gyn Proc", "n": 83, "overturned": 30, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "etoh-rehab-program", "tx_sub": "ETOH Rehab Program", "tx_cat": "Mental Health", "n": 83, "overturned": 23, "year_min": 2003, "year_max": 2019 }, { "tx_sub_slug": "breast-augmentation", "tx_sub": "Breast Augmentation", "tx_cat": "Reconstr/Plast Proc", "n": 83, "overturned": 37, "year_min": 2003, "year_max": 2025 }, { "tx_sub_slug": "inpt-discharge", "tx_sub": "Inpt Discharge", "tx_cat": "Rehab/Svcs SNF Inpt", "n": 83, "overturned": 13, "year_min": 2005, "year_max": 2025 }, { "tx_sub_slug": "bariatric-surgery", "tx_sub": "Bariatric Surgery", "tx_cat": "Gen Surg Proc", "n": 82, "overturned": 45, "year_min": 2001, "year_max": 2026 }, { "tx_sub_slug": "urgent-care", "tx_sub": "Urgent Care", "tx_cat": "Emergency/Urg Care", "n": 82, "overturned": 32, "year_min": 2008, "year_max": 2025 }, { "tx_sub_slug": "braces", "tx_sub": "Braces", "tx_cat": "DME", "n": 81, "overturned": 29, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "biofeedback", "tx_sub": "Biofeedback", "tx_cat": "Alternative Tx", "n": 80, "overturned": 28, "year_min": 2002, "year_max": 2024 }, { "tx_sub_slug": "behavioral-therapy", "tx_sub": "Behavioral Therapy", "tx_cat": "Mental Health", "n": 77, "overturned": 39, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "sedatives-hypnotics", "tx_sub": "Sedatives/ Hypnotics", "tx_cat": "Pharmacy", "n": 77, "overturned": 26, "year_min": 2004, "year_max": 2026 }, { "tx_sub_slug": "bone-density-scan", "tx_sub": "Bone Density Scan", "tx_cat": "Diag Imag & Screen", "n": 76, "overturned": 28, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "tx-for-impotence", "tx_sub": "Tx for Impotence", "tx_cat": "Pharmacy", "n": 75, "overturned": 45, "year_min": 2002, "year_max": 2018 }, { "tx_sub_slug": "hyperbaric-o2-chamb", "tx_sub": "Hyperbaric O2 Chamb", "tx_cat": "Special Proc", "n": 73, "overturned": 25, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "sleep-study", "tx_sub": "Sleep Study", "tx_cat": "Diag Imag & Screen", "n": 71, "overturned": 29, "year_min": 2005, "year_max": 2025 }, { "tx_sub_slug": "ambulance-transport", "tx_sub": "Ambulance/Transport", "tx_cat": "Emergency/Urg Care", "n": 67, "overturned": 25, "year_min": 2005, "year_max": 2017 }, { "tx_sub_slug": "c-pap-machine", "tx_sub": "C-Pap Machine", "tx_cat": "DME", "n": 66, "overturned": 37, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "analgesic-rx", "tx_sub": "Analgesic Rx", "tx_cat": "Pain Management", "n": 65, "overturned": 12, "year_min": 2005, "year_max": 2017 }, { "tx_sub_slug": "gerd-procedure", "tx_sub": "GERD Procedure", "tx_cat": "Gen Surg Proc", "n": 64, "overturned": 25, "year_min": 2019, "year_max": 2025 }, { "tx_sub_slug": "bariatric-roux-en-y", "tx_sub": "Bariatric Roux-en-y", "tx_cat": "Gen Surg Proc", "n": 63, "overturned": 46, "year_min": 2005, "year_max": 2017 }, { "tx_sub_slug": "add-adhd-rx", "tx_sub": "ADD/ADHD Rx", "tx_cat": "Pharmacy", "n": 63, "overturned": 41, "year_min": 2019, "year_max": 2026 }, { "tx_sub_slug": "cont-glucose-monitor", "tx_sub": "Cont Glucose Monitor", "tx_cat": "DME", "n": 62, "overturned": 55, "year_min": 2008, "year_max": 2020 }, { "tx_sub_slug": "breast-surgery", "tx_sub": "Breast Surgery", "tx_cat": "Gen Surg Proc", "n": 62, "overturned": 25, "year_min": 2002, "year_max": 2018 }, { "tx_sub_slug": "oncotype-dx-assay", "tx_sub": "Oncotype DX Assay", "tx_cat": "Diag Imag & Screen", "n": 61, "overturned": 29, "year_min": 2007, "year_max": 2019 }, { "tx_sub_slug": "allergy-testing", "tx_sub": "Allergy Testing", "tx_cat": "Diag Imag & Screen", "n": 60, "overturned": 6, "year_min": 2004, "year_max": 2024 }, { "tx_sub_slug": "excess-skin-removal", "tx_sub": "Excess Skin Removal", "tx_cat": "Reconstr/Plast Proc", "n": 59, "overturned": 17, "year_min": 2005, "year_max": 2019 }, { "tx_sub_slug": "ongoing-oon-tx", "tx_sub": "Ongoing OON Tx", "tx_cat": "Diag/ MD Eval", "n": 57, "overturned": 21, "year_min": 2002, "year_max": 2024 }, { "tx_sub_slug": "diskectomy", "tx_sub": "Diskectomy", "tx_cat": "Neurosurgery Proc", "n": 57, "overturned": 10, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "compression-garments", "tx_sub": "Compression Garments", "tx_cat": "DME", "n": 57, "overturned": 24, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "glucagon-like-peptide-1-glp", "tx_sub": "Glucagon-Like Peptide-1 (GLP)", "tx_cat": "Pharmacy", "n": 56, "overturned": 41, "year_min": 2025, "year_max": 2026 }, { "tx_sub_slug": "elect-bone-stim", "tx_sub": "Elect Bone Stim", "tx_cat": "DME", "n": 56, "overturned": 19, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "stem-cell-transplant", "tx_sub": "Stem Cell Transplant", "tx_cat": "Special Proc", "n": 56, "overturned": 23, "year_min": 2002, "year_max": 2023 }, { "tx_sub_slug": "osteoporosis-rx", "tx_sub": "Osteoporosis Rx", "tx_cat": "Pharmacy", "n": 55, "overturned": 37, "year_min": 2019, "year_max": 2025 }, { "tx_sub_slug": "wearable-cardio-defib", "tx_sub": "Wearable Cardio Defib", "tx_cat": "DME", "n": 53, "overturned": 34, "year_min": 2019, "year_max": 2025 }, { "tx_sub_slug": "tx-for-allergies", "tx_sub": "Tx for Allergies", "tx_cat": "Pharmacy", "n": 52, "overturned": 28, "year_min": 2002, "year_max": 2018 }, { "tx_sub_slug": "biopsy", "tx_sub": "Biopsy", "tx_cat": "Diag Imag & Screen", "n": 51, "overturned": 19, "year_min": 2003, "year_max": 2025 }, { "tx_sub_slug": "asthma-rx", "tx_sub": "Asthma Rx", "tx_cat": "Pharmacy", "n": 50, "overturned": 35, "year_min": 2019, "year_max": 2026 }, { "tx_sub_slug": "facial-feminization-surgery", "tx_sub": "Facial Feminization Surgery", "tx_cat": "Reconstr/Plast Proc", "n": 48, "overturned": 42, "year_min": 2019, "year_max": 2025 }, { "tx_sub_slug": "inpt-early-discharge", "tx_sub": "Inpt Early Discharge", "tx_cat": "Rehab/Svcs SNF Inpt", "n": 46, "overturned": 9, "year_min": 2007, "year_max": 2018 }, { "tx_sub_slug": "fract-bone-repair", "tx_sub": "Fract/Bone Repair", "tx_cat": "Orthopedic Proc", "n": 45, "overturned": 21, "year_min": 2004, "year_max": 2025 }, { "tx_sub_slug": "implant-removal", "tx_sub": "Implant Removal", "tx_cat": "Gen Surg Proc", "n": 45, "overturned": 11, "year_min": 2006, "year_max": 2025 }, { "tx_sub_slug": "blepharoplasty", "tx_sub": "Blepharoplasty", "tx_cat": "Reconstr/Plast Proc", "n": 45, "overturned": 14, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "vision-therapy", "tx_sub": "Vision Therapy", "tx_cat": "Autism Related Tx", "n": 44, "overturned": 9, "year_min": 2002, "year_max": 2023 }, { "tx_sub_slug": "heart-monitor", "tx_sub": "Heart Monitor", "tx_cat": "Diag Imag & Screen", "n": 44, "overturned": 11, "year_min": 2011, "year_max": 2025 }, { "tx_sub_slug": "oxygen", "tx_sub": "Oxygen", "tx_cat": "DME", "n": 44, "overturned": 8, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "cognitive-therapy", "tx_sub": "Cognitive Therapy", "tx_cat": "Autism Related Tx", "n": 44, "overturned": 23, "year_min": 2003, "year_max": 2025 }, { "tx_sub_slug": "revision-procedures", "tx_sub": "Revision Procedures", "tx_cat": "Gen Surg Proc", "n": 41, "overturned": 12, "year_min": 2005, "year_max": 2023 }, { "tx_sub_slug": "endoscopy", "tx_sub": "Endoscopy", "tx_cat": "Diag Imag & Screen", "n": 41, "overturned": 23, "year_min": 2019, "year_max": 2026 }, { "tx_sub_slug": "extracorp-shock-wave", "tx_sub": "Extracorp Shock Wave", "tx_cat": "Elect/Therm/Radfreq", "n": 41, "overturned": 8, "year_min": 2005, "year_max": 2019 }, { "tx_sub_slug": "anti-hypertensives", "tx_sub": "Anti-hypertensives", "tx_cat": "Pharmacy", "n": 40, "overturned": 11, "year_min": 2005, "year_max": 2023 }, { "tx_sub_slug": "jaw-surgery", "tx_sub": "Jaw Surgery", "tx_cat": "Orthopedic Proc", "n": 40, "overturned": 31, "year_min": 2001, "year_max": 2025 }, { "tx_sub_slug": "acute-psych", "tx_sub": "Acute Psych", "tx_cat": "Mental Health", "n": 39, "overturned": 30, "year_min": 2020, "year_max": 2025 }, { "tx_sub_slug": "shoe-inserts", "tx_sub": "Shoe Inserts", "tx_cat": "DME", "n": 38, "overturned": 26, "year_min": 2009, "year_max": 2025 }, { "tx_sub_slug": "special-foods", "tx_sub": "Special Foods", "tx_cat": "Pharmacy", "n": 38, "overturned": 19, "year_min": 2006, "year_max": 2025 }, { "tx_sub_slug": "pain-management", "tx_sub": "Pain Management", "tx_cat": "Chiropractic Care", "n": 38, "overturned": 14, "year_min": 2002, "year_max": 2018 }, { "tx_sub_slug": "interferon", "tx_sub": "Interferon", "tx_cat": "Pharmacy", "n": 37, "overturned": 13, "year_min": 2002, "year_max": 2024 }, { "tx_sub_slug": "antacids", "tx_sub": "Antacids", "tx_cat": "Pharmacy", "n": 37, "overturned": 21, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "skin-resurfacing", "tx_sub": "Skin Resurfacing", "tx_cat": "Reconstr/Plast Proc", "n": 36, "overturned": 15, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "dental-anesthesia", "tx_sub": "Dental Anesthesia", "tx_cat": "Dent/Orthodont Proc", "n": 36, "overturned": 21, "year_min": 2003, "year_max": 2022 }, { "tx_sub_slug": "septoplasty", "tx_sub": "Septoplasty", "tx_cat": "Ear-Nose-Thro Proc", "n": 36, "overturned": 22, "year_min": 2001, "year_max": 2024 }, { "tx_sub_slug": "hernia-repair", "tx_sub": "Hernia Repair", "tx_cat": "Gen Surg Proc", "n": 35, "overturned": 15, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "mastectomy", "tx_sub": "Mastectomy", "tx_cat": "Reconstr/Plast Proc", "n": 34, "overturned": 25, "year_min": 2019, "year_max": 2025 }, { "tx_sub_slug": "vein-ablation", "tx_sub": "Vein Ablation", "tx_cat": "Cardio-Vasc Proc", "n": 34, "overturned": 17, "year_min": 2019, "year_max": 2025 }, { "tx_sub_slug": "organ-transplant", "tx_sub": "Organ Transplant", "tx_cat": "Special Proc", "n": 34, "overturned": 17, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "acute-psych-dischg", "tx_sub": "Acute Psych/Dischg", "tx_cat": "Mental Health", "n": 34, "overturned": 25, "year_min": 2003, "year_max": 2020 }, { "tx_sub_slug": "pneumatic-vest", "tx_sub": "Pneumatic Vest", "tx_cat": "DME", "n": 33, "overturned": 16, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "anti-psychotic", "tx_sub": "Anti-Psychotic", "tx_cat": "Pharmacy", "n": 33, "overturned": 13, "year_min": 2005, "year_max": 2025 }, { "tx_sub_slug": "oon-acad-ctr-ref", "tx_sub": "OON/ Acad Ctr Ref", "tx_cat": "Cancer Care", "n": 33, "overturned": 14, "year_min": 2003, "year_max": 2016 }, { "tx_sub_slug": "emergency", "tx_sub": "Emergency", "tx_cat": "Transportation", "n": 32, "overturned": 21, "year_min": 2017, "year_max": 2025 }, { "tx_sub_slug": "allergy-rx", "tx_sub": "Allergy Rx", "tx_cat": "Pharmacy", "n": 31, "overturned": 18, "year_min": 2019, "year_max": 2025 }, { "tx_sub_slug": "non-emerg-med-nemt", "tx_sub": "Non Emerg Med (NEMT)", "tx_cat": "Transportation", "n": 31, "overturned": 13, "year_min": 2019, "year_max": 2025 }, { "tx_sub_slug": "not-applicable", "tx_sub": "Not Applicable", "tx_cat": "Not Applicable", "n": 30, "overturned": 14, "year_min": 2009, "year_max": 2017 }, { "tx_sub_slug": "idet", "tx_sub": "IDET", "tx_cat": "Elect/Therm/Radfreq", "n": 30, "overturned": 2, "year_min": 2002, "year_max": 2016 }, { "tx_sub_slug": "laminectomy", "tx_sub": "Laminectomy", "tx_cat": "Neurosurgery Proc", "n": 30, "overturned": 11, "year_min": 2003, "year_max": 2025 }, { "tx_sub_slug": "injection-admin-drugs", "tx_sub": "Injection Admin Drugs", "tx_cat": "Drug Ad Oth Oral", "n": 29, "overturned": 25, "year_min": 2026, "year_max": 2026 }, { "tx_sub_slug": "epileptic-medication", "tx_sub": "Epileptic Medication", "tx_cat": "Pharmacy", "n": 29, "overturned": 19, "year_min": 2017, "year_max": 2026 }, { "tx_sub_slug": "req-2nd-opin-oon", "tx_sub": "Req 2nd Opin/OON", "tx_cat": "Diag/ MD Eval", "n": 28, "overturned": 13, "year_min": 2004, "year_max": 2021 }, { "tx_sub_slug": "mammoplasty", "tx_sub": "Mammoplasty", "tx_cat": "Reconstr/Plast Proc", "n": 28, "overturned": 15, "year_min": 2002, "year_max": 2018 }, { "tx_sub_slug": "cochlear-implant", "tx_sub": "Cochlear Implant", "tx_cat": "Ear-Nose-Thro Proc", "n": 28, "overturned": 9, "year_min": 2004, "year_max": 2025 }, { "tx_sub_slug": "special-chair", "tx_sub": "Special Chair", "tx_cat": "DME", "n": 27, "overturned": 17, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "vein-stripping", "tx_sub": "Vein Stripping", "tx_cat": "Cardio-Vasc Proc", "n": 26, "overturned": 6, "year_min": 2002, "year_max": 2022 }, { "tx_sub_slug": "walker", "tx_sub": "Walker", "tx_cat": "DME", "n": 26, "overturned": 12, "year_min": 2003, "year_max": 2024 }, { "tx_sub_slug": "early-discharge", "tx_sub": "Early Discharge", "tx_cat": "Acute Med Svc Inpt", "n": 26, "overturned": 8, "year_min": 2005, "year_max": 2025 }, { "tx_sub_slug": "abi-vest", "tx_sub": "ABI Vest", "tx_cat": "DME", "n": 26, "overturned": 17, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "scoping-procedure", "tx_sub": "Scoping Procedure", "tx_cat": "Diag Imag & Screen", "n": 25, "overturned": 9, "year_min": 2002, "year_max": 2018 }, { "tx_sub_slug": "hearing-aid", "tx_sub": "Hearing Aid", "tx_cat": "DME", "n": 25, "overturned": 9, "year_min": 2004, "year_max": 2025 }, { "tx_sub_slug": "invest-tx-protocol", "tx_sub": "Invest Tx Protocol", "tx_cat": "Pharmacy", "n": 25, "overturned": 14, "year_min": 2003, "year_max": 2011 }, { "tx_sub_slug": "hair-removal", "tx_sub": "Hair Removal", "tx_cat": "Reconstr/Plast Proc", "n": 25, "overturned": 19, "year_min": 2019, "year_max": 2025 }, { "tx_sub_slug": "cns-extracranial-autonomic", "tx_sub": "CNS Extracranial/Autonomic", "tx_cat": "Surgery", "n": 24, "overturned": 15, "year_min": 2026, "year_max": 2026 }, { "tx_sub_slug": "vitamins", "tx_sub": "Vitamins", "tx_cat": "Pharmacy", "n": 24, "overturned": 11, "year_min": 2009, "year_max": 2025 }, { "tx_sub_slug": "anxiety-rx", "tx_sub": "Anxiety Rx", "tx_cat": "Pharmacy", "n": 24, "overturned": 3, "year_min": 2019, "year_max": 2026 }, { "tx_sub_slug": "stent", "tx_sub": "Stent", "tx_cat": "Cardio-Vasc Proc", "n": 23, "overturned": 16, "year_min": 2007, "year_max": 2025 }, { "tx_sub_slug": "circumcision", "tx_sub": "Circumcision", "tx_cat": "Gen Surg Proc", "n": 23, "overturned": 8, "year_min": 2005, "year_max": 2024 }, { "tx_sub_slug": "card-valve-repl", "tx_sub": "Card Valve Repl", "tx_cat": "Cardio-Vasc Proc", "n": 23, "overturned": 17, "year_min": 2003, "year_max": 2023 }, { "tx_sub_slug": "tonsillectomy", "tx_sub": "Tonsillectomy", "tx_cat": "Ear-Nose-Thro Proc", "n": 23, "overturned": 5, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "ligament-tendon-repair", "tx_sub": "Ligament/Tendon Repair", "tx_cat": "Orthopedic Proc", "n": 23, "overturned": 7, "year_min": 2019, "year_max": 2025 }, { "tx_sub_slug": "fibroid-removal", "tx_sub": "Fibroid Removal", "tx_cat": "Ob-Gyn Proc", "n": 23, "overturned": 12, "year_min": 2002, "year_max": 2022 }, { "tx_sub_slug": "tens-unit", "tx_sub": "TENS Unit", "tx_cat": "DME", "n": 22, "overturned": 5, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "spinal-adjustment", "tx_sub": "Spinal Adjustment", "tx_cat": "Chiropractic Care", "n": 22, "overturned": 7, "year_min": 2003, "year_max": 2025 }, { "tx_sub_slug": "speech-generate-device", "tx_sub": "Speech Generate Device", "tx_cat": "DME", "n": 22, "overturned": 21, "year_min": 2022, "year_max": 2025 }, { "tx_sub_slug": "psychological-evaluation", "tx_sub": "Psychological Evaluation", "tx_cat": "Diag Imag & Screen", "n": 21, "overturned": 7, "year_min": 2019, "year_max": 2024 }, { "tx_sub_slug": "pain-mgmt-prog", "tx_sub": "Pain Mgmt Prog", "tx_cat": "Pain Management", "n": 21, "overturned": 8, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "charite", "tx_sub": "Charite", "tx_cat": "Orthopedic Proc", "n": 21, "overturned": 0, "year_min": 2005, "year_max": 2005 }, { "tx_sub_slug": "social-skills-thpy", "tx_sub": "Social Skills Thpy", "tx_cat": "Autism Related Tx", "n": 21, "overturned": 9, "year_min": 2009, "year_max": 2018 }, { "tx_sub_slug": "laparoscopy", "tx_sub": "Laparoscopy", "tx_cat": "Ob-Gyn Proc", "n": 21, "overturned": 12, "year_min": 2004, "year_max": 2025 }, { "tx_sub_slug": "cataract-surgery", "tx_sub": "Cataract Surgery", "tx_cat": "Ophthalmology Proc", "n": 20, "overturned": 9, "year_min": 2003, "year_max": 2022 }, { "tx_sub_slug": "birth-control", "tx_sub": "Birth Control", "tx_cat": "Pharmacy", "n": 20, "overturned": 9, "year_min": 2003, "year_max": 2022 }, { "tx_sub_slug": "clin-trial-i", "tx_sub": "Clin Trial (I)", "tx_cat": "Cancer Care", "n": 19, "overturned": 5, "year_min": 2001, "year_max": 2016 }, { "tx_sub_slug": "inject-infus", "tx_sub": "Inject/ Infus", "tx_cat": "Home Health Care", "n": 19, "overturned": 8, "year_min": 2010, "year_max": 2025 }, { "tx_sub_slug": "joint-manipulation", "tx_sub": "Joint Manipulation", "tx_cat": "Chiropractic Care", "n": 19, "overturned": 8, "year_min": 2003, "year_max": 2024 }, { "tx_sub_slug": "pyschotherapy", "tx_sub": "Pyschotherapy", "tx_cat": "Mental Health", "n": 19, "overturned": 5, "year_min": 2002, "year_max": 2006 }, { "tx_sub_slug": "aids-wasting-tx", "tx_sub": "AIDS Wasting Tx", "tx_cat": "Pharmacy", "n": 18, "overturned": 11, "year_min": 2002, "year_max": 2025 }, { "tx_sub_slug": "cranial-helmet", "tx_sub": "Cranial Helmet", "tx_cat": "DME", "n": 18, "overturned": 12, "year_min": 2019, "year_max": 2025 }, { "tx_sub_slug": "pacemaker-defib", "tx_sub": "Pacemaker/Defib", "tx_cat": "Cardio-Vasc Proc", "n": 18, "overturned": 10, "year_min": 2019, "year_max": 2025 }, { "tx_sub_slug": "clin-trial-ii-iv", "tx_sub": "Clin Trial (II - IV)", "tx_cat": "Cancer Care", "n": 18, "overturned": 9, "year_min": 2003, "year_max": 2017 }, { "tx_sub_slug": "autonomic-testing", "tx_sub": "Autonomic Testing", "tx_cat": "Diag Imag & Screen", "n": 18, "overturned": 14, "year_min": 2019, "year_max": 2025 }, { "tx_sub_slug": "orthodontia-braces", "tx_sub": "Orthodontia/ Braces", "tx_cat": "Dent/Orthodont Proc", "n": 17, "overturned": 6, "year_min": 2004, "year_max": 2024 }, { "tx_sub_slug": "adult-immunization", "tx_sub": "Adult Immunization", "tx_cat": "Prev Health Screen", "n": 17, "overturned": 3, "year_min": 2004, "year_max": 2024 }, { "tx_sub_slug": "abdominoplasty", "tx_sub": "Abdominoplasty", "tx_cat": "Reconstr/Plast Proc", "n": 17, "overturned": 5, "year_min": 2019, "year_max": 2024 }, { "tx_sub_slug": "referral-out-of-mg", "tx_sub": "Referral out of MG", "tx_cat": "Diag/ MD Eval", "n": 17, "overturned": 5, "year_min": 2003, "year_max": 2013 }, { "tx_sub_slug": "uter-art-emboliz", "tx_sub": "Uter Art Emboliz", "tx_cat": "Ob-Gyn Proc", "n": 16, "overturned": 3, "year_min": 2001, "year_max": 2025 }, { "tx_sub_slug": "inpt-trnsf-to-llc", "tx_sub": "Inpt Trnsf to LLC", "tx_cat": "Rehab/Svcs SNF Inpt", "n": 16, "overturned": 4, "year_min": 2007, "year_max": 2025 }, { "tx_sub_slug": "trau-brain-inj-prog", "tx_sub": "Trau Brain Inj Prog", "tx_cat": "Rehab/ Svc - Outpt", "n": 16, "overturned": 7, "year_min": 2004, "year_max": 2024 }, { "tx_sub_slug": "x-ray", "tx_sub": "X-Ray", "tx_cat": "Diag Imag & Screen", "n": 16, "overturned": 10, "year_min": 2003, "year_max": 2024 }, { "tx_sub_slug": "med-surg", "tx_sub": "Med/ Surg", "tx_cat": "Acute Med Svc Inpt", "n": 16, "overturned": 7, "year_min": 2007, "year_max": 2024 }, { "tx_sub_slug": "incontinence-supplies", "tx_sub": "Incontinence Supplies", "tx_cat": "DME", "n": 15, "overturned": 10, "year_min": 2020, "year_max": 2025 }, { "tx_sub_slug": "sensory-integration", "tx_sub": "Sensory Integration", "tx_cat": "Autism Related Tx", "n": 15, "overturned": 8, "year_min": 2008, "year_max": 2024 }, { "tx_sub_slug": "infertility-tx", "tx_sub": "Infertility Tx", "tx_cat": "Ob-Gyn Proc", "n": 15, "overturned": 8, "year_min": 2019, "year_max": 2025 }, { "tx_sub_slug": "fertility-preservation", "tx_sub": "Fertility Preservation", "tx_cat": "Ob-Gyn Proc", "n": 15, "overturned": 12, "year_min": 2019, "year_max": 2023 }, { "tx_sub_slug": "deep-brain-stimulator", "tx_sub": "Deep Brain Stimulator", "tx_cat": "Neurosurgery Proc", "n": 15, "overturned": 14, "year_min": 2019, "year_max": 2025 }, { "tx_sub_slug": "drug-alcohol-behav-hlth-serv", "tx_sub": "Drug Alcohol Behav Hlth Serv", "tx_cat": "Alcohol Drug Tmt", "n": 14, "overturned": 13, "year_min": 2026, "year_max": 2026 }, { "tx_sub_slug": "rx-management", "tx_sub": "Rx Management", "tx_cat": "Mental Health", "n": 14, "overturned": 3, "year_min": 2007, "year_max": 2018 }, { "tx_sub_slug": "diabetic-supplies", "tx_sub": "Diabetic Supplies", "tx_cat": "DME", "n": 14, "overturned": 8, "year_min": 2019, "year_max": 2024 }, { "tx_sub_slug": "erectile-dysfunct-rx", "tx_sub": "Erectile Dysfunct Rx", "tx_cat": "Pharmacy", "n": 13, "overturned": 7, "year_min": 2019, "year_max": 2025 }, { "tx_sub_slug": "eecp-dvc", "tx_sub": "EECP Dvc", "tx_cat": "Cardio-Vasc Proc", "n": 13, "overturned": 4, "year_min": 2005, "year_max": 2016 }, { "tx_sub_slug": "cholesterol-screen", "tx_sub": "Cholesterol Screen", "tx_cat": "Diag Imag & Screen", "n": 13, "overturned": 0, "year_min": 2011, "year_max": 2025 }, { "tx_sub_slug": "anti-histamines", "tx_sub": "Anti-histamines", "tx_cat": "Pharmacy", "n": 13, "overturned": 7, "year_min": 2003, "year_max": 2018 }, { "tx_sub_slug": "spect-scan", "tx_sub": "SPECT Scan", "tx_cat": "Diag Imag & Screen", "n": 13, "overturned": 7, "year_min": 2019, "year_max": 2025 }, { "tx_sub_slug": "cryoablation", "tx_sub": "Cryoablation", "tx_cat": "Special Proc", "n": 13, "overturned": 5, "year_min": 2005, "year_max": 2018 }, { "tx_sub_slug": "colonoscopy", "tx_sub": "Colonoscopy", "tx_cat": "Diag Imag & Screen", "n": 13, "overturned": 5, "year_min": 2002, "year_max": 2005 }, { "tx_sub_slug": "ekg", "tx_sub": "EKG", "tx_cat": "Diag Imag & Screen", "n": 12, "overturned": 4, "year_min": 2002, "year_max": 2018 }, { "tx_sub_slug": "rhinoplasty", "tx_sub": "Rhinoplasty", "tx_cat": "Reconstr/Plast Proc", "n": 12, "overturned": 9, "year_min": 2019, "year_max": 2024 }, { "tx_sub_slug": "cardiac-mapping", "tx_sub": "Cardiac Mapping", "tx_cat": "Diag Imag & Screen", "n": 12, "overturned": 5, "year_min": 2005, "year_max": 2025 }, { "tx_sub_slug": "family-counseling", "tx_sub": "Family Counseling", "tx_cat": "Mental Health", "n": 12, "overturned": 6, "year_min": 2009, "year_max": 2024 }, { "tx_sub_slug": "rtc-dishcharge", "tx_sub": "RTC/Dishcharge", "tx_cat": "Mental Health", "n": 12, "overturned": 5, "year_min": 2005, "year_max": 2006 }, { "tx_sub_slug": "misc-drugs", "tx_sub": "Misc Drugs", "tx_cat": "Drug Ad Oth Oral", "n": 12, "overturned": 12, "year_min": 2026, "year_max": 2026 }, { "tx_sub_slug": "ptns", "tx_sub": "PTNS", "tx_cat": "Elect/Therm/Radfreq", "n": 11, "overturned": 7, "year_min": 2020, "year_max": 2024 }, { "tx_sub_slug": "autism-screening", "tx_sub": "Autism Screening", "tx_cat": "Autism Related Tx", "n": 11, "overturned": 7, "year_min": 2008, "year_max": 2025 }, { "tx_sub_slug": "laparotomy", "tx_sub": "Laparotomy", "tx_cat": "Gen Surg Proc", "n": 11, "overturned": 4, "year_min": 2002, "year_max": 2016 }, { "tx_sub_slug": "dental-implants", "tx_sub": "Dental Implants", "tx_cat": "Dent/Orthodont Proc", "n": 10, "overturned": 6, "year_min": 2004, "year_max": 2025 }, { "tx_sub_slug": "thigh-buttock-lift", "tx_sub": "Thigh/Buttock Lift", "tx_cat": "Reconstr/Plast Proc", "n": 10, "overturned": 0, "year_min": 2005, "year_max": 2015 }, { "tx_sub_slug": "fertility-rx", "tx_sub": "Fertility Rx", "tx_cat": "Pharmacy", "n": 10, "overturned": 3, "year_min": 2003, "year_max": 2024 }, { "tx_sub_slug": "corneal-procedure", "tx_sub": "Corneal Procedure", "tx_cat": "Vision Services/Ophthalmology", "n": 10, "overturned": 9, "year_min": 2019, "year_max": 2025 }, { "tx_sub_slug": "extraction", "tx_sub": "Extraction", "tx_cat": "Dent/Orthodont Proc", "n": 10, "overturned": 7, "year_min": 2005, "year_max": 2021 }, { "tx_sub_slug": "craniotomy", "tx_sub": "Craniotomy", "tx_cat": "Neurosurgery Proc", "n": 9, "overturned": 5, "year_min": 2003, "year_max": 2025 }, { "tx_sub_slug": "anti-acne-treatment", "tx_sub": "Anti-Acne Treatment", "tx_cat": "Pharmacy", "n": 9, "overturned": 5, "year_min": 2002, "year_max": 2018 }, { "tx_sub_slug": "stroke-rec-prog", "tx_sub": "Stroke Rec Prog", "tx_cat": "Rehab/ Svc - Outpt", "n": 9, "overturned": 1, "year_min": 2003, "year_max": 2023 }, { "tx_sub_slug": "eye-test", "tx_sub": "Eye Test", "tx_cat": "Diag Imag & Screen", "n": 9, "overturned": 6, "year_min": 2012, "year_max": 2019 }, { "tx_sub_slug": "prostatectomy", "tx_sub": "Prostatectomy", "tx_cat": "Urology Proc", "n": 9, "overturned": 3, "year_min": 2003, "year_max": 2018 }, { "tx_sub_slug": "brachiaplasty", "tx_sub": "Brachiaplasty", "tx_cat": "Reconstr/Plast Proc", "n": 8, "overturned": 2, "year_min": 2005, "year_max": 2018 }, { "tx_sub_slug": "chemo-cancer-rx", "tx_sub": "Chemo/ Cancer Rx", "tx_cat": "Pharmacy", "n": 8, "overturned": 2, "year_min": 2002, "year_max": 2005 }, { "tx_sub_slug": "childhood-immun", "tx_sub": "Childhood Immun", "tx_cat": "Prev Health Screen", "n": 8, "overturned": 3, "year_min": 2007, "year_max": 2025 }, { "tx_sub_slug": "proton-beam-therapy", "tx_sub": "Proton Beam Therapy", "tx_cat": "Elect/Therm/Radfreq", "n": 8, "overturned": 0, "year_min": 2001, "year_max": 2004 }, { "tx_sub_slug": "caregiver-services", "tx_sub": "Caregiver Services", "tx_cat": "Home Health Care", "n": 8, "overturned": 2, "year_min": 2019, "year_max": 2024 }, { "tx_sub_slug": "opioid-dependence-rx", "tx_sub": "Opioid Dependence Rx", "tx_cat": "Pharmacy", "n": 8, "overturned": 4, "year_min": 2019, "year_max": 2026 }, { "tx_sub_slug": "ect", "tx_sub": "ECT", "tx_cat": "Elect/Therm/Radfreq", "n": 8, "overturned": 4, "year_min": 2006, "year_max": 2024 }, { "tx_sub_slug": "electrocardiogram-ekg", "tx_sub": "Electrocardiogram/EKG", "tx_cat": "Diag Imag & Screen", "n": 8, "overturned": 4, "year_min": 2019, "year_max": 2024 }, { "tx_sub_slug": "shoulder-replacement", "tx_sub": "Shoulder Replacement", "tx_cat": "Orthopedic Proc", "n": 8, "overturned": 4, "year_min": 2012, "year_max": 2025 }, { "tx_sub_slug": "cryotherapy", "tx_sub": "Cryotherapy", "tx_cat": "Special Proc", "n": 8, "overturned": 2, "year_min": 2005, "year_max": 2012 }, { "tx_sub_slug": "mastopexy", "tx_sub": "Mastopexy", "tx_cat": "Reconstr/Plast Proc", "n": 8, "overturned": 1, "year_min": 2018, "year_max": 2026 }, { "tx_sub_slug": "cholecystectomy", "tx_sub": "Cholecystectomy", "tx_cat": "Gen Surg Proc", "n": 8, "overturned": 5, "year_min": 2002, "year_max": 2022 }, { "tx_sub_slug": "laser-surgery", "tx_sub": "Laser Surgery", "tx_cat": "Special Proc", "n": 7, "overturned": 2, "year_min": 2002, "year_max": 2005 }, { "tx_sub_slug": "hearing-test", "tx_sub": "Hearing Test", "tx_cat": "Diag Imag & Screen", "n": 7, "overturned": 6, "year_min": 2005, "year_max": 2024 }, { "tx_sub_slug": "vnus-closure", "tx_sub": "VNUS Closure", "tx_cat": "Cardio-Vasc Proc", "n": 7, "overturned": 5, "year_min": 2003, "year_max": 2013 }, { "tx_sub_slug": "tmj-splint", "tx_sub": "TMJ Splint", "tx_cat": "Dent/Orthodont Proc", "n": 7, "overturned": 5, "year_min": 2007, "year_max": 2021 }, { "tx_sub_slug": "pacemaker-insertion", "tx_sub": "Pacemaker Insertion", "tx_cat": "Cardio-Vasc Proc", "n": 7, "overturned": 4, "year_min": 2010, "year_max": 2018 }, { "tx_sub_slug": "inpt-trnsf-home", "tx_sub": "Inpt Trnsf Home", "tx_cat": "Rehab/Svcs SNF Inpt", "n": 7, "overturned": 0, "year_min": 2006, "year_max": 2018 }, { "tx_sub_slug": "adult-icu", "tx_sub": "Adult ICU", "tx_cat": "Acute Med Svc Inpt", "n": 7, "overturned": 5, "year_min": 2018, "year_max": 2024 }, { "tx_sub_slug": "in-net-acad-ctr", "tx_sub": "In-Net Acad Ctr", "tx_cat": "Diag/ MD Eval", "n": 7, "overturned": 5, "year_min": 2003, "year_max": 2025 }, { "tx_sub_slug": "conscious-sedation", "tx_sub": "Conscious Sedation", "tx_cat": "Special Proc", "n": 7, "overturned": 2, "year_min": 2011, "year_max": 2025 }, { "tx_sub_slug": "gastros-tube-place", "tx_sub": "Gastros Tube Place", "tx_cat": "Gen Surg Proc", "n": 6, "overturned": 2, "year_min": 2013, "year_max": 2023 }, { "tx_sub_slug": "skin-surgical-repair-proc", "tx_sub": "Skin Surgical Repair Proc", "tx_cat": "Surgery", "n": 6, "overturned": 3, "year_min": 2026, "year_max": 2026 }, { "tx_sub_slug": "pediatric", "tx_sub": "Pediatric", "tx_cat": "Acute Med Svc Inpt", "n": 6, "overturned": 5, "year_min": 2016, "year_max": 2024 }, { "tx_sub_slug": "clinical-trial", "tx_sub": "Clinical Trial", "tx_cat": "Cancer Care", "n": 6, "overturned": 3, "year_min": 2002, "year_max": 2023 }, { "tx_sub_slug": "imaging-lower-extremities", "tx_sub": "Imaging Lower Extremities", "tx_cat": "Radio Proc", "n": 6, "overturned": 5, "year_min": 2026, "year_max": 2026 }, { "tx_sub_slug": "cardiac-rehab", "tx_sub": "Cardiac Rehab", "tx_cat": "Rehab/ Svc - Outpt", "n": 6, "overturned": 4, "year_min": 2016, "year_max": 2022 }, { "tx_sub_slug": "crowns", "tx_sub": "Crowns", "tx_cat": "Dent/Orthodont Proc", "n": 6, "overturned": 2, "year_min": 2008, "year_max": 2019 }, { "tx_sub_slug": "trnsf-to-in-pln-fac", "tx_sub": "Trnsf to In Pln Fac", "tx_cat": "Acute Med Svc Inpt", "n": 6, "overturned": 2, "year_min": 2018, "year_max": 2021 }, { "tx_sub_slug": "discharge-to-home", "tx_sub": "Discharge to Home", "tx_cat": "Acute Med Svc Inpt", "n": 6, "overturned": 3, "year_min": 2005, "year_max": 2022 }, { "tx_sub_slug": "social-skills-therapy", "tx_sub": "Social Skills Therapy", "tx_cat": "Autism Related Tx", "n": 6, "overturned": 4, "year_min": 2019, "year_max": 2025 }, { "tx_sub_slug": "hi-int-focused-ultrasnd-hifu", "tx_sub": "Hi-Int Focused Ultrasnd (HIFU)", "tx_cat": "Cancer Care", "n": 5, "overturned": 1, "year_min": 2025, "year_max": 2025 }, { "tx_sub_slug": "tubes-in-ears", "tx_sub": "Tubes in ears", "tx_cat": "Ear-Nose-Thro Proc", "n": 5, "overturned": 3, "year_min": 2014, "year_max": 2024 }, { "tx_sub_slug": "tumor-removal", "tx_sub": "Tumor Removal", "tx_cat": "Gen Surg Proc", "n": 5, "overturned": 1, "year_min": 2019, "year_max": 2025 }, { "tx_sub_slug": "oon-pain-mgmt-prog", "tx_sub": "OON Pain Mgmt Prog", "tx_cat": "Pain Management", "n": 5, "overturned": 2, "year_min": 2004, "year_max": 2016 }, { "tx_sub_slug": "cosmetic-treatment", "tx_sub": "Cosmetic Treatment", "tx_cat": "Pharmacy", "n": 5, "overturned": 3, "year_min": 2009, "year_max": 2018 }, { "tx_sub_slug": "evaluation", "tx_sub": "Evaluation", "tx_cat": "Chiropractic Care", "n": 5, "overturned": 2, "year_min": 2010, "year_max": 2024 }, { "tx_sub_slug": "brand-v-generic", "tx_sub": "Brand v Generic", "tx_cat": "Pharmacy", "n": 5, "overturned": 0, "year_min": 2003, "year_max": 2011 }, { "tx_sub_slug": "imaging-spine-pelvis", "tx_sub": "Imaging Spine Pelvis", "tx_cat": "Radio Proc", "n": 5, "overturned": 1, "year_min": 2026, "year_max": 2026 }, { "tx_sub_slug": "trnsf-to-llc", "tx_sub": "Trnsf to LLC", "tx_cat": "Acute Med Svc Inpt", "n": 5, "overturned": 2, "year_min": 2005, "year_max": 2010 }, { "tx_sub_slug": "msk-surgical-spine-proc", "tx_sub": "MSK Surgical Spine Proc", "tx_cat": "Surgery", "n": 5, "overturned": 4, "year_min": 2026, "year_max": 2026 }, { "tx_sub_slug": "pt-ot-ath-train-and-wound-care", "tx_sub": "PT/OT Ath Train & Wound Care", "tx_cat": "Medicine Serv Proc", "n": 5, "overturned": 4, "year_min": 2026, "year_max": 2026 }, { "tx_sub_slug": "art-reprod-tech", "tx_sub": "Art Reprod Tech", "tx_cat": "Ob-Gyn Proc", "n": 5, "overturned": 3, "year_min": 2003, "year_max": 2018 } ] }