| auth_id,member_id,auth_request_date,auth_decision_date,auth_turnaround_days,auth_procedure_category,auth_urgency,auth_decision,auth_denial_reason,auth_units_requested,auth_units_approved,peer_to_peer_requested,appeal_filed,appeal_outcome,clinical_criteria_met,payer_type |
| PA61969747,MBR00000001,2023-10-01,2023-10-02,1,Surgery,Urgent,Partial_Approval,Not Covered Benefit,2,0,0,1,Upheld,0,Commercial |
| PA33809187,MBR00000001,2023-11-05,2023-11-19,14,DME,Routine,Denied,Out-of-Network,1,0,0,0,,0,Commercial |
| PA80898745,MBR00000007,2023-03-12,2023-03-20,8,DME,Routine,Approved,,9,9,0,0,,1,Commercial |
| PA72926358,MBR00000007,2023-06-26,2023-06-29,3,Infusion Therapy,Routine,Approved,,3,3,0,0,,1,Commercial |
| PA42582943,MBR00000007,2023-08-01,2023-08-11,10,Infusion Therapy,Routine,Partial_Approval,Missing Documentation,3,1,0,1,Partial_Overturn,0,Commercial |
| PA45742549,MBR00000010,2023-04-29,2023-05-10,11,Transplant Evaluation,Routine,Approved,,11,11,0,0,,1,Medicare_Advantage |
| PA27583749,MBR00000014,2023-11-28,2023-12-12,14,Transplant Evaluation,Routine,Approved,,9,9,0,0,,1,Commercial |
| PA29159514,MBR00000014,2023-08-03,2023-08-17,14,DME,Routine,Denied,Step Therapy Not Completed,9,0,0,0,,0,Commercial |
| PA15959624,MBR00000014,2023-05-29,2023-06-01,3,Home Health,Routine,Approved,,1,1,0,0,,1,Commercial |
| PA24761842,MBR00000017,2023-04-10,2023-04-17,7,Cardiac Procedures,Routine,Approved,,4,4,0,0,,1,Commercial |
| PA67643572,MBR00000018,2023-07-25,2023-08-08,14,Chemotherapy,Routine,Approved,,3,3,0,0,,1,Commercial |
| PA18345100,MBR00000018,2023-07-31,2023-08-09,9,Orthopedic Procedures,Routine,Approved,,6,6,0,0,,1,Commercial |
| PA66152253,MBR00000022,2023-04-22,2023-04-25,3,DME,Urgent,Approved,,9,9,0,0,,1,Medicare_Advantage |
| PA41029671,MBR00000025,2023-08-29,2023-09-05,7,DME,Routine,Approved,,4,4,0,0,,1,Commercial |
| PA44325095,MBR00000027,2023-05-23,2023-06-03,11,Behavioral Health,Routine,Pending,,10,0,0,0,,0,Medicare_Advantage |
| PA24402696,MBR00000027,2023-05-19,2023-05-21,2,Behavioral Health,Emergency,Approved,,8,8,0,0,,1,Medicare_Advantage |
| PA58568144,MBR00000027,2023-03-10,2023-03-11,1,Infusion Therapy,Urgent,Approved,,3,3,0,0,,1,Medicare_Advantage |
| PA58555030,MBR00000028,2023-04-10,2023-04-17,7,Radiation Therapy,Routine,Approved,,10,10,0,0,,1,Commercial |
| PA30136391,MBR00000028,2023-01-12,2023-01-16,4,Transplant Evaluation,Routine,Approved,,11,11,0,0,,1,Commercial |
| PA47190970,MBR00000028,2023-06-25,2023-06-27,2,Orthopedic Procedures,Urgent,Approved,,11,11,0,0,,1,Commercial |
| PA20257352,MBR00000031,2023-08-10,2023-08-13,3,Bariatric Procedures,Urgent,Approved,,8,8,0,0,,1,Commercial |
| PA29153174,MBR00000033,2023-06-11,2023-06-19,8,Sleep Studies,Routine,Approved,,2,2,0,0,,1,Medicare_Advantage |
| PA86291306,MBR00000033,2023-04-02,2023-04-15,13,Transplant Evaluation,Routine,Approved,,4,4,0,0,,1,Medicare_Advantage |
| PA45798539,MBR00000033,2023-08-26,2023-09-02,7,DME,Routine,Partial_Approval,Step Therapy Not Completed,5,3,0,0,,0,Medicare_Advantage |
| PA17116756,MBR00000040,2023-01-23,2023-01-24,1,Neurology Services,Urgent,Approved,,7,7,0,0,,1,Medicare_Advantage |
| PA95387745,MBR00000041,2023-04-20,2023-04-22,2,Specialty Drugs,Urgent,Partial_Approval,Missing Documentation,2,1,0,1,Overturned,0,Commercial |
| PA49220569,MBR00000041,2023-08-20,2023-08-29,9,Surgery,Routine,Partial_Approval,Not Covered Benefit,1,0,0,0,,0,Commercial |
| PA38971913,MBR00000041,2023-07-03,2023-07-15,12,Specialty Imaging (MRI/CT),Routine,Approved,,5,5,0,0,,1,Commercial |
| PA25945775,MBR00000043,2023-12-18,2023-12-21,3,Genetic Testing,Routine,Approved,,11,11,0,0,,1,Commercial |
| PA23921600,MBR00000043,2023-10-06,2023-10-09,3,Physical Therapy Extended,Routine,Approved,,6,6,0,0,,1,Commercial |
| PA21677180,MBR00000043,2023-02-18,2023-02-28,10,Cardiac Procedures,Routine,Approved,,10,10,0,0,,1,Commercial |
| PA58273216,MBR00000045,2023-09-28,2023-10-08,10,Radiation Therapy,Routine,Approved,,9,9,0,0,,1,Commercial |
| PA13981364,MBR00000047,2023-01-30,2023-02-01,2,Infusion Therapy,Urgent,Approved,,11,11,0,0,,1,Commercial |
| PA96808740,MBR00000047,2023-08-04,2023-08-18,14,Skilled Nursing,Routine,Approved,,10,10,0,0,,1,Commercial |
| PA53876561,MBR00000050,2023-05-17,2023-05-18,1,DME,Emergency,Approved,,10,10,0,0,,1,Medicare_Advantage |
| PA69539398,MBR00000050,2023-05-12,2023-05-25,13,Infusion Therapy,Routine,Partial_Approval,Step Therapy Not Completed,1,0,0,0,,0,Medicare_Advantage |
| PA19865688,MBR00000050,2023-06-27,2023-07-07,10,Physical Therapy Extended,Routine,Approved,,2,2,0,0,,1,Medicare_Advantage |
| PA16090591,MBR00000053,2023-05-04,2023-05-18,14,Physical Therapy Extended,Routine,Partial_Approval,Step Therapy Not Completed,9,5,0,1,Overturned,0,Medicaid_MCO |
| PA14094605,MBR00000053,2023-04-09,2023-04-13,4,Specialty Drugs,Routine,Approved,,4,4,0,0,,1,Medicaid_MCO |
| PA45380195,MBR00000053,2023-11-28,2023-12-03,5,Specialty Drugs,Routine,Approved,,10,10,0,0,,1,Medicaid_MCO |
| PA72257682,MBR00000054,2023-05-28,2023-06-08,11,Chemotherapy,Routine,Pending,,10,0,0,0,,0,Medicare_Advantage |
| PA36984000,MBR00000054,2023-04-22,2023-04-27,5,Radiation Therapy,Routine,Approved,,4,4,0,0,,1,Medicare_Advantage |
| PA42382354,MBR00000057,2023-11-21,2023-11-24,3,Sleep Studies,Urgent,Approved,,4,4,0,0,,1,Medicare_Advantage |
| PA13288797,MBR00000057,2023-01-11,2023-01-20,9,Bariatric Procedures,Routine,Partial_Approval,Out-of-Network,10,5,0,0,,0,Medicare_Advantage |
| PA79415134,MBR00000059,2023-06-17,2023-06-21,4,Transplant Evaluation,Routine,Approved,,8,8,0,0,,1,Medicare_Advantage |
| PA62612918,MBR00000059,2023-03-02,2023-03-07,5,Surgery,Routine,Approved,,5,5,0,0,,1,Medicare_Advantage |
| PA18592761,MBR00000059,2023-05-22,2023-05-30,8,Skilled Nursing,Routine,Approved,,2,2,0,0,,1,Medicare_Advantage |
| PA93071425,MBR00000060,2023-05-06,2023-05-07,1,Cardiac Procedures,Urgent,Approved,,6,6,0,0,,1,ACA_Marketplace |
| PA22678551,MBR00000060,2023-03-08,2023-03-11,3,Bariatric Procedures,Routine,Denied,Out-of-Network,10,0,0,1,Upheld,0,ACA_Marketplace |
| PA81650538,MBR00000060,2023-02-09,2023-02-20,11,Genetic Testing,Routine,Denied,Medical Necessity,2,0,0,0,,0,ACA_Marketplace |
| PA48587456,MBR00000062,2023-05-12,2023-05-25,13,Home Health,Routine,Approved,,11,11,0,0,,1,Commercial |
| PA78125395,MBR00000062,2023-07-12,2023-07-19,7,Radiation Therapy,Routine,Approved,,5,5,0,0,,1,Commercial |
| PA28536547,MBR00000063,2023-11-10,2023-11-17,7,Cardiac Procedures,Routine,Approved,,3,3,0,0,,1,ACA_Marketplace |
| PA85276407,MBR00000065,2023-05-30,2023-06-06,7,Infusion Therapy,Routine,Approved,,2,2,0,0,,1,Commercial |
| PA19749040,MBR00000066,2023-10-24,2023-10-30,6,Sleep Studies,Routine,Approved,,2,2,0,0,,1,Medicaid_MCO |
| PA62445785,MBR00000072,2023-07-19,2023-07-27,8,Physical Therapy Extended,Routine,Approved,,2,2,0,0,,1,Medicare_Advantage |
| PA50293881,MBR00000074,2023-01-26,2023-02-06,11,Radiation Therapy,Routine,Approved,,8,8,0,0,,1,Medicare_Advantage |
| PA74840326,MBR00000074,2023-09-25,2023-09-27,2,Bariatric Procedures,Emergency,Approved,,9,9,0,0,,1,Medicare_Advantage |
| PA70988657,MBR00000075,2023-07-27,2023-07-30,3,Home Health,Urgent,Approved,,11,11,0,0,,1,Medicaid_MCO |
| PA36937980,MBR00000079,2023-09-09,2023-09-12,3,Specialty Drugs,Urgent,Approved,,8,8,0,0,,1,Medicaid_MCO |
| PA42280876,MBR00000080,2023-08-13,2023-08-19,6,Bariatric Procedures,Routine,Approved,,1,1,0,0,,1,Commercial |
| PA94882986,MBR00000080,2023-11-23,2023-12-06,13,Home Health,Routine,Approved,,3,3,0,0,,1,Commercial |
| PA85855182,MBR00000084,2023-07-06,2023-07-08,2,Radiation Therapy,Emergency,Approved,,4,4,0,0,,1,Medicare_Advantage |
| PA81103439,MBR00000085,2023-07-17,2023-07-18,1,Specialty Imaging (MRI/CT),Emergency,Approved,,2,2,0,0,,1,Medicare_Advantage |
| PA28862842,MBR00000085,2023-01-09,2023-01-11,2,Bariatric Procedures,Urgent,Approved,,8,8,0,0,,1,Medicare_Advantage |
| PA35250632,MBR00000088,2023-05-29,2023-05-31,2,Transplant Evaluation,Urgent,Approved,,11,11,0,0,,1,ACA_Marketplace |
| PA78772275,MBR00000088,2023-08-28,2023-09-03,6,Orthopedic Procedures,Routine,Approved,,11,11,0,0,,1,ACA_Marketplace |
| PA79753227,MBR00000088,2023-01-08,2023-01-18,10,Home Health,Routine,Approved,,8,8,0,0,,1,ACA_Marketplace |
| PA98791255,MBR00000089,2023-11-29,2023-12-13,14,Radiation Therapy,Routine,Pending,,2,0,0,0,,0,Commercial |
| PA27807007,MBR00000089,2023-06-27,2023-06-28,1,Genetic Testing,Emergency,Denied,Experimental/Investigational,8,0,0,0,,0,Commercial |
| PA68996806,MBR00000089,2023-07-15,2023-07-17,2,Radiation Therapy,Urgent,Approved,,7,7,0,0,,1,Commercial |
| PA45074934,MBR00000090,2023-01-17,2023-01-26,9,Genetic Testing,Routine,Approved,,4,4,0,0,,1,Medicare_Advantage |
| PA82168473,MBR00000091,2023-10-13,2023-10-20,7,DME,Routine,Approved,,5,5,0,0,,1,Commercial |
| PA81422380,MBR00000093,2023-06-11,2023-06-19,8,Specialty Imaging (MRI/CT),Routine,Approved,,2,2,0,0,,1,Medicare_Advantage |
| PA84791716,MBR00000093,2023-03-03,2023-03-06,3,Transplant Evaluation,Urgent,Approved,,7,7,0,0,,1,Medicare_Advantage |
| PA56246245,MBR00000098,2023-11-29,2023-12-05,6,Skilled Nursing,Routine,Approved,,9,9,0,0,,1,Medicare_Advantage |
| PA28632303,MBR00000098,2023-07-10,2023-07-24,14,Specialty Imaging (MRI/CT),Routine,Denied,Duplicate Request,7,0,0,1,Partial_Overturn,0,Medicare_Advantage |
| PA60099571,MBR00000098,2023-05-09,2023-05-12,3,Specialty Drugs,Routine,Approved,,9,9,0,0,,1,Medicare_Advantage |
| PA63886458,MBR00000099,2023-05-22,2023-06-02,11,DME,Routine,Approved,,7,7,0,0,,1,Commercial |
| PA32104986,MBR00000099,2023-12-01,2023-12-02,1,Neurology Services,Urgent,Approved,,4,4,0,0,,1,Commercial |
| PA55056956,MBR00000099,2023-04-15,2023-04-29,14,Chemotherapy,Routine,Approved,,7,7,0,0,,1,Commercial |
| PA24652994,MBR00000100,2023-12-19,2023-12-28,9,Skilled Nursing,Routine,Approved,,3,3,0,0,,1,ACA_Marketplace |
| PA97087245,MBR00000102,2023-06-23,2023-06-30,7,Neurology Services,Routine,Approved,,1,1,0,0,,1,Commercial |
| PA32253543,MBR00000102,2023-09-03,2023-09-14,11,Physical Therapy Extended,Routine,Approved,,3,3,0,0,,1,Commercial |
| PA13421788,MBR00000102,2023-11-19,2023-11-20,1,DME,Urgent,Approved,,7,7,0,0,,1,Commercial |
| PA20024477,MBR00000104,2023-03-29,2023-04-12,14,Behavioral Health,Routine,Approved,,1,1,0,0,,1,Medicaid_MCO |
| PA61458498,MBR00000104,2023-01-03,2023-01-17,14,Radiation Therapy,Routine,Approved,,11,11,0,0,,1,Medicaid_MCO |
| PA55387438,MBR00000104,2023-10-31,2023-11-11,11,Bariatric Procedures,Routine,Approved,,9,9,0,0,,1,Medicaid_MCO |
| PA64770671,MBR00000105,2023-05-06,2023-05-08,2,Neurology Services,Urgent,Approved,,3,3,0,0,,1,Commercial |
| PA82234429,MBR00000105,2023-02-21,2023-03-06,13,Chemotherapy,Routine,Approved,,9,9,0,0,,1,Commercial |
| PA90714148,MBR00000110,2023-04-18,2023-05-02,14,Radiation Therapy,Routine,Approved,,10,10,0,0,,1,Medicare_Advantage |
| PA47395221,MBR00000110,2023-06-12,2023-06-14,2,Transplant Evaluation,Urgent,Approved,,10,10,0,0,,1,Medicare_Advantage |
| PA27721752,MBR00000110,2023-10-08,2023-10-19,11,Radiation Therapy,Routine,Approved,,11,11,0,0,,1,Medicare_Advantage |
| PA49710487,MBR00000111,2023-12-02,2023-12-13,11,Home Health,Routine,Approved,,1,1,0,0,,1,Medicare_Advantage |
| PA65955662,MBR00000111,2023-01-04,2023-01-08,4,Radiation Therapy,Routine,Approved,,4,4,0,0,,1,Medicare_Advantage |
| PA10168736,MBR00000115,2023-07-07,2023-07-20,13,Physical Therapy Extended,Routine,Approved,,3,3,0,0,,1,Commercial |
| PA53755955,MBR00000117,2023-12-06,2023-12-16,10,Orthopedic Procedures,Routine,Approved,,5,5,0,0,,1,Medicaid_MCO |
| PA42120429,MBR00000117,2023-06-11,2023-06-17,6,Neurology Services,Routine,Approved,,9,9,0,0,,1,Medicaid_MCO |
| PA69284993,MBR00000123,2023-05-31,2023-06-13,13,Behavioral Health,Routine,Approved,,6,6,0,0,,1,ACA_Marketplace |
| PA36906198,MBR00000123,2023-05-07,2023-05-21,14,DME,Routine,Approved,,11,11,0,0,,1,ACA_Marketplace |
| PA77068841,MBR00000129,2023-08-19,2023-08-25,6,Cardiac Procedures,Routine,Approved,,3,3,0,0,,1,Medicare_Advantage |
| PA67852922,MBR00000135,2023-10-31,2023-11-03,3,Infusion Therapy,Routine,Approved,,9,9,0,0,,1,Commercial |
| PA44530159,MBR00000135,2023-08-31,2023-09-13,13,Skilled Nursing,Routine,Partial_Approval,Step Therapy Not Completed,8,2,0,1,Overturned,0,Commercial |
| PA86885928,MBR00000135,2023-04-17,2023-04-18,1,Specialty Imaging (MRI/CT),Urgent,Denied,Out-of-Network,5,0,0,0,,0,Commercial |
| PA67339365,MBR00000143,2023-06-12,2023-06-16,4,Physical Therapy Extended,Routine,Approved,,9,9,0,0,,1,Commercial |
| PA10996321,MBR00000143,2023-07-09,2023-07-13,4,Behavioral Health,Routine,Pending,,4,0,0,0,,0,Commercial |
| PA15165921,MBR00000143,2023-03-09,2023-03-15,6,Transplant Evaluation,Routine,Approved,,7,7,0,0,,1,Commercial |
| PA32296941,MBR00000144,2023-05-27,2023-06-04,8,Sleep Studies,Routine,Approved,,7,7,0,0,,1,Commercial |
| PA98170536,MBR00000146,2023-05-26,2023-05-30,4,Behavioral Health,Routine,Approved,,2,2,0,0,,1,Medicaid_MCO |
| PA69245013,MBR00000146,2023-06-23,2023-07-06,13,Skilled Nursing,Routine,Approved,,5,5,0,0,,1,Medicaid_MCO |
| PA35075941,MBR00000146,2023-11-23,2023-11-26,3,Bariatric Procedures,Urgent,Approved,,6,6,0,0,,1,Medicaid_MCO |
| PA51118984,MBR00000148,2023-06-24,2023-07-05,11,Genetic Testing,Routine,Denied,Medical Necessity,1,0,0,0,,0,Commercial |
| PA26405681,MBR00000148,2023-05-10,2023-05-14,4,Transplant Evaluation,Routine,Approved,,3,3,0,0,,1,Commercial |
| PA79857623,MBR00000150,2023-08-25,2023-09-05,11,Cardiac Procedures,Routine,Approved,,7,7,0,0,,1,Medicare_Advantage |
| PA37764654,MBR00000150,2023-11-02,2023-11-13,11,Cardiac Procedures,Routine,Approved,,2,2,0,0,,1,Medicare_Advantage |
| PA33089350,MBR00000150,2023-02-28,2023-03-01,1,Home Health,Urgent,Approved,,7,7,0,0,,1,Medicare_Advantage |
| PA11028619,MBR00000151,2023-08-26,2023-08-27,1,Specialty Drugs,Urgent,Approved,,3,3,0,0,,1,Medicare_Advantage |
| PA42265506,MBR00000153,2023-07-08,2023-07-12,4,Radiation Therapy,Routine,Approved,,3,3,0,0,,1,Commercial |
| PA54767153,MBR00000153,2023-03-16,2023-03-23,7,Infusion Therapy,Routine,Approved,,6,6,0,0,,1,Commercial |
| PA60840595,MBR00000154,2023-01-14,2023-01-19,5,Genetic Testing,Routine,Approved,,4,4,0,0,,1,Medicare_Advantage |
| PA44873411,MBR00000155,2023-10-05,2023-10-12,7,Skilled Nursing,Routine,Approved,,1,1,0,0,,1,ACA_Marketplace |
| PA62558931,MBR00000156,2023-01-20,2023-02-03,14,Home Health,Routine,Approved,,1,1,0,0,,1,Medicare_Advantage |
| PA85481565,MBR00000158,2023-09-14,2023-09-25,11,Specialty Drugs,Routine,Partial_Approval,Experimental/Investigational,2,0,0,0,,0,Commercial |
| PA19939809,MBR00000158,2023-03-20,2023-03-30,10,Sleep Studies,Routine,Approved,,5,5,0,0,,1,Commercial |
| PA16777357,MBR00000163,2023-04-07,2023-04-19,12,Neurology Services,Routine,Approved,,4,4,0,0,,1,Medicaid_MCO |
| PA67558296,MBR00000163,2023-05-23,2023-05-26,3,Cardiac Procedures,Routine,Approved,,9,9,0,0,,1,Medicaid_MCO |
| PA87173390,MBR00000163,2023-07-20,2023-07-31,11,Cardiac Procedures,Routine,Denied,Step Therapy Not Completed,6,0,0,0,,0,Medicaid_MCO |
| PA47252309,MBR00000166,2023-10-11,2023-10-14,3,DME,Urgent,Approved,,10,10,0,0,,1,ACA_Marketplace |
| PA28267218,MBR00000166,2023-04-06,2023-04-10,4,Chemotherapy,Routine,Approved,,5,5,0,0,,1,ACA_Marketplace |
| PA11243468,MBR00000171,2023-02-05,2023-02-09,4,Cardiac Procedures,Routine,Approved,,8,8,0,0,,1,Commercial |
| PA47931646,MBR00000171,2023-02-08,2023-02-10,2,Surgery,Emergency,Approved,,7,7,0,0,,1,Commercial |
| PA19261267,MBR00000175,2023-04-05,2023-04-19,14,Transplant Evaluation,Routine,Approved,,1,1,0,0,,1,Commercial |
| PA15997416,MBR00000175,2023-03-05,2023-03-09,4,Specialty Drugs,Routine,Denied,Coding Error,5,0,0,0,,0,Commercial |
| PA61395823,MBR00000175,2023-12-05,2023-12-13,8,DME,Routine,Approved,,8,8,0,0,,1,Commercial |
| PA17417156,MBR00000176,2023-08-21,2023-09-03,13,Cardiac Procedures,Routine,Denied,Coding Error,7,0,0,0,,0,Commercial |
| PA61990375,MBR00000176,2023-07-17,2023-07-25,8,Home Health,Routine,Approved,,6,6,0,0,,1,Commercial |
| PA36960315,MBR00000178,2023-05-25,2023-06-08,14,Sleep Studies,Routine,Approved,,4,4,0,0,,1,Medicaid_MCO |
| PA45447269,MBR00000179,2023-10-04,2023-10-16,12,DME,Routine,Approved,,1,1,0,0,,1,Medicare_Advantage |
| PA93465426,MBR00000182,2023-11-07,2023-11-09,2,Specialty Imaging (MRI/CT),Urgent,Approved,,11,11,0,0,,1,Commercial |
| PA96632885,MBR00000182,2023-07-28,2023-08-11,14,Surgery,Routine,Denied,Experimental/Investigational,9,0,0,0,,0,Commercial |
| PA44577100,MBR00000182,2023-02-01,2023-02-08,7,Orthopedic Procedures,Routine,Approved,,11,11,0,0,,1,Commercial |
| PA88826077,MBR00000186,2023-01-17,2023-01-19,2,Sleep Studies,Emergency,Approved,,8,8,0,0,,1,Commercial |
| PA11455891,MBR00000186,2023-01-23,2023-02-01,9,Orthopedic Procedures,Routine,Approved,,1,1,0,0,,1,Commercial |
| PA41311371,MBR00000187,2023-01-29,2023-02-04,6,Infusion Therapy,Routine,Approved,,9,9,0,0,,1,Medicaid_MCO |
| PA72499304,MBR00000187,2023-01-07,2023-01-12,5,Infusion Therapy,Routine,Approved,,10,10,0,0,,1,Medicaid_MCO |
| PA80091171,MBR00000189,2023-01-07,2023-01-09,2,Neurology Services,Urgent,Approved,,9,9,0,0,,1,Medicaid_MCO |
| PA97887024,MBR00000191,2023-04-07,2023-04-14,7,Infusion Therapy,Routine,Approved,,9,9,0,0,,1,Commercial |
| PA59239275,MBR00000203,2023-08-02,2023-08-03,1,Physical Therapy Extended,Urgent,Partial_Approval,Duplicate Request,3,2,0,1,Upheld,0,Commercial |
| PA63636454,MBR00000203,2023-01-09,2023-01-12,3,Physical Therapy Extended,Routine,Approved,,10,10,0,0,,1,Commercial |
| PA46316812,MBR00000210,2023-06-25,2023-07-05,10,Sleep Studies,Routine,Denied,Missing Documentation,1,0,0,1,Upheld,0,Medicare_Advantage |
| PA89169681,MBR00000210,2023-01-18,2023-01-29,11,Transplant Evaluation,Routine,Approved,,2,2,0,0,,1,Medicare_Advantage |
| PA94360897,MBR00000212,2023-10-10,2023-10-20,10,Specialty Drugs,Routine,Approved,,9,9,0,0,,1,Commercial |
| PA14300159,MBR00000213,2023-04-04,2023-04-14,10,Neurology Services,Routine,Approved,,4,4,0,0,,1,Commercial |
| PA17308787,MBR00000213,2023-09-07,2023-09-12,5,Radiation Therapy,Routine,Approved,,3,3,0,0,,1,Commercial |
| PA20777574,MBR00000213,2023-07-20,2023-07-25,5,Behavioral Health,Routine,Approved,,10,10,0,0,,1,Commercial |
| PA26984061,MBR00000214,2023-05-29,2023-06-01,3,Sleep Studies,Urgent,Approved,,4,4,0,0,,1,Commercial |
| PA31503043,MBR00000216,2023-11-18,2023-11-20,2,DME,Urgent,Approved,,8,8,0,0,,1,Medicare_Advantage |
| PA86532366,MBR00000216,2023-05-11,2023-05-17,6,Neurology Services,Routine,Approved,,7,7,0,0,,1,Medicare_Advantage |
| PA48817389,MBR00000216,2023-12-09,2023-12-15,6,Orthopedic Procedures,Routine,Approved,,3,3,0,0,,1,Medicare_Advantage |
| PA77263035,MBR00000220,2023-06-17,2023-06-24,7,Skilled Nursing,Routine,Approved,,1,1,0,0,,1,Commercial |
| PA49627102,MBR00000220,2023-08-07,2023-08-15,8,Specialty Imaging (MRI/CT),Routine,Partial_Approval,Coding Error,5,2,0,0,,0,Commercial |
| PA22721529,MBR00000220,2023-07-07,2023-07-10,3,Bariatric Procedures,Urgent,Partial_Approval,Duplicate Request,3,2,1,0,,0,Commercial |
| PA22533534,MBR00000221,2023-02-11,2023-02-17,6,Genetic Testing,Routine,Approved,,9,9,0,0,,1,Commercial |
| PA94953769,MBR00000232,2023-01-19,2023-01-26,7,DME,Routine,Approved,,5,5,0,0,,1,Medicaid_MCO |
| PA36561340,MBR00000232,2023-01-03,2023-01-12,9,Infusion Therapy,Routine,Partial_Approval,Step Therapy Not Completed,6,3,0,0,,0,Medicaid_MCO |
| PA10219535,MBR00000232,2023-08-14,2023-08-24,10,Transplant Evaluation,Routine,Approved,,3,3,0,0,,1,Medicaid_MCO |
| PA60164759,MBR00000233,2023-08-17,2023-08-24,7,Home Health,Routine,Approved,,5,5,0,0,,1,Medicare_Advantage |
| PA74947294,MBR00000233,2023-11-19,2023-11-27,8,Sleep Studies,Routine,Approved,,10,10,0,0,,1,Medicare_Advantage |
| PA15088321,MBR00000236,2023-02-15,2023-02-21,6,Chemotherapy,Routine,Approved,,3,3,0,0,,1,Medicaid_MCO |
| PA74908765,MBR00000236,2023-09-11,2023-09-23,12,Home Health,Routine,Approved,,6,6,0,0,,1,Medicaid_MCO |
| PA67482133,MBR00000236,2023-11-29,2023-12-11,12,Home Health,Routine,Approved,,6,6,0,0,,1,Medicaid_MCO |
| PA97908555,MBR00000238,2023-01-25,2023-01-28,3,Specialty Imaging (MRI/CT),Routine,Denied,Duplicate Request,2,0,1,0,,0,Commercial |
| PA48537522,MBR00000238,2023-10-18,2023-10-21,3,Sleep Studies,Urgent,Approved,,2,2,0,0,,1,Commercial |
| PA81122686,MBR00000238,2023-08-15,2023-08-16,1,Genetic Testing,Urgent,Approved,,3,3,0,0,,1,Commercial |
| PA69540151,MBR00000239,2023-01-04,2023-01-16,12,Orthopedic Procedures,Routine,Approved,,2,2,0,0,,1,Commercial |
| PA69075349,MBR00000242,2023-01-12,2023-01-25,13,Orthopedic Procedures,Routine,Denied,Step Therapy Not Completed,2,0,0,0,,0,Medicaid_MCO |
| PA29995074,MBR00000242,2023-08-18,2023-08-28,10,Radiation Therapy,Routine,Approved,,8,8,0,0,,1,Medicaid_MCO |
| PA37296988,MBR00000242,2023-04-03,2023-04-06,3,Cardiac Procedures,Urgent,Approved,,10,10,0,0,,1,Medicaid_MCO |
| PA57160799,MBR00000251,2023-03-17,2023-03-20,3,Surgery,Urgent,Approved,,7,7,0,0,,1,Commercial |
| PA40282067,MBR00000252,2023-07-03,2023-07-17,14,Home Health,Routine,Denied,Missing Documentation,6,0,0,0,,0,Medicare_Advantage |
| PA60460368,MBR00000252,2023-11-06,2023-11-13,7,Specialty Drugs,Routine,Approved,,3,3,0,0,,1,Medicare_Advantage |
| PA42835265,MBR00000256,2023-09-06,2023-09-16,10,DME,Routine,Approved,,6,6,0,0,,1,Commercial |
| PA18020327,MBR00000256,2023-05-25,2023-05-27,2,Skilled Nursing,Emergency,Approved,,5,5,0,0,,1,Commercial |
| PA62300332,MBR00000256,2023-01-08,2023-01-11,3,Chemotherapy,Urgent,Approved,,5,5,0,0,,1,Commercial |
| PA67288914,MBR00000258,2023-03-13,2023-03-27,14,Orthopedic Procedures,Routine,Approved,,11,11,0,0,,1,Commercial |
| PA59775438,MBR00000258,2023-11-20,2023-11-25,5,Skilled Nursing,Routine,Approved,,9,9,0,0,,1,Commercial |
| PA34300348,MBR00000263,2023-05-07,2023-05-18,11,Bariatric Procedures,Routine,Approved,,8,8,0,0,,1,Medicare_Advantage |
| PA29461446,MBR00000263,2023-01-25,2023-01-31,6,Cardiac Procedures,Routine,Approved,,3,3,0,0,,1,Medicare_Advantage |
| PA21388294,MBR00000275,2023-05-04,2023-05-16,12,Skilled Nursing,Routine,Approved,,11,11,0,0,,1,Medicare_Advantage |
| PA81406565,MBR00000275,2023-06-14,2023-06-27,13,Orthopedic Procedures,Routine,Approved,,2,2,0,0,,1,Medicare_Advantage |
| PA11239531,MBR00000279,2023-02-02,2023-02-12,10,Cardiac Procedures,Routine,Approved,,10,10,0,0,,1,Medicare_Advantage |
| PA93254423,MBR00000283,2023-08-22,2023-08-29,7,Surgery,Routine,Approved,,2,2,0,0,,1,Medicare_Advantage |
| PA30027012,MBR00000283,2023-10-18,2023-10-28,10,Infusion Therapy,Routine,Approved,,3,3,0,0,,1,Medicare_Advantage |
| PA97310419,MBR00000284,2023-05-14,2023-05-20,6,Transplant Evaluation,Routine,Approved,,3,3,0,0,,1,Medicaid_MCO |
| PA75726123,MBR00000286,2023-11-28,2023-12-09,11,Neurology Services,Routine,Approved,,4,4,0,0,,1,Medicare_Advantage |
| PA91843099,MBR00000286,2023-05-15,2023-05-16,1,Neurology Services,Emergency,Approved,,5,5,0,0,,1,Medicare_Advantage |
| PA15796072,MBR00000290,2023-06-03,2023-06-04,1,Sleep Studies,Urgent,Approved,,2,2,0,0,,1,Commercial |
| PA65674141,MBR00000290,2023-10-16,2023-10-29,13,Transplant Evaluation,Routine,Partial_Approval,Coding Error,10,7,0,0,,0,Commercial |
| PA41933908,MBR00000294,2023-08-04,2023-08-09,5,Specialty Imaging (MRI/CT),Routine,Approved,,8,8,0,0,,1,Medicare_Advantage |
| PA12639092,MBR00000295,2023-05-29,2023-06-01,3,Surgery,Routine,Approved,,1,1,0,0,,1,Commercial |
| PA54639221,MBR00000295,2023-10-14,2023-10-24,10,Physical Therapy Extended,Routine,Approved,,7,7,0,0,,1,Commercial |
| PA12857338,MBR00000295,2023-11-30,2023-12-03,3,Sleep Studies,Routine,Approved,,8,8,0,0,,1,Commercial |
| PA51639010,MBR00000298,2023-03-26,2023-03-29,3,Specialty Drugs,Routine,Approved,,5,5,0,0,,1,Medicaid_MCO |
| PA41102375,MBR00000298,2023-05-16,2023-05-23,7,Genetic Testing,Routine,Pending,,9,0,0,0,,0,Medicaid_MCO |
| PA14425193,MBR00000298,2023-11-19,2023-11-23,4,Behavioral Health,Routine,Approved,,2,2,0,0,,1,Medicaid_MCO |
| PA14193326,MBR00000300,2023-04-25,2023-04-26,1,Physical Therapy Extended,Urgent,Approved,,8,8,0,0,,1,Commercial |
| PA54210659,MBR00000300,2023-03-17,2023-03-24,7,Specialty Drugs,Routine,Approved,,10,10,0,0,,1,Commercial |
|
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