About this Dataset

Independent Medical Review (IMR) Determinations, Trend

This data is from the California Department of Managed Health Care (DMHC). It contains all decisions from Independent Medical Reviews (IMR) administered by the DMHC since January 1, 2001. An IMR is an independent review of a denied, delayed, or modified health care service that the health plan has determined to be not medically necessary, experimental/investigational or non-emergent/urgent. If the IMR is decided in an enrollees favor, the health plan must authorize the service or treatment requested.
Organization: State of California
Last updated: 2025-07-23T19:45:47.496556
Tags: california-department-of-managed-health-care, dmhc, hmo-help-center, imr, independent-medical-review

Tables

Independent Medical Review (IMR) Determinations, Trend

@usgov.ca_gov_independent_medical_review_imr_determinations_t_4a260db0.independent_medical_review_imr_determinations_trend

28.96 MB
40,918 rows
14 columns

CREATE TABLE independent_medical_review_imr_determinations_trend (
  "referenceid" VARCHAR,
  "reportyear" BIGINT,
  "diagnosiscategory" VARCHAR,
  "diagnosissubcategory" VARCHAR,
  "treatmentcategory" VARCHAR,
  "treatmentsubcategory" VARCHAR,
  "determination" VARCHAR,
  "type" VARCHAR,
  "agerange" VARCHAR,
  "patientgender" VARCHAR,
  "imrtype" VARCHAR,
  "daystoreview" DOUBLE,
  "daystoadopt" BIGINT,
  "findings" VARCHAR
);