{
  "fields": [{"id":"_id","type":"int"},{"id":"Index","type":"text"},{"id":"Carrier","type":"text"},{"id":"Year","type":"text"},{"id":"Service category","type":"text"},{"id":"Request","type":"text"},{"id":"Code type","type":"text"},{"id":"Code","type":"text"},{"id":"Description of service","type":"text"},{"id":"Number of requests per code","type":"text"},{"id":"Approval rate","type":"text"},{"id":"Initially denied then approved - approval rate","type":"text"},{"id":"Expedited - Avg response time","type":"text"},{"id":"Standard - Avg response time","type":"text"},{"id":"Extenuating circumstances - Avg response time","type":"text"},{"id":"Expedited - Number of requests","type":"text"},{"id":"Standard - Number of requests","type":"text"},{"id":"Extenuating circumstances - Number of requests","type":"text"},{"id":"Drug name","type":"text"},{"id":"Drug brand names","type":"text"}],
  "records": [
    [1,"1","Carrier A","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","9","0.89",null,null,"25.04","240",null,null,null,"NA","NA"],
    [2,"2","Carrier A","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0781","External Ambulatory Infus Pu","6","0",null,null,null,"384",null,null,null,"NA","NA"],
    [3,"3","Carrier A","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9279","Monitoring feature/deviceNOC","1","0",null,null,null,"432",null,null,null,"NA","NA"],
    [4,"4","Carrier A","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","9","0.89",null,null,"25.04",null,null,null,null,"NA","NA"],
    [5,"5","Carrier A","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0781","External Ambulatory Infus Pu","6","0",null,null,null,null,null,null,null,"NA","NA"],
    [6,"6","Carrier A","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9279","Monitoring feature/deviceNOC","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [7,"7","Carrier B","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9276","DISPOSABLE SENSOR FOR CONTINUOUS GLUCOSE MONITOR SYSTEM","30","1",null,"39.07","92.8","0.46",null,null,null,"NA","NA"],
    [8,"8","Carrier B","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9274","EXTERNAL AMBULATORY  INSULIN DELIVERY SYSTEM","13","1",null,"0","92.34","0",null,null,null,"NA","NA"],
    [9,"9","Carrier B","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9277","EXTERNAL TRANSMITTER  CONTINUOUS GLUCOSE MONITOR","71","0.96",null,"64.63","90.11","0.46",null,null,null,"NA","NA"],
    [10,"10","Carrier B","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9278","EXTERNAL RECEIVER  FOR CONTINUOUS GLUCOSE MONITOR SYSTEM","21","0.95",null,"0","84.42","0",null,null,null,"NA","NA"],
    [11,"11","Carrier B","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","EXTERNAL AMBULATORY INFUSION PUMP, INSULIN","13","0.92",null,"0","114.75","0",null,null,null,"NA","NA"],
    [12,"12","Carrier B","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0554","THERAPEUTIC  CONTINUOUS GLUCOSE MONITOR RECEIVER/MONITOR","1","0",null,"0","193.68","0",null,null,null,"NA","NA"],
    [13,"13","Carrier B","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0553","CONTINUOUS GLUCOSE MONITOR SYSTEM SUPPLIES","1","0",null,"0","193.68","0",null,null,null,"NA","NA"],
    [14,"14","Carrier B","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9276","DISPOSABLE SENSOR FOR CONTINUOUS GLUCOSE MONITOR SYSTEM","30","1",null,"39.07","92.8","0.46",null,null,null,"NA","NA"],
    [15,"15","Carrier B","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9274","EXTERNAL AMBULATORY  INSULIN DELIVERY SYSTEM","13","1",null,"0","92.34","0",null,null,null,"NA","NA"],
    [16,"16","Carrier B","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9277","EXTERNAL TRANSMITTER  CONTINUOUS GLUCOSE MONITOR","71","0.96",null,"64.63","90.11","0.46",null,null,null,"NA","NA"],
    [17,"17","Carrier B","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9278","EXTERNAL RECEIVER  FOR CONTINUOUS GLUCOSE MONITOR SYSTEM","21","0.95",null,"0","84.42","0",null,null,null,"NA","NA"],
    [18,"18","Carrier B","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","EXTERNAL AMBULATORY INFUSION PUMP, INSULIN","13","0.92",null,"0","114.75","0",null,null,null,"NA","NA"],
    [19,"19","Carrier B","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0554","THERAPEUTIC  CONTINUOUS GLUCOSE MONITOR RECEIVER/MONITOR","1","0",null,"0","193.68","0",null,null,null,"NA","NA"],
    [20,"20","Carrier B","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0553","CONTINUOUS GLUCOSE MONITOR SYSTEM SUPPLIES","1","0",null,"0","193.68","0",null,null,null,"NA","NA"],
    [21,"21","Carrier C","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95249","GLUCOSE MONITORING 72 HRS, PT PROVIDED EQUIP, TRAINING AND RECORDING","11","1",null,null,"188.2",null,null,null,null,"NA","NA"],
    [22,"22","Carrier C","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A9277","TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS","8","1",null,"0.3","75.4",null,null,null,null,"NA","NA"],
    [23,"23","Carrier C","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4230","INFUS SET INSULIN PUMP NON NEEDLE","449","0.99",null,"6.7","199.1",null,null,null,null,"NA","NA"],
    [24,"24","Carrier C","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A9274","EXT AMB INSULIN DELIVERY","62","0.98",null,"10.5","270.1",null,null,null,null,"NA","NA"],
    [25,"25","Carrier C","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4456","ADHESIVE REMOVER, WIPES, ANY TYPE, EACH","11","0.91",null,"7.2","368.8",null,null,null,null,"NA","NA"],
    [26,"26","Carrier C","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95250","GLUCOSE MONITORING 72 HRS MD OR OTH QUAL, EQUIP PROV, REC/STORAGE GL","29","0.86",null,"16.1","429.4",null,null,null,null,"NA","NA"],
    [27,"27","Carrier C","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A9276","SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D","1041","0.85",null,"14.7","371.7",null,null,null,null,"NA","NA"],
    [28,"28","Carrier C","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0607","HOME BLOOD GLUCOSE MONITOR","10","0.8",null,"7.3","193.9",null,null,null,null,"NA","NA"],
    [29,"29","Carrier C","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0784","EXTERN AMBUL INSULIN INFUS PUMP","179","0.78",null,"63.9","385.1",null,null,null,null,"NA","NA"],
    [30,"30","Carrier C","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","K0553","SUPPLY ALLOWANCE FOR THERAPEUTIC CONTINUOUS GLUCOSE MONITOR (CGM), INCLUDES ALL SUPPLIES AND ACCESSORIES","21","0.67",null,"34.3","956.6",null,null,null,null,"NA","NA"],
    [31,"31","Carrier C","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95249","GLUCOSE MONITORING 72 HRS, PT PROVIDED EQUIP, TRAINING AND RECORDING","11","1",null,null,"188.2",null,null,null,null,"NA","NA"],
    [32,"32","Carrier C","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A9277","TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS","8","1",null,"0.3","75.4",null,null,null,null,"NA","NA"],
    [33,"33","Carrier C","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A6460","SYNTHETIC DRSG <= 16 SQ I","2","1",null,null,"0.1",null,null,null,null,"NA","NA"],
    [34,"34","Carrier C","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4221","WEEKLY SUPPLIES DRUG INFUS CATH","2","1",null,null,"382.5",null,null,null,null,"NA","NA"],
    [35,"35","Carrier C","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4245","ALCOHOL WIPES PER BOX","1","1",null,"0.2",null,null,null,null,null,"NA","NA"],
    [36,"36","Carrier C","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A6461","SYNTHETIC DRSG >16<=48 SQ","1","1",null,null,"0.1",null,null,null,null,"NA","NA"],
    [37,"37","Carrier C","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A9278","RECEIVER MON; EXT INTERSTITIAL CONT GLU MON SYS","1","1",null,null,"1.5",null,null,null,null,"NA","NA"],
    [38,"38","Carrier C","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4340","INDWELLING CATH SPECIAL","1","1",null,"0.1",null,null,null,null,null,"NA","NA"],
    [39,"39","Carrier C","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A5120","SKIN BARRIER, WIPE OR SWA","1","1",null,null,"191.6",null,null,null,null,"NA","NA"],
    [40,"40","Carrier C","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4352","COUDE TIP URINARY CATH","1","1",null,"4.4",null,null,null,null,null,"NA","NA"],
    [41,"41","Carrier C","2020","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0781","INFUS PUMP AMBULATORY","1","0","1",null,"1013",null,null,null,null,"NA","NA"],
    [42,"42","Carrier C","2020","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0784","EXTERN AMBUL INSULIN INFUS PUMP","179","0","0.02","63.9","385.1",null,null,null,null,"NA","NA"],
    [43,"43","Carrier C","2020","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A9276","SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D","1041","0","0.01","14.7","371.7",null,null,null,null,"NA","NA"],
    [44,"44","Carrier D","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4230","INFUS INSULIN PUMP NON NE","74","1",null,"6.2","197.2",null,null,null,null,"NA","NA"],
    [45,"45","Carrier D","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A9274","EXT AMB INSULIN DELIVERY","17","1",null,"9.8","517.4",null,null,null,null,"NA","NA"],
    [46,"46","Carrier D","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A9277","TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS","7","1",null,"42.7","594.1",null,null,null,null,"NA","NA"],
    [47,"47","Carrier D","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","K0553","SUPPLY ALLOWANCE FOR THERAPEUTIC CONTINUOUS GLUCOSE MONITOR (CGM), INCLUDES ALL SUPPLIES AND ACCESSORIES","19","0.79",null,"19.9","2064.6",null,null,null,null,"NA","NA"],
    [48,"48","Carrier D","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A9276","SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D","469","0.75",null,"13.1","554.1",null,null,null,null,"NA","NA"],
    [49,"49","Carrier D","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0784","EXTERN AMBUL INSULIN INFUS PUMP","86","0.69",null,"33.7","474.1",null,null,null,null,"NA","NA"],
    [50,"50","Carrier D","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4456","ADHESIVE REMOVER, WIPES, ANY TYPE, EACH","3","0.67",null,null,"199.1",null,null,null,null,"NA","NA"],
    [51,"51","Carrier D","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","Q4186","EPIFIX, PER SQ CM","4","0.5",null,"60.1","258.8",null,null,null,null,"NA","NA"],
    [52,"52","Carrier D","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4253","BLOOD GLUCOSE/REAGENT STR","2","0.5",null,"1.2",null,null,null,null,null,"NA","NA"],
    [53,"53","Carrier D","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A6209","FOAM DRSG <=16 SQ IN W/O","2","0",null,"1.2",null,null,null,null,null,"NA","NA"],
    [54,"54","Carrier D","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4230","INFUS INSULIN PUMP NON NE","74","1",null,"6.2","197.2",null,null,null,null,"NA","NA"],
    [55,"55","Carrier D","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A9274","EXT AMB INSULIN DELIVERY","17","1",null,"9.8","517.4",null,null,null,null,"NA","NA"],
    [56,"56","Carrier D","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A9277","TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS","7","1",null,"42.7","594.1",null,null,null,null,"NA","NA"],
    [57,"57","Carrier D","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","Q4110","PRIMATRIX PER SQ CM","1","1",null,"3.3",null,null,null,null,null,"NA","NA"],
    [58,"58","Carrier D","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","K0553","SUPPLY ALLOWANCE FOR THERAPEUTIC CONTINUOUS GLUCOSE MONITOR (CGM), INCLUDES ALL SUPPLIES AND ACCESSORIES","19","0.79",null,"19.9","2064.6",null,null,null,null,"NA","NA"],
    [59,"59","Carrier D","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A9276","SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D","469","0.75",null,"13.1","554.1",null,null,null,null,"NA","NA"],
    [60,"60","Carrier D","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0784","EXTERN AMBUL INSULIN INFUS PUMP","86","0.69",null,"33.7","474.1",null,null,null,null,"NA","NA"],
    [61,"61","Carrier D","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4456","ADHESIVE REMOVER, WIPES, ANY TYPE, EACH","3","0.67",null,null,"199.1",null,null,null,null,"NA","NA"],
    [62,"62","Carrier D","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","Q4186","EPIFIX, PER SQ CM","4","0.5",null,"60.1","258.8",null,null,null,null,"NA","NA"],
    [63,"63","Carrier D","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4253","BLOOD GLUCOSE/REAGENT STR","2","0.5",null,"1.2",null,null,null,null,null,"NA","NA"],
    [64,"64","Carrier D","2020","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0781","EXTERNAL AMBULATORY INFUS","2","0","0.5","26.2","1429.8",null,null,null,null,"NA","NA"],
    [65,"65","Carrier D","2020","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A9276","SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D","469","0","0.01","13.1","554.1","0",null,null,null,"NA","NA"],
    [66,"66","Carrier D","2020","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0784","EXTERN AMBUL INSULIN INFUS PUMP","86","0","0.01","33.7","474.1","0",null,null,null,"NA","NA"],
    [67,"67","Carrier E","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0553","SUPPLY ALLOW FOR TX CGM1 MO SPL = 1 U OF SERVICE","49","1",null,null,"18.8",null,null,null,null,"NA","NA"],
    [68,"68","Carrier E","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4230","INFUS INSULIN PUMP NON NEEDL","48","1",null,"3.4","22.6",null,null,null,null,"NA","NA"],
    [69,"69","Carrier E","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4232","SYRINGE W/NEEDLE INSULIN 3CC","28","1",null,null,"16.4",null,null,null,null,"NA","NA"],
    [70,"70","Carrier E","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9276","SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D","4","1",null,null,"5.2",null,null,null,null,"NA","NA"],
    [71,"71","Carrier E","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A6257","TRANSPARENT FILM STERL 16 SQ IN OR LESS EA DRESS","3","1",null,null,"11.2",null,null,null,null,"NA","NA"],
    [72,"72","Carrier E","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0554","RECEIVER DEDICATED FOR USE W/THERAPEUTIC GCM SYS","132","0.9",null,null,"33.9",null,null,null,null,"NA","NA"],
    [73,"73","Carrier E","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","EXT AMB INFUSN PUMP INSULIN","22","0.86",null,null,"41.1",null,null,null,null,"NA","NA"],
    [74,"74","Carrier E","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95250","Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor","32","0.38",null,null,null,null,null,null,null,"NA","NA"],
    [75,"75","Carrier E","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A5120","SKIN BARRIER WIPES OR SWABS EACH","3","0.33",null,null,"65",null,null,null,null,"NA","NA"],
    [76,"76","Carrier E","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0553","SUPPLY ALLOW FOR TX CGM1 MO SPL = 1 U OF SERVICE","49","1",null,null,"18.8",null,null,null,null,"NA","NA"],
    [77,"77","Carrier E","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4230","INFUS INSULIN PUMP NON NEEDL","48","1",null,"3.4","22.6",null,null,null,null,"NA","NA"],
    [78,"78","Carrier E","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4232","SYRINGE W/NEEDLE INSULIN 3CC","28","1",null,null,"16.4",null,null,null,null,"NA","NA"],
    [79,"79","Carrier E","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9276","SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D","4","1",null,null,"5.2",null,null,null,null,"NA","NA"],
    [80,"80","Carrier E","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A6257","TRANSPARENT FILM STERL 16 SQ IN OR LESS EA DRESS","3","1",null,null,"11.2",null,null,null,null,"NA","NA"],
    [81,"81","Carrier E","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0554","RECEIVER DEDICATED FOR USE W/THERAPEUTIC GCM SYS","132","0.9",null,null,"33.9",null,null,null,null,"NA","NA"],
    [82,"82","Carrier E","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","EXT AMB INFUSN PUMP INSULIN","22","0.86",null,null,"41.1",null,null,null,null,"NA","NA"],
    [83,"83","Carrier E","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95250","Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor","32","0.38",null,null,null,null,null,null,null,"NA","NA"],
    [84,"84","Carrier E","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A5120","SKIN BARRIER WIPES OR SWABS EACH","3","0.33",null,null,"65",null,null,null,null,"NA","NA"],
    [85,"85","Carrier F","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","test strips","14","0.84",null,"6.57","45.22",null,null,null,null,"NA","NA"],
    [86,"86","Carrier F","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","test strips","14","0.84",null,"6.57","45.22",null,null,null,null,"NA","NA"],
    [87,"87","Carrier F","2020","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NA","NA","test strips","14","0","0","6.57","45.22",null,null,null,null,"NA","NA"],
    [88,"88","Carrier G","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0784","EXTERNAL AMBULATORY INFUSION PUMP INSULIN","13","1",null,"14.8","99.5",null,null,null,null,"NA","NA"],
    [89,"89","Carrier G","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","Q4186","EPIFIX PER SQ CM","1","1",null,null,"24",null,null,null,null,"NA","NA"],
    [90,"90","Carrier G","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4230","INFUS SET EXT INSULIN PUMP NONNDLE CANNULA TYPE","10","0.8",null,"13.2","31.7",null,null,null,null,"NA","NA"],
    [91,"91","Carrier G","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A9276","SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U Equal to 1D","29","0.79",null,"7.9","37.9",null,null,null,null,"NA","NA"],
    [92,"92","Carrier G","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4232","SYRINGE W/NDLE EXTERNAL INSULIN PUMP STERILE 3CC","9","0.78",null,null,"38.5",null,null,null,null,"NA","NA"],
    [93,"93","Carrier G","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A9277","TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS","13","0.77",null,"12.2","22",null,null,null,null,"NA","NA"],
    [94,"94","Carrier G","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","K0553","SUPPLY ALLOW FOR TX CGM1 MO SPL  Equal to  1 U OF SERVICE","3","0.67",null,null,null,null,null,null,null,"NA","NA"],
    [95,"95","Carrier G","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4253","BLD GLU TEST/REAGT STRIPS HOME BLD GLU MON-50","2","0.5",null,null,null,null,null,null,null,"NA","NA"],
    [96,"96","Carrier G","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A5500","DIAB ONLY FIT CSTM PREP AND SPL SHOE MX DNSITY INSRT","1","0",null,null,"46.5",null,null,null,null,"NA","NA"],
    [97,"97","Carrier G","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99499","UNLISTED EVALUATION AND MANAGEMENT SERVICE","1","0",null,"69.1",null,null,null,null,null,"NA","NA"],
    [98,"98","Carrier G","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0784","EXTERNAL AMBULATORY INFUSION PUMP INSULIN","13","1",null,"14.8","95.5",null,null,null,null,"NA","NA"],
    [99,"99","Carrier G","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A9274","EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA","1","1",null,null,"56.9",null,null,null,null,"NA","NA"],
    [100,"100","Carrier G","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A5514","DIAB ONLY MX DEN INSRT DIRECT CARV CUSTOM FAB EA","1","1",null,null,"76.5",null,null,null,null,"NA","NA"],
    [101,"101","Carrier G","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","Q4186","EPIFIX PER SQ CM","1","1",null,null,"24",null,null,null,null,"NA","NA"],
    [102,"102","Carrier G","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95249","CONT GLUC MONITORING PATIENT PROVIDED EQUIPTMENT","1","1",null,null,"18.5",null,null,null,null,"NA","NA"],
    [103,"103","Carrier G","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4230","INFUS SET EXT INSULIN PUMP NONNDLE CANNULA TYPE","10","0.8",null,"14.8","35.4",null,null,null,null,"NA","NA"],
    [104,"104","Carrier G","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A9276","SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U Equal to 1D","29","0.79",null,"8.5","29.2",null,null,null,null,"NA","NA"],
    [105,"105","Carrier G","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4232","SYRINGE W/NDLE EXTERNAL INSULIN PUMP STERILE 3CC","9","0.78",null,"14.8","38.5",null,null,null,null,"NA","NA"],
    [106,"106","Carrier G","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A9277","TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS","13","0.77",null,"12.2","22",null,null,null,null,"NA","NA"],
    [107,"107","Carrier G","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","K0553","SUPPLY ALLOW FOR TX CGM1 MO SPL  Equal to  1 U OF SERVICE","3","0.67",null,"1.7","213.8",null,null,null,null,"NA","NA"],
    [108,"108","Carrier G","2020","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A4232","SYRINGE W/NDLE EXTERNAL INSULIN PUMP STERILE 3CC","9","0","0.11","14.8","38.5",null,null,null,null,"NA","NA"],
    [109,"109","Carrier G","2020","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A4230","INFUS SET EXT INSULIN PUMP NONNDLE CANNULA TYPE","10","0","0.1","14.8","35.4",null,null,null,null,"NA","NA"],
    [110,"110","Carrier G","2020","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A9277","TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS","13","0","0.08","12.2","22",null,null,null,null,"NA","NA"],
    [111,"111","Carrier G","2020","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0784","EXTERNAL AMBULATORY INFUSION PUMP INSULIN","13","0","0.08","14.8","95.5",null,null,null,null,"NA","NA"],
    [112,"112","Carrier G","2020","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A9276","SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U Equal to 1D","29","0","0.03","8.5","29.2",null,null,null,null,"NA","NA"],
    [113,"113","Carrier H","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","test strips","218","0.84",null,"6.51","8.17",null,null,null,null,"NA","NA"],
    [114,"114","Carrier H","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","test strips","218","0.84",null,"6.51","8.17",null,null,null,null,"NA","NA"],
    [115,"115","Carrier H","2020","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NA","NA","test strips","218","0","0","6.5","8.17",null,null,null,null,"NA","NA"],
    [116,"116","Carrier I","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","8","1",null,null,"20.44","360",null,null,null,"NA","NA"],
    [117,"117","Carrier I","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","8","1",null,null,"20.44","0.2",null,null,null,"NA","NA"],
    [118,"118","Carrier J","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","95","0.99",null,null,"49.14",null,null,null,null,"NA","NA"],
    [119,"119","Carrier J","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0781","External Ambulatory Infus Pu","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [120,"120","Carrier J","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9276","Disposable sensor, CGM sys","1","0",null,null,"125.98",null,null,null,null,"NA","NA"],
    [121,"121","Carrier J","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9277","External transmitter, CGM","1","0",null,null,"125.98",null,null,null,null,"NA","NA"],
    [122,"122","Carrier J","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","95","0.99",null,null,"49.14",null,null,null,null,"NA","NA"],
    [123,"123","Carrier J","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0781","External Ambulatory Infus Pu","1","0",null,null,null,"11.1",null,null,null,"NA","NA"],
    [124,"124","Carrier J","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9276","Disposable sensor, CGM sys","1","0",null,null,"125.98","28.7",null,null,null,"NA","NA"],
    [125,"125","Carrier J","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9277","External transmitter, CGM","1","0",null,null,"125.98",null,null,null,null,"NA","NA"],
    [126,"126","Carrier K","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0784","EXTERNAL AMBULATORY INFUSION PUMP INSULIN","3","1",null,"15.6","57.55",null,null,null,null,"NA","NA"],
    [127,"127","Carrier K","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0784","EXTERNAL AMBULATORY INFUSION PUMP INSULIN","3","1",null,"15.6","57.55",null,null,null,null,"NA","NA"],
    [128,"128","Carrier K","2020","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0784","EXTERNAL AMBULATORY INFUSION PUMP INSULIN","3","0","1","15.6","57.55",null,null,null,null,"NA","NA"],
    [129,"129","Carrier L","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0784","EXTERNAL AMBULATORY INFUSION PUMP INSULIN","7","1",null,"16.6","40.26",null,null,null,null,"NA","NA"],
    [130,"130","Carrier L","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A9274","EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA","3","1",null,null,"47.4",null,null,null,null,"NA","NA"],
    [131,"131","Carrier L","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0607","HOME BLOOD GLUCOSE MONITOR","1","1",null,null,"95.5",null,null,null,null,"NA","NA"],
    [132,"132","Carrier L","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A9276","SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D","3","0.67",null,null,"71.31",null,null,null,null,"NA","NA"],
    [133,"133","Carrier L","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A9277","TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS","3","0.67",null,null,"71.31",null,null,null,null,"NA","NA"],
    [134,"134","Carrier L","2020","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A9278","RECEIVER MON; EXT INTERSTITIAL CONT GLU MON SYS","3","0.67",null,null,"71.31",null,null,null,null,"NA","NA"],
    [135,"135","Carrier L","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0784","EXTERNAL AMBULATORY INFUSION PUMP INSULIN","7","1",null,"16.6","40.26",null,null,null,null,"NA","NA"],
    [136,"136","Carrier L","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A9274","EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA","3","1",null,null,"47.4",null,null,null,null,"NA","NA"],
    [137,"137","Carrier L","2020","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0607","HOME BLOOD GLUCOSE MONITOR","1","1",null,null,"95.5",null,null,null,null,"NA","NA"],
    [138,"138","Carrier M","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5301","BELOW KNEE, MOLDED SOCKET, SHIN, SACH FOOT, ENDOSKELETAL SYSTEM","2","1",null,"0","36",null,null,null,null,"NA","NA"],
    [139,"139","Carrier M","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5620","S/A L5618,BELOW KNEE","2","1",null,"0","36",null,null,null,null,"NA","NA"],
    [140,"140","Carrier M","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5637","ADDITION TO LOWER EXTREMITY, BELOW KNEE, TOTAL CONTACT","2","1",null,"0","36",null,null,null,null,"NA","NA"],
    [141,"141","Carrier M","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5671","ADDITION TO LOWER EXTREMITY, BELOW KNEE / ABOVE KNEE SUSPENSION LOCKING","2","1",null,"0","36",null,null,null,null,"NA","NA"],
    [142,"142","Carrier M","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5673","ADDITION TO LOWER EXTREMITY, BELOW KNEE/ABOVE KNEE, CUSTOM FABRICATED FROM EXISTING MOLD OR PREFABRICATED, SOCKET INSERT, SILICONE GEL, ELASTOMERIC OR EQUAL, FOR USE WITH LOCKING MECHANISM","2","1",null,"0","36",null,null,null,null,"NA","NA"],
    [143,"143","Carrier M","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5910","ADDITION, ENDOSKELETAL SYSTEM, BELOW KNEE, ALIGNABLE SYSTEM","2","1",null,"0","36",null,null,null,null,"NA","NA"],
    [144,"144","Carrier M","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5940","(TITANIUM, CARBON FIBER OR EQUAL) ADDITION, ENDOSKELETAL SYSTEM, BELOW KNEE, ULTRA-LIGHT MATERIAL","2","1",null,"0","36",null,null,null,null,"NA","NA"],
    [145,"145","Carrier M","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5986","EQUAL) ALL LOWER EXTREMITY PROSTHESES, MULTI-AXIAL ROTATION UNIT (\"MCP\" OR","2","1",null,"0","36",null,null,null,null,"NA","NA"],
    [146,"146","Carrier M","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1007","WHEELCHAIR ACCESSORY, POWER SEATING SYSTEM, COMBINATION TILT AND RECLINE, WITH MECHANICAL SHEAR REDUCTION","2","0.5",null,"12","36",null,null,null,null,"NA","NA"],
    [147,"147","Carrier M","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2311","POWER WHEELCHAIR ACCESSORY, ELECTRONIC CONNECTION BETWEEN WHEELCHAIR CONTROLLER AND TWO OR MORE POWER SEATING SYSTEM MOTORS, INCLUDING ALL RELATED ELECTRONICS, INDICATOR FEATURE, MECHANICAL FUNCTION SELECTION SWITCH, AND FIXEDMOUNTING HARDWARE","2","0.5",null,"12","36",null,null,null,null,"NA","NA"],
    [148,"148","Carrier M","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5301","BELOW KNEE, MOLDED SOCKET, SHIN, SACH FOOT, ENDOSKELETAL SYSTEM","2","1",null,null,"36",null,null,null,null,"NA","NA"],
    [149,"149","Carrier M","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5620","S/A L5618,BELOW KNEE","2","1",null,null,"36",null,null,null,null,"NA","NA"],
    [150,"150","Carrier M","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5637","ADDITION TO LOWER EXTREMITY, BELOW KNEE, TOTAL CONTACT","2","1",null,null,"36",null,null,null,null,"NA","NA"],
    [151,"151","Carrier M","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5671","ADDITION TO LOWER EXTREMITY, BELOW KNEE / ABOVE KNEE SUSPENSION LOCKING","2","1",null,null,"36",null,null,null,null,"NA","NA"],
    [152,"152","Carrier M","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5673","ADDITION TO LOWER EXTREMITY, BELOW KNEE/ABOVE KNEE, CUSTOM FABRICATED FROM EXISTING MOLD OR PREFABRICATED, SOCKET INSERT, SILICONE GEL, ELASTOMERIC OR EQUAL, FOR USE WITH LOCKING MECHANISM","2","1",null,null,"36",null,null,null,null,"NA","NA"],
    [153,"153","Carrier M","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5910","ADDITION, ENDOSKELETAL SYSTEM, BELOW KNEE, ALIGNABLE SYSTEM","2","1",null,null,"36",null,null,null,null,"NA","NA"],
    [154,"154","Carrier M","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5940","(TITANIUM, CARBON FIBER OR EQUAL) ADDITION, ENDOSKELETAL SYSTEM, BELOW KNEE, ULTRA-LIGHT MATERIAL","2","1",null,null,"36",null,null,null,null,"NA","NA"],
    [155,"155","Carrier M","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5986","EQUAL) ALL LOWER EXTREMITY PROSTHESES, MULTI-AXIAL ROTATION UNIT (\"MCP\" OR","2","1",null,null,"36",null,null,null,null,"NA","NA"],
    [156,"156","Carrier M","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5987","ALL LOWER EXTREMITY PROSTHESIS, SHANK FOOT SYSTEM WITH VERTICAL LOADING PYLON.","2","1",null,null,"36",null,null,null,null,"NA","NA"],
    [157,"157","Carrier M","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8420","PROSTHETIC SOCK, MULTIPLE PLY, BELOW KNEE, EACH","2","1",null,null,"36",null,null,null,null,"NA","NA"],
    [158,"158","Carrier A","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0466","HOME VENT NON-INVASIVE INTER","1","1",null,"19.4",null,null,null,null,null,"NA","NA"],
    [159,"159","Carrier A","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2599","Accessory for speech generating device, not otherwise classified","1","1",null,null,"45.8",null,null,null,null,"NA","NA"],
    [160,"160","Carrier A","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","Cont Airway Pressure Device","226","0.95",null,null,"2.3",null,null,null,null,"NA","NA"],
    [161,"161","Carrier A","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without backup rate","10","0.8",null,null,"17.4","496",null,null,null,"NA","NA"],
    [162,"162","Carrier A","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate","5","0.8",null,null,"5.4",null,null,null,null,"NA","NA"],
    [163,"163","Carrier A","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0748","Elec Osteogen Stim Spinal","9","0.56",null,null,"51.9",null,null,null,null,"NA","NA"],
    [164,"164","Carrier A","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0747","Elec Osteogen Stim Not Spine","2","0.5",null,null,"121.5",null,null,null,null,"NA","NA"],
    [165,"165","Carrier A","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1399","Durable Medical Equipment Mi","10","0.2",null,null,"107.3",null,null,null,null,"NA","NA"],
    [166,"166","Carrier A","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0637","Combination sit to stand system, any size, with seat lift feature, with or without wheels","2","0",null,null,"112.7",null,null,null,null,"NA","NA"],
    [167,"167","Carrier A","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1233","Wheelchair, Pediatric Size, Tilt-In-Space, Rigid, Adj, Wo Seating","1","0",null,null,"81.1",null,null,null,null,"NA","NA"],
    [168,"168","Carrier A","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0240","Bath/shower chair, with or without wheels, any size","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [169,"169","Carrier A","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2213","Pneumatic prop tire insert","1","0",null,null,"81.1",null,null,null,null,"NA","NA"],
    [170,"170","Carrier A","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0973","Wheelchair Adjustabl Height","1","0",null,null,"81.1",null,null,null,null,"NA","NA"],
    [171,"171","Carrier A","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0978","Wheelchair Belt W/Airplane B","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [172,"172","Carrier A","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1028","Wheelchair accessory, manual swingaway, retractable or removable mounting hardware","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [173,"173","Carrier A","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2231","Solid seat support base","1","0",null,null,"81.1",null,null,null,null,"NA","NA"],
    [174,"174","Carrier A","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0445","Oximeter Device For Measuring Blood Oxygen Levels Non-Invasively","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [175,"175","Carrier A","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0562","Humidifier, heated, used with positive airway pressure device","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [176,"176","Carrier A","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2221","Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","1","0",null,null,"81.1",null,null,null,null,"NA","NA"],
    [177,"177","Carrier A","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2613","Position back cush wd <22in","1","0",null,null,"81.1",null,null,null,null,"NA","NA"],
    [178,"178","Carrier A","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2607","Skin pro/pos wc cus wd <22in","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [179,"179","Carrier A","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0950","Tray","1","0",null,null,"81.1",null,null,null,null,"NA","NA"],
    [180,"180","Carrier A","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E8001","Upright gait trainer","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [181,"181","Carrier A","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0956","Wheelchair accessory, lateral trunk or hip support, prefabricated, including fixed mounting hardware, each","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [182,"182","Carrier A","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0957","Wheelchair accessory, medial thigh support, prefabricated, including fixed mounting hardware, each","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [183,"183","Carrier A","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2599","Accessory for speech generating device, not otherwise classified","1","1",null,null,"45.8",null,null,null,null,"NA","NA"],
    [184,"184","Carrier A","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0466","HOME VENT NON-INVASIVE INTER","1","1",null,"19.4",null,null,null,null,null,"NA","NA"],
    [185,"185","Carrier A","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0601","Cont Airway Pressure Device","226","0.95",null,null,"2.3",null,null,null,null,"NA","NA"],
    [186,"186","Carrier A","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without backup rate","10","0.8",null,null,"17.4",null,null,null,null,"NA","NA"],
    [187,"187","Carrier A","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate","5","0.8",null,null,"5.4",null,null,null,null,"NA","NA"],
    [188,"188","Carrier A","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0748","Elec Osteogen Stim Spinal","9","0.56",null,null,"51.9",null,null,null,null,"NA","NA"],
    [189,"189","Carrier A","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0747","Elec Osteogen Stim Not Spine","2","0.5",null,null,"121.5",null,null,null,null,"NA","NA"],
    [190,"190","Carrier A","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1399","Durable Medical Equipment Mi","10","0.2",null,null,"107.3",null,null,null,null,"NA","NA"],
    [191,"191","Carrier A","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0637","Combination sit to stand system, any size, with seat lift feature, with or without wheels","2","0",null,null,"112.7",null,null,null,null,"NA","NA"],
    [192,"192","Carrier A","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1028","Wheelchair accessory, manual swingaway, retractable or removable mounting hardware","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [193,"193","Carrier A","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2221","Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","1","0",null,null,"81.1",null,null,null,null,"NA","NA"],
    [194,"194","Carrier A","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0973","Wheelchair Adjustabl Height","1","0",null,null,"81.1",null,null,null,null,"NA","NA"],
    [195,"195","Carrier A","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0978","Wheelchair Belt W/Airplane B","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [196,"196","Carrier A","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2231","Solid seat support base","1","0",null,null,"81.1",null,null,null,null,"NA","NA"],
    [197,"197","Carrier A","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1233","Wheelchair, Pediatric Size, Tilt-In-Space, Rigid, Adj, Wo Seating","1","0",null,null,"81.1",null,null,null,null,"NA","NA"],
    [198,"198","Carrier A","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0562","Humidifier, heated, used with positive airway pressure device","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [199,"199","Carrier A","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2213","Pneumatic prop tire insert","1","0",null,null,"81.1",null,null,null,null,"NA","NA"],
    [200,"200","Carrier A","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2613","Position back cush wd <22in","1","0",null,null,"81.1",null,null,null,null,"NA","NA"],
    [201,"201","Carrier A","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0445","Oximeter Device For Measuring Blood Oxygen Levels Non-Invasively","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [202,"202","Carrier A","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0240","Bath/shower chair, with or without wheels, any size","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [203,"203","Carrier A","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2607","Skin pro/pos wc cus wd <22in","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [204,"204","Carrier A","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0950","Tray","1","0",null,null,"81.1",null,null,null,null,"NA","NA"],
    [205,"205","Carrier A","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E8001","Upright gait trainer","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [206,"206","Carrier A","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0956","Wheelchair accessory, lateral trunk or hip support, prefabricated, including fixed mounting hardware, each","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [207,"207","Carrier A","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0957","Wheelchair accessory, medial thigh support, prefabricated, including fixed mounting hardware, each","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [208,"208","Carrier N","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0766","ELEC STIM CANCER TREATMENT","2","1",null,null,"96",null,null,null,null,"NA","NA"],
    [209,"209","Carrier N","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0760","OSTEOGEN ULTRASOUND STIMLTOR","2","1",null,null,"24",null,null,null,null,"NA","NA"],
    [210,"210","Carrier N","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E1002","PWR SEAT TILT","1","1",null,null,"72",null,null,null,null,"NA","NA"],
    [211,"211","Carrier N","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0748","ELEC OSTEOGEN STIM SPINAL","1","1",null,null,"48",null,null,null,null,"NA","NA"],
    [212,"212","Carrier N","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","K0856","PWC GP3 STD SING POW OPT S/B","1","1",null,null,"72",null,null,null,null,"NA","NA"],
    [213,"213","Carrier N","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L8614","COCHLEAR DEVICE","1","1",null,null,"48",null,null,null,null,"NA","NA"],
    [214,"214","Carrier N","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0747","ELEC OSTEOGEN STIM NOT SPINE","1","0",null,null,"48",null,null,null,null,"NA","NA"],
    [215,"215","Carrier N","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E2300","PWR SEAT ELEVATION SYS","1","0",null,null,"72",null,null,null,null,"NA","NA"],
    [216,"216","Carrier N","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L8699","PROSTHETIC IMPLANT NOS","1","0",null,null,"72",null,null,null,null,"NA","NA"],
    [217,"217","Carrier N","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0766","ELEC STIM CANCER TREATMENT","2","1",null,null,"96",null,null,null,null,"NA","NA"],
    [218,"218","Carrier N","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0760","OSTEOGEN ULTRASOUND STIMLTOR","2","1",null,null,"24",null,null,null,null,"NA","NA"],
    [219,"219","Carrier N","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E1002","PWR SEAT TILT","1","1",null,null,"72",null,null,null,null,"NA","NA"],
    [220,"220","Carrier N","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0748","ELEC OSTEOGEN STIM SPINAL","1","1",null,null,"48",null,null,null,null,"NA","NA"],
    [221,"221","Carrier N","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","K0856","PWC GP3 STD SING POW OPT S/B","1","1",null,null,"72",null,null,null,null,"NA","NA"],
    [222,"222","Carrier N","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L8614","COCHLEAR DEVICE","1","1",null,null,"48",null,null,null,null,"NA","NA"],
    [223,"223","Carrier N","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0747","ELEC OSTEOGEN STIM NOT SPINE","1","0",null,null,"48",null,null,null,null,"NA","NA"],
    [224,"224","Carrier N","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E2300","PWR SEAT ELEVATION SYS","1","0",null,null,"72",null,null,null,null,"NA","NA"],
    [225,"225","Carrier N","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L8699","PROSTHETIC IMPLANT NOS","1","0",null,null,"72",null,null,null,null,"NA","NA"],
    [226,"226","Carrier B","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","B9004","PARENTERAL NUTRITION INFUSION PUMP PORTABLE","14","1",null,"0","218.62","0",null,null,null,"NA","NA"],
    [227,"227","Carrier B","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","B9002","ENTERAL NUTRITION INFUSION PUMP WITH ALARM","12","1",null,"26.15","84.31","0",null,null,null,"NA","NA"],
    [228,"228","Carrier B","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","CONTINUOUS AIRWAY PRESSURE (CPAP) DEVICE","514","0.95",null,"28.76","129.91","0",null,null,null,"NA","NA"],
    [229,"229","Carrier B","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0471","RESPIRATORY DEVICE/BI-LEVEL PRESSURE CAPABILITY WITH BACKUP RATE FEATURE WITH NONINVASIVE INTERFACE","20","0.95",null,"35.48","111.49","0",null,null,null,"NA","NA"],
    [230,"230","Carrier B","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1390","OXYGEN  CONCENTRATOR/1 DELIVERY PORTABLE/CAPABLE OF DELIVERNG 85% OR>OXYGEN  CONCENTRATION","154","0.94",null,"24.31","191.52","0",null,null,null,"NA","NA"],
    [231,"231","Carrier B","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0781","AMBULATORY INFUSION PUMP SINGLE OR MULTIPLE  CHANNELS WORN BY PATIENT","96","0.93",null,"54.37","125.18","0",null,null,null,"NA","NA"],
    [232,"232","Carrier B","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0466","HOME VENTILATOR TYPE USED NON-INVASIVE INTERFACE","14","0.93",null,"21.4","108.13","0",null,null,null,"NA","NA"],
    [233,"233","Carrier B","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2402","NEGATIVE PRESSURE WOUND THERAPY ELECTRICAL PUMP, STATIONARY OR PORTABLE","31","0.87",null,"0","165.58","0",null,null,null,"NA","NA"],
    [234,"234","Carrier B","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0470","RESPIRATORY DEVICE/BI-LEVEL PRESSURE CAPABILITY WITHOUT BACKUP RATE FEATURE WITH NONINVASIVE INTERFACE","21","0.81",null,"0","129.03","0",null,null,null,"NA","NA"],
    [235,"235","Carrier B","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0935","PASSIVE MOTION EXERCISE DEVICE","10","0.8",null,"66.32","144.16","0",null,null,null,"NA","NA"],
    [236,"236","Carrier B","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","B9004","PARENTERAL NUTRITION INFUSION PUMP PORTABLE","14","1",null,"0","218.62","0",null,null,null,"NA","NA"],
    [237,"237","Carrier B","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","B9002","ENTERAL NUTRITION INFUSION PUMP WITH ALARM","12","1",null,"26.15","84.31","0",null,null,null,"NA","NA"],
    [238,"238","Carrier B","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0791","PARENTERAL INFUSION PUMP STATIONARY SINGLE OR MULTICHANNEL","7","1",null,"0","169.11","0",null,null,null,"NA","NA"],
    [239,"239","Carrier B","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0739","REPAIR OR NONROUTINE SERVICE ON DURABLE MEDICAL EQUIPMENT OTHER THAN OXYGEN EQUIPMENT","5","1",null,"0","44.18","0",null,null,null,"NA","NA"],
    [240,"240","Carrier B","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0260","HOSPITAL BED SEMI-ELECTRIC WITH ANY RAILS  WITH MATTRESS","5","1",null,"0","228.24","0",null,null,null,"NA","NA"],
    [241,"241","Carrier B","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0760","OSTEOGENESIS STIMULATOR-LOW INTENSITY ULTRASOUND NON-INVASIVE","4","1",null,"0","136.65","0",null,null,null,"NA","NA"],
    [242,"242","Carrier B","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0483","HIGH FREQUENCY CHEST WALL OSCILLATION SYSTEM, INCLUDES ALL ACCESSORIES AND SUPPLIES","4","1",null,"0","211.55","0",null,null,null,"NA","NA"],
    [243,"243","Carrier B","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0003","LIGHTWEIGHT WHEELCHAIR","4","1",null,"28.06","78.01","0",null,null,null,"NA","NA"],
    [244,"244","Carrier B","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0565","COMPRESSOR AIR POWER SOURCE EQUIPMENT","3","1",null,"29.03","119.6","0",null,null,null,"NA","NA"],
    [245,"245","Carrier B","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0108","OTHER ACCESSORY","3","1",null,"0","78.23","0",null,null,null,"NA","NA"],
    [246,"246","Carrier C","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A7034","NASAL APPLICATION DEVICE","4096","1",null,"1.78","50.04",null,null,null,null,"NA","NA"],
    [247,"247","Carrier C","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0603","DME ELECTRIC BREAST PUMP KIT PURCHASE","1263","1",null,"3.28","13.36",null,null,null,null,"NA","NA"],
    [248,"248","Carrier C","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0118","CRUTCH SUBSTITUTE, LOWER LEG PLATFORM, WITH OR WITHOUT WHEELS, EACH","451","0.99",null,"5.48","288.24","0",null,null,null,"NA","NA"],
    [249,"249","Carrier C","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0143","WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT","545","0.98",null,"8.52","153.8",null,null,null,null,"NA","NA"],
    [250,"250","Carrier C","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L4361","PNEUMATIC, WALKING BOOT","517","0.98",null,"5.24","105.74",null,null,null,null,"NA","NA"],
    [251,"251","Carrier C","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A7030","CPAP FULL FACE MASK","516","0.98",null,"0.84","28.42",null,null,null,null,"NA","NA"],
    [252,"252","Carrier C","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0114","CRUTCHES METAL UNDERARM PAIR","475","0.98",null,"1.83","125.98",null,null,null,null,"NA","NA"],
    [253,"253","Carrier C","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0439","STATIONARY LIQUID 02","462","0.98",null,"3.84","116.45",null,null,null,null,"NA","NA"],
    [254,"254","Carrier C","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0604","DME ELECTRIC BREAST PUMP KIT RENTAL","1280","0.93",null,"14.68","164.9",null,null,null,null,"NA","NA"],
    [255,"255","Carrier C","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0601","CPAP DEVICE","3186","0.91",null,"4.53","162.26",null,null,null,null,"NA","NA"],
    [256,"256","Carrier C","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A7031","REPLACEMENT FACEMASK INTERFA","416","1",null,"22.75","816.21",null,null,null,null,"NA","NA"],
    [257,"257","Carrier C","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A7027","COMB ORAL/NASAL MASK USED W/CPAP DEVICE EA","365","1",null,"6.86","596.81",null,null,null,null,"NA","NA"],
    [258,"258","Carrier C","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","94762","NONINVASIVE EAR/PULSE OXIM O2 SAT CONT OVERNIGHT","79","1",null,"12.3","142.81",null,null,null,null,"NA","NA"],
    [259,"259","Carrier C","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A7032","CUSHN NASAL MASK INTERFACE REPLACEMENT ONLY EACH","76","1",null,null,"52.87",null,null,null,null,"NA","NA"],
    [260,"260","Carrier C","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0445","OXIMETER DEVICE FOR MEASURING BLOOD OXYGEN LEVELS, NON INVASIVE","64","1",null,"3.56","76.61",null,null,null,null,"NA","NA"],
    [261,"261","Carrier C","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","S9497","HIT ANTIBIOTIC Q3H DIEM","56","1",null,"6.94","91.48",null,null,null,null,"NA","NA"],
    [262,"262","Carrier C","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L1846","KO W ADJ FLEX/EXT ROTAT MOLD","51","1",null,"1.34","84.28",null,null,null,null,"NA","NA"],
    [263,"263","Carrier C","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4361","OSTOMY FACE PLATE","48","1",null,"29.1","7.62",null,null,null,null,"NA","NA"],
    [264,"264","Carrier C","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0849","TRACTION EQUIP,CERVICAL,FREE STAND,TRACTION FORCE OTHER THAN MANDIBLE","47","1",null,"1.24","60.58",null,null,null,null,"NA","NA"],
    [265,"265","Carrier C","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0100","CANES OF ANY MATERIAL","46","1",null,"0.98","267.66",null,null,null,null,"NA","NA"],
    [266,"266","Carrier C","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0483","HIGH FREQ CHEST WALL OCSILLATION SYSTEM, INCL ALL ACCESSORIES/SUPPLIES, EA","7","0","0.29",null,"227.38","0",null,null,null,"NA","NA"],
    [267,"267","Carrier C","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L5701","REPLACE SOCKET AB KNEE/KNEE","6","0","0.17",null,"598.09",null,null,null,null,"NA","NA"],
    [268,"268","Carrier C","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E2510","SPEECH GENERATING DEVICE, SYNTHESIZED SPEECH","8","0","0.13",null,"759.75","0",null,null,null,"NA","NA"],
    [269,"269","Carrier C","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L5301","BK MOLD SOCKET SACH FT ENDO","17","0","0.06",null,"733.66",null,null,null,null,"NA","NA"],
    [270,"270","Carrier C","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","B4150","ENTERAL FORMULAE CATEGORY I","39","0","0.05","31.66","641.68",null,null,null,null,"NA","NA"],
    [271,"271","Carrier C","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0691","UV LIGHT THERAPY SYS, INCL BULBS/LAMPS/TIMER/EYE PROT; TX AREA 2 SQ FT OR <","26","0","0.04","35.97","234.88",null,null,null,null,"NA","NA"],
    [272,"272","Carrier C","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L1970","AFO PLASTIC MOLDED W/ANKLE J","47","0","0.02","1.29","242.97",null,null,null,null,"NA","NA"],
    [273,"273","Carrier C","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A6549","GRADIENT COMPRESSION STOCKING/SLEEVE NOS","122","0","0.01","16.43","503.16",null,null,null,null,"NA","NA"],
    [274,"274","Carrier C","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0485","ORAL DEVICE/APPLIANCE PRE","73","0","0.01","3.95","411.01","0",null,null,null,"NA","NA"],
    [275,"275","Carrier C","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E2402","NEGATIVE PRESSURE WOUND THERAPY ELECT PUMP, STATIONARY OR PORTABLE","263","0","0","29.09","396.45",null,null,null,null,"NA","NA"],
    [276,"276","Carrier D","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A7034","NASAL APPLICATION DEVICE","1033","1",null,"1.8","128.7",null,null,null,null,"NA","NA"],
    [277,"277","Carrier D","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0603","ELECTRIC BREAST PUMP","452","1",null,"3.6","14.6",null,null,null,null,"NA","NA"],
    [278,"278","Carrier D","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A7031","REPLACEMENT FACEMASK INTERFA","194","1",null,"11.1","732.6",null,null,null,null,"NA","NA"],
    [279,"279","Carrier D","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L3660","SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND","147","1",null,null,"172.1",null,null,null,null,"NA","NA"],
    [280,"280","Carrier D","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A7027","COMB ORAL/NASAL MASK USED W/CPAP DEVICE EA","143","1",null,"7.1","427.1",null,null,null,null,"NA","NA"],
    [281,"281","Carrier D","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0439","STATIONARY LIQUID 02","155","0.99",null,"4.7","179.8",null,null,null,null,"NA","NA"],
    [282,"282","Carrier D","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A7030","CPAP FULL FACE MASK","138","0.99",null,"2.2","238.2",null,null,null,null,"NA","NA"],
    [283,"283","Carrier D","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0143","WALKER FOLDING WHEELED W/","136","0.99",null,"24.2","423.6",null,null,null,null,"NA","NA"],
    [284,"284","Carrier D","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0601","CPAP DEVICE","1318","0.95",null,"3.8","126.4",null,null,null,null,"NA","NA"],
    [285,"285","Carrier D","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0604","HOSP GRADE ELEC BREAST PU","435","0.89",null,"4.9","168.1",null,null,null,null,"NA","NA"],
    [286,"286","Carrier D","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A7031","REPLACEMENT FACEMASK INTERFA","194","1",null,"11.1","732.6",null,null,null,null,"NA","NA"],
    [287,"287","Carrier D","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L3660","SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND","147","1",null,null,"172.1",null,null,null,null,"NA","NA"],
    [288,"288","Carrier D","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A7027","COMB ORAL/NASAL MASK USED W/CPAP DEVICE EA","143","1",null,"7.1","427.1",null,null,null,null,"NA","NA"],
    [289,"289","Carrier D","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L3260","POST-OP SHOE CANVAS","56","1",null,null,"84.2",null,null,null,null,"NA","NA"],
    [290,"290","Carrier D","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L3809","WRIST THUMB SPICA","55","1",null,null,"303.9",null,null,null,null,"NA","NA"],
    [291,"291","Carrier D","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","S9500","HIT ANTIBIOTIC Q24H DIEM","44","1",null,"4.1","115",null,null,null,null,"NA","NA"],
    [292,"292","Carrier D","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L3670","SHLDER IMMOB W/ABDUCTION PILLOW","42","1",null,null,"274.6",null,null,null,null,"NA","NA"],
    [293,"293","Carrier D","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L4205","ORTHO DVC REPAIR PER 15 M","35","1",null,"1.9","232.1",null,null,null,null,"NA","NA"],
    [294,"294","Carrier D","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","S9379","HIT NOC PER DIEM","31","1",null,"6.3","91.4",null,null,null,null,"NA","NA"],
    [295,"295","Carrier D","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E1390","OXYGEN CONCENTRATOR","25","1",null,"6.2","861.5",null,null,null,null,"NA","NA"],
    [296,"296","Carrier D","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0986","MAN W/C PUSH-RIM POWR SYS","1","0","1",null,"256.9","0",null,null,null,"NA","NA"],
    [297,"297","Carrier D","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E2622","ADJ SKIN PRO W/C CUS WD<2","2","0","0.5",null,"388.4","0",null,null,null,"NA","NA"],
    [298,"298","Carrier D","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","B4161","ENTERAL FORM,PEDS, HYDROLYZED/AMINO ACID/PEPTIDE CHAIN PROT,100 CAL=1 UN","13","0","0.15",null,"486.1","0",null,null,null,"NA","NA"],
    [299,"299","Carrier D","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A6533","GRADIENT COMPRESSION STK THIGH LEN 18-30 MMHG EA","8","0","0.13",null,"528.6","0",null,null,null,"NA","NA"],
    [300,"300","Carrier D","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0652","PNEUMATIC COMPRESS SEGMNT W GRAD","11","0","0.09",null,"417.2","0",null,null,null,"NA","NA"],
    [301,"301","Carrier D","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0766","ELECT STIMULATION DEV USED FOR CANCER TX, INCL ALL ACCESS, ANY TYPE","14","0","0.07",null,"551.3","0",null,null,null,"NA","NA"],
    [302,"302","Carrier D","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","K0739","REPAIR OR NONROUTN SVC DME OTHER THAN O2 EQUIP,REQ TECH SKILL,PER 15 MINS","41","0","0.02","13.4","569.5","0",null,null,null,"NA","NA"],
    [303,"303","Carrier D","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E2402","NEGATIVE PRESSURE WOUND THERAPY ELECT PUMP, STATIONARY OR PORTABLE","93","0","0.01","32.8","1022.2","0",null,null,null,"NA","NA"],
    [304,"304","Carrier D","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0601","CPAP DEVICE","1318","0","0","3.8","126.4","0",null,null,null,"NA","NA"],
    [305,"305","Carrier E","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0143","WALKER FOLDING WHEELED W/O S","154","1",null,"1.5","28.8",null,null,null,null,"NA","NA"],
    [306,"306","Carrier E","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0570","NEBULIZER WITH COMPRESSOR","96","1",null,"9.3","12.6","216",null,null,null,"NA","NA"],
    [307,"307","Carrier E","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0202","PHOTOTHERAPY LIGHT W/ PHOTOM","28","1",null,"4.8","24.6",null,null,null,null,"NA","NA"],
    [308,"308","Carrier E","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L1970","AFO PLASTIC MOLDED W/ANKLE J","25","1",null,null,"30.8",null,null,null,null,"NA","NA"],
    [309,"309","Carrier E","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1390","OXYGEN CONCENTRATOR","79","0.99",null,"4.3","22.6",null,null,null,null,"NA","NA"],
    [310,"310","Carrier E","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L1852","KNEE ORTHOSIS DOUBLE UPRIGHT THIGH AND CALF","58","0.98",null,null,"29.1",null,null,null,null,"NA","NA"],
    [311,"311","Carrier E","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A5500","DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE","54","0.98",null,null,"33.7",null,null,null,null,"NA","NA"],
    [312,"312","Carrier E","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0604","BREAST PUMP HEAVY DUTY HOSP GRADE PISTON OP","131","0.97",null,"5","17.4",null,null,null,null,"NA","NA"],
    [313,"313","Carrier E","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L0464","TLSO 4MOD SACRO-SCAP PRE","27","0.93",null,"1.8","39.2",null,null,null,null,"NA","NA"],
    [314,"314","Carrier E","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0730","TENS DEVICE 4/MORE LEADS MULTI NERVE STIMULATION","102","0.89",null,null,"33",null,null,null,null,"NA","NA"],
    [315,"315","Carrier E","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0143","WALKER FOLDING WHEELED W/O S","154","1",null,"1.5","28.8",null,null,null,null,"NA","NA"],
    [316,"316","Carrier E","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0570","NEBULIZER WITH COMPRESSOR","96","1",null,"9.3","12.6",null,null,null,null,"NA","NA"],
    [317,"317","Carrier E","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0202","PHOTOTHERAPY LIGHT W/ PHOTOM","28","1",null,"4.8","24.6",null,null,null,null,"NA","NA"],
    [318,"318","Carrier E","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L1970","AFO PLASTIC MOLDED W/ANKLE J","25","1",null,null,"30.8",null,null,null,null,"NA","NA"],
    [319,"319","Carrier E","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0001","STANDARD WHEELCHAIR","25","1",null,"0.3","13.8",null,null,null,null,"NA","NA"],
    [320,"320","Carrier E","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0693","UV LT TX SYS PANL W/BULBS/LAMPS TIMER 6 FT PANEL","24","1",null,null,"23.6",null,null,null,null,"NA","NA"],
    [321,"321","Carrier E","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0260","HOSP BED SEMI-ELECTR W/ MATT","23","1",null,"0.4","15.5",null,null,null,null,"NA","NA"],
    [322,"322","Carrier E","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2402","NEG PRESS WOUND THERAPY PUMP","19","1",null,null,"9.3",null,null,null,null,"NA","NA"],
    [323,"323","Carrier E","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0691","UV LIGHT TX SYS BULB/LAMP TIMER; TX 2 SQ FT/LESS","18","1",null,null,"27.3",null,null,null,null,"NA","NA"],
    [324,"324","Carrier E","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A6212","FOAM DRESS STERL PAD SZ 16 SQ/> W/ADHES BORDR EA","16","1",null,null,"31.4",null,null,null,null,"NA","NA"],
    [325,"325","Carrier E","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E1399","DURABLE MEDICAL EQUIPMENT MISC","5","0","0.2",null,"35.7",null,null,null,null,"NA","NA"],
    [326,"326","Carrier F","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0486","Oral Device/appliance Cusfab","5","1",null,null,"24",null,null,null,null,"NA","NA"],
    [327,"327","Carrier F","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0108","Wheelchair Component Or Accessory, Not Otherwise Specified","1","1",null,null,"120",null,null,null,null,"NA","NA"],
    [328,"328","Carrier F","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L2755","Addition To Lower Extremity Orthosis Carbon Graphite Lamination","1","1",null,null,"96",null,null,null,null,"NA","NA"],
    [329,"329","Carrier F","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L1945","Afo, Molded To Patient Model, Plastic, Rigid Anterior Tibial Section","1","1",null,null,"96",null,null,null,null,"NA","NA"],
    [330,"330","Carrier F","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S1040","Cranial Remolding Orthosis, Rigid, With Soft Interface Material, Custom Fabricated, Includes Fitting And Adjustment(s)","2","0.5",null,null,"36",null,null,null,null,"NA","NA"],
    [331,"331","Carrier F","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0760","Osteogenesis Stimulator Low Intensity Ultrasound Noninvasive","1","0",null,null,"120",null,null,null,null,"NA","NA"],
    [332,"332","Carrier F","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L0650","Lumbar-sacral orthosis (LSO), sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to T-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf","6","1",null,null,"89",null,null,null,null,"NA","NA"],
    [333,"333","Carrier F","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A6550","Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","5","1",null,"34","153",null,null,null,null,"NA","NA"],
    [334,"334","Carrier F","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A7000","Canister, disposable, used with suction pump, each","5","1",null,"34","153",null,null,null,null,"NA","NA"],
    [335,"335","Carrier F","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2402","Negative pressure wound therapy electrical pump, stationary or portable","5","1",null,"34","153",null,null,null,null,"NA","NA"],
    [336,"336","Carrier F","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L2755","Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","5","1",null,null,"88",null,null,null,null,"NA","NA"],
    [337,"337","Carrier F","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0486","Oral Device/appliance Cusfab","5","1",null,null,"24",null,null,null,null,"NA","NA"],
    [338,"338","Carrier F","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0108","Wheelchair Component Or Accessory, Not Otherwise Specified","1","1",null,null,"120",null,null,null,null,"NA","NA"],
    [339,"339","Carrier F","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L2755","Addition To Lower Extremity Orthosis Carbon Graphite Lamination","1","1",null,null,"96",null,null,null,null,"NA","NA"],
    [340,"340","Carrier F","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L1945","Afo, Molded To Patient Model, Plastic, Rigid Anterior Tibial Section","1","1",null,null,"96",null,null,null,null,"NA","NA"],
    [341,"341","Carrier F","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S1040","Cranial Remolding Orthosis, Rigid, With Soft Interface Material, Custom Fabricated, Includes Fitting And Adjustment(s)","2","0.5",null,null,"36",null,null,null,null,"NA","NA"],
    [342,"342","Carrier F","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0694","Ultraviolet multidirectional light therapy system in 6 ft cabinet, includes bulbs/lamps, timer, and eye protection","4","0","0.25","29","76",null,null,null,null,"NA","NA"],
    [343,"343","Carrier F","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","A9276","Sensor; invasive (e.g., subcutaneous), disposable, for use with interstitial continuous glucose monitoring system, 1 unit = 1 day supply","38","0","0.03","31","100",null,null,null,null,"NA","NA"],
    [344,"344","Carrier G","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0784","EXTERNAL AMBULATORY INFUSION PUMP INSULIN","13","1",null,"14.8","98.5",null,null,null,null,"NA","NA"],
    [345,"345","Carrier G","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","V2624","POLISHING/RESURFACING OF OCULAR PROSTHESIS","5","1",null,null,"44.7",null,null,null,null,"NA","NA"],
    [346,"346","Carrier G","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4230","INFUS SET EXT INSULIN PUMP NONNDLE CANNULA TYPE","10","0.8",null,"14.8","35.4",null,null,null,null,"NA","NA"],
    [347,"347","Carrier G","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A9276","SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U Equal to 1D","29","0.79",null,"8.5","29.2",null,null,null,null,"NA","NA"],
    [348,"348","Carrier G","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4232","SYRINGE W/NDLE EXTERNAL INSULIN PUMP STERILE 3CC","9","0.78",null,"14.8","38.5",null,null,null,null,"NA","NA"],
    [349,"349","Carrier G","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A9277","TRANSMITTER; EXT INTERSTITIAL CONT GLU MON SYS","13","0.77",null,"12.2","22",null,null,null,null,"NA","NA"],
    [350,"350","Carrier G","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0294","HOSPITAL BED SEMI-ELEC W/O SIDE RAILS W/MATTRSS","4","0.75",null,null,"91",null,null,null,null,"NA","NA"],
    [351,"351","Carrier G","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","K0606","AUTO EXT DEFIB W/INTGR ECG ANALY GARMENT TYPE","5","0.6",null,"98.8","100.9",null,null,null,null,"NA","NA"],
    [352,"352","Carrier G","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0652","PNEUMAT COMPRS SEG HOM MDL W/CALBRTD GRADNT PRSS","7","0.43",null,null,"79.2",null,null,null,null,"NA","NA"],
    [353,"353","Carrier G","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0601","CONTINUOUS POSITIVE AIRWAY PRESSURE DEVICE","4","0",null,null,"62.6",null,null,null,null,"NA","NA"],
    [354,"354","Carrier G","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0784","EXTERNAL AMBULATORY INFUSION PUMP INSULIN","13","1",null,"14.8","95.5",null,null,null,null,"NA","NA"],
    [355,"355","Carrier G","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","V2624","POLISHING/RESURFACING OF OCULAR PROSTHESIS","5","1",null,null,"44.7",null,null,null,null,"NA","NA"],
    [356,"356","Carrier G","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E2611","GEN WC BACK CUSHN WDTH  LT  22 IN HT MOUNT HARDWARE","3","1",null,"22.4","77.1",null,null,null,null,"NA","NA"],
    [357,"357","Carrier G","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A6550","WND CARE SET NEG PRSS WND TX ELEC PUMP SPL","3","1",null,"49.2","124.7",null,null,null,null,"NA","NA"],
    [358,"358","Carrier G","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A7000","CANISTER DISPOSABLE USED WITH SUCTION PUMP EACH","3","1",null,"49.2","124.7",null,null,null,null,"NA","NA"],
    [359,"359","Carrier G","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E2402","NEG PRESS WOUND THERAPY ELEC PUMP STATION/PRTBLE","3","1",null,"49.2","124.7",null,null,null,null,"NA","NA"],
    [360,"360","Carrier G","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E2624","SKIN PROTECT  and  POSITIONING WC CUSH WIDTH  LT  22 IN","3","1",null,"22.4","32.9",null,null,null,null,"NA","NA"],
    [361,"361","Carrier G","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L1960","AFO POSTERIOR SOLID ANK PLASTIC CUSTOM FAB","3","1",null,null,"93.7",null,null,null,null,"NA","NA"],
    [362,"362","Carrier G","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0295","HOSP BED SEMI-ELEC W/O SIDE RAILS W/O MATTRSS","2","1",null,"17.3","326.1",null,null,null,null,"NA","NA"],
    [363,"363","Carrier G","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","K0108","OTHER ACCESSORIES","2","1",null,"22.4","4.9",null,null,null,null,"NA","NA"],
    [364,"364","Carrier G","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","V2623","PROSTHETIC EYE PLASTIC CUSTOM","1","0","1",null,"140.8",null,null,null,null,"NA","NA"],
    [365,"365","Carrier G","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0766","ELEC STIM DVC U CANCER TX INCL ALL ACC ANY TYPE","2","0","0.5",null,"77.3",null,null,null,null,"NA","NA"],
    [366,"366","Carrier G","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","V2628","FABRICATION AND FITTING OF OCULAR CONFORMER","2","0","0.5",null,"72.2",null,null,null,null,"NA","NA"],
    [367,"367","Carrier G","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","V2627","SCLERAL COVER SHELL","2","0","0.5",null,"72.2",null,null,null,null,"NA","NA"],
    [368,"368","Carrier G","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E1399","DURABLE MEDICAL EQUIPMENT MISCELLANEOUS","3","0","0.33","5.6","64.7",null,null,null,null,"NA","NA"],
    [369,"369","Carrier G","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L8699","PROSTHETIC IMPLANT NOT OTHERWISE SPECIFIED","3","0","0.33",null,"215.4",null,null,null,null,"NA","NA"],
    [370,"370","Carrier G","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0667","SEG PNEUMAT APPLINC W/PNEUMAT COMPRS FULL LEG","3","0","0.33",null,"63",null,null,null,null,"NA","NA"],
    [371,"371","Carrier G","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0652","PNEUMAT COMPRS SEG HOM MDL W/CALBRTD GRADNT PRSS","7","0","0.29",null,"79.2",null,null,null,null,"NA","NA"],
    [372,"372","Carrier G","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A4232","SYRINGE W/NDLE EXTERNAL INSULIN PUMP STERILE 3CC","9","0","0.11","14.8","38.5",null,null,null,null,"NA","NA"],
    [373,"373","Carrier G","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A4230","INFUS SET EXT INSULIN PUMP NONNDLE CANNULA TYPE","10","0","0.1","14.8","35.4",null,null,null,null,"NA","NA"],
    [374,"374","Carrier H","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0486","Oral Device/appliance Cusfab","284","0.99",null,null,"3.39",null,null,null,null,"NA","NA"],
    [375,"375","Carrier H","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L8680","Implantable Neurostimulator Electrode Each","26","0.93",null,null,"143.35",null,null,null,null,"NA","NA"],
    [376,"376","Carrier H","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0005","Ultralightweight Wheelchair","28","0.86",null,null,"102.77","9.2",null,null,null,"NA","NA"],
    [377,"377","Carrier H","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0108","Wheelchair Component Or Accessory, Not Otherwise Specified","87","0.78",null,null,"102.04",null,null,null,null,"NA","NA"],
    [378,"378","Carrier H","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S1040","Cranial Remolding Orthosis, Rigid, With Soft Interface Material, Custom Fabricated, Includes Fitting And Adjustment(s)","58","0.78",null,null,"76.54",null,null,null,null,"NA","NA"],
    [379,"379","Carrier H","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0652","Pneumatic Compressor, Segmental Home Model With Calibrated Gradient Pr","30","0.64",null,null,"66.98","164.4",null,null,null,"NA","NA"],
    [380,"380","Carrier H","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0606","Aed Garment With Electrocardiogram Analysis","25","0.64",null,"31.54","60",null,null,null,null,"NA","NA"],
    [381,"381","Carrier H","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0760","Osteogenesis Stimulator Low Intensity Ultrasound Noninvasive","38","0.6",null,null,"83.4","146.3",null,null,null,"NA","NA"],
    [382,"382","Carrier H","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0748","Osteogenic Stimulator, Noninvasive, Spinal Applications","57","0.43",null,null,"86.2",null,null,null,null,"NA","NA"],
    [383,"383","Carrier H","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0747","Osteogenesis Stimulator (non-invasive)","30","0.37",null,null,"82.38",null,null,null,null,"NA","NA"],
    [384,"384","Carrier H","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0861","Pwc Gp3 Std Mult Pow Opt S/b","13","1",null,null,"159.16",null,null,null,null,"NA","NA"],
    [385,"385","Carrier H","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2622","Skin Protection Wheelchair Seat Cushion, Adjustable, Width Less Than 22 Inches, Any Depth","11","1",null,null,"96",null,null,null,null,"NA","NA"],
    [386,"386","Carrier H","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8614","Cochlear Device/system","10","1",null,null,"91.64",null,null,null,null,"NA","NA"],
    [387,"387","Carrier H","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2617","Custom Fabricated Wheelchair Back Cushion, Any Size, Including Any Type","6","1",null,null,"63",null,null,null,null,"NA","NA"],
    [388,"388","Carrier H","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8619","Cochlear Implant External Speech Processor And Controller, Integrated System, Replacement","6","1",null,null,"54.86",null,null,null,null,"NA","NA"],
    [389,"389","Carrier H","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2609","Custom Fabricated Wheelchair Seat Cushion, Any Size","6","1",null,null,"66",null,null,null,null,"NA","NA"],
    [390,"390","Carrier H","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1161","Manual Adult Size Wheelchair, Includes Tilt In Space","6","1",null,null,"111.27",null,null,null,null,"NA","NA"],
    [391,"391","Carrier H","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0260","Hospital Bed, Seimi-electric (head And Foot Adjustment), With Any Type","5","1",null,null,"85.33",null,null,null,null,"NA","NA"],
    [392,"392","Carrier H","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8694","Auditory Osseointegrated Device, Transducer/actuator, Replacement Only, Each","5","1",null,null,"87.43",null,null,null,null,"NA","NA"],
    [393,"393","Carrier H","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8691","Auditory Osseointegrated Device, External Sound Processor, Excludes Transducer/actuator, Replacement Only, Each","5","1",null,null,"79.06",null,null,null,null,"NA","NA"],
    [394,"394","Carrier H","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","S1040","Cranial Remolding Orthosis, Rigid, With Soft Interface Material, Custom Fabricated, Includes Fitting And Adjustment(s)","58","0","1",null,"76.54",null,null,null,null,"NA","NA"],
    [395,"395","Carrier H","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0748","Osteogenic Stimulator, Noninvasive, Spinal Applications","57","0","1",null,"86.2",null,null,null,null,"NA","NA"],
    [396,"396","Carrier H","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L5856","Addition To Lower Extremity Prosthesis, Endoskeletal Knee-shin System,","4","0","1",null,"78",null,null,null,null,"NA","NA"],
    [397,"397","Carrier H","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0748","Osteogenic Stimulator, Noninvasive, Spinal Applications","3","0","1",null,"96",null,null,null,null,"NA","NA"],
    [398,"398","Carrier H","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L8690","Aud Osseo Dev, Int/ext Comp","2","0","1",null,"52.8",null,null,null,null,"NA","NA"],
    [399,"399","Carrier H","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0652","Pneumatic Compressor, Segmental Home Model With Calibrated Gradient Pr","30","0","0.6",null,"66.98",null,null,null,null,"NA","NA"],
    [400,"400","Carrier H","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0483","High Frequency Chest Wall Oscillation Air-pulse Generator System, (inc","11","0","0.5",null,"88.7",null,null,null,null,"NA","NA"],
    [401,"401","Carrier H","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0986","Manual Wheelchair Accessory, Push-rim Activated Power Assist, Each","1","0","0.5",null,"120",null,null,null,null,"NA","NA"],
    [402,"402","Carrier H","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","K0606","Aed Garment With Electrocardiogram Analysis","25","0","0.29","31.54","60",null,null,null,null,"NA","NA"],
    [403,"403","Carrier H","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0766","Electrical Stimulation Device Used For Cancer Treatment, Includes All Accessories, Any Type","10","0","0.27","24","55.79",null,null,null,null,"NA","NA"],
    [404,"404","Carrier I","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate","4","1",null,null,"7.67","432",null,null,null,"NA","NA"],
    [405,"405","Carrier I","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1399","Durable Medical Equipment Mi","1","1",null,null,"91.24",null,null,null,null,"NA","NA"],
    [406,"406","Carrier I","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0483","High frequency chest wall oscillation system, includes all accessories and supplies, each","1","1",null,null,"23.75",null,null,null,null,"NA","NA"],
    [407,"407","Carrier I","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0748","Elec Osteogen Stim Spinal","1","1",null,null,"41.07",null,null,null,null,"NA","NA"],
    [408,"408","Carrier I","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","Cont Airway Pressure Device","254","0.98",null,null,"1.12",null,null,null,null,"NA","NA"],
    [409,"409","Carrier I","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without backup rate","9","0.89",null,null,"9.79",null,null,null,null,"NA","NA"],
    [410,"410","Carrier I","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0760","Osteogen Ultrasound Stimltor","1","0",null,null,"24.06",null,null,null,null,"NA","NA"],
    [411,"411","Carrier I","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0995","Wheelchair accessory, calf rest/pad, replacement only, each","1","0",null,null,"139.76",null,null,null,null,"NA","NA"],
    [412,"412","Carrier I","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2361","Power wheelchair accessory, 22nf sealed lead acid battery, each","1","0",null,null,"139.76",null,null,null,null,"NA","NA"],
    [413,"413","Carrier I","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0484","Oscillatory Positive Expiratory Pressure Device, Nonelectric, Any Type","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [414,"414","Carrier I","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate","4","1",null,null,"7.67","2",null,null,null,"NA","NA"],
    [415,"415","Carrier I","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1399","Durable Medical Equipment Mi","1","1",null,null,"91.24","95",null,null,null,"NA","NA"],
    [416,"416","Carrier I","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0748","Elec Osteogen Stim Spinal","1","1",null,null,"41.07","7.6",null,null,null,"NA","NA"],
    [417,"417","Carrier I","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0483","High frequency chest wall oscillation system, includes all accessories and supplies, each","1","1",null,null,"23.75","16.5",null,null,null,"NA","NA"],
    [418,"418","Carrier I","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0601","Cont Airway Pressure Device","254","0.98",null,null,"1.12",null,null,null,null,"NA","NA"],
    [419,"419","Carrier I","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without backup rate","9","0.89",null,null,"9.79",null,null,null,null,"NA","NA"],
    [420,"420","Carrier I","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0484","Oscillatory Positive Expiratory Pressure Device, Nonelectric, Any Type","1","0",null,null,null,"15.8",null,null,null,"NA","NA"],
    [421,"421","Carrier I","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2361","Power wheelchair accessory, 22nf sealed lead acid battery, each","1","0",null,null,"139.76","24",null,null,null,"NA","NA"],
    [422,"422","Carrier I","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0760","Osteogen Ultrasound Stimltor","1","0",null,null,"24.06",null,null,null,null,"NA","NA"],
    [423,"423","Carrier I","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0995","Wheelchair accessory, calf rest/pad, replacement only, each","1","0",null,null,"139.76",null,null,null,null,"NA","NA"],
    [424,"424","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","Cont Airway Pressure Device","3538","0.96",null,null,"2.17",null,null,null,null,"NA","NA"],
    [425,"425","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without backup rate","165","0.95",null,null,"2.18",null,null,null,null,"NA","NA"],
    [426,"426","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate","66","0.91",null,null,"4.21",null,null,null,null,"NA","NA"],
    [427,"427","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0748","Elec Osteogen Stim Spinal","15","0.6",null,null,"63.03",null,null,null,null,"NA","NA"],
    [428,"428","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1399","Durable Medical Equipment Mi","31","0.55",null,null,"86",null,null,null,null,"NA","NA"],
    [429,"429","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0747","Elec Osteogen Stim Not Spine","11","0.36",null,null,"90.09",null,null,null,null,"NA","NA"],
    [430,"430","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0760","Osteogen Ultrasound Stimltor","12","0.33",null,null,"102.28",null,null,null,null,"NA","NA"],
    [431,"431","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0466","HOME VENT NON-INVASIVE INTER","6","0.33",null,null,"44.45",null,null,null,null,"NA","NA"],
    [432,"432","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2615","Pos back post/lat wdth <22in","2","0",null,null,"24.98",null,null,null,null,"NA","NA"],
    [433,"433","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2293","Contour back for ped size wc","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [434,"434","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1234","Wheelchair, Pediatric Size, Tilt-In-Space, Folding, Adj, Wo Seating","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [435,"435","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0978","Wheelchair Belt W/Airplane B","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [436,"436","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0652","Pneum Compres W/Cal Pressure","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [437,"437","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2231","Solid seat support base","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [438,"438","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0667","Seg Pneumatic Appl Full Leg","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [439,"439","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0641","Multi-position stnd fram sys","1","0",null,null,"110.86",null,null,null,null,"NA","NA"],
    [440,"440","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0637","Combination sit to stand system, any size, with seat lift feature, with or without wheels","1","0",null,null,"73.83",null,null,null,null,"NA","NA"],
    [441,"441","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0990","Whellchair Elevating Leg Res","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [442,"442","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0328","Ped hospital bed, manual","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [443,"443","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0483","High frequency chest wall oscillation system, includes all accessories and supplies, each","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [444,"444","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0638","Standing frame system, any size, with or without wheels","1","0",null,null,"47.08",null,null,null,null,"NA","NA"],
    [445,"445","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2292","Planar seat for ped size wc","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [446,"446","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2613","Position back cush wd <22in","1","0",null,null,"126.74",null,null,null,null,"NA","NA"],
    [447,"447","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2607","Skin pro/pos wc cus wd <22in","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [448,"448","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0562","Humidifier, heated, used with positive airway pressure device","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [449,"449","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0973","Wheelchair Adjustabl Height","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [450,"450","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0950","Tray","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [451,"451","Carrier J","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0956","Wheelchair accessory, lateral trunk or hip support, prefabricated, including fixed mounting hardware, each","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [452,"452","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0601","Cont Airway Pressure Device","3538","0.96",null,null,"2.17",null,null,null,null,"NA","NA"],
    [453,"453","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without backup rate","165","0.95",null,null,"2.18",null,null,null,null,"NA","NA"],
    [454,"454","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate","66","0.91",null,null,"4.21","15.3",null,null,null,"NA","NA"],
    [455,"455","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0748","Elec Osteogen Stim Spinal","15","0.6",null,null,"63.03",null,null,null,null,"NA","NA"],
    [456,"456","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1399","Durable Medical Equipment Mi","31","0.55",null,null,"86",null,null,null,null,"NA","NA"],
    [457,"457","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0747","Elec Osteogen Stim Not Spine","11","0.36",null,null,"90.09",null,null,null,null,"NA","NA"],
    [458,"458","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0760","Osteogen Ultrasound Stimltor","12","0.33",null,null,"102.28","28.9",null,null,null,"NA","NA"],
    [459,"459","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0466","HOME VENT NON-INVASIVE INTER","6","0.33",null,null,"44.45","6.2",null,null,null,"NA","NA"],
    [460,"460","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2615","Pos back post/lat wdth <22in","2","0",null,null,"24.98","25",null,null,null,"NA","NA"],
    [461,"461","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2293","Contour back for ped size wc","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [462,"462","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1234","Wheelchair, Pediatric Size, Tilt-In-Space, Folding, Adj, Wo Seating","1","0",null,null,null,"3.2",null,null,null,"NA","NA"],
    [463,"463","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0978","Wheelchair Belt W/Airplane B","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [464,"464","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0652","Pneum Compres W/Cal Pressure","1","0",null,null,null,"32.6",null,null,null,"NA","NA"],
    [465,"465","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2231","Solid seat support base","1","0",null,null,null,"29.4",null,null,null,"NA","NA"],
    [466,"466","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0667","Seg Pneumatic Appl Full Leg","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [467,"467","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0973","Wheelchair Adjustabl Height","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [468,"468","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0562","Humidifier, heated, used with positive airway pressure device","1","0",null,null,null,"28.9",null,null,null,"NA","NA"],
    [469,"469","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0990","Whellchair Elevating Leg Res","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [470,"470","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0328","Ped hospital bed, manual","1","0",null,null,null,"29.4",null,null,null,"NA","NA"],
    [471,"471","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0638","Standing frame system, any size, with or without wheels","1","0",null,null,"47.08",null,null,null,null,"NA","NA"],
    [472,"472","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2613","Position back cush wd <22in","1","0",null,null,"126.74","6.1",null,null,null,"NA","NA"],
    [473,"473","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2292","Planar seat for ped size wc","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [474,"474","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2607","Skin pro/pos wc cus wd <22in","1","0",null,null,null,"2.4",null,null,null,"NA","NA"],
    [475,"475","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0641","Multi-position stnd fram sys","1","0",null,null,"110.86",null,null,null,null,"NA","NA"],
    [476,"476","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0637","Combination sit to stand system, any size, with seat lift feature, with or without wheels","1","0",null,null,"73.83",null,null,null,null,"NA","NA"],
    [477,"477","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0956","Wheelchair accessory, lateral trunk or hip support, prefabricated, including fixed mounting hardware, each","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [478,"478","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0483","High frequency chest wall oscillation system, includes all accessories and supplies, each","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [479,"479","Carrier J","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0950","Tray","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [480,"480","Carrier J","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0760","Osteogen Ultrasound Stimltor","12","0","0.08",null,"102.28",null,null,null,null,"NA","NA"],
    [481,"481","Carrier J","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E1399","Durable Medical Equipment Mi","31","0","0.03",null,"86",null,null,null,null,"NA","NA"],
    [482,"482","Carrier J","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0601","Cont Airway Pressure Device","3538","0","0",null,"2.17",null,null,null,null,"NA","NA"],
    [483,"483","Carrier J","2020","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0747","Elec Osteogen Stim Not Spine","11","0","0",null,"90.09",null,null,null,null,"NA","NA"],
    [484,"484","Carrier K","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0748","OSTOGNS STIMULATOR ELEC NONINVASV SPINAL APPLIC","2","1",null,"0","13.35",null,null,null,null,"NA","NA"],
    [485,"485","Carrier K","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0760","OSTOGNS STIM LOW INTENS ULTRASOUND NON-INVASV","1","1",null,"0","0.2",null,null,null,null,"NA","NA"],
    [486,"486","Carrier K","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E2402","NEG PRESS WOUND THERAPY ELEC PUMP STATION/PRTBLE","1","1",null,"0","53.6",null,null,null,null,"NA","NA"],
    [487,"487","Carrier K","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0486","ORL DEVC/APPL RDUC UP AIRWAY COLLAPSIBILITY CSTM","1","1",null,"0","75.7","56.9",null,null,null,"NA","NA"],
    [488,"488","Carrier K","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0747","OSTOGNS STIM ELEC NONINVASV OTH THAN SP APPLIC","2","0",null,"0","69.2",null,null,null,null,"NA","NA"],
    [489,"489","Carrier K","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0748","OSTOGNS STIMULATOR ELEC NONINVASV SPINAL APPLIC","2","1",null,"0","13.35",null,null,null,null,"NA","NA"],
    [490,"490","Carrier K","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0760","OSTOGNS STIM LOW INTENS ULTRASOUND NON-INVASV","1","1",null,"0","0.2",null,null,null,null,"NA","NA"],
    [491,"491","Carrier K","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E2402","NEG PRESS WOUND THERAPY ELEC PUMP STATION/PRTBLE","1","1",null,"0","53.6",null,null,null,null,"NA","NA"],
    [492,"492","Carrier K","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0486","ORL DEVC/APPL RDUC UP AIRWAY COLLAPSIBILITY CSTM","1","1",null,"0","75.7",null,null,null,null,"NA","NA"],
    [493,"493","Carrier L","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0471","RESP ASST DEVC BI-LEVL PRSS CAPABILITY W/BACK-UP","3","1",null,"21.8","59.5",null,null,null,null,"NA","NA"],
    [494,"494","Carrier L","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5679","ADD LW EXT BK/AK CSTM MOLD/PRFAB NOT W/LOCK MECH","3","0.67",null,null,"62.67",null,null,null,null,"NA","NA"],
    [495,"495","Carrier L","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5981","ALL LOWER EXTREM PROSTH FLEX-WALK SYSTEM/EQUAL","3","0.67",null,null,"52.9",null,null,null,null,"NA","NA"],
    [496,"496","Carrier L","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5321","ABOVE KNEE OPEN END SACH FT ENDO SYS 1 AXIS KNEE","3","0.33",null,null,"62.67",null,null,null,null,"NA","NA"],
    [497,"497","Carrier L","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5624","ADDITION LOWER EXTREMITY TEST SOCKET ABOVE KNEE","3","0.33",null,null,"62.67",null,null,null,null,"NA","NA"],
    [498,"498","Carrier L","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5631","ADD LW EXT ABVE KNEE/KNEE DISARTIC ACRYLC SOCKT","3","0.33",null,null,"62.67",null,null,null,null,"NA","NA"],
    [499,"499","Carrier L","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5649","ADD LW EXT ISCHIAL CONTAINMENT/NARROW M-L SOCKET","3","0.33",null,null,"62.67",null,null,null,null,"NA","NA"],
    [500,"500","Carrier L","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5650","ADD LW EXT TOTAL CONTACT ABVE KNEE/KNEE DISARTC","3","0.33",null,null,"62.67",null,null,null,null,"NA","NA"],
    [501,"501","Carrier L","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5671","ADD LW EXTRM BELW/ABVE KNEE SUSP LOCK MECH","3","0.33",null,null,"62.67",null,null,null,null,"NA","NA"],
    [502,"502","Carrier L","2020","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5673","ADD LW EXT CSTM MOLD/PRFAB FOR USE W/LOCK MECH","3","0.33",null,null,"62.67",null,null,null,null,"NA","NA"],
    [503,"503","Carrier L","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0471","RESP ASST DEVC BI-LEVL PRSS CAPABILITY W/BACK-UP","3","1",null,"21.8","59.5",null,null,null,null,"NA","NA"],
    [504,"504","Carrier L","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0562","HUMDIFIR HEATED USED W/POS ARWAY PRESSURE DEVICE","2","1",null,"21.8","44.2",null,null,null,null,"NA","NA"],
    [505,"505","Carrier L","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2402","NEG PRESS WOUND THERAPY ELEC PUMP STATION/PRTBLE","2","1",null,null,"20.7",null,null,null,null,"NA","NA"],
    [506,"506","Carrier L","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L2820","ADD LW EXT ORTH SFT INTERFCE MOLD BELW KNEE","2","1",null,null,"47.25",null,null,null,null,"NA","NA"],
    [507,"507","Carrier L","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5620","ADDITION LOWER EXTREMITY TEST SOCKET BELOW KNEE","2","1",null,null,"42.25",null,null,null,null,"NA","NA"],
    [508,"508","Carrier L","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5637","ADDITION LOWER EXTREMITY BELOW KNEE TOTAL CNTC","2","1",null,null,"42.25",null,null,null,null,"NA","NA"],
    [509,"509","Carrier L","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5679","ADD LW EXT BK/AK CSTM MOLD/PRFAB NOT W/LOCK MECH","2","1",null,null,"42.25",null,null,null,null,"NA","NA"],
    [510,"510","Carrier L","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5685","ADD LOW EXT PROS BELW KNEE SUSP/SEAL SLEEVE EA","2","1",null,null,"42.25",null,null,null,null,"NA","NA"],
    [511,"511","Carrier L","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5910","ADD ENDOSKEL SYSTEM BELOW KNEE ALIGNABLE SYSTEM","2","1",null,null,"42.25",null,null,null,null,"NA","NA"],
    [512,"512","Carrier L","2020","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5940","ADD ENDOSKEL SYSTEM BELW KNEE ULTRA-LGHT MATL","2","1",null,null,"42.25",null,null,null,null,"NA","NA"],
    [513,"513","Carrier M","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44207","LAPAROSCOPY, SURGICAL; COLECTOMY, PARTIAL, WITH ANASTOMOSIS, WITH COLOPROCTOSTOMY (LOW PELVIC ANASTOMOSIS)","8","1",null,"0","309",null,null,null,null,"NA","NA"],
    [514,"514","Carrier M","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22842","POSTERIOR SEGMENTAL INSTRUMENTATION (EG, PEDICLE FIXATION, DUAL RODS WITH MULTIPLE HOOKS AND SUBLAMINAR WIRES); 3 TO 6 VERTEBRAL SEGMENTS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)","8","0.88",null,"9","48",null,null,null,null,"NA","NA"],
    [515,"515","Carrier M","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22612","ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLE LEVEL ; LUMBAR (WITH LATERAL TRANSVERSE TECHNIQUE, WHEN PERFORMED)","8","0.75",null,"9","96",null,null,null,null,"NA","NA"],
    [516,"516","Carrier M","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20931","ALLOGRAFT, STRUCTURAL, FOR SPINE SURGERY ONLY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)","7","0.71",null,"3.43","61.71",null,null,null,null,"NA","NA"],
    [517,"517","Carrier M","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20930","ALLOGRAFT, MORSELIZED, OR PLACEMENT OF OSTEOPROMOTIVE MATERIAL, FOR SPINE SURGERY ONLY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)","17","0.65",null,"4.24","25.41",null,null,null,null,"NA","NA"],
    [518,"518","Carrier M","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22840","POSTERIOR NON-SEGMENTAL INSTRUMENTATION (EG, HARRINGTON ROD TECHNIQUE, PEDICLE FIXATION ACROSS ONE INTERSPACE, ATLANTOAXIAL TRANSARTICULAR SCREW FIXATION, SUBLAMINAR WIRING AT C1, FACET SCREW FIXATION) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PRO","11","0.64",null,"6.55","28.36",null,null,null,null,"NA","NA"],
    [519,"519","Carrier M","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20936","AUTOGRAFT FOR SPINE SURGERY ONLY (INCLUDES HARVESTING THE GRAFT); LOCAL (EG, RIBS, SPINOUS PROCESS, OR LAMINAR FRAGMENTS) OBTAINED FROM SAME INCISION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)","8","0.63",null,"9","63",null,null,null,null,"NA","NA"],
    [520,"520","Carrier M","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","ARTHRODESIS, ANTERIOR INTERBODY TECHNIQUE, INCLUDING MINIMAL DESKECTOMY TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION); LUMBAR","8","0.63",null,"9","69",null,null,null,null,"NA","NA"],
    [521,"521","Carrier M","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63047","LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA AND/OR NERVE ROOT(S) (EG; SPINAL OR LATERAL RECESS STENOSIS) SINGLE VERTEBRAL SEGMENT; LUMBAR","8","0.63",null,"9","45",null,null,null,null,"NA","NA"],
    [522,"522","Carrier M","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","INSERTION OF INTERBODY BIOMECHANICAL DEVICE(S) (EG, SYNTHETIC CAGE, MESH) WITH INTEGRAL ANTERIOR INSTRUMENTATION FOR DEVICE ANCHORING (EG, SCREWS, FLANGES), WHEN PERFORMED, TO INTERVERTEBRAL DISC SPACE IN CONJUNCTION WITH INTERBODY ARTHRODESIS, EACH INTE","18","0.56",null,"4","44",null,null,null,null,"NA","NA"],
    [523,"523","Carrier M","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22840","LAPAROSCOPY, SURGICAL; COLECTOMY, PARTIAL, WITH ANASTOMOSIS, WITH COLOPROCTOSTOMY (LOW PELVIC ANASTOMOSIS)","8","1",null,"0","309",null,null,null,null,"NA","NA"],
    [524,"524","Carrier M","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22612","LAPAROSCOPY, SURGICAL PROSTATECTOMY, RETROPUBIC RADICAL, INCLUDING NERVE SPARING, INCLUDES ROBOTIC ASSISTANCE, WHEN PERFORMED","7","1",null,"3.43","48",null,null,null,null,"NA","NA"],
    [525,"525","Carrier M","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22842","TOTAL HYSTERECTOMY (CORPUS AND CERVIX), WITH OR WITHOUT REMOVAL OF TUBE(S), WITH OR WITHOUT REMOVAL OF OVARY(S);","7","1",null,"0","24",null,null,null,null,"NA","NA"],
    [526,"526","Carrier M","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44207","INITIAL HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A COMPREHENSIVE HISTORY; A COMPREHENSIVE EXAMINATION; AND MEDICAL DECISION MAKING OF MODERATE COMPLEXITY. COUNSELING AND/OR COORDINATIO","7","1",null,"10.29","48",null,null,null,null,"NA","NA"],
    [527,"527","Carrier M","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22558","POSTERIOR SEGMENTAL INSTRUMENTATION (EG, PEDICLE FIXATION, DUAL RODS WITH MULTIPLE HOOKS AND SUBLAMINAR WIRES); 3 TO 6 VERTEBRAL SEGMENTS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)","8","0.88",null,"9","48",null,null,null,null,"NA","NA"],
    [528,"528","Carrier M","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63047","ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLE LEVEL ; LUMBAR (WITH LATERAL TRANSVERSE TECHNIQUE, WHEN PERFORMED)","8","0.75",null,"9","96",null,null,null,null,"NA","NA"],
    [529,"529","Carrier M","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22853","ALLOGRAFT, MORSELIZED, OR PLACEMENT OF OSTEOPROMOTIVE MATERIAL, FOR SPINE SURGERY ONLY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)","17","0.65",null,"4.24","25.41",null,null,null,null,"NA","NA"],
    [530,"530","Carrier M","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","20936","POSTERIOR NON-SEGMENTAL INSTRUMENTATION (EG, HARRINGTON ROD TECHNIQUE, PEDICLE FIXATION ACROSS ONE INTERSPACE, ATLANTOAXIAL TRANSARTICULAR SCREW FIXATION, SUBLAMINAR WIRING AT C1, FACET SCREW FIXATION) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PRO","11","0.64",null,"6.55","28.36",null,null,null,null,"NA","NA"],
    [531,"531","Carrier M","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","20931","AUTOGRAFT FOR SPINE SURGERY ONLY (INCLUDES HARVESTING THE GRAFT); LOCAL (EG, RIBS, SPINOUS PROCESS, OR LAMINAR FRAGMENTS) OBTAINED FROM SAME INCISION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)","8","0.63",null,"9","63",null,null,null,null,"NA","NA"],
    [532,"532","Carrier M","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","20930","INSERTION OF INTERBODY BIOMECHANICAL DEVICE(S) (EG, SYNTHETIC CAGE, MESH) WITH INTEGRAL ANTERIOR INSTRUMENTATION FOR DEVICE ANCHORING (EG, SCREWS, FLANGES), WHEN PERFORMED, TO INTERVERTEBRAL DISC SPACE IN CONJUNCTION WITH INTERBODY ARTHRODESIS, EACH INTE","18","0.56",null,"4","44",null,null,null,null,"NA","NA"],
    [533,"533","Carrier A","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22551","Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2","7","1",null,null,"42.71",null,null,null,null,"NA","NA"],
    [534,"534","Carrier A","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22842","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)","9","0.89",null,"97.24","84.54",null,null,null,null,"NA","NA"],
    [535,"535","Carrier A","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","27","0.82",null,"97.24","61.33",null,null,null,null,"NA","NA"],
    [536,"536","Carrier A","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","11","0.82",null,null,"64.01",null,null,null,null,"NA","NA"],
    [537,"537","Carrier A","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22845","Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure)","14","0.71",null,null,"66.08",null,null,null,null,"NA","NA"],
    [538,"538","Carrier A","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","20","0.7",null,"194.36","82.72",null,null,null,null,"NA","NA"],
    [539,"539","Carrier A","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22614","Arthrodesis, posterior or posterolateral technique, single level; each additional vertebral segment (List separately in addition to code for primary procedure)","10","0.7",null,"97.24","77.6",null,null,null,null,"NA","NA"],
    [540,"540","Carrier A","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22612","Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)","18","0.67",null,"194.36","91.31",null,null,null,null,"NA","NA"],
    [541,"541","Carrier A","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63047","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","15","0.67",null,"194.36","79.52",null,null,null,null,"NA","NA"],
    [542,"542","Carrier A","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22585","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace (List separately in addition to code for primary procedure)","11","0.55",null,"97.24","113.88",null,null,null,null,"NA","NA"],
    [543,"543","Carrier A","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22551","Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2","7","1",null,null,"42.71",null,null,null,null,"NA","NA"],
    [544,"544","Carrier A","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22552","Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2, each additional interspace (List separately in addition to code for separate procedure)","6","1",null,null,"49.55",null,null,null,null,"NA","NA"],
    [545,"545","Carrier A","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58150","Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);","5","1",null,"3.51","30.44",null,null,null,null,"NA","NA"],
    [546,"546","Carrier A","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29888","Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction","4","1",null,"1.16","26.16",null,null,null,null,"NA","NA"],
    [547,"547","Carrier A","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22846","Anterior instrumentation; 4 to 7 vertebral segments (List separately in addition to code for primary procedure)","3","1",null,null,"37.93",null,null,null,null,"NA","NA"],
    [548,"548","Carrier A","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","20931","Allograft, structural, for spine surgery only (List separately in addition to code for primary procedure)","3","1",null,null,"77.56",null,null,null,null,"NA","NA"],
    [549,"549","Carrier A","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22610","Arthrodesis, posterior or posterolateral technique, single level; thoracic (with lateral transverse technique, when performed)","2","1",null,"0.13","0.13",null,null,null,null,"NA","NA"],
    [550,"550","Carrier A","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22630","Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; lumbar","2","1",null,null,"41.48",null,null,null,null,"NA","NA"],
    [551,"551","Carrier A","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22633","Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar","2","1",null,null,"41.48",null,null,null,null,"NA","NA"],
    [552,"552","Carrier A","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22855","Removal of anterior instrumentation","2","1",null,null,"22.48",null,null,null,null,"NA","NA"],
    [553,"553","Carrier A","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","11","0","0.09",null,"64.01",null,null,null,null,"NA","NA"],
    [554,"554","Carrier A","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63047","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","15","0","0.07","194.36","79.52",null,null,null,null,"NA","NA"],
    [555,"555","Carrier A","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22612","Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)","18","0","0.06","194.36","91.31",null,null,null,null,"NA","NA"],
    [556,"556","Carrier A","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22558","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","20","0","0.05","194.36","82.72",null,null,null,null,"NA","NA"],
    [557,"557","Carrier A","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","27","0","0.04","97.24","61.33",null,null,null,null,"NA","NA"],
    [558,"558","Carrier A","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22845","Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure)","14","0","0",null,"66.08",null,null,null,null,"NA","NA"],
    [559,"559","Carrier A","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22585","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace (List separately in addition to code for primary procedure)","11","0","0","97.24","113.88",null,null,null,null,"NA","NA"],
    [560,"560","Carrier A","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22614","Arthrodesis, posterior or posterolateral technique, single level; each additional vertebral segment (List separately in addition to code for primary procedure)","10","0","0","97.24","77.6",null,null,null,null,"NA","NA"],
    [561,"561","Carrier A","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63048","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure)","6","0","0","194.36","54.79",null,null,null,null,"NA","NA"],
    [562,"562","Carrier A","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63056","Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; lumbar (including transfacet, or lateral extraforaminal approach) (eg, far lateral herniated intervertebral disc)","4","0","0",null,"91.05",null,null,null,null,"NA","NA"],
    [563,"563","Carrier N","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44120","REMOVAL OF SMALL INTESTINE","2","1",null,null,"0",null,null,null,null,"NA","NA"],
    [564,"564","Carrier N","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44625","REPAIR BOWEL OPENING","1","1",null,null,"0",null,null,null,null,"NA","NA"],
    [565,"565","Carrier N","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","33416","REVISE VENTRICLE MUSCLE","1","1",null,null,"0",null,null,null,null,"NA","NA"],
    [566,"566","Carrier N","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","61582","CRANIOFACIAL APPROACH SKULL","1","1",null,null,"0",null,null,null,null,"NA","NA"],
    [567,"567","Carrier N","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58952","RESECT OVARIAN MALIGNANCY","1","1",null,null,"24",null,null,null,null,"NA","NA"],
    [568,"568","Carrier N","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","38571","LAPAROSCOPY LYMPHADENECTOMY","1","1",null,null,"0",null,null,null,null,"NA","NA"],
    [569,"569","Carrier N","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19303","MAST SIMPLE COMPLETE","1","1",null,null,"72",null,null,null,null,"NA","NA"],
    [570,"570","Carrier N","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44139","MOBILIZATION OF COLON","1","1",null,null,"24",null,null,null,null,"NA","NA"],
    [571,"571","Carrier N","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22633","LUMBAR SPINE FUSION COMBINED","2","0.5",null,null,"60",null,null,null,null,"NA","NA"],
    [572,"572","Carrier N","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","49320","DIAG LAPARO SEPARATE PROC","2","0",null,null,"96",null,null,null,null,"NA","NA"],
    [573,"573","Carrier N","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44120","REMOVAL OF SMALL INTESTINE","2","1",null,null,"0",null,null,null,null,"NA","NA"],
    [574,"574","Carrier N","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44625","REPAIR BOWEL OPENING","1","1",null,null,"0",null,null,null,null,"NA","NA"],
    [575,"575","Carrier N","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33416","REVISE VENTRICLE MUSCLE","1","1",null,null,"0",null,null,null,null,"NA","NA"],
    [576,"576","Carrier N","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","61582","CRANIOFACIAL APPROACH SKULL","1","1",null,null,"0",null,null,null,null,"NA","NA"],
    [577,"577","Carrier N","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58952","RESECT OVARIAN MALIGNANCY","1","1",null,null,"24",null,null,null,null,"NA","NA"],
    [578,"578","Carrier N","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","38571","LAPAROSCOPY LYMPHADENECTOMY","1","1",null,null,"0",null,null,null,null,"NA","NA"],
    [579,"579","Carrier N","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19303","MAST SIMPLE COMPLETE","1","1",null,null,"72",null,null,null,null,"NA","NA"],
    [580,"580","Carrier N","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44139","MOBILIZATION OF COLON","1","1",null,null,"24",null,null,null,null,"NA","NA"],
    [581,"581","Carrier N","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22633","LUMBAR SPINE FUSION COMBINED","2","0.5",null,null,"60",null,null,null,null,"NA","NA"],
    [582,"582","Carrier N","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","49320","DIAG LAPARO SEPARATE PROC","2","0",null,null,"96",null,null,null,null,"NA","NA"],
    [583,"583","Carrier B","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","TOTAL  ABDOMINAL  HYSTORECOMY WITH/WITHOUT REMOVAL OF  TUBE(S) - OVARY(S)","12","1",null,"69.74","161.59","0",null,null,null,"NA","NA"],
    [584,"584","Carrier B","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","49000","EXPLORATORY LAPAROTOMY-CELIOTOMY WITH OR WITHOUT  BIOPSY","9","1",null,"0","86.56","0",null,null,null,"NA","NA"],
    [585,"585","Carrier B","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22612","LUMBAR SPINE FUSION","8","1",null,"0","44.85","0",null,null,null,"NA","NA"],
    [586,"586","Carrier B","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96416","CHEMOTHERAPY ADMNIISTRATION TO INITIALIZE  PROLONG CHEMOTHERAPY WITH I NFUSION PUMP","8","1",null,"7.68","83.3","0",null,null,null,"NA","NA"],
    [587,"587","Carrier B","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27130","HIP JOINT REPLACEMENT BY PROSTHESIS OR ARTIFICIAL JOINT","23","0.96",null,"0","35.55","0",null,null,null,"NA","NA"],
    [588,"588","Carrier B","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22840","PLACEMENT OF SPINAL INSTRUMENTATION IN NECK ACROSS A SINGLE LEVEL TO CORRECT SPINAL DEFORMITY","12","0.92",null,"0","64.48","0",null,null,null,"NA","NA"],
    [589,"589","Carrier B","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","INSERTION OF METALLIC CAGE OR MESH DEVICE BETWEEN TWO VERTEBRAE WITH SCREWS AND FLANGES","16","0.88",null,"0","68.91","0",null,null,null,"NA","NA"],
    [590,"590","Carrier B","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20930","BONE GRAFT OF DONOR OR SYNTHETIC MATERIAL-ADD ON","12","0.83",null,"0","45.25","0",null,null,null,"NA","NA"],
    [591,"591","Carrier B","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63047","LAMINECTOMY OF SINGLE VERTEBRAE EITHER UNILATERAL OR BILATERAL OF LUMBAR SPINE","15","0.67",null,"0","43.1","0",null,null,null,"NA","NA"],
    [592,"592","Carrier B","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63048","ADDITIONAL VERTEBRAL LAMINECTOMY, FACETECTOMY, and FORAMINOTOMY PROCEDURES","10","0.6",null,"0","49.27","0",null,null,null,"NA","NA"],
    [593,"593","Carrier B","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58150","TOTAL  ABDOMINAL  HYSTORECOMY WITH/WITHOUT REMOVAL OF  TUBE(S) - OVARY(S)","12","1",null,"69.74","161.59","0",null,null,null,"NA","NA"],
    [594,"594","Carrier B","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","49000","EXPLORATORY LAPAROTOMY-CELIOTOMY WITH OR WITHOUT  BIOPSY","9","1",null,"0","86.56","0",null,null,null,"NA","NA"],
    [595,"595","Carrier B","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27447","ARTHROPLASTY OF KNEE CONDYLE AND PLATEAU; MEDIAL AND LATERAL COMPARTMENTS OF THE KNEE","8","1",null,"0","127.47","0",null,null,null,"NA","NA"],
    [596,"596","Carrier B","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96416","CHEMOTHERAPY ADMNIISTRATION TO INITIALIZE  PROLONG CHEMOTHERAPY WITH I NFUSION PUMP","8","1",null,"7.68","83.3","0",null,null,null,"NA","NA"],
    [597,"597","Carrier B","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22612","LUMBAR SPINE FUSION","8","1",null,"0","44.85","0",null,null,null,"NA","NA"],
    [598,"598","Carrier B","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22558","ARTHRODESIS-ANTERIOR INTERBODY WITH MINI DISKECTOMYOF LUMBAR SPINE","7","1",null,"0","36.39","0",null,null,null,"NA","NA"],
    [599,"599","Carrier B","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","38571","LAPAROSCOPY WITH BILATERAL TOTAL PELVIC LYMPHADENECTOMY","7","1",null,"0.71","79.47","0",null,null,null,"NA","NA"],
    [600,"600","Carrier B","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","20936","AUTOGRAFT DURING SPINAL SURGERY ONLY; LOCAL THRU SAME INCISION","7","1",null,"0","38.3","0",null,null,null,"NA","NA"],
    [601,"601","Carrier B","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22842","PLACEMENT OF SPINAL INTRUMENTATION; 3 TO 6 VERTEBRAE SEGMENT","6","1",null,"0","63.49","0",null,null,null,"NA","NA"],
    [602,"602","Carrier B","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","47120","HEPATECTOMY RESECTION OF  LIVER; PART LOBECTOMY OF LIVER","6","1",null,"7.23","251.89","0",null,null,null,"NA","NA"],
    [603,"603","Carrier B","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","61760","STEREOTACTIC IMPLANT DEPTH ELECTRODES-CEREBRUM","1","0","1","0","100.88","0",null,null,null,"NA","NA"],
    [604,"604","Carrier B","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22610","THORACIC SPINE FUSION","1","0","1","0","0","0",null,null,null,"NA","NA"],
    [605,"605","Carrier B","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63046","LAMINECTOMY SINGLE VERTEBRAL SEGMENT-UNILATERAL/BILATERLA; THORACIC REGION","1","0","1","0","0","0",null,null,null,"NA","NA"],
    [606,"606","Carrier B","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","61781","COM:UTED TOMOGRAPHY or MAGNETIC RESONANCE IMAGING DURING PROCEDURE OF  INTRADUAL CRANIAL PROCEDURE","3","0","0.33","0","91.23","0",null,null,null,"NA","NA"],
    [607,"607","Carrier B","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27487","REVISION  TOTAL KNEE ARTHROPLASTY; FEMORAL AND WHOLE TIBIA COMPARTMENTS","3","0","0.33","0","39.94","0",null,null,null,"NA","NA"],
    [608,"608","Carrier B","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22842","PLACEMENT OF SPINAL INTRUMENTATION; 3 TO 6 VERTEB SEGMENT","6","0","0.17","0","63.49","0",null,null,null,"NA","NA"],
    [609,"609","Carrier B","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22614","ARTHRODESIS-POST/POSTLATERAL TECHNIQUE; EACH ADD VERTEBRAE SEGMENT","7","0","0.14","0","60.71","0",null,null,null,"NA","NA"],
    [610,"610","Carrier B","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63048","ADDITIONAL VERTEBRAL LAMINECTOMY, FACETECTOMY, and FORAMINOTOMY PROCEDURES","10","0","0.1","0","49.27","0",null,null,null,"NA","NA"],
    [611,"611","Carrier C","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44204","LAPARO PARTIAL COLECTOMY","51","1",null,"2.95","128.38","600",null,null,null,"NA","NA"],
    [612,"612","Carrier C","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","59510","FULL ROUT OBSTE CARE,CESAREAN DELIV","99","0.99",null,"6.42","112.83",null,null,null,null,"NA","NA"],
    [613,"613","Carrier C","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","762","MISC SERVICES","5526","0.98",null,"40.54","530.38",null,null,null,null,"NA","NA"],
    [614,"614","Carrier C","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","120","ROOM AND BOARD","11682","0.97",null,"37.54","247.41",null,null,null,null,"NA","NA"],
    [615,"615","Carrier C","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","59514","CESAREAN DELIVERY ONLY","48","0.96",null,"0.88","55.73",null,null,null,null,"NA","NA"],
    [616,"616","Carrier C","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43644","LAP GASTRIC BYPASS/ROUX-EN-Y","55","0.95",null,null,"66.05",null,null,null,null,"NA","NA"],
    [617,"617","Carrier C","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43775","LAP SLEEVE GASTRECTOMY","38","0.92",null,null,"140.76",null,null,null,null,"NA","NA"],
    [618,"618","Carrier C","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","59400","FULL ROUT OBSTE CARE,VAGINAL DELIV","101","0.9",null,"5.4","434.69",null,null,null,null,"NA","NA"],
    [619,"619","Carrier C","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU","58","0.74",null,"53.13","1068.04",null,null,null,null,"NA","NA"],
    [620,"620","Carrier C","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","128","ROOM AND BOARD","154","0.59",null,"37.32","70.48",null,null,null,null,"NA","NA"],
    [621,"621","Carrier C","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44204","LAPARO PARTIAL COLECTOMY","51","1",null,"2.95","128.38",null,null,null,null,"NA","NA"],
    [622,"622","Carrier C","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","55866","LAPARO RADICAL PROSTATECT","21","1",null,"0.48","121.39",null,null,null,null,"NA","NA"],
    [623,"623","Carrier C","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58960","EXPLORATION OF ABDOMEN","21","1",null,"1.01","21.99",null,null,null,null,"NA","NA"],
    [624,"624","Carrier C","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","362","SURGERY","20","1",null,"0.17","45.39",null,null,null,null,"NA","NA"],
    [625,"625","Carrier C","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","656","HOSPICE GEN INPT/NOT RESP","18","1",null,"157.02","73.52",null,null,null,null,"NA","NA"],
    [626,"626","Carrier C","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","61781","SCAN PROC CRANIAL INTRA","17","1",null,"1.13","40.63",null,null,null,null,"NA","NA"],
    [627,"627","Carrier C","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","50543","LAPARO PARTIAL NEPHRECTOM","16","1",null,"12.59","36.42",null,null,null,null,"NA","NA"],
    [628,"628","Carrier C","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27487","REVISE/REPLACE KNEE JOINT","15","1",null,"52.78","178.65",null,null,null,null,"NA","NA"],
    [629,"629","Carrier C","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","55970","INTERSEX SURG MALE TO FEMALE","14","1",null,null,"383.01",null,null,null,null,"NA","NA"],
    [630,"630","Carrier C","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27570","FIXATION OF KNEE JOINT","14","1",null,"0.74","4.28",null,null,null,null,"NA","NA"],
    [631,"631","Carrier C","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21141","LEFORT I-1 PIECE W/O GRAF","1","0","1",null,"2103.45",null,null,null,null,"NA","NA"],
    [632,"632","Carrier C","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","53854","TRANSURETHRAL DESTRUCT PROSTAT TISSUE;BY RADIOFRQ WATER THERMOTHERPY","2","0","0.5",null,"483.88",null,null,null,null,"NA","NA"],
    [633,"633","Carrier C","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","33270","INS/REP SUBQ DEFIBRILLATO","3","0","0.33","23.82","596.94",null,null,null,null,"NA","NA"],
    [634,"634","Carrier C","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22514","PERQ VERTEBRAL AUGMENTATI","3","0","0.33","46.7","347.14",null,null,null,null,"NA","NA"],
    [635,"635","Carrier C","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","33945","TRANSPLANTATION OF HEART","4","0","0.25","81.76","211.16",null,null,null,null,"NA","NA"],
    [636,"636","Carrier C","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43645","LAP GASTR BYPASS INCL SML","8","0","0.13",null,"159.29",null,null,null,null,"NA","NA"],
    [637,"637","Carrier C","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","128","ROOM AND BOARD","154","0","0.02","37.32","70.48",null,null,null,null,"NA","NA"],
    [638,"638","Carrier C","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43644","LAP GASTRIC BYPASS/ROUX-EN-Y","55","0","0.02",null,"66.05",null,null,null,null,"NA","NA"],
    [639,"639","Carrier C","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22558","ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU","58","0","0.02","53.13","1068.04",null,null,null,null,"NA","NA"],
    [640,"640","Carrier C","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","120","ROOM AND BOARD","11682","0","0","37.54","247.41",null,null,null,null,"NA","NA"],
    [641,"641","Carrier D","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","59400","OBSTETRICAL CARE","27","1",null,"3.8","194.23",null,null,null,null,"NA","NA"],
    [642,"642","Carrier D","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","59510","CESAREAN DELIVERY","21","1",null,"0.11","77.22",null,null,null,null,"NA","NA"],
    [643,"643","Carrier D","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99221","INITIAL HOSPITAL CARE,LEVL I","16","1",null,null,"62.12",null,null,null,null,"NA","NA"],
    [644,"644","Carrier D","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","367","SURGERY","14","1",null,null,"162.31",null,null,null,null,"NA","NA"],
    [645,"645","Carrier D","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","762","MISC SERVICES","1204","0.99",null,"45.98",null,null,null,null,null,"NA","NA"],
    [646,"646","Carrier D","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","120","ROOM AND BOARD","4830","0.97",null,"37.07","72.8",null,null,null,null,"NA","NA"],
    [647,"647","Carrier D","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27130","TOTAL HIP ARTHROPLASTY","44","0.75",null,"38.01","339.93",null,null,null,null,"NA","NA"],
    [648,"648","Carrier D","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43644","LAP GASTRIC BYPASS/ROUX-EN-Y","12","0.75",null,"31.32","203.96",null,null,null,null,"NA","NA"],
    [649,"649","Carrier D","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","LUMBAR SPINE FUSION","15","0.53",null,"57.11","613.99",null,null,null,null,"NA","NA"],
    [650,"650","Carrier D","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","128","ROOM AND BOARD","88","0.52",null,"34.87","74.87",null,null,null,null,"NA","NA"],
    [651,"651","Carrier D","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","59400","OBSTETRICAL CARE","27","1",null,"3.8","194.23",null,null,null,null,"NA","NA"],
    [652,"652","Carrier D","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","59510","CESAREAN DELIVERY","21","1",null,"0.11","77.22",null,null,null,null,"NA","NA"],
    [653,"653","Carrier D","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99221","INITIAL HOSPITAL CARE,LEVL I","16","1",null,null,"62.12",null,null,null,null,"NA","NA"],
    [654,"654","Carrier D","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","367","SURGERY","14","1",null,null,"162.31",null,null,null,null,"NA","NA"],
    [655,"655","Carrier D","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44207","L COLECTOMY/COLOPROCTOSTO","11","1",null,"1.1","14.1",null,null,null,null,"NA","NA"],
    [656,"656","Carrier D","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","55866","LAPARO RADICAL PROSTATECT","10","1",null,null,"91.33",null,null,null,null,"NA","NA"],
    [657,"657","Carrier D","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","23472","ARTHROPLASTY GLENOHUM JNT TOTAL SHOULDER","9","1",null,null,"127.07",null,null,null,null,"NA","NA"],
    [658,"658","Carrier D","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44620","REPAIR BOWEL OPENING","8","1",null,"0.56","170.91",null,null,null,null,"NA","NA"],
    [659,"659","Carrier D","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58150","TOTAL ABDOM HYSTERECTOMY","8","1",null,"28.44","3.63",null,null,null,null,"NA","NA"],
    [660,"660","Carrier D","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44204","LAPARO PARTIAL COLECTOMY","7","1",null,null,"39.86",null,null,null,null,"NA","NA"],
    [661,"661","Carrier D","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43775","LAP SLEEVE GASTRECTOMY","9","0","0.22",null,"534.68",null,null,null,null,"NA","NA"],
    [662,"662","Carrier D","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22633","ARTHDSIS POST/POSTEROLATRL/POSTINTERBODY LUMBAR","11","0","0.18","76.86","346.45",null,null,null,null,"NA","NA"],
    [663,"663","Carrier D","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22558","LUMBAR SPINE FUSION","15","0","0.13","57.11","613.99",null,null,null,null,"NA","NA"],
    [664,"664","Carrier D","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","128","ROOM AND BOARD","88","0","0.02","34.87","74.87",null,null,null,null,"NA","NA"],
    [665,"665","Carrier E","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27130","ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT","5","1",null,null,"57.1",null,null,null,null,"NA","NA"],
    [666,"666","Carrier E","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","50360","RENAL ALLOTRANSPLANTATION, IMPLANTATION OF GRAFT","4","1",null,null,null,null,null,null,null,"NA","NA"],
    [667,"667","Carrier E","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96409","CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG","3","1",null,"4.5",null,null,null,null,null,"NA","NA"],
    [668,"668","Carrier E","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","J9328","INJECTION TEMOZOLOMIDE 1 MG","2","1",null,null,"29.8",null,null,null,null,"NA","NA"],
    [669,"669","Carrier E","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71046","RADIOLOGIC EXAM CHEST 2 VIEWS","2","1",null,null,null,null,null,null,null,"NA","NA"],
    [670,"670","Carrier E","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","38240","BONE MARROW STEM CELL TRANSPLANTATION, ALLOGENIC","2","1",null,null,"0.3",null,null,null,null,"NA","NA"],
    [671,"671","Carrier E","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27447","ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS","2","1",null,null,"15.8",null,null,null,null,"NA","NA"],
    [672,"672","Carrier E","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","Q5006","HOSPICE CARE PROV INPATIENT HOSPICE FACILITY","1","1",null,null,null,null,null,null,null,"NA","NA"],
    [673,"673","Carrier E","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","J7187","INJ VONWILLEBRND FACTOR CMPLX HUMN RISTOCETIN IU","1","1",null,"4.3",null,"600",null,null,null,"NA","NA"],
    [674,"674","Carrier E","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","D0301","D0301NON-TRAUMATIC BRAIN INJURY WITH MOTOR >41.05.,COMORBIDITY IN TIER 3","1","1",null,null,"0.1",null,null,null,null,"NA","NA"],
    [675,"675","Carrier E","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27130","ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT","5","1",null,null,"57.1",null,null,null,null,"NA","NA"],
    [676,"676","Carrier E","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","50360","RENAL ALLOTRANSPLANTATION, IMPLANTATION OF GRAFT","4","1",null,null,null,null,null,null,null,"NA","NA"],
    [677,"677","Carrier E","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96409","CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG","3","1",null,"4.5",null,null,null,null,null,"NA","NA"],
    [678,"678","Carrier E","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J9328","INJECTION TEMOZOLOMIDE 1 MG","2","1",null,null,"29.8",null,null,null,null,"NA","NA"],
    [679,"679","Carrier E","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","71046","RADIOLOGIC EXAM CHEST 2 VIEWS","2","1",null,null,null,null,null,null,null,"NA","NA"],
    [680,"680","Carrier E","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","38240","BONE MARROW STEM CELL TRANSPLANTATION, ALLOGENIC","2","1",null,null,"0.3",null,null,null,null,"NA","NA"],
    [681,"681","Carrier E","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27447","ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS","2","1",null,null,"15.8",null,null,null,null,"NA","NA"],
    [682,"682","Carrier E","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","Q5006","HOSPICE CARE PROV INPATIENT HOSPICE FACILITY","1","1",null,null,null,null,null,null,null,"NA","NA"],
    [683,"683","Carrier E","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J7187","INJ VONWILLEBRND FACTOR CMPLX HUMN RISTOCETIN IU","1","1",null,"4.3",null,null,null,null,null,"NA","NA"],
    [684,"684","Carrier E","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","D0301","D0301NON-TRAUMATIC BRAIN INJURY WITH MOTOR >41.05.,COMORBIDITY IN TIER 3","1","1",null,null,"0.1",null,null,null,null,"NA","NA"],
    [685,"685","Carrier F","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63047","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","21","0.81",null,null,"67","18.29",null,null,null,"NA","NA"],
    [686,"686","Carrier F","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27130","Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft","40","0.8",null,"20","55",null,null,null,null,"NA","NA"],
    [687,"687","Carrier F","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27447","Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)","20","0.8",null,"43","61",null,null,null,null,"NA","NA"],
    [688,"688","Carrier F","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20936","Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar fragments) obtained from same incision (List separately in addition to code for primary procedure)","15","0.8",null,"28","91","18.3",null,null,null,"NA","NA"],
    [689,"689","Carrier F","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22612","Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)","18","0.78",null,"3","72",null,null,null,null,"NA","NA"],
    [690,"690","Carrier F","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","37","0.76",null,"27","79",null,null,null,null,"NA","NA"],
    [691,"691","Carrier F","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22842","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)","16","0.75",null,null,"82",null,null,null,null,"NA","NA"],
    [692,"692","Carrier F","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","121","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Medical/Surgical/GYN","355","0.72",null,"23","67",null,null,null,null,"NA","NA"],
    [693,"693","Carrier F","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20930","Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for primary procedure)","20","0.7",null,"37","75",null,null,null,null,"NA","NA"],
    [694,"694","Carrier F","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","22","0.68",null,"23","66",null,null,null,null,"NA","NA"],
    [695,"695","Carrier F","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44207","Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)","11","1",null,"37","67",null,null,null,null,"NA","NA"],
    [696,"696","Carrier F","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22633","Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar","10","1",null,"33","86",null,null,null,null,"NA","NA"],
    [697,"697","Carrier F","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22634","Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; each additional interspace and segment (List separately in addition to code for primary procedure)","7","1",null,"1","86",null,null,null,null,"NA","NA"],
    [698,"698","Carrier F","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","55866","Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed","7","1",null,"47","44",null,null,null,null,"NA","NA"],
    [699,"699","Carrier F","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","50545","Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy)","5","1",null,"2","43",null,null,null,null,"NA","NA"],
    [700,"700","Carrier F","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","36223","Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the extracranial carotid and cervicocerebral arch, when performed","4","1",null,null,"87",null,null,null,null,"NA","NA"],
    [701,"701","Carrier F","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","36224","Selective catheter placement, internal carotid artery, unilateral, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the extracranial carotid and cervicocerebral arch, when performed","4","1",null,null,"87",null,null,null,null,"NA","NA"],
    [702,"702","Carrier F","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","36226","Selective catheter placement, vertebral artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed","4","1",null,null,"87",null,null,null,null,"NA","NA"],
    [703,"703","Carrier F","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","36227","Selective catheter placement, external carotid artery, unilateral, with angiography of the ipsilateral external carotid circulation and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)","4","1",null,null,"87",null,null,null,null,"NA","NA"],
    [704,"704","Carrier F","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","36228","Selective catheter placement, each intracranial branch of the internal carotid or vertebral arteries, unilateral, with angiography of the selected vessel circulation and all associated radiological supervision and interpretation (eg, middle cerebral artery, posterior inferior cerebellar artery) (List separately in addition to code for primary procedure)","4","1",null,null,"87",null,null,null,null,"NA","NA"],
    [705,"705","Carrier F","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","33418","Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; initial prosthesis","1","0","1","26",null,null,null,null,null,"NA","NA"],
    [706,"706","Carrier F","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22634","Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; each additional interspace and segment (List separately in addition to code for primary procedure)","7","0","0.14","1","86",null,null,null,null,"NA","NA"],
    [707,"707","Carrier F","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22633","Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar","10","0","0.1","33","86",null,null,null,null,"NA","NA"],
    [708,"708","Carrier F","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22842","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)","16","0","0.06",null,"82",null,null,null,null,"NA","NA"],
    [709,"709","Carrier F","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","121","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Medical/Surgical/GYN","355","0","0.01","23","67",null,null,null,null,"NA","NA"],
    [710,"710","Carrier G","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","120","Room & Board - Semiprivate - 2 Beds - General","10","1",null,"32.6",null,null,null,null,null,"NA","NA"],
    [711,"711","Carrier G","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22633","ARTHDSIS POST/POSTEROLATRL/POSTINTERBODY LUMBAR","13","0.92",null,null,"159.9",null,null,null,null,"NA","NA"],
    [712,"712","Carrier G","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63047","LAM FACETECTOMY  AND  FORAMOTOMY 1 SEGMENT LUMBAR","11","0.91",null,null,"159",null,null,null,null,"NA","NA"],
    [713,"713","Carrier G","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63048","LAM FACETECTOMY and FORAMTOMY 1 SGM EA CRV THRC/LMBR","10","0.9",null,null,"145.9",null,null,null,null,"NA","NA"],
    [714,"714","Carrier G","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22840","POSTERIOR NON-SEGMENTAL INSTRUMENTATION","13","0.85",null,null,"132.8",null,null,null,null,"NA","NA"],
    [715,"715","Carrier G","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27130","ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT","13","0.85",null,null,"42.7",null,null,null,null,"NA","NA"],
    [716,"716","Carrier G","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20930","ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED","12","0.83",null,null,"132",null,null,null,null,"NA","NA"],
    [717,"717","Carrier G","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96416","CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP","11","0.82",null,"32.3","42.2",null,null,null,null,"NA","NA"],
    [718,"718","Carrier G","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20936","AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION","11","0.82",null,null,"139.2",null,null,null,null,"NA","NA"],
    [719,"719","Carrier G","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD","19","0.79",null,"7.5","133.6",null,null,null,null,"NA","NA"],
    [720,"720","Carrier G","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","120","Room & Board - Semiprivate - 2 Beds - General","10","1",null,"32.6",null,null,null,null,null,"NA","NA"],
    [721,"721","Carrier G","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33518","CORONARY ARTERY BYP W/VEIN  and  ARTERY GRAFT 2 VEIN","8","1",null,"4","108.3",null,null,null,null,"NA","NA"],
    [722,"722","Carrier G","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44207","LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST","6","1",null,"14.4","43",null,null,null,null,"NA","NA"],
    [723,"723","Carrier G","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J9070","CYCLOPHOSPHAMIDE 100 MG","6","1",null,"17.9","64.1",null,null,null,null,"NA","NA"],
    [724,"724","Carrier G","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","38571","LAPS SURG BILATERAL TOTAL PELVIC LMPHADECTOMY","6","1",null,"5.1","50.6",null,null,null,null,"NA","NA"],
    [725,"725","Carrier G","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J1453","INJECTION FOSAPREPITANT 1 MG","5","1",null,"30.1","114.9",null,null,null,null,"NA","NA"],
    [726,"726","Carrier G","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22614","ARTHRODESIS POSTERIOR/POSTEROLATERAL EA ADDL","5","1",null,null,"135.6",null,null,null,null,"NA","NA"],
    [727,"727","Carrier G","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44204","LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS","5","1",null,null,"45.9",null,null,null,null,"NA","NA"],
    [728,"728","Carrier G","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","61624","TCAT PERMANENT OCCLUSION/EMBOLIZATION PRQ CNS","5","1",null,"18.7","131",null,null,null,null,"NA","NA"],
    [729,"729","Carrier G","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","36226","SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY","4","1",null,"9.7","160.1",null,null,null,null,"NA","NA"],
    [730,"730","Carrier G","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","164","Other Room & Board - Sterile Environment","1","0","1","73.9",null,null,null,null,null,"NA","NA"],
    [731,"731","Carrier G","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22846","ANTERIOR INSTRUMENTATION 4-7 VERTEBRAL SEGMENTS","1","0","1",null,"145.6",null,null,null,null,"NA","NA"],
    [732,"732","Carrier G","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27685","LNGTH/SHRT TENDON LEG/ANKLE 1 TENDON SPX","1","0","1",null,"241.7",null,null,null,null,"NA","NA"],
    [733,"733","Carrier G","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27702","ARTHROPLASTY ANKLE W/IMPLANT","1","0","1",null,"241.7",null,null,null,null,"NA","NA"],
    [734,"734","Carrier G","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","33979","INSJ VENTR ASSIST DEV IMPLTABLE ICORP 1 VNTRC","1","0","1","49.3",null,null,null,null,null,"NA","NA"],
    [735,"735","Carrier G","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","20680","REMOVAL IMPLANT DEEP","3","0","0.67","42.5","141.8",null,null,null,null,"NA","NA"],
    [736,"736","Carrier G","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","206","Intensive Care - Intermediate  (ICU)","2","0","0.5","50.1",null,null,null,null,null,"NA","NA"],
    [737,"737","Carrier G","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22552","ARTHRD ANT INTERDY CERVCL BELW C2 EA ADDL NTRSPC","3","0","0.33",null,"103.8",null,null,null,null,"NA","NA"],
    [738,"738","Carrier G","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","120","Room & Board - Semiprivate - 2 Beds - General","10","0","0.3","32.6",null,null,null,null,null,"NA","NA"],
    [739,"739","Carrier G","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","55866","LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT","4","0","0.25","5.1","70.1",null,null,null,null,"NA","NA"],
    [740,"740","Carrier H","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27487","Revis.totl Knee Arthroplas,w/wo Allogft;","10","1",null,null,"52.8",null,null,null,null,"NA","NA"],
    [741,"741","Carrier H","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27134","Revis.tot.hip Arthropl;both Compnts","9","1",null,null,"90",null,null,null,null,"NA","NA"],
    [742,"742","Carrier H","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43644","Laparoscopy, Surg, Gastric Restrictive Procedure; W Gastric Bypass And Roux-en-y Gastroenterostomy (roux Limb <= 150 Cm)","31","0.97",null,"48","135.77",null,null,null,null,"NA","NA"],
    [743,"743","Carrier H","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27447","Replacement Knee Total","85","0.91",null,null,"82.05",null,null,null,null,"NA","NA"],
    [744,"744","Carrier H","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27130","Replacement Hip Total Simple","116","0.9",null,"12","44",null,null,null,null,"NA","NA"],
    [745,"745","Carrier H","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43775","Laps Gstrc Rstrictiv Px Longitudinal Gastrectomy","49","0.9",null,null,"110.4",null,null,null,null,"NA","NA"],
    [746,"746","Carrier H","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22551","Arthodesis, Anterior Interbody, Including Disc Space Preparation, Discectomy, Osteophytectomy And Decompression Of Spinal Cord And/or Nerve Roots; Cervical Below C2","42","0.86",null,"8","75.13",null,null,null,null,"NA","NA"],
    [747,"747","Carrier H","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22633","Arthrodesis, Combnd Post Or Postlat Techq W/post Interbdy Techq Incl Laminctmy And/or Discctmy Suffcnt To Prepre Interspce (oth Thn For Decomp), Sgl Interspce&segmnt; Lumbar","43","0.73",null,"24","102.92",null,null,null,null,"NA","NA"],
    [748,"748","Carrier H","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","Arthrod,interbdy Tech;lumbar,allogf","65","0.67",null,null,"117.33",null,null,null,null,"NA","NA"],
    [749,"749","Carrier H","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63047","Laminectomy W Facetectomy-lumbar","31","0.55",null,null,"94.86",null,null,null,null,"NA","NA"],
    [750,"750","Carrier H","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27487","Revis.totl Knee Arthroplas,w/wo Allogft;","10","1",null,null,"52.8",null,null,null,null,"NA","NA"],
    [751,"751","Carrier H","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27134","Revis.tot.hip Arthropl;both Compnts","9","1",null,null,"90",null,null,null,null,"NA","NA"],
    [752,"752","Carrier H","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22802","Arthrod,post,spin.deform,gft;7+vert","7","1",null,null,"61.71",null,null,null,null,"NA","NA"],
    [753,"753","Carrier H","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","75894","Transcatheter Therapy Embolize Any Meth","6","1",null,null,"68.57",null,null,null,null,"NA","NA"],
    [754,"754","Carrier H","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22533","Arthrodesis, Lateral Extracavitary Technique, Including Minimal Diskectomy To Prepare Interspace; Lumbar","5","1",null,"24","67.2",null,null,null,null,"NA","NA"],
    [755,"755","Carrier H","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22804","Arthrodesis, 13 Or More Vertebral Segments","4","1",null,null,"100.8",null,null,null,null,"NA","NA"],
    [756,"756","Carrier H","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","38241","Hematopoietic Progenitor Cell (hpc);autologous Transplantation","4","1",null,"24","64",null,null,null,null,"NA","NA"],
    [757,"757","Carrier H","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27486","Revis.totl Knee Arthroplas;1 Compon","4","1",null,null,"36",null,null,null,null,"NA","NA"],
    [758,"758","Carrier H","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63056","Transped App/decomp;sgle;lumb","3","1",null,null,"72",null,null,null,null,"NA","NA"],
    [759,"759","Carrier H","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63045","Laminectomy W Facetectomy-cervical","5","0",null,"48","84",null,null,null,null,"NA","NA"],
    [760,"760","Carrier H","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22551","Arthodesis, Anterior Interbody, Including Disc Space Preparation, Discectomy, Osteophytectomy And Decompression Of Spinal Cord And/or Nerve Roots; Cervical Below C2","42","0","1","0.333333","75.13",null,null,null,null,"NA","NA"],
    [761,"761","Carrier H","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43644","Laparoscopy, Surg, Gastric Restrictive Procedure; W Gastric Bypass And Roux-en-y Gastroenterostomy (roux Limb <= 150 Cm)","31","0","1","2","135.77",null,null,null,null,"NA","NA"],
    [762,"762","Carrier H","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","55970","Intersex Op Male To Female","8","0","1",null,"121.6",null,null,null,null,"NA","NA"],
    [763,"763","Carrier H","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22600","Fusion Cervical Post < C1","8","0","1","1","153",null,null,null,null,"NA","NA"],
    [764,"764","Carrier H","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22630","Arthrodesis Post Interbody-lumbar","7","0","1",null,"154",null,null,null,null,"NA","NA"],
    [765,"765","Carrier H","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22614","Arthrodesis, Each Additional Vertebral Segment","4","0","1",null,"216",null,null,null,null,"NA","NA"],
    [766,"766","Carrier H","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","20931","Allograft, Structural, For Spine Surgery Only; (list Separately In Addition To Code For Primary Procedure)","1","0","1",null,"108",null,null,null,null,"NA","NA"],
    [767,"767","Carrier H","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","38999","Unlisted Proc Hemic/lymphatic Syst","1","0","1","2","72",null,null,null,null,"NA","NA"],
    [768,"768","Carrier H","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22214","Osteotomy Spine Post Appr-lumbar","1","0","1",null,"72",null,null,null,null,"NA","NA"],
    [769,"769","Carrier H","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27130","Replacement Hip Total Simple","116","0","0.9","12","44",null,null,null,null,"NA","NA"],
    [770,"770","Carrier I","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27130","Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft","7","1",null,null,"23.04667278",null,null,null,null,"NA","NA"],
    [771,"771","Carrier I","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","5","1",null,null,"21.82893333",null,null,null,null,"NA","NA"],
    [772,"772","Carrier I","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);","3","1",null,"1.390000001","51.785",null,null,null,null,"NA","NA"],
    [773,"773","Carrier I","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22845","Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure)","3","1",null,null,"13.96756852",null,null,null,null,"NA","NA"],
    [774,"774","Carrier I","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27447","Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)","11","0.91",null,null,"13.08",null,null,null,null,"NA","NA"],
    [775,"775","Carrier I","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22614","Arthrodesis, posterior or posterolateral technique, single level; each additional vertebral segment (List separately in addition to code for primary procedure)","4","0.75",null,null,"7.796146042",null,null,null,null,"NA","NA"],
    [776,"776","Carrier I","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22600","Arthrodesis, posterior or posterolateral technique, single level; cervical below C2 segment","3","0.67",null,null,"9.986528055",null,null,null,null,"NA","NA"],
    [777,"777","Carrier I","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","47600","Cholecystectomy;","4","0",null,"68.65444445","46.25231454",null,null,null,null,"NA","NA"],
    [778,"778","Carrier I","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","47605","Cholecystectomy; with cholangiography","3","0",null,"68.65444445","35.73902736",null,null,null,null,"NA","NA"],
    [779,"779","Carrier I","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44204","Laparoscopy, surgical; colectomy, partial, with anastomosis","3","0",null,null,"72.79083333",null,null,null,null,"NA","NA"],
    [780,"780","Carrier I","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27130","Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft","7","1",null,null,"23.05",null,null,null,null,"NA","NA"],
    [781,"781","Carrier I","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","5","1",null,null,"21.83",null,null,null,null,"NA","NA"],
    [782,"782","Carrier I","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58150","Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);","3","1",null,"1.39","51.79",null,null,null,null,"NA","NA"],
    [783,"783","Carrier I","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22845","Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure)","3","1",null,null,"13.97",null,null,null,null,"NA","NA"],
    [784,"784","Carrier I","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27487","Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component","2","1",null,null,"139.77",null,null,null,null,"NA","NA"],
    [785,"785","Carrier I","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","23472","Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder))","2","1",null,null,"69.77",null,null,null,null,"NA","NA"],
    [786,"786","Carrier I","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","2","1",null,null,"33.62","199.4",null,null,null,"NA","NA"],
    [787,"787","Carrier I","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22842","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)","2","1",null,null,"0.09",null,null,null,null,"NA","NA"],
    [788,"788","Carrier I","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22552","Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2, each additional interspace (List separately in addition to code for separate procedure)","2","1",null,null,"0.41",null,null,null,null,"NA","NA"],
    [789,"789","Carrier I","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63047","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","2","1",null,null,"54.14",null,null,null,null,"NA","NA"],
    [790,"790","Carrier I","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22633","Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar","2","1",null,null,"33.62",null,null,null,null,"NA","NA"],
    [791,"791","Carrier I","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22551","Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2","2","1",null,null,"0.41",null,null,null,null,"NA","NA"],
    [792,"792","Carrier I","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","23470","Arthroplasty, glenohumeral joint; hemiarthroplasty","2","1",null,null,"23.76","32.3",null,null,null,"NA","NA"],
    [793,"793","Carrier I","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43280","Laparoscopy, surgical, esophagogastric fundoplasty (eg, Nissen, Toupet procedures)","2","1",null,null,"205.43",null,null,null,null,"NA","NA"],
    [794,"794","Carrier I","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43280","Laparoscopy, surgical, esophagogastric fundoplasty (eg, Nissen, Toupet procedures)","2","0","1",null,"205.43",null,null,null,null,"NA","NA"],
    [795,"795","Carrier I","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63042","Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumbar","1","0","1",null,"67.21",null,null,null,null,"NA","NA"],
    [796,"796","Carrier I","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","52332","Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type)","1","0","1",null,"22.11",null,null,null,null,"NA","NA"],
    [797,"797","Carrier I","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63012","Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (Gill type procedure)","1","0","1",null,"67.21",null,null,null,null,"NA","NA"],
    [798,"798","Carrier I","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22633","Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar","2","0","0.5",null,"33.62",null,null,null,null,"NA","NA"],
    [799,"799","Carrier I","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","2","0","0.5",null,"33.62",null,null,null,null,"NA","NA"],
    [800,"800","Carrier I","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63047","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","2","0","0.5",null,"54.14",null,null,null,null,"NA","NA"],
    [801,"801","Carrier I","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","5","0","0.2",null,"21.83",null,null,null,null,"NA","NA"],
    [802,"802","Carrier J","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27130","Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft","64","0.86",null,"0.89","32.22",null,null,null,null,"NA","NA"],
    [803,"803","Carrier J","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22845","Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure)","31","0.84",null,"0.73","61.39",null,null,null,null,"NA","NA"],
    [804,"804","Carrier J","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","25","0.8",null,"0.18","64.04",null,null,null,null,"NA","NA"],
    [805,"805","Carrier J","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","28","0.79",null,"0.18","61.12",null,null,null,null,"NA","NA"],
    [806,"806","Carrier J","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63048","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure)","27","0.78",null,null,"72.88",null,null,null,null,"NA","NA"],
    [807,"807","Carrier J","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63047","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","34","0.77",null,"0.18","68.48",null,null,null,null,"NA","NA"],
    [808,"808","Carrier J","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27447","Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)","31","0.77",null,null,"63.78",null,null,null,null,"NA","NA"],
    [809,"809","Carrier J","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22633","Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar","22","0.77",null,null,"56.5",null,null,null,null,"NA","NA"],
    [810,"810","Carrier J","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","54","0.74",null,"0.35","70.67",null,null,null,null,"NA","NA"],
    [811,"811","Carrier J","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22842","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)","25","0.72",null,"0.15","52.33",null,null,null,null,"NA","NA"],
    [812,"812","Carrier J","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22843","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in addition to code for primary procedure)","7","1",null,null,"89.48","17.8",null,null,null,"NA","NA"],
    [813,"813","Carrier J","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29881","Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed","7","1",null,"2.98","9.04","36.7",null,null,null,"NA","NA"],
    [814,"814","Carrier J","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","38240","Hematopoietic progenitor cell (HPC); allogeneic transplantation per donor","7","1",null,null,"111.35","27.3",null,null,null,"NA","NA"],
    [815,"815","Carrier J","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33340","Percutaneous transcatheter closure of the left atrial appendage with endocardial implant, including fluoroscopy, transseptal puncture, catheter placement(s), left atrial angiography, left atrial appendage angiography, when performed, and radiological supervision and interpretation","5","1",null,null,"106.12",null,null,null,null,"NA","NA"],
    [816,"816","Carrier J","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15769","Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia)","5","1",null,null,"123.06",null,null,null,null,"NA","NA"],
    [817,"817","Carrier J","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22856","Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); single interspace, cervical","4","1",null,null,"86.09",null,null,null,null,"NA","NA"],
    [818,"818","Carrier J","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27486","Revision of total knee arthroplasty, with or without allograft; 1 component","4","1",null,"0.41","52.8",null,null,null,null,"NA","NA"],
    [819,"819","Carrier J","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","47370","Laparoscopy, surgical, ablation of 1 or more liver tumor(s); radiofrequency","4","1",null,null,"89.51",null,null,null,null,"NA","NA"],
    [820,"820","Carrier J","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63012","Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (Gill type procedure)","4","1",null,null,"53.19",null,null,null,null,"NA","NA"],
    [821,"821","Carrier J","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29882","Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)","4","1",null,"0.8","40.73",null,null,null,null,"NA","NA"],
    [822,"822","Carrier J","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27446","Arthroplasty, knee, condyle and plateau; medial OR lateral compartment","6","0","0.5",null,"168.88",null,null,null,null,"NA","NA"],
    [823,"823","Carrier J","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43282","Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh","3","0","0.33",null,"148.34",null,null,null,null,"NA","NA"],
    [824,"824","Carrier J","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21141","Reconstruction midface, LeFort I; single piece, segment movement in any direction (eg, for Long Face Syndrome), without bone graft","3","0","0.33",null,"183.67",null,null,null,null,"NA","NA"],
    [825,"825","Carrier J","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","95720","Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of EEG recording, interpret","6","0","0.17",null,"85.74",null,null,null,null,"NA","NA"],
    [826,"826","Carrier J","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21085","Impression and custom preparation; oral surgical splint","7","0","0.14",null,"142.47",null,null,null,null,"NA","NA"],
    [827,"827","Carrier J","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21196","Reconstruction of mandibular rami and/or body, sagittal split; with internal rigid fixation","7","0","0.14",null,"146.54",null,null,null,null,"NA","NA"],
    [828,"828","Carrier J","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","20931","Allograft, structural, for spine surgery only (List separately in addition to code for primary procedure)","14","0","0.07",null,"59.64",null,null,null,null,"NA","NA"],
    [829,"829","Carrier J","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22612","Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)","19","0","0.05","0.18","78.39",null,null,null,null,"NA","NA"],
    [830,"830","Carrier J","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22551","Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2","21","0","0.05","0.73","63.36",null,null,null,null,"NA","NA"],
    [831,"831","Carrier J","2020","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22558","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","25","0","0.04","0.18","64.04",null,null,null,null,"NA","NA"],
    [832,"832","Carrier K","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","MH Inpatient Adult","269","1",null,"5.97","2.14","89.3",null,null,null,"NA","NA"],
    [833,"833","Carrier K","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","MH Inpatient Adolescent","49","1",null,"7.58","28.31",null,null,null,null,"NA","NA"],
    [834,"834","Carrier K","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","MH Inpatient Child","15","1",null,"11.13","0.02",null,null,null,null,"NA","NA"],
    [835,"835","Carrier K","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27447","ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS","7","1",null,null,"46","42.5",null,null,null,"NA","NA"],
    [836,"836","Carrier K","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","23472","ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER","5","1",null,null,"65","42.5",null,null,null,"NA","NA"],
    [837,"837","Carrier K","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","SUD Inpatient Adult","5","1",null,"5.63","0.02",null,null,null,null,"NA","NA"],
    [838,"838","Carrier K","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","MH Inpatient Adult Intensive","5","1",null,"0.05",null,"213.9",null,null,null,"NA","NA"],
    [839,"839","Carrier K","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","MH Acute Inpatient Adult","4","1",null,"0.96",null,"42.5",null,null,null,"NA","NA"],
    [840,"840","Carrier K","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","SUD Inpatient Detox Adult","47","0.98",null,"5.94","0.05",null,null,null,null,"NA","NA"],
    [841,"841","Carrier K","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22633","ARTHDSIS POST/POSTEROLATRL/POSTINTERBODY LUMBAR","8","0.88",null,"46","61","0",null,null,null,"NA","NA"],
    [842,"842","Carrier K","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","MH Inpatient Adult","269","1",null,"5.97","2.14",null,null,null,null,"NA","NA"],
    [843,"843","Carrier K","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","MH Inpatient Adolescent","49","1",null,"7.58","28.31",null,null,null,null,"NA","NA"],
    [844,"844","Carrier K","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","MH Inpatient Child","15","1",null,"11.13","0.02",null,null,null,null,"NA","NA"],
    [845,"845","Carrier K","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","23472","ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER","5","1",null,null,"65",null,null,null,null,"NA","NA"],
    [846,"846","Carrier K","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","SUD Inpatient Adult","5","1",null,"5.63","0.02",null,null,null,null,"NA","NA"],
    [847,"847","Carrier K","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","MH Inpatient Adult Intensive","5","1",null,"0.05",null,null,null,null,null,"NA","NA"],
    [848,"848","Carrier K","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","MH Acute Inpatient Adult","4","1",null,"0.96",null,null,null,null,null,"NA","NA"],
    [849,"849","Carrier K","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27134","REVJ TOT HIP ARTHRP BTH W/WO AGRFT/ALGRFT","3","1",null,"71","66",null,null,null,null,"NA","NA"],
    [850,"850","Carrier K","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22558","ARTHRODESIS ANTERIOR INTERBODY LUMBAR","2","1",null,"0","70",null,null,null,null,"NA","NA"],
    [851,"851","Carrier K","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22551","ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C2","2","1",null,null,"109",null,null,null,null,"NA","NA"],
    [852,"852","Carrier L","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96413","CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG","4","1",null,"28.35","68.2",null,null,null,null,"NA","NA"],
    [853,"853","Carrier L","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96409","CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG","2","1",null,"28.35",null,null,null,null,null,"NA","NA"],
    [854,"854","Carrier L","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96411","CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG","2","1",null,"28.35",null,null,null,null,null,"NA","NA"],
    [855,"855","Carrier L","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96415","CHEMOTHERAPY ADMN IV INFUSION TQ EA HR","2","1",null,null,"68.2","35",null,null,null,"NA","NA"],
    [856,"856","Carrier L","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96417","CHEMOTX ADMN IV NFS TQ EA SEQL NFS TO 1 HR","2","1",null,null,"68.2",null,null,null,null,"NA","NA"],
    [857,"857","Carrier L","2020","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","26951","AMP F/TH 1/2 JT/PHALANX W/NEURECT W/DIR CLSR","2","0",null,null,"92.3",null,null,null,null,"NA","NA"],
    [858,"858","Carrier L","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96413","CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG","4","1",null,"28.35","68.2",null,null,null,null,"NA","NA"],
    [859,"859","Carrier L","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96409","CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG","2","1",null,"28.35",null,null,null,null,null,"NA","NA"],
    [860,"860","Carrier L","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96411","CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG","2","1",null,"28.35",null,null,null,null,null,"NA","NA"],
    [861,"861","Carrier L","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96415","CHEMOTHERAPY ADMN IV INFUSION TQ EA HR","2","1",null,null,"68.2",null,null,null,null,"NA","NA"],
    [862,"862","Carrier L","2020","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96417","CHEMOTX ADMN IV NFS TQ EA SEQL NFS TO 1 HR","2","1",null,null,"68.2",null,null,null,null,"NA","NA"],
    [863,"863","Carrier M","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Internal","RMH","Residential Mental Health","19","0.74",null,"1.3","72",null,null,null,null,"NA","NA"],
    [864,"864","Carrier M","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Internal","DAA","Detoxification","45","0.53",null,"0.5","72",null,null,null,null,"NA","NA"],
    [865,"865","Carrier M","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Internal","MEN","Mental Health","112","0.51",null,"0.21","84",null,null,null,null,"NA","NA"],
    [866,"866","Carrier M","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Internal","RSA","Residential Substance Abuse","53","0.45",null,"1.7","21",null,null,null,null,"NA","NA"],
    [867,"867","Carrier M","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Internal","REH","Rehabilitation","36","0.44",null,"2.6","57",null,null,null,null,"NA","NA"],
    [868,"868","Carrier M","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Internal","DAR","Drug & Alcohol Rehabilitation","6","0.17",null,"0",null,null,null,null,null,"NA","NA"],
    [869,"869","Carrier M","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Internal","DAA","Detoxification","16","1",null,"4.5","229.5",null,null,null,null,"NA","NA"],
    [870,"870","Carrier M","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Internal","DAR","Drug & Alcohol Rehabilitation","1","1",null,"0","0",null,null,null,null,"NA","NA"],
    [871,"871","Carrier M","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Internal","MEN","Mental Health","57","0.98",null,"0.42","32.84",null,null,null,null,"NA","NA"],
    [872,"872","Carrier M","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Internal","RSA","Residential Substance Abuse","24","0.96",null,"1","118",null,null,null,null,"NA","NA"],
    [873,"873","Carrier M","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Internal","RMH","Residential Mental Health","24","0.79",null,"1","458",null,null,null,null,"NA","NA"],
    [874,"874","Carrier M","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Internal","REH","Rehabilitation","14","0.71",null,"5.14","77.14",null,null,null,null,"NA","NA"],
    [875,"875","Carrier A","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99251","Inpatient consultation for a new or established patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 20 minutes","1","0",null,"41.59",null,null,null,null,null,"NA","NA"],
    [876,"876","Carrier A","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99251","Inpatient consultation for a new or established patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 20 minutes","1","0",null,"41.59",null,null,null,null,null,"NA","NA"],
    [877,"877","Carrier N","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","Substance Abuse Residential","3","1",null,null,"24",null,null,null,null,"NA","NA"],
    [878,"878","Carrier N","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","Detox","1","1",null,null,"24",null,null,null,null,"NA","NA"],
    [879,"879","Carrier N","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","Mental Health Inpatient","1","1",null,null,"24",null,null,null,null,"NA","NA"],
    [880,"880","Carrier N","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","Substance Abuse Residential","3","1",null,null,"24",null,null,null,null,"NA","NA"],
    [881,"881","Carrier N","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","Detox","1","1",null,null,"24",null,null,null,null,"NA","NA"],
    [882,"882","Carrier N","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","Mental Health Inpatient","1","1",null,null,"24",null,null,null,null,"NA","NA"],
    [883,"883","Carrier B","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","Psychiatric Admission","1","1",null,"26.8","0","0",null,null,null,"NA","NA"],
    [884,"884","Carrier B","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","Psychiatric Admission","1","1",null,"26.8","0","0",null,null,null,"NA","NA"],
    [885,"885","Carrier C","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90870","ECT (W/ MONITORING) SINGLE SEIZURE","5","1",null,null,"164.53",null,null,null,null,"NA","NA"],
    [886,"886","Carrier C","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96132","NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR","2","1",null,null,"350.4",null,null,null,null,"NA","NA"],
    [887,"887","Carrier C","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96156","HEALTH BEHAVIOR ASSESSMENT, OR RE-ASSESSMENT","1","1",null,null,"89.12",null,null,null,null,"NA","NA"],
    [888,"888","Carrier C","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","912","OTHER THERAPY SERV","1","1",null,null,"590.18",null,null,null,null,"NA","NA"],
    [889,"889","Carrier C","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","126","ACCOM SEMI-PRVT DETOX/2BD","230","0.99",null,"28.55","183.66",null,null,null,null,"NA","NA"],
    [890,"890","Carrier C","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","124","ACCOM SEMI-PRVT 2 BED PSY","797","0.98",null,"22.57","277.87",null,null,null,null,"NA","NA"],
    [891,"891","Carrier C","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","900","OTHER THERAPY SERV","228","0.97",null,"32.67","740",null,null,null,null,"NA","NA"],
    [892,"892","Carrier C","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","128","ROOM AND BOARD","301","0.88",null,"70.79","321.87",null,null,null,null,"NA","NA"],
    [893,"893","Carrier C","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","BEHAV IDENTIFICATION ASSESSMNT, ADM BY PHYS OR QUAL PROF, EA 15 MINS","3","0.67",null,null,"318.51",null,null,null,null,"NA","NA"],
    [894,"894","Carrier C","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","905","BH/INTENS OP/PSYCH","2","0.5",null,null,"852.84",null,null,null,null,"NA","NA"],
    [895,"895","Carrier C","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90870","ECT (W/ MONITORING) SINGLE SEIZURE","5","1",null,null,"164.53",null,null,null,null,"NA","NA"],
    [896,"896","Carrier C","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96132","NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR","2","1",null,null,"350.4",null,null,null,null,"NA","NA"],
    [897,"897","Carrier C","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96156","HEALTH BEHAVIOR ASSESSMENT, OR RE-ASSESSMENT","1","1",null,null,"89.12",null,null,null,null,"NA","NA"],
    [898,"898","Carrier C","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","912","OTHER THERAPY SERV","1","1",null,null,"590.18",null,null,null,null,"NA","NA"],
    [899,"899","Carrier C","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","126","ACCOM SEMI-PRVT DETOX/2BD","230","0.99",null,"28.55","183.66",null,null,null,null,"NA","NA"],
    [900,"900","Carrier C","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","124","ACCOM SEMI-PRVT 2 BED PSY","797","0.98",null,"22.57","277.87",null,null,null,null,"NA","NA"],
    [901,"901","Carrier C","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","900","OTHER THERAPY SERV","228","0.97",null,"32.67","740",null,null,null,null,"NA","NA"],
    [902,"902","Carrier C","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","128","ROOM AND BOARD","301","0.88",null,"70.79","321.87",null,null,null,null,"NA","NA"],
    [903,"903","Carrier C","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97151","BEHAV IDENTIFICATION ASSESSMNT, ADM BY PHYS OR QUAL PROF, EA 15 MINS","3","0.67",null,null,"318.51",null,null,null,null,"NA","NA"],
    [904,"904","Carrier C","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","905","BH/INTENS OP/PSYCH","2","0.5",null,null,"852.84",null,null,null,null,"NA","NA"],
    [905,"905","Carrier C","2020","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","128","ROOM AND BOARD","301","0","0.01","70.79","321.87",null,null,null,null,"NA","NA"],
    [906,"906","Carrier C","2020","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","900","OTHER THERAPY SERV","228","0","0","32.67","740",null,null,null,null,"NA","NA"],
    [907,"907","Carrier C","2020","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","126","ACCOM SEMI-PRVT DETOX/2BD","230","0","0","28.55","183.66",null,null,null,null,"NA","NA"],
    [908,"908","Carrier D","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90870","ELECTROCONVULSIVE THERAPY","1","1",null,null,"87.96",null,null,null,null,"NA","NA"],
    [909,"909","Carrier D","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","900","PSYCH TREATMENTS GEN THER","190","0.99",null,"32.06",null,null,null,null,null,"NA","NA"],
    [910,"910","Carrier D","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","124","ROOM AND BOARD","337","0.97",null,"34","423.7",null,null,null,null,"NA","NA"],
    [911,"911","Carrier D","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","126","ROOM AND BOARD","91","0.93",null,"27.08","4.07",null,null,null,null,"NA","NA"],
    [912,"912","Carrier D","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","128","ROOM AND BOARD","311","0.89",null,"39.95","732.43",null,null,null,null,"NA","NA"],
    [913,"913","Carrier D","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90870","ELECTROCONVULSIVE THERAPY","1","1",null,null,"87.96",null,null,null,null,"NA","NA"],
    [914,"914","Carrier D","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","900","PSYCH TREATMENTS GEN THER","190","0.99",null,"32.06",null,null,null,null,null,"NA","NA"],
    [915,"915","Carrier D","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","124","ROOM AND BOARD","337","0.97",null,"34","423.7",null,null,null,null,"NA","NA"],
    [916,"916","Carrier D","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","126","ROOM AND BOARD","91","0.93",null,"27.08","4.07",null,null,null,null,"NA","NA"],
    [917,"917","Carrier D","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","128","ROOM AND BOARD","311","0.89",null,"39.95","732.43",null,null,null,null,"NA","NA"],
    [918,"918","Carrier D","2020","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","124","ROOM AND BOARD","337","0","0.01","34","423.7",null,null,null,null,"NA","NA"],
    [919,"919","Carrier D","2020","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","128","ROOM AND BOARD","311","0","0.01","39.95","732.43",null,null,null,null,"NA","NA"],
    [920,"920","Carrier E","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC","57","1",null,null,"17.5",null,null,null,null,"NA","NA"],
    [921,"921","Carrier E","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","128","ROOM & BOARD, SEMIPRIVATE TWO-BED - REHABILITATION","5","1",null,null,"21.2",null,null,null,null,"NA","NA"],
    [922,"922","Carrier E","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","194","SUBACUTE CARE, LEVEL IV","3","1",null,null,"9.7",null,null,null,null,"NA","NA"],
    [923,"923","Carrier E","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0005","ALCOHOL AND/OR DRUG SERVICES GROUP COUNSELING BY CLINICIAN","1","1",null,null,"26.2",null,null,null,null,"NA","NA"],
    [924,"924","Carrier E","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99284","EMERGENCY DEPARTMENT VISIT HIGH/URGENT SEVERITY","1","1",null,null,"45.8",null,null,null,null,"NA","NA"],
    [925,"925","Carrier E","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","129","ROOM & BOARD, SEMIPRIVATE TWO-BED - OTHER","1","1",null,null,"68.2",null,null,null,null,"NA","NA"],
    [926,"926","Carrier E","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1002","BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP","10","0.9",null,null,"33.2",null,null,null,null,"NA","NA"],
    [927,"927","Carrier E","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1001","BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC","12","0.83",null,null,"26.1",null,null,null,null,"NA","NA"],
    [928,"928","Carrier E","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99255","INITIAL INPATIENT CONSULT NEW/ESTAB PT 110 MIN","1","0",null,null,"72.4",null,null,null,null,"NA","NA"],
    [929,"929","Carrier E","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","136","ROOM & BOARD, THREE AND FOUR BEDS - DETOXIFICATION","1","0",null,null,"98.4",null,null,null,null,"NA","NA"],
    [930,"930","Carrier E","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC","57","1",null,null,"17.5",null,null,null,null,"NA","NA"],
    [931,"931","Carrier E","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","128","ROOM & BOARD, SEMIPRIVATE TWO-BED - REHABILITATION","5","1",null,null,"21.2",null,null,null,null,"NA","NA"],
    [932,"932","Carrier E","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","194","SUBACUTE CARE, LEVEL IV","3","1",null,null,"9.7",null,null,null,null,"NA","NA"],
    [933,"933","Carrier E","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0005","ALCOHOL AND/OR DRUG SERVICES GROUP COUNSELING BY CLINICIAN","1","1",null,null,"26.2",null,null,null,null,"NA","NA"],
    [934,"934","Carrier E","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99284","EMERGENCY DEPARTMENT VISIT HIGH/URGENT SEVERITY","1","1",null,null,"45.8",null,null,null,null,"NA","NA"],
    [935,"935","Carrier E","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","129","ROOM & BOARD, SEMIPRIVATE TWO-BED - OTHER","1","1",null,null,"68.2",null,null,null,null,"NA","NA"],
    [936,"936","Carrier E","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","114","ROOM & BOARD, PRIVATE - PSYCHIATRIC","1","1",null,null,null,null,null,null,null,"NA","NA"],
    [937,"937","Carrier E","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1002","BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP","10","0.9",null,null,"33.2",null,null,null,null,"NA","NA"],
    [938,"938","Carrier E","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1001","BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC","12","0.83",null,null,"26.1",null,null,null,null,"NA","NA"],
    [939,"939","Carrier E","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99255","INITIAL INPATIENT CONSULT NEW/ESTAB PT 110 MIN","1","0",null,null,"72.4",null,null,null,null,"NA","NA"],
    [940,"940","Carrier F","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Psychiatric","3","1",null,"20","39",null,null,null,null,"NA","NA"],
    [941,"941","Carrier F","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","128","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation","8","0.75",null,"16","38",null,null,null,null,"NA","NA"],
    [942,"942","Carrier F","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Psychiatric","3","1",null,"20","39",null,null,null,null,"NA","NA"],
    [943,"943","Carrier F","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","128","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation","8","0.75",null,"16","38",null,null,null,null,"NA","NA"],
    [944,"944","Carrier G","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","55970","INTERSEX SURG MALE FEMALE","2","1",null,null,"117.5",null,null,null,null,"NA","NA"],
    [945,"945","Carrier G","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90870","ELECTROCONVULSIVE THERAPY","2","1",null,"65",null,null,null,null,null,"NA","NA"],
    [946,"946","Carrier G","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","Room & Board - Semiprivate - 2 Beds - Psychiatric","1","1",null,null,null,null,null,null,null,"NA","NA"],
    [947,"947","Carrier G","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","450","Emergency Room - General","1","0",null,null,null,"432",null,null,null,"NA","NA"],
    [948,"948","Carrier G","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","424","Physical Therapy - Evaluation or Reevaluation","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [949,"949","Carrier G","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","259","Pharmacy - Other Pharmacy","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [950,"950","Carrier G","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","440","Speech-Language Pathology - General","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [951,"951","Carrier G","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","300","Laboratory - General","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [952,"952","Carrier G","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","730","EKG/ECG (Electrocardiogram) - General","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [953,"953","Carrier G","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","636","Drugs Requiring Specific Identification - Drug Requiring Det","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [954,"954","Carrier G","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","55970","INTERSEX SURG MALE FEMALE","2","1",null,null,"117.5",null,null,null,null,"NA","NA"],
    [955,"955","Carrier G","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90870","ELECTROCONVULSIVE THERAPY","2","1",null,"64.3",null,null,null,null,null,"NA","NA"],
    [956,"956","Carrier G","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","Room & Board - Semiprivate - 2 Beds - Psychiatric","1","1",null,"0",null,null,null,null,null,"NA","NA"],
    [957,"957","Carrier G","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","120","Room & Board - Semiprivate - 2 Beds - General","1","1",null,"146.3",null,null,null,null,null,"NA","NA"],
    [958,"958","Carrier G","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","259","Pharmacy - Other Pharmacy","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [959,"959","Carrier G","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","450","Emergency Room - General","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [960,"960","Carrier G","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","440","Speech-Language Pathology - General","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [961,"961","Carrier G","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","636","Drugs Requiring Specific Identification - Drug Requiring Det","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [962,"962","Carrier G","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","730","EKG/ECG (Electrocardiogram) - General","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [963,"963","Carrier G","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","214","Coronary Care - Intermediate Coronary Care Unit (CCU)","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [964,"964","Carrier G","2020","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","120","Room & Board - Semiprivate - 2 Beds - General","1","0","1","146.3",null,null,null,null,null,"NA","NA"],
    [965,"965","Carrier H","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0017","Behavioral health; residential (hospital residential treatment program), without room and board, per diem","3","1",null,null,"3480","0",null,null,null,"NA","NA"],
    [966,"966","Carrier H","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","128","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation","6","0.67",null,"31","36",null,null,null,null,"NA","NA"],
    [967,"967","Carrier H","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Psychiatric","4","0.5",null,null,"29",null,null,null,null,"NA","NA"],
    [968,"968","Carrier H","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0017","Behavioral health; residential (hospital residential treatment program), without room and board, per diem","3","1",null,"0","3480",null,null,null,null,"NA","NA"],
    [969,"969","Carrier H","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","128","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation","6","0.67",null,"31","36",null,null,null,null,"NA","NA"],
    [970,"970","Carrier H","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Psychiatric","4","0.5",null,null,"29",null,null,null,null,"NA","NA"],
    [971,"971","Carrier J","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H2036","Alcohol And/Or Drug Services","2","1",null,null,"132.43",null,null,null,null,"NA","NA"],
    [972,"972","Carrier J","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90791","Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is unstable or has developed","1","1",null,null,"21.85",null,null,null,null,"NA","NA"],
    [973,"973","Carrier J","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0019","Alcohol And/Or Drug Services","4","0",null,null,"24.56",null,null,null,null,"NA","NA"],
    [974,"974","Carrier J","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0017","Alcohol And/Or Drug Services","1","0",null,null,"142.44",null,null,null,null,"NA","NA"],
    [975,"975","Carrier J","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","1","0",null,null,"43.35",null,null,null,null,"NA","NA"],
    [976,"976","Carrier J","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99233","Alcohol And/Or Drug Services","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [977,"977","Carrier J","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95720","Alcohol And/Or Drug Services","1","0",null,null,"67.56",null,null,null,null,"NA","NA"],
    [978,"978","Carrier J","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0018","Alcohol and/or other drug treatment program, per diem","1","0",null,"73.15",null,null,null,null,null,"NA","NA"],
    [979,"979","Carrier J","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0010","Psychiatric diagnostic evaluation","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [980,"980","Carrier J","2020","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0011","Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of EEG recording, interpret","1","0",null,null,"124.9",null,null,null,null,"NA","NA"],
    [981,"981","Carrier J","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H2036","Alcohol and/or other drug treatment program, per diem","2","1",null,null,"132.43","42.4",null,null,null,"NA","NA"],
    [982,"982","Carrier J","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90791","Psychiatric diagnostic evaluation","1","1",null,null,"21.85","14.4",null,null,null,"NA","NA"],
    [983,"983","Carrier J","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0019","Alcohol And/Or Drug Services","4","0",null,null,"24.56","18.9",null,null,null,"NA","NA"],
    [984,"984","Carrier J","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0017","Alcohol And/Or Drug Services","1","0",null,null,"142.44",null,null,null,null,"NA","NA"],
    [985,"985","Carrier J","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99233","Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is unstable or has developed","1","0",null,null,null,"19.3",null,null,null,"NA","NA"],
    [986,"986","Carrier J","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0010","Alcohol And/Or Drug Services","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [987,"987","Carrier J","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0018","Alcohol And/Or Drug Services","1","0",null,"73.15",null,null,null,null,null,"NA","NA"],
    [988,"988","Carrier J","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95720","Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of EEG recording, interpret","1","0",null,null,"67.56",null,null,null,null,"NA","NA"],
    [989,"989","Carrier J","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","1","0",null,null,"43.35",null,null,null,null,"NA","NA"],
    [990,"990","Carrier J","2020","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0011","Alcohol And/Or Drug Services","1","0",null,null,"124.9",null,null,null,null,"NA","NA"],
    [991,"991","Carrier M","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S4016","FROZEN IN VITRO FERTILIZATION CYCLE, CASE RATE","56","0.88",null,"1.29","54.86",null,null,null,null,"NA","NA"],
    [992,"992","Carrier M","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19318","REDUCTION MAMMAPLASTY","41","0.59",null,"1.76","14.63",null,null,null,null,"NA","NA"],
    [993,"993","Carrier M","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","89253","ASSISTED EMBRYO HATCHING, MICROTECHNIQUES (ANY METHOD)","71","0.48",null,"1.01","56.79",null,null,null,null,"NA","NA"],
    [994,"994","Carrier M","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","89342","STORAGE, (PER YEAR); EMBRYO(S)","42","0.36",null,"1.71","75.43",null,null,null,null,"NA","NA"],
    [995,"995","Carrier M","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","89258","CRYOPRESERVATION; EMBRYO","42","0.31",null,"1.71","86.29",null,null,null,null,"NA","NA"],
    [996,"996","Carrier M","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S4015","COMPLETE IN VITRO FERTILIZATION CYCLE, CASE RATE; NOT OTHERWISE SPECIFIED","29","0.31",null,"2.48","82.76",null,null,null,null,"NA","NA"],
    [997,"997","Carrier M","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S4011","IN VITRO FERTILIZATION; INCLUDING BUT NOT LIMITED TO IDENTIFICATION","51","0.2",null,"1.41","64.47",null,null,null,null,"NA","NA"],
    [998,"998","Carrier M","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S4022","ASSISTED OOCYTE FERTILIZATION, CASE RATE","61","0.16",null,"1.18","74.75",null,null,null,null,"NA","NA"],
    [999,"999","Carrier M","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","89290","BIOPSY, OOCYTE POLAR BODY OR EMBRYO BLASTOMERE, MICROTECHNIQUE (FOR PRE-IMPLANTATION GENETIC DIAGNOSIS); LESS THAN OR EQUAL TO 5 EMBRYOS","39","0.05",null,"1.85","78.77",null,null,null,null,"NA","NA"],
    [1000,"1000","Carrier M","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","89291","BIOPSY, OOCYTE POLAR BODY OR EMBRYO BLASTOMERE, MICROTECHNIQUE (FOR PRE-IMPLANTATION GENETIC DIAGNOSIS); GREATER THAN 5 EMBRYOS","39","0.05",null,"1.85","70.77",null,null,null,null,"NA","NA"],
    [1001,"1001","Carrier M","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58322","ARTIFICIAL INSEMINATION; INTRA-UTERINE","23","1",null,"3.13","65.74",null,null,null,null,"NA","NA"],
    [1002,"1002","Carrier M","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19325","MAMMAPLASTY, AUGMENTATION; WITH PROSTHETIC IMPLANT","17","1",null,"4.24","31.06",null,null,null,null,"NA","NA"],
    [1003,"1003","Carrier M","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S4016","FROZEN IN VITRO FERTILIZATION CYCLE, CASE RATE","56","0.88",null,"1.29","54.86",null,null,null,null,"NA","NA"],
    [1004,"1004","Carrier M","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99499","UNLISTED EVALUATION AND MANAGEMENT SERVICE","16","0.88",null,"4.5","27",null,null,null,null,"NA","NA"],
    [1005,"1005","Carrier M","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63047","LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA AND/OR NERVE ROOT(S) (EG; SPINAL OR LATERAL RECESS STENOSIS) SINGLE VERTEBRAL SEGMENT; LUMBAR","23","0.78",null,"3.13","29.22",null,null,null,null,"NA","NA"],
    [1006,"1006","Carrier M","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63030","LAMINOTOMY (HEMILAMINECTOMY), WITH DECOMPRESSION OF NERVE ROOT(S), INCLUDING PARTIAL FACETECTOMY, FORAMINOTOMY AND/OR EXCISION OF HERNIATED INTERVERTEBRAL DISC; 1 INTERSPACE, LUMBAR","25","0.76",null,"2.88","32.64",null,null,null,null,"NA","NA"],
    [1007,"1007","Carrier M","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","36475","ENDOVENOUS ABLATION THERAPY OF INCOMPETENT VEIN, EXTREMITY, INCLUSIVE OF ALL IMAGING GUIDANCE AND MONITORING, PERCUTANEOUS, RADIOFREQUENCY; FIRST VEIN TREATED","27","0.74",null,"2.67","16.89",null,null,null,null,"NA","NA"],
    [1008,"1008","Carrier M","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19318","REDUCTION MAMMAPLASTY","41","0.59",null,"1.76","14.63",null,null,null,null,"NA","NA"],
    [1009,"1009","Carrier M","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","89253","ASSISTED EMBRYO HATCHING, MICROTECHNIQUES (ANY METHOD)","71","0.48",null,"1.01","56.79",null,null,null,null,"NA","NA"],
    [1010,"1010","Carrier M","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","89342","STORAGE, (PER YEAR); EMBRYO(S)","42","0.36",null,"1.71","75.43",null,null,null,null,"NA","NA"],
    [1011,"1011","Carrier M","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","S4042","MANAGEMENT OF OVULATION INDUCTION (INTERPRETATION OF DIAGNOSTIC TESTS AND STUDIES, NON-FACE-TO-FACE MEDICAL MANAGEMENT OF THE PATIENT), PER CYCLE","2","0","1",null,"12",null,null,null,null,"NA","NA"],
    [1012,"1012","Carrier M","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","76948","ULTRASONIC GUIDANCE FOR ASPIRATION OF OVA, IMAGING AND INTERPRETATION","2","0","0.67",null,"12",null,null,null,null,"NA","NA"],
    [1013,"1013","Carrier M","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","58970","FOLLICLE PUNCTURE FOR OOCYTE RETRIEVAL, ANY METHOD","2","0","0.5",null,"12",null,null,null,null,"NA","NA"],
    [1014,"1014","Carrier M","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","76942","ULTRASONIC GUIDANCE FOR NEEDLE PLACEMENT (EG, BIOPSY, ASPIRATION, INJECTION, LOCALIZATION DEVICE), IMAGING SUPERVISION AND INTERPRETATION","2","0","0.5",null,"12",null,null,null,null,"NA","NA"],
    [1015,"1015","Carrier M","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22856","TOTAL DISC ARTHROPLASTY (ARTIFICIAL DISC), ANTERIOR APPROACH, INCLUDING DISCECTOMY WITH END PLATE PREPARATION (INCLUDES OSTEOPHYTECTOMY FOR NERVE ROOT OR SPINAL CORD DECOMPRESSION AND MICRODISSECTION); SINGLE INTERSPACE, CERVICAL","2","0","0.4",null,"48",null,null,null,null,"NA","NA"],
    [1016,"1016","Carrier M","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","36471","INJECTION OF SCLEROSING SOLUTION; MULTIPLE VEINS, SAME LEG","1","0","0.33",null,"48",null,null,null,null,"NA","NA"],
    [1017,"1017","Carrier M","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","58974","EMBRYO TRANSFER, INTRAUTERINE","2","0","0.29",null,"12",null,null,null,null,"NA","NA"],
    [1018,"1018","Carrier M","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","S4015","COMPLETE IN VITRO FERTILIZATION CYCLE, CASE RATE; NOT OTHERWISE SPECIFIED","2","0","0.1",null,"12",null,null,null,null,"NA","NA"],
    [1019,"1019","Carrier M","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","89258","CRYOPRESERVATION; EMBRYO","2","0","0.07",null,"12",null,null,null,null,"NA","NA"],
    [1020,"1020","Carrier M","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","89253","ASSISTED EMBRYO HATCHING, MICROTECHNIQUES (ANY METHOD)","2","0","0.05",null,"12",null,null,null,null,"NA","NA"],
    [1021,"1021","Carrier A","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74176","Computed tomography, abdomen and pelvis; without contrast material","304","0.94",null,"10.5","5.5",null,null,null,null,"NA","NA"],
    [1022,"1022","Carrier A","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography","280","0.91",null,null,"5.8",null,null,null,null,"NA","NA"],
    [1023,"1023","Carrier A","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material","229","0.88",null,null,"4.5",null,null,null,null,"NA","NA"],
    [1024,"1024","Carrier A","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73221","Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)","124","0.87",null,null,"6.1",null,null,null,null,"NA","NA"],
    [1025,"1025","Carrier A","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72148","Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material","194","0.78",null,null,"9.5",null,null,null,null,"NA","NA"],
    [1026,"1026","Carrier A","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","550","0.77",null,"9.9","22.8",null,null,null,null,"NA","NA"],
    [1027,"1027","Carrier A","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97014","Application of a modality to 1 or more areas; electrical stimulation (unattended)","162","0.77",null,"16.2","24.4",null,null,null,null,"NA","NA"],
    [1028,"1028","Carrier A","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97140","Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes","505","0.75",null,"12","23.6",null,null,null,null,"NA","NA"],
    [1029,"1029","Carrier A","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97530","Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","241","0.73",null,null,"24.7",null,null,null,null,"NA","NA"],
    [1030,"1030","Carrier A","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97112","Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities","288","0.71",null,null,"25.5",null,null,null,null,"NA","NA"],
    [1031,"1031","Carrier A","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29827","Arthroscopy, shoulder, surgical; with rotator cuff repair","26","1",null,null,"67.57",null,null,null,null,"NA","NA"],
    [1032,"1032","Carrier A","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","73722","Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s)","14","1",null,null,"3.61",null,null,null,null,"NA","NA"],
    [1033,"1033","Carrier A","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93303","Transthoracic echocardiography for congenital cardiac anomalies; complete","13","1",null,null,"1.73",null,null,null,null,"NA","NA"],
    [1034,"1034","Carrier A","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77046","Magnetic resonance imaging, breast, without contrast material; unilateral","12","1",null,"20.09","2.04",null,null,null,null,"NA","NA"],
    [1035,"1035","Carrier A","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70480","Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material","12","1",null,null,"0.02",null,null,null,null,"NA","NA"],
    [1036,"1036","Carrier A","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72125","Computed tomography, cervical spine; without contrast material","11","1",null,null,"2.82",null,null,null,null,"NA","NA"],
    [1037,"1037","Carrier A","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29888","Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction","11","1",null,null,"45.32",null,null,null,null,"NA","NA"],
    [1038,"1038","Carrier A","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72157","Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic","9","1",null,null,"5.38",null,null,null,null,"NA","NA"],
    [1039,"1039","Carrier A","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64495","Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; third and any additional level(s) (List separately in addition to code for primary procedure)","9","1",null,null,"5.33",null,null,null,null,"NA","NA"],
    [1040,"1040","Carrier A","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","73218","Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s)","9","1",null,null,"5.92",null,null,null,null,"NA","NA"],
    [1041,"1041","Carrier A","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58552","Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)","9","1",null,null,"55.22",null,null,null,null,"NA","NA"],
    [1042,"1042","Carrier A","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","42145","Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty)","1","0","1",null,"93.99",null,null,null,null,"NA","NA"],
    [1043,"1043","Carrier A","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","58353","Endometrial ablation, thermal, without hysteroscopic guidance","1","0","1",null,"173.5",null,null,null,null,"NA","NA"],
    [1044,"1044","Carrier A","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43282","Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh","1","0","1",null,"317.1",null,null,null,null,"NA","NA"],
    [1045,"1045","Carrier A","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22899","Unlisted procedure, spine","1","0","1",null,"101.25",null,null,null,null,"NA","NA"],
    [1046,"1046","Carrier A","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22858","Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); second level, cervical (List separately in addition to code for primary procedure)","4","0","0.5","0.44","188.61",null,null,null,null,"NA","NA"],
    [1047,"1047","Carrier A","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22856","Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); single interspace, cervical","4","0","0.5","0.44","188.61",null,null,null,null,"NA","NA"],
    [1048,"1048","Carrier A","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64590","Insertion or replacement of peripheral or gastric neurostimulator pulse generator or receiver, direct or inductive coupling","2","0","0.5",null,"81.09",null,null,null,null,"NA","NA"],
    [1049,"1049","Carrier A","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","29867","Arthroscopy, knee, surgical; osteochondral allograft (eg, mosaicplasty)","2","0","0.5",null,"17.01",null,null,null,null,"NA","NA"],
    [1050,"1050","Carrier A","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43281","Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh","5","0","0.4",null,"206.86",null,null,null,null,"NA","NA"],
    [1051,"1051","Carrier A","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43280","Laparoscopy, surgical, esophagogastric fundoplasty (eg, Nissen, Toupet procedures)","5","0","0.4",null,"217.56",null,null,null,null,"NA","NA"],
    [1052,"1052","Carrier N","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","77049","Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (CAD real-time lesion detection, characterization and pharmacokinetic analysis), when performed; bilateral","22","1",null,null,"12",null,null,null,null,"NA","NA"],
    [1053,"1053","Carrier N","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","MRI, brain, including brain stem; without contrast material(s), followed by contrast material(s) and further sequences","51","0.96",null,null,"12",null,null,null,null,"NA","NA"],
    [1054,"1054","Carrier N","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64483","Injection, anesthetic agent and/or steroid, transforaminal epidural;lumbar or sacral, single level","22","0.95",null,null,"12",null,null,null,null,"NA","NA"],
    [1055,"1055","Carrier N","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74177","Computed tomography, abdomen and pelvis; with contrast material(s","77","0.91",null,null,"12",null,null,null,null,"NA","NA"],
    [1056,"1056","Carrier N","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","MRI, any joint of lower extremity; without contrast materia","81","0.88",null,null,"12",null,null,null,null,"NA","NA"],
    [1057,"1057","Carrier N","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71260","Computed tomography (CT), thorax; with contrast material(s)","57","0.88",null,null,"12",null,null,null,null,"NA","NA"],
    [1058,"1058","Carrier N","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74183","MRI, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences","24","0.83",null,null,"12",null,null,null,null,"NA","NA"],
    [1059,"1059","Carrier N","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72141","MRI, spinal canal and contents, cervical; without contrast material","40","0.82",null,null,"12",null,null,null,null,"NA","NA"],
    [1060,"1060","Carrier N","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72148","MRI spinal canal and contents, lumbar; without contrast material","52","0.69",null,null,"12",null,null,null,null,"NA","NA"],
    [1061,"1061","Carrier N","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73221","MRI, any joint of upper extremity; without contrast material(s)","30","0.67",null,null,"12",null,null,null,null,"NA","NA"],
    [1062,"1062","Carrier N","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63650","Percutaneous implantation of neurostimulator electrode array, epidural","12","1",null,null,"12",null,null,null,null,"NA","NA"],
    [1063,"1063","Carrier N","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","75571","Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium","12","1",null,null,"12",null,null,null,null,"NA","NA"],
    [1064,"1064","Carrier N","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J1745","INFLIXIMAB NOT BIOSIMIL 10MG","10","1",null,"72","126",null,null,null,null,"NA","NA"],
    [1065,"1065","Carrier N","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","92507","SPEECH/HEARING THERAPY","8","1",null,"48","61.7",null,null,null,null,"NA","NA"],
    [1066,"1066","Carrier N","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63042","LAMINOTOMY SINGLE LUMBAR","4","1",null,null,"12",null,null,null,null,"NA","NA"],
    [1067,"1067","Carrier N","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J3380","INJECTION, VEDOLIZUMAB","4","1",null,null,"12",null,null,null,null,"NA","NA"],
    [1068,"1068","Carrier N","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J9035","BEVACIZUMAB INJECTION","4","1",null,null,"12",null,null,null,null,"NA","NA"],
    [1069,"1069","Carrier N","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99213","OFFICE O/P EST LOW 20-29 MIN","4","1",null,null,"90",null,null,null,null,"NA","NA"],
    [1070,"1070","Carrier N","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","30465","REPAIR NASAL STENOSIS","4","1",null,null,"66",null,null,null,null,"NA","NA"],
    [1071,"1071","Carrier N","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29999","Unlisted procedure, arthroscopy","4","1",null,null,"12",null,null,null,null,"NA","NA"],
    [1072,"1072","Carrier B","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","551","SKILLED NURSING VISIT IN HOME","126","0.98",null,"18.97","129.96","0",null,null,null,"NA","NA"],
    [1073,"1073","Carrier B","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99601","HOME INFUSION/SPCAILTY DRUG ADMINISTRATION-SKILLED NURSE VISIT","109","0.9",null,"0","129.61","0",null,null,null,"NA","NA"],
    [1074,"1074","Carrier B","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","J0585","INJECTION OF ONABOTULINUMTOXINA","99","0.87",null,"22.83","206.59","0",null,null,null,"NA","NA"],
    [1075,"1075","Carrier B","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64483","TRANSFORAMINAL EPIDURAL INJECTION INTO A SINGLE LEVEL EITHER LUMBAR OR SACRAL","80","0.84",null,"34.84","234.69","0",null,null,null,"NA","NA"],
    [1076,"1076","Carrier B","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0481","DEFNITIVE DRUG TEST FOR DRUG CLASSES  8-14","202","0.6",null,"34.48","99.43","0",null,null,null,"NA","NA"],
    [1077,"1077","Carrier B","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99212","OFFICE/OUTPATIENT VISIT ESTABLISHED","133","0.56",null,"103.53","261.3","42.78",null,null,null,"NA","NA"],
    [1078,"1078","Carrier B","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","0296T","EXTENDED  ECG RECORDING","71","0.55",null,"219.48","153.64","0.15",null,null,null,"NA","NA"],
    [1079,"1079","Carrier B","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0480","DEFNITIVE DRUG TEST FOR DRUG CLASSES  1-7","148","0.53",null,"0","118.5","0",null,null,null,"NA","NA"],
    [1080,"1080","Carrier B","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0483","DEFNITIVE DRUG TEST FOR DRUG CLASSES  22+","139","0.37",null,"0","116.46","0",null,null,null,"NA","NA"],
    [1081,"1081","Carrier B","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0482","DEFNITIVE DRUG TEST FOR DRUG CLASSES  15-21","134","0.36",null,"0","113.64","0",null,null,null,"NA","NA"],
    [1082,"1082","Carrier B","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99442","PHONE EVALUTATION/MANAGEMENT PHYSICIAN WITH ESTABLISHED PATIENT OF 11-20 MINUTES","67","1",null,"0","0.03","0",null,null,null,"NA","NA"],
    [1083,"1083","Carrier B","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","Q5101","INJECTION OF FILGRASTIM-SNDZ(ZARXIO), BIOSIMILAR 1 MICROGRAM","53","1",null,"11.17","67.28","0",null,null,null,"NA","NA"],
    [1084,"1084","Carrier B","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","30520","SEPTOPLASTY OF DEVIATED SEPTUM","41","1",null,"2.67","119.35","0",null,null,null,"NA","NA"],
    [1085,"1085","Carrier B","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99443","PHONE EVALUTATION/MANAGEMENT PHYSICIAN WITH ESTABLISHED PATIENT OF 21-30 MINUTES","26","1",null,"0","0","0",null,null,null,"NA","NA"],
    [1086,"1086","Carrier B","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99441","PHONE EVALUTATION/MANAGEMENT PHYSICIAN WITH ESTABLISHED PATIENT OF 5-10 MINUTES","25","1",null,"0","0","0",null,null,null,"NA","NA"],
    [1087,"1087","Carrier B","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J2350","INJECTION OF OCRELIZUMAB 1 MG","16","1",null,"24.03","125.1","0",null,null,null,"NA","NA"],
    [1088,"1088","Carrier B","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J9299","INJECTION OF NIVOLUMAB 1 MG","13","1",null,"14.86","96.29","0",null,null,null,"NA","NA"],
    [1089,"1089","Carrier B","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J9306","INJECTION OF PERTUZUMAB, 1 MG","13","1",null,"22.43","81.97","0",null,null,null,"NA","NA"],
    [1090,"1090","Carrier B","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","Q5119","INJ RITUXIMAB-PVVR(RUXIENCE) BIOSIMILAR RUXIENCE 10 MG","13","1",null,"80.71","91.25","0",null,null,null,"NA","NA"],
    [1091,"1091","Carrier B","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","66982","EXTRACAPSULAR CATARACT REMOVAL  WITH COMPLEX TECHNIQUE AND DEVICES","12","1",null,"0","59.79","0",null,null,null,"NA","NA"],
    [1092,"1092","Carrier B","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","88305","LEVEL IV-SURGICAL  PATHOLOGY GROSS/MICROSCOPIC EXAM","3","0","1","0","0","0.22",null,null,null,"NA","NA"],
    [1093,"1093","Carrier B","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","88321","CONSULTATION AND REPORT OF SLIDES PREPARED  ELSEWHERE","1","0","1","0","0","0",null,null,null,"NA","NA"],
    [1094,"1094","Carrier B","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","45385","COLONOSCOPY FLEXIBLE; WITH REMOVAL IF  TUMOR/LESION BY SNARE TECHNIQUE","1","0","1","0","0","0",null,null,null,"NA","NA"],
    [1095,"1095","Carrier B","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43239","UPPER GATROINTESTIAL  ENDOSCOPY WITH REMOVAL OF ONE OR MORE BIOPSIES","1","0","1","0","0","0",null,null,null,"NA","NA"],
    [1096,"1096","Carrier B","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","99202","OFFICE/OUTPATIENT NEW PATIENT FOR MEDICAL DECISION MAKING of 15-29 MINUTES","1","0","1","0","74.31","0",null,null,null,"NA","NA"],
    [1097,"1097","Carrier B","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","J1650","INJECTION OF ENOXAPARIN SODIUM, 10 MG","1","0","1","0","0","0",null,null,null,"NA","NA"],
    [1098,"1098","Carrier B","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","36415","COLLECTION VENOUS BLOOD VENIPUNCTURE","1","0","1","0","0","0",null,null,null,"NA","NA"],
    [1099,"1099","Carrier B","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","11104","PUNCH BIOPSY SKIN SINGLE LESION","1","0","1","0","0","0",null,null,null,"NA","NA"],
    [1100,"1100","Carrier B","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","80053","COMPREHENSIVE METABOLIC PANEL","1","0","1","0","0","0",null,null,null,"NA","NA"],
    [1101,"1101","Carrier B","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","99203","OFFICE/OUTPATIENT VISIT NEW PATIENT","2","0","0.5","0","313.77","0.07",null,null,null,"NA","NA"],
    [1102,"1102","Carrier C","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","COLONOSCOPY W/ BX SINGLE/MULT","3105","0.99",null,"1.76","13.32",null,null,null,null,"NA","NA"],
    [1103,"1103","Carrier C","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","COLONOSCOPY W/ BX SINGLE/MULT","4416","0.98",null,"16.25","178.1",null,null,null,null,"NA","NA"],
    [1104,"1104","Carrier C","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73218","MRI, UPPER EXTREMITY","2022","0.98",null,"7.76","136.31",null,null,null,null,"NA","NA"],
    [1105,"1105","Carrier C","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43235","UPPER GI ENDO DX (SEP PROC)","1686","0.97",null,"13.06","159.87",null,null,null,null,"NA","NA"],
    [1106,"1106","Carrier C","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS","52496","0.96",null,"17.59","126.64",null,null,null,null,"NA","NA"],
    [1107,"1107","Carrier C","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97802","MED NUTRIT THRPY INIT ASSESS 15 MIN","3230","0.96",null,"25.88","156.24",null,null,null,null,"NA","NA"],
    [1108,"1108","Carrier C","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99202","OFFICE VISIT E&M NEW PT STRAIGHTFORWARD MDM, 15-29 MINS","2367","0.93",null,"17.17","250.08",null,null,null,null,"NA","NA"],
    [1109,"1109","Carrier C","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99201","OFFICE VISIT E&M NEW SELF LIMIT/MINOR 10","13013","0.91",null,"22.27","228.84",null,null,null,null,"NA","NA"],
    [1110,"1110","Carrier C","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES","4792","0.85",null,"17.51","227.26",null,null,null,null,"NA","NA"],
    [1111,"1111","Carrier C","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97124","THERA PROC 1+ AREAS EA 15 MIN MASSAGE","4430","0.83",null,"15.79","189.24",null,null,null,null,"NA","NA"],
    [1112,"1112","Carrier C","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","76885","ECHOGRAPHY OF INFANT HIPS, DYNAMIC","183","1",null,"8.05","110.96",null,null,null,null,"NA","NA"],
    [1113,"1113","Carrier C","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","73222","MRI JOINT UPR EXTREM W/ DYE","173","1",null,"8.88","85.93",null,null,null,null,"NA","NA"],
    [1114,"1114","Carrier C","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","91034","GASTROESOPHAGEAL REFLUX TEST","154","1",null,"22.14","320.84",null,null,null,null,"NA","NA"],
    [1115,"1115","Carrier C","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","76642","ULTRASOUND BREAST LIMITED","150","1",null,"1.43","37.94",null,null,null,null,"NA","NA"],
    [1116,"1116","Carrier C","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93971","BACK OFFICE DUPLEX SCAN, VEINS, UNILATERAL","122","1",null,"8.51","81.04",null,null,null,null,"NA","NA"],
    [1117,"1117","Carrier C","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58300","INSERT INTRAUTERINE DEVICE","108","1",null,"6.32","124.43",null,null,null,null,"NA","NA"],
    [1118,"1118","Carrier C","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93922","UPR/L XTREMITY ART 2 LEVE","107","1",null,"13.3","160.33",null,null,null,null,"NA","NA"],
    [1119,"1119","Carrier C","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93880","DUPLEX SCAN EXTRACRANIAL,BILAT","102","1",null,"6.72","69.06",null,null,null,null,"NA","NA"],
    [1120,"1120","Carrier C","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","78227","HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ","90","1",null,"3.32","77.16",null,null,null,null,"NA","NA"],
    [1121,"1121","Carrier C","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","76882","BACK OFFICE US, LIMITED, JOINT OR OTH NONVASC EXT, REAL TIME W/IMAG DOC","83","1",null,"10.93","19.69",null,null,null,null,"NA","NA"],
    [1122,"1122","Carrier C","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","81479","UNLISTED MOLELCULAR PATHOLOGY PROCEDURE","94","0","0.05","68.34","658.76",null,null,null,null,"NA","NA"],
    [1123,"1123","Carrier C","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","812","ANES LWR INTESTINAL ENDO PX, INTRO DISTAL/DUODENUM, SCREENING COL","533","0","0.02","43.07","541.01",null,null,null,null,"NA","NA"],
    [1124,"1124","Carrier C","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","813","ANES COMBINED UPR/LWR GI ENDOSCOPIC PX, INTRO BOTH PROX/DISTAL DUODENUM","188","0","0.02","29.52","297.51",null,null,null,null,"NA","NA"],
    [1125,"1125","Carrier C","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","740","ANES UPR GI NDSC PX PROX DUO","142","0","0.02","37.07","682.69",null,null,null,null,"NA","NA"],
    [1126,"1126","Carrier C","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97530","THERA ACTVI DIRECT PAT CONTACT EA 15 MIN","880","0","0.01","38.47","291.57",null,null,null,null,"NA","NA"],
    [1127,"1127","Carrier C","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","811","ANES LWR INTESTINAL ENDO PX, INTRO DISTAL/DUODENUM, NOS","485","0","0.01","27.82","332.51",null,null,null,null,"NA","NA"],
    [1128,"1128","Carrier C","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","78815","TUMORIMAGE PET/CT SKUL-THIGH","455","0","0.01","33.73","441.52",null,null,null,null,"NA","NA"],
    [1129,"1129","Carrier C","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","99214","OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS","52496","0","0","17.59","126.64",null,null,null,null,"NA","NA"],
    [1130,"1130","Carrier C","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97110","THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES","4792","0","0","17.51","227.26",null,null,null,null,"NA","NA"],
    [1131,"1131","Carrier C","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","99201","OFFICE VISIT E&M NEW SELF LIMIT/MINOR 10","13013","0","0","22.27","228.84",null,null,null,null,"NA","NA"],
    [1132,"1132","Carrier D","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","COLONOSCOPY W/ BX SINGLE/MULT","1328","1",null,"18.22","114.75",null,null,null,null,"NA","NA"],
    [1133,"1133","Carrier D","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","MRI JNT OF LWR EXTRE W/O","543","1",null,"1.6","57.01",null,null,null,null,"NA","NA"],
    [1134,"1134","Carrier D","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74177","CT ABD & PELV W/CONTRAST","497","1",null,"2.32","68.72",null,null,null,null,"NA","NA"],
    [1135,"1135","Carrier D","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS","11503","0.99",null,"13.4","184.68",null,null,null,null,"NA","NA"],
    [1136,"1136","Carrier D","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73218","MRI, UPPER EXTREMITY","851","0.99",null,"17.13","227.02",null,null,null,null,"NA","NA"],
    [1137,"1137","Carrier D","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97802","MED NUTRIT THRPY INIT ASSESS 15 MIN","514","0.99",null,"17.29","163.46",null,null,null,null,"NA","NA"],
    [1138,"1138","Carrier D","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES","781","0.98",null,"18.93","195.01",null,null,null,null,"NA","NA"],
    [1139,"1139","Carrier D","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99201","OFFICE VISIT E&M NEW SELF LIMIT/MINOR 10","1843","0.97",null,"19.78","222.38",null,null,null,null,"NA","NA"],
    [1140,"1140","Carrier D","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","762","MISC SERVICES","1176","0.97",null,"29.19","126.32",null,null,null,null,"NA","NA"],
    [1141,"1141","Carrier D","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97124","THERA PROC 1+ AREAS EA 15 MIN MASSAGE","643","0.97",null,"58.09","226.44",null,null,null,null,"NA","NA"],
    [1142,"1142","Carrier D","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70553","MRI BRAIN STEM W/O & W/DY","435","1",null,"2.82","91.38",null,null,null,null,"NA","NA"],
    [1143,"1143","Carrier D","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","73221","MAGNETIC RESONANCE (EG, PROTON) JOINT","284","1",null,"2.8","72.68",null,null,null,null,"NA","NA"],
    [1144,"1144","Carrier D","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77080","DXA BONE DENSITY STUDY 1+ SITS AXIAL SKE","267","1",null,"8.11","202.78",null,null,null,null,"NA","NA"],
    [1145,"1145","Carrier D","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","71260","COMPUTED TOMOGRAPHY, THORAX, DIAGNOSTIC; W/CONTRAST MATERIAL(S)","267","1",null,"6.37","124.48",null,null,null,null,"NA","NA"],
    [1146,"1146","Carrier D","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70551","MRI BRAIN STEM W/O DYE","250","1",null,"14.16","189.13",null,null,null,null,"NA","NA"],
    [1147,"1147","Carrier D","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72141","MRI NECK SPINE W/O DYE","232","1",null,"0.78","90.43",null,null,null,null,"NA","NA"],
    [1148,"1148","Carrier D","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","45378","DIAGNOSTIC COLONOSCOPY","211","1",null,"9.53","71.09",null,null,null,null,"NA","NA"],
    [1149,"1149","Carrier D","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70010","MYLOGRAPHY POSTERIOR FOSSA COMPLETE","195","1",null,"8.23","249.34",null,null,null,null,"NA","NA"],
    [1150,"1150","Carrier D","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","11102","TANGNTL BX SKIN SINGLE LE","191","1",null,"1.62","117.94",null,null,null,null,"NA","NA"],
    [1151,"1151","Carrier D","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70486","CT MAXILLOFACIAL W/O DYE","184","1",null,"2.16","102.29",null,null,null,null,"NA","NA"],
    [1152,"1152","Carrier D","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","J7330","CULTURED CHONDROCYTES IMP","3","0","0.67",null,"1631.68",null,null,null,null,"NA","NA"],
    [1153,"1153","Carrier D","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27279","ARTHRODESIS, SACROID JNT, PERCUTANE OR MINIMAL INVASIVE W/ IMAGE GUIDE","3","0","0.67",null,"427.26",null,null,null,null,"NA","NA"],
    [1154,"1154","Carrier D","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","77522","PROTON TRMT SIMPLE W/COMP","5","0","0.4","37.28","840.14",null,null,null,null,"NA","NA"],
    [1155,"1155","Carrier D","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","19318","BREAST REDUCTION","63","0","0.03","71.94","450.34",null,null,null,null,"NA","NA"],
    [1156,"1156","Carrier D","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","77049","MRI BREAST C-+ W/CAD BI","331","0","0.02","22.68","293.71",null,null,null,null,"NA","NA"],
    [1157,"1157","Carrier D","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","731","ANES UPR GI NDSC PX NOS","209","0","0.02","32.07","318.62",null,null,null,null,"NA","NA"],
    [1158,"1158","Carrier D","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","811","ANES LWR INTESTINAL ENDO PX, INTRO DISTAL/DUODENUM, NOS","354","0","0.01","35.69","334.59",null,null,null,null,"NA","NA"],
    [1159,"1159","Carrier D","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","812","ANES LWR INTESTINAL ENDO PX, INTRO DISTAL/DUODENUM, SCREENING COL","244","0","0.01","45.43","594.55",null,null,null,null,"NA","NA"],
    [1160,"1160","Carrier D","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","72148","MRI LUMBAR SPINE W/O DYE","462","0","0","14.08","122.05",null,null,null,null,"NA","NA"],
    [1161,"1161","Carrier D","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","99201","OFFICE VISIT E&M NEW SELF LIMIT/MINOR 10","1843","0","0","19.78","222.38",null,null,null,null,"NA","NA"],
    [1162,"1162","Carrier E","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97162","PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS","72","1",null,"0.3","20",null,null,null,null,"NA","NA"],
    [1163,"1163","Carrier E","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","NA","PT IN THE HOME PER DIEM","70","1",null,null,"8.3",null,null,null,null,"NA","NA"],
    [1164,"1164","Carrier E","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES","86","0.99",null,"0.5","14.4",null,null,null,null,"NA","NA"],
    [1165,"1165","Carrier E","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL","72","0.97",null,"4.8","27.2",null,null,null,null,"NA","NA"],
    [1166,"1166","Carrier E","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97161","PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS","749","0.96",null,"10.5","19.4",null,null,null,null,"NA","NA"],
    [1167,"1167","Carrier E","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99203","OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES","410","0.96",null,"1.2","25.9",null,null,null,null,"NA","NA"],
    [1168,"1168","Carrier E","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99213","OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN","103","0.95",null,"0.5","27.2",null,null,null,null,"NA","NA"],
    [1169,"1169","Carrier E","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97810","ACUPUNCTURE 1/> NDLES W/O ELEC STIMJ INIT 15 MIN","302","0.89",null,null,"39.6",null,null,null,null,"NA","NA"],
    [1170,"1170","Carrier E","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","98940","CHIROPRACTIC MANIPULATIVE TX SPINAL 1-2 REGIONS","165","0.76",null,null,"39.2",null,null,null,null,"NA","NA"],
    [1171,"1171","Carrier E","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99202","OFFICE/OUTPATIENT NEW SF MDM 15-29 MINUTES","68","0.63",null,"11.4","35.2",null,null,null,null,"NA","NA"],
    [1172,"1172","Carrier E","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97162","PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS","72","1",null,"0.3","20",null,null,null,null,"NA","NA"],
    [1173,"1173","Carrier E","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S9131","PT IN THE HOME PER DIEM","70","1",null,null,"8.3",null,null,null,null,"NA","NA"],
    [1174,"1174","Carrier E","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70553","MRI BRAIN WO/W CONTRAST","58","1",null,"11.3","15.3",null,null,null,null,"NA","NA"],
    [1175,"1175","Carrier E","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96040","MEDICAL GENETICS COUNSELING EACH 30 MINUTES","48","1",null,null,"29.1",null,null,null,null,"NA","NA"],
    [1176,"1176","Carrier E","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","73721","MRI RIGHT KNEE NO CONTRAST","37","1",null,"17.3","16.5",null,null,null,null,"NA","NA"],
    [1177,"1177","Carrier E","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70551","MRI BRAIN NO CONTRAST","36","1",null,"0.1","16.1",null,null,null,null,"NA","NA"],
    [1178,"1178","Carrier E","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","73721","MRI LEFT KNEE NO CONTRAST","29","1",null,"1.5","8.5",null,null,null,null,"NA","NA"],
    [1179,"1179","Carrier E","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99204","OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES","28","1",null,"10.7","36.1",null,null,null,null,"NA","NA"],
    [1180,"1180","Carrier E","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97813","ACUPUNCTURE 1/> NDLS W/ELEC STIMJ 1ST 15 MIN","26","1",null,null,"32",null,null,null,null,"NA","NA"],
    [1181,"1181","Carrier E","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","74177","CT ABD AND PELVIS W CONTRAST","26","1",null,"7.1","28.7",null,null,null,null,"NA","NA"],
    [1182,"1182","Carrier E","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97533","SENSORY INTEGRATIVE TECHNIQUES EACH 15 MINUTES","2","0","0.5",null,"50.5",null,null,null,null,"NA","NA"],
    [1183,"1183","Carrier E","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","10005","FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION","4","0","0.25",null,"53.2",null,null,null,null,"NA","NA"],
    [1184,"1184","Carrier E","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","99202","OFFICE/OUTPATIENT NEW SF MDM 15-29 MINUTES","68","0","0.03","11.4","35.2",null,null,null,null,"NA","NA"],
    [1185,"1185","Carrier F","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","Mri Brain; W/o Contrast & W/contrast & A","60","1",null,null,"0","0",null,null,null,"NA","NA"],
    [1186,"1186","Carrier F","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","66984","Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); without endoscopic cyclophotocoagulation","62","0.94",null,"30","123",null,null,null,null,"NA","NA"],
    [1187,"1187","Carrier F","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27447","Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)","54","0.94",null,"37","127",null,null,null,null,"NA","NA"],
    [1188,"1188","Carrier F","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43239","Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple","481","0.91",null,"30","98",null,null,null,null,"NA","NA"],
    [1189,"1189","Carrier F","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64483","Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, single level","86","0.91",null,"2","111",null,null,null,null,"NA","NA"],
    [1190,"1190","Carrier F","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","29881","Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed","75","0.91",null,"19","94",null,null,null,null,"NA","NA"],
    [1191,"1191","Carrier F","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43235","Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","380","0.9",null,"30","98","0",null,null,null,"NA","NA"],
    [1192,"1192","Carrier F","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27130","Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft","69","0.9",null,"51","94",null,null,null,null,"NA","NA"],
    [1193,"1193","Carrier F","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99215","Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter.","119","0.61",null,"36","113",null,null,null,null,"NA","NA"],
    [1194,"1194","Carrier F","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using time for code selection, 30-39 minutes of total time is spent on the date of the encounter.","198","0.31",null,"34","92","0",null,null,null,"NA","NA"],
    [1195,"1195","Carrier F","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70553","Mri Brain; W/o Contrast & W/contrast & A","60","1",null,null,"0.35",null,null,null,null,"NA","NA"],
    [1196,"1196","Carrier F","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95800","Slp Stdy Unatnd W/hrt Rate/o2 Sat/resp/slp Time","20","1",null,null,"9.33",null,null,null,null,"NA","NA"],
    [1197,"1197","Carrier F","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","71260","Computed Tomography, Thorax, Diagnostic; With Contrast Material(s)","20","1",null,null,"6.26",null,null,null,null,"NA","NA"],
    [1198,"1198","Carrier F","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","37765","Stab phlebectomy of varicose veins, 1 extremity; 10-20 stab incisions","17","1",null,"45","83",null,null,null,null,"NA","NA"],
    [1199,"1199","Carrier F","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70491","Ct,soft Tissue Neck;w/contrast Mat.","11","1",null,null,"16",null,null,null,null,"NA","NA"],
    [1200,"1200","Carrier F","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","73722","Mri, Any Joint Of Lower Extremity; With Contrast Material(s)","9","1",null,null,null,null,null,null,null,"NA","NA"],
    [1201,"1201","Carrier F","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72157","Mri Spinal Canal Wo & W Contrast; Thorac","9","1",null,null,"25.41",null,null,null,null,"NA","NA"],
    [1202,"1202","Carrier F","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72197","Mri, Pelvis; W/o Contrast Then With Contrast And Further Sequences","7","1",null,null,null,null,null,null,null,"NA","NA"],
    [1203,"1203","Carrier F","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72156","Mri Spinal Wo & W Contrast: Cerv","7","1",null,null,"29",null,null,null,null,"NA","NA"],
    [1204,"1204","Carrier F","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90837","Psychotherapy, 60 Minutes With Patient","6","1",null,null,"84",null,null,null,null,"NA","NA"],
    [1205,"1205","Carrier F","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97110","Tx,1 Area,15 Min,ea.vist;ther.exerc","32","0","1","24","86",null,null,null,null,"NA","NA"],
    [1206,"1206","Carrier F","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","19350","Reconstruct Nipple/areolar Unil","4","0","1",null,"72",null,null,null,null,"NA","NA"],
    [1207,"1207","Carrier F","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","15877","Suction Assist Lipectomy Trunk","1","0","1",null,"84",null,null,null,null,"NA","NA"],
    [1208,"1208","Carrier F","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","19303","Mastectomy Simple Complete","4","0","1",null,"72",null,null,null,null,"NA","NA"],
    [1209,"1209","Carrier F","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","55970","Intersex Op Male To Female","3","0","1",null,"112",null,null,null,null,"NA","NA"],
    [1210,"1210","Carrier F","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","54520","Orchiectomy Simple Unilat","1","0","1","16","120",null,null,null,null,"NA","NA"],
    [1211,"1211","Carrier F","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","15840","Graft for facial nerve paralysis; free fascia graft (including obtaining fascia)","1","0","1",null,"97",null,null,null,null,"NA","NA"],
    [1212,"1212","Carrier F","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","15830","Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy","1","0","1",null,"96",null,null,null,null,"NA","NA"],
    [1213,"1213","Carrier F","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63020","Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical","1","0","1",null,"118",null,null,null,null,"NA","NA"],
    [1214,"1214","Carrier F","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","93622","Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and recording (List separately in addition to code for primary procedure)","1","0","1",null,"118",null,null,null,null,"NA","NA"],
    [1215,"1215","Carrier G","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19325","BREAST AUGMENTATION WITH IMPLANT","1","1",null,null,"98.2",null,null,null,null,"NA","NA"],
    [1216,"1216","Carrier G","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63030","LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR","1","1",null,"1",null,null,null,null,null,"NA","NA"],
    [1217,"1217","Carrier G","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","33518","CORONARY ARTERY BYP W/VEIN  and  ARTERY GRAFT 2 VEIN","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [1218,"1218","Carrier G","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","52310","CYSTO W/SIMPLE REMOVAL STONE  and  STENT","1","0",null,null,"45.8",null,null,null,null,"NA","NA"],
    [1219,"1219","Carrier G","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","49329","UNLISTED LAPAROSCOPIC PX ABD PERTONEUM  AND  OMENTUM","1","0",null,null,"0.6",null,null,null,null,"NA","NA"],
    [1220,"1220","Carrier G","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20902","BONE GRAFT ANY DONOR AREA MAJOR/LARGE","1","0",null,null,"107.2",null,null,null,null,"NA","NA"],
    [1221,"1221","Carrier G","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43621","GSTRCT TOT W/ROUX-EN-Y RCNSTJ","1","0",null,null,"16.7",null,null,null,null,"NA","NA"],
    [1222,"1222","Carrier G","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","21040","EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL  and  CURT","1","0",null,null,"107.2",null,null,null,null,"NA","NA"],
    [1223,"1223","Carrier G","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","49905","OMENTAL FLAP INTRA-ABDOMINAL","1","0",null,null,"0.6",null,null,null,null,"NA","NA"],
    [1224,"1224","Carrier G","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","23472","ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER","1","0",null,null,"89.8",null,null,null,null,"NA","NA"],
    [1225,"1225","Carrier G","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63030","LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR","1","1",null,"1",null,null,null,null,null,"NA","NA"],
    [1226,"1226","Carrier G","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","55970","INTERSEX SURG MALE FEMALE","1","1",null,null,"98.2",null,null,null,null,"NA","NA"],
    [1227,"1227","Carrier G","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19325","BREAST AUGMENTATION WITH IMPLANT","1","1",null,null,"98.2",null,null,null,null,"NA","NA"],
    [1228,"1228","Carrier G","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","49905","OMENTAL FLAP INTRA-ABDOMINAL","1","0",null,null,"0.6",null,null,null,null,"NA","NA"],
    [1229,"1229","Carrier G","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","21040","EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL  and  CURT","1","0",null,null,"107.2",null,null,null,null,"NA","NA"],
    [1230,"1230","Carrier G","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","11044","DEBRIDEMENT BONE MUSCLE  and /FASCIA 20 SQ CM OR LT","1","0",null,null,"107.2",null,null,null,null,"NA","NA"],
    [1231,"1231","Carrier G","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","23472","ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER","1","0",null,null,"89.8",null,null,null,null,"NA","NA"],
    [1232,"1232","Carrier G","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","49329","UNLISTED LAPAROSCOPIC PX ABD PERTONEUM  AND  OMENTUM","1","0",null,null,"0.6",null,null,null,null,"NA","NA"],
    [1233,"1233","Carrier G","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","31536","LARYNGOSCOPY W/BIOPSY MICROSCOPE/TELESCOPE","1","0",null,null,"6",null,null,null,null,"NA","NA"],
    [1234,"1234","Carrier G","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","52310","CYSTO W/SIMPLE REMOVAL STONE  and  STENT","1","0",null,null,"45.8",null,null,null,null,"NA","NA"],
    [1235,"1235","Carrier H","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0399","Home Sleep Test W/type Iii Portable Monitor","3012","0.97",null,null,"3.7",null,null,null,null,"NA","NA"],
    [1236,"1236","Carrier H","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","Echocardiography, Transthoracic, Real-time W/ Image Documentation (2d), Includes M-mode Recording, When Performed","4949","0.96",null,null,"3.71",null,null,null,null,"NA","NA"],
    [1237,"1237","Carrier H","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","Mri Brain; W/o Contrast & W/contrast & A","2493","0.96",null,null,"5",null,null,null,null,"NA","NA"],
    [1238,"1238","Carrier H","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43239","Esophagogastroduodenoscopy Flexible, Transoral; With Biopsy, Single Or Multiple","1983","0.94",null,"16.35","47.47",null,null,null,null,"NA","NA"],
    [1239,"1239","Carrier H","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74176","Ct Abd & Pelvis W/o Contrast","5042","0.93",null,"1.71","5.72",null,null,null,null,"NA","NA"],
    [1240,"1240","Carrier H","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","Magnetic Resonance Imaging, Any Jnt-lowe","4215","0.87",null,null,"7.35",null,null,null,null,"NA","NA"],
    [1241,"1241","Carrier H","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73221","Mri, Any Joint Of Upper Extremity","2218","0.84",null,null,"8.38",null,null,null,null,"NA","NA"],
    [1242,"1242","Carrier H","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72141","Mri,spin.canal,cerv;w/o Contrst Mat","1808","0.84",null,null,"10.45",null,null,null,null,"NA","NA"],
    [1243,"1243","Carrier H","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72148","Mri,spin.canal,lumb;w/o Cntrst Matl","3101","0.83",null,"18","9.72","0",null,null,null,"NA","NA"],
    [1244,"1244","Carrier H","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","MSMPT","Physical Therapy","11186","0.71",null,"1","39",null,null,null,null,"NA","NA"],
    [1245,"1245","Carrier H","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29888","Arthroscopically Aided Anter,cruciate Li","151","1",null,"72","81.43",null,null,null,null,"NA","NA"],
    [1246,"1246","Carrier H","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","75557","Cardiac Mri For Morph","50","1",null,null,"4",null,null,null,null,"NA","NA"],
    [1247,"1247","Carrier H","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","75572","Ct Heart Contrast Eval Cardiac Structure&morph","36","1",null,null,null,null,null,null,null,"NA","NA"],
    [1248,"1248","Carrier H","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43242","Egd Flex Transoral W/transendoscpic Us-guided Intramrl Or Transmrl Fine Ndl Aspiratn/biop(s) Esophag (incl Endoscpic Us Exam Of Esoph, Stom, &either Duod, Or Surg Altrd Stomac","33","1",null,"18","48",null,null,null,null,"NA","NA"],
    [1249,"1249","Carrier H","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63035","Laminotomy, With Decompression Of Nerve Root(s), Incl Partial Facetectomy, Formaninotomy And/or Excision Of Herniated Intervertabral Disc, Cervical Or Lumbar","28","1",null,"24","70.55",null,null,null,null,"NA","NA"],
    [1250,"1250","Carrier H","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77790","Supervise,handle,load Radioelement","26","1",null,null,"15",null,null,null,null,"NA","NA"],
    [1251,"1251","Carrier H","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77761","Intracavitary Radioelement Application;s","26","1",null,null,"15",null,null,null,null,"NA","NA"],
    [1252,"1252","Carrier H","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77316","Brachytherapy Isodose Plan; Simple (calculation[s] Made From 1 To 4 Sources, Or Remote Afterloading Brachytherapy, 1 Channel), Includes Basic Dosimetry Calculation(s)","26","1",null,null,"15",null,null,null,null,"NA","NA"],
    [1253,"1253","Carrier H","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","38241","Hematopoietic Progenitor Cell (hpc);autologous Transplantation","25","1",null,"96","105.88",null,null,null,null,"NA","NA"],
    [1254,"1254","Carrier H","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19380","Revision Of Reconstructed Breast (eg, Significant Removal Of Tissue, Re-advancement And/or Re-inset Of Flaps In Autologous Reconstruction Or Significant Capsular Revision","23","1",null,null,"85.39",null,null,null,null,"NA","NA"],
    [1255,"1255","Carrier H","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","31267","Nasal/sinus Endoscopy, Surgical, With Maxillary Antrostomy; With Removal Of Tissue From Maxillary Sinus","179","0","1","43.2","77.29",null,null,null,null,"NA","NA"],
    [1256,"1256","Carrier H","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63048","Lam.,facetect,foraminot;ea Adtl.seg","169","0","1","72","94.97",null,null,null,null,"NA","NA"],
    [1257,"1257","Carrier H","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","29888","Arthroscopically Aided Anter,cruciate Li","151","0","1","72","81.43",null,null,null,null,"NA","NA"],
    [1258,"1258","Carrier H","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","31253","Nasal/sinus Endoscopy, Surgical With Ethmoidectomy; Total (anterior And Posterior), Incl Frontal Sinus Exploration, With Removal Of Tissue From Frontal Sinus, When Performed","66","0","1","24","74.48",null,null,null,null,"NA","NA"],
    [1259,"1259","Carrier H","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","29874","Arthroscop Knee W Remov Loose Body","54","0","1",null,"74.47",null,null,null,null,"NA","NA"],
    [1260,"1260","Carrier H","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","31288","Endoscopy,surg, Wtih Sphenoidotomy; W Sphenoid Sinus Tissue Removal","49","0","1",null,"85.66",null,null,null,null,"NA","NA"],
    [1261,"1261","Carrier H","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","31259","Nasal/sinus Endoscopy, Surgical With Ethmoidectomy; Total (anterior And Posterior), Including Sphenoidotomy, With Removal Of Tissue From The Sphenoid Sinus","46","0","1",null,"78.21",null,null,null,null,"NA","NA"],
    [1262,"1262","Carrier H","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","31287","Endoscopy, Surgical, With Sphenoidotomy","44","0","1","24","98.71",null,null,null,null,"NA","NA"],
    [1263,"1263","Carrier H","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27446","Arthropls,knee,cond/plat;medor Lat","44","0","1","61.5","76.36",null,null,null,null,"NA","NA"],
    [1264,"1264","Carrier H","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","77386","Intensity Modulated Radiation Treatment Delivery (imrt), Includes Guidance And Tracking, When Performed; Complex","39","0","1",null,"141.26",null,null,null,null,"NA","NA"],
    [1265,"1265","Carrier I","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences","127","0.95",null,null,"4.34",null,null,null,null,"NA","NA"],
    [1266,"1266","Carrier I","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0399","Home sleep test/type III Porta","126","0.95",null,null,"4.34",null,null,null,null,"NA","NA"],
    [1267,"1267","Carrier I","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography","154","0.92",null,null,"3.42",null,null,null,null,"NA","NA"],
    [1268,"1268","Carrier I","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74176","Computed tomography, abdomen and pelvis; without contrast material","206","0.9",null,null,"7.4",null,null,null,null,"NA","NA"],
    [1269,"1269","Carrier I","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material","153","0.86",null,null,"6.07",null,null,null,null,"NA","NA"],
    [1270,"1270","Carrier I","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72148","Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material","117","0.85",null,"17.35","8.48",null,null,null,null,"NA","NA"],
    [1271,"1271","Carrier I","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","349","0.77",null,"22.44","25.18",null,null,null,null,"NA","NA"],
    [1272,"1272","Carrier I","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97112","Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities","134","0.76",null,"161.21","24.25",null,null,null,null,"NA","NA"],
    [1273,"1273","Carrier I","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97140","Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes","350","0.75",null,"22.44","24.49",null,null,null,null,"NA","NA"],
    [1274,"1274","Carrier I","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97530","Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","213","0.74",null,null,"19.14",null,null,null,null,"NA","NA"],
    [1275,"1275","Carrier I","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","74183","Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences","22","1",null,null,"4.1",null,null,null,null,"NA","NA"],
    [1276,"1276","Carrier I","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29881","Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed","20","1",null,null,"29.44","1.6",null,null,null,"NA","NA"],
    [1277,"1277","Carrier I","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27447","Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)","15","1",null,null,"6.52",null,null,null,null,"NA","NA"],
    [1278,"1278","Carrier I","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72157","Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic","15","1",null,null,"4.56",null,null,null,null,"NA","NA"],
    [1279,"1279","Carrier I","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64493","Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level","14","1",null,null,"0.17",null,null,null,null,"NA","NA"],
    [1280,"1280","Carrier I","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64494","Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level (List separately in addition to code for primary procedure)","12","1",null,null,"0.18",null,null,null,null,"NA","NA"],
    [1281,"1281","Carrier I","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","73222","Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s)","10","1",null,null,"9.42",null,null,null,null,"NA","NA"],
    [1282,"1282","Carrier I","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27130","Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft","10","1",null,null,"7.16",null,null,null,null,"NA","NA"],
    [1283,"1283","Carrier I","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58573","Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)","9","1",null,"16.77","41.52","32.3",null,null,null,"NA","NA"],
    [1284,"1284","Carrier I","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70496","Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing","9","1",null,null,"2.29",null,null,null,null,"NA","NA"],
    [1285,"1285","Carrier I","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63020","Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical","1","0","1",null,"115.68",null,null,null,null,"NA","NA"],
    [1286,"1286","Carrier I","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63045","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; cervical","3","0","0.67",null,"53",null,null,null,null,"NA","NA"],
    [1287,"1287","Carrier I","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","49568","Implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection (List separately in addition to code for the incisional or ventral hernia repair)","2","0","0.5",null,"118.09",null,null,null,null,"NA","NA"],
    [1288,"1288","Carrier I","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","58353","Endometrial ablation, thermal, without hysteroscopic guidance","5","0","0.4","2.58","65.95",null,null,null,null,"NA","NA"],
    [1289,"1289","Carrier I","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","29862","Arthroscopy, hip, surgical; with debridement/shaving of articular cartilage (chondroplasty), abrasion arthroplasty, and/or resection of labrum","3","0","0.33",null,"35.73",null,null,null,null,"NA","NA"],
    [1290,"1290","Carrier I","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","29875","Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure)","3","0","0.33",null,"38.49",null,null,null,null,"NA","NA"],
    [1291,"1291","Carrier I","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","29824","Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (Mumford procedure)","4","0","0.25",null,"28.01",null,null,null,null,"NA","NA"],
    [1292,"1292","Carrier I","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","49560","Repair initial incisional or ventral hernia; reducible","4","0","0.25",null,"94.9",null,null,null,null,"NA","NA"],
    [1293,"1293","Carrier I","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63030","Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar","6","0","0.17","0.19","7.39",null,null,null,null,"NA","NA"],
    [1294,"1294","Carrier I","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","29828","Arthroscopy, shoulder, surgical; biceps tenodesis","7","0","0.14",null,"55.21",null,null,null,null,"NA","NA"],
    [1295,"1295","Carrier J","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography","2275","0.96",null,null,"2.9","504",null,null,null,"NA","NA"],
    [1296,"1296","Carrier J","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0399","Home sleep test/type III Porta","1547","0.96",null,null,"4.85",null,null,null,null,"NA","NA"],
    [1297,"1297","Carrier J","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences","1375","0.95",null,"6.85","3.9",null,null,null,null,"NA","NA"],
    [1298,"1298","Carrier J","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74176","Computed tomography, abdomen and pelvis; without contrast material","2789","0.93",null,"2.84","5.07",null,null,null,null,"NA","NA"],
    [1299,"1299","Carrier J","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material","1955","0.87",null,"0.21","6.06",null,null,null,null,"NA","NA"],
    [1300,"1300","Carrier J","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72148","Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material","1473","0.85",null,"0.29","6.88",null,null,null,null,"NA","NA"],
    [1301,"1301","Carrier J","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97530","Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","4410","0.79",null,"20.98","30.65",null,null,null,null,"NA","NA"],
    [1302,"1302","Carrier J","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","5491","0.78",null,"15.33","31.52",null,null,null,null,"NA","NA"],
    [1303,"1303","Carrier J","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97140","Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes","5170","0.78",null,"23.64","31.49",null,null,null,null,"NA","NA"],
    [1304,"1304","Carrier J","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97112","Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities","3530","0.76",null,"29.34","32.36",null,null,null,null,"NA","NA"],
    [1305,"1305","Carrier J","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93312","Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report","91","1",null,null,"0.3","17.8",null,null,null,"NA","NA"],
    [1306,"1306","Carrier J","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70490","Computed tomography, soft tissue neck; without contrast material","43","1",null,null,"5.07",null,null,null,null,"NA","NA"],
    [1307,"1307","Carrier J","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72142","Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s)","36","1",null,null,"0.02",null,null,null,null,"NA","NA"],
    [1308,"1308","Carrier J","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58552","Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)","30","1",null,null,"71.66",null,null,null,null,"NA","NA"],
    [1309,"1309","Carrier J","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72147","Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s)","27","1",null,null,"0",null,null,null,null,"NA","NA"],
    [1310,"1310","Carrier J","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","78472","Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative processing","19","1",null,null,"1.58",null,null,null,null,"NA","NA"],
    [1311,"1311","Carrier J","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","75572","Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed)","18","1",null,null,"2.18","19.6",null,null,null,"NA","NA"],
    [1312,"1312","Carrier J","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29898","Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive","18","1",null,"0.27","0.03","27.3",null,null,null,"NA","NA"],
    [1313,"1313","Carrier J","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77371","Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s) consisting of 1 session; multi-source Cobalt 60 based","17","1",null,"2.16","60.64","36.7",null,null,null,"NA","NA"],
    [1314,"1314","Carrier J","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70487","Computed tomography, maxillofacial area; with contrast material(s)","17","1",null,null,"1.65",null,null,null,null,"NA","NA"],
    [1315,"1315","Carrier J","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","29887","Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion with internal fixation","1","0","1",null,"69.12",null,null,null,null,"NA","NA"],
    [1316,"1316","Carrier J","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","37216","Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; without distal embolic protection","1","0","1",null,"144.59",null,null,null,null,"NA","NA"],
    [1317,"1317","Carrier J","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","37215","Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; with distal embolic protection","1","0","1",null,"144.59",null,null,null,null,"NA","NA"],
    [1318,"1318","Carrier J","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","0075T","Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; initial vessel","1","0","1",null,"144.59",null,null,null,null,"NA","NA"],
    [1319,"1319","Carrier J","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","67961","Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangement; up to one-fourth of lid margin","4","0","0.5",null,"118.15",null,null,null,null,"NA","NA"],
    [1320,"1320","Carrier J","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","81215","BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant","2","0","0.5",null,"60.51",null,null,null,null,"NA","NA"],
    [1321,"1321","Carrier J","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43236","Esophagogastroduodenoscopy, flexible, transoral; with directed submucosal injection(s), any substance","2","0","0.5",null,"76.93",null,null,null,null,"NA","NA"],
    [1322,"1322","Carrier J","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","99152","Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intraservice time, patient age 5 years or older","5","0","0.4",null,"79.28",null,null,null,null,"NA","NA"],
    [1323,"1323","Carrier J","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21121","Genioplasty; sliding osteotomy, single piece","5","0","0.4",null,"76.91",null,null,null,null,"NA","NA"],
    [1324,"1324","Carrier J","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","67917","Repair of ectropion; extensive (eg, tarsal strip operations)","6","0","0.33",null,"108.64",null,null,null,null,"NA","NA"],
    [1325,"1325","Carrier J","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21141","Reconstruction midface, LeFort I; single piece, segment movement in any direction (eg, for Long Face Syndrome), without bone graft","6","0","0.33",null,"189.47",null,null,null,null,"NA","NA"],
    [1326,"1326","Carrier J","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","58660","Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure)","3","0","0.33",null,"50.22",null,null,null,null,"NA","NA"],
    [1327,"1327","Carrier J","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27412","Autologous chondrocyte implantation, knee","3","0","0.33",null,"71.84",null,null,null,null,"NA","NA"],
    [1328,"1328","Carrier J","2020","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","20999","Unlisted procedure, musculoskeletal system, general","3","0","0.33",null,"64.07",null,null,null,null,"NA","NA"],
    [1329,"1329","Carrier K","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","ECHO, Complete with Doppler","666","1",null,null,null,null,null,null,null,"NA","NA"],
    [1330,"1330","Carrier K","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","98941","Chiropractic Care","432","0.99",null,null,"3.5",null,null,null,null,"NA","NA"],
    [1331,"1331","Carrier K","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","98943","Chiropractic Care","220","0.99",null,null,"2.75","213.9",null,null,null,"NA","NA"],
    [1332,"1332","Carrier K","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","SUD Residential Adult","116","0.97",null,"12.96","1.19",null,null,null,null,"NA","NA"],
    [1333,"1333","Carrier K","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71260","CT THORAX WITH CONTRAST","247","0.96",null,null,null,null,null,null,null,"NA","NA"],
    [1334,"1334","Carrier K","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","MRI Brain WITH & WITHOUT CONTRAST","348","0.95",null,null,null,null,null,null,null,"NA","NA"],
    [1335,"1335","Carrier K","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74177","CT ABDOMEN & PELVIS WITH CONTRAST","400","0.94",null,null,null,null,null,null,null,"NA","NA"],
    [1336,"1336","Carrier K","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","MRI LOWER EXTREMITY JOINT WITHOUT CONTRAST","388","0.89",null,null,null,null,null,null,null,"NA","NA"],
    [1337,"1337","Carrier K","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72148","MRI LUMBAR SPINE WITHOUT CONTRAST","275","0.81",null,null,null,null,null,null,null,"NA","NA"],
    [1338,"1338","Carrier K","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73221","MRI UPPER EXTREMITY JOINT WITHOUT CONTRAST","204","0.78",null,null,null,null,null,null,null,"NA","NA"],
    [1339,"1339","Carrier K","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","Psychological and Neuropsychological Test Administration","54","1",null,null,"19.82",null,null,null,null,"NA","NA"],
    [1340,"1340","Carrier K","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","98942","Chiropractic Care","35","1",null,null,"48",null,null,null,null,"NA","NA"],
    [1341,"1341","Carrier K","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","98940","Chiropractic Care","32","1",null,null,"48",null,null,null,null,"NA","NA"],
    [1342,"1342","Carrier K","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","45385","COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ","29","1",null,"0","1.38",null,null,null,null,"NA","NA"],
    [1343,"1343","Carrier K","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","ABA Behavior Identification Assessments","27","1",null,null,"5.97",null,null,null,null,"NA","NA"],
    [1344,"1344","Carrier K","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","MH IOP Adolescent","26","1",null,null,"0.92",null,null,null,null,"NA","NA"],
    [1345,"1345","Carrier K","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","MH Residential Eating Disorder Adult","25","1",null,"2.99","24.64",null,null,null,null,"NA","NA"],
    [1346,"1346","Carrier K","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","ABA Direct Care Codes","25","1",null,null,"2.63",null,null,null,null,"NA","NA"],
    [1347,"1347","Carrier K","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","87660","IADNA TRICHOMONAS VAGINALIS DIRECT PROBE TQ","23","1",null,"0","1.46",null,null,null,null,"NA","NA"],
    [1348,"1348","Carrier K","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","87480","IADNA CANDIDA SPECIES DIRECT PROBE TQ","23","1",null,"0","1.46",null,null,null,null,"NA","NA"],
    [1349,"1349","Carrier L","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45385","COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ","57","1",null,null,"6.52",null,null,null,null,"NA","NA"],
    [1350,"1350","Carrier L","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","98940","Chiropractic Care","53","1",null,null,"84",null,null,null,null,"NA","NA"],
    [1351,"1351","Carrier L","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45378","COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD","76","0.99",null,"15.2","7.75",null,null,null,null,"NA","NA"],
    [1352,"1352","Carrier L","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE","73","0.99",null,"18.16","7.47",null,null,null,null,"NA","NA"],
    [1353,"1353","Carrier L","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","98941","Chiropractic Care","402","0.98",null,null,"84",null,null,null,null,"NA","NA"],
    [1354,"1354","Carrier L","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","98943","Chiropractic Care","206","0.97",null,null,"84",null,null,null,null,"NA","NA"],
    [1355,"1355","Carrier L","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","81479","UNLISTED MOLELCULAR PATHOLOGY PROCEDURE","54","0.96",null,null,"6.06","35",null,null,null,"NA","NA"],
    [1356,"1356","Carrier L","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","81420","FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS","48","0.65",null,null,"31.54",null,null,null,null,"NA","NA"],
    [1357,"1357","Carrier L","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95810","POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND","69","0.59",null,null,"62.07",null,null,null,null,"NA","NA"],
    [1358,"1358","Carrier L","2020","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95811","POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND","56","0.59",null,null,"59.98","35",null,null,null,"NA","NA"],
    [1359,"1359","Carrier L","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","45385","COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ","57","1",null,null,"6.52",null,null,null,null,"NA","NA"],
    [1360,"1360","Carrier L","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43239","EGD TRANSORAL BIOPSY SINGLE/MULTIPLE","47","1",null,"1.31","7.38",null,null,null,null,"NA","NA"],
    [1361,"1361","Carrier L","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43235","ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC","36","1",null,"1.13","11.25",null,null,null,null,"NA","NA"],
    [1362,"1362","Carrier L","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","45384","COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS","30","1",null,null,"3.78",null,null,null,null,"NA","NA"],
    [1363,"1363","Carrier L","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81374","HLA I LOW RESOLUTION ONE ANTIGEN EQUIVALENT EACH","19","1",null,null,"1.06",null,null,null,null,"NA","NA"],
    [1364,"1364","Carrier L","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43249","EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM","16","1",null,"0.1","0.58",null,null,null,null,"NA","NA"],
    [1365,"1365","Carrier L","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64493","NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL","13","1",null,null,"21.36",null,null,null,null,"NA","NA"],
    [1366,"1366","Carrier L","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81220","CFTR GENE ANALYSIS COMMON VARIANTS","13","1",null,null,"0.13",null,null,null,null,"NA","NA"],
    [1367,"1367","Carrier L","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58571","LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY","12","1",null,"20.1","66.11",null,null,null,null,"NA","NA"],
    [1368,"1368","Carrier L","2020","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58558","HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C","10","1",null,null,"10.58",null,null,null,null,"NA","NA"],
    [1369,"1369","Carrier M","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H2036","ALCOHOL AND/OR DRUG TREATMENT PROGRAM, PER DIEM","40","1",null,"1.8","100.2",null,null,null,null,"NA","NA"],
    [1370,"1370","Carrier M","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY, 60 MINUTES WITH PATIENT","39","0.97",null,"1.85","217.85",null,null,null,null,"NA","NA"],
    [1371,"1371","Carrier M","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","MENTAL HEALTH PARTIAL HOSPITALIZATION, TREATMENT, LESS THAN 24 HOURS","46","0.96",null,"0.52","78.26",null,null,null,null,"NA","NA"],
    [1372,"1372","Carrier M","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97156","FAMILY ADAPTIVE BEHAVIOR TREATMENT GUIDANCE, ADMINISTERED BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL (WITH OR WITHOUT THE PATIENT PRESENT),FACE- TO-FACE WITH GUARDIAN(S)/CAREGIVER(S), EACH 15 MINUTES","19","0.95",null,"3.79","990.32",null,null,null,null,"NA","NA"],
    [1373,"1373","Carrier M","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97153","ADAPTIVE BEHAVIOR TREATMENT BY PROTOCOL, ADMINISTERED BY TECHNICIAN UNDER THE DIRECTION OF A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, FACE-TO-FACE WITH ONE PATIENT, EACH 15 MINUTES","19","0.89",null,"-195.79","1784.84",null,null,null,null,"NA","NA"],
    [1374,"1374","Carrier M","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","BEHAVIOR IDENTIFICATION ASSESSMENT, ADMINISTERED BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, EACH 15 MINUTES OF THE PHYSICIANS OR OTHER QUALI FIED HEALTH CARE PROFESSIONALS TIME FACE-TO-FACE WITH PATIENT AND/OR GUARDIAN( S)/CAREGIVER(S) A","25","0.88",null,"-148.8","744.96",null,null,null,null,"NA","NA"],
    [1375,"1375","Carrier M","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97155","ADAPTIVE BEHAVIOR TREATMENT WITH PROTOCOL MODIFICATION, ADMINISTERED BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, WHICH MAY INCLUDE SIMULTANEOUS DIRECTION OF TECHNICIAN, FACE-TO-FACE WITH ONE PATIENT, EACH 15 MINUTES","23","0.87",null,"-161.74","1562.09",null,null,null,null,"NA","NA"],
    [1376,"1376","Carrier M","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT MOTOR THRESHOLD RE-DETERMINATION WITH DELIVERY AND MANAGEMENT","20","0.65",null,"3.6","102",null,null,null,null,"NA","NA"],
    [1377,"1377","Carrier M","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; INITIAL, INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, DELIVERY AND MANAGEMENT","26","0.62",null,"2.77","216.92",null,null,null,null,"NA","NA"],
    [1378,"1378","Carrier M","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT DELIVERY AND MANAGEMENT, PER SESSION","28","0.61",null,"2.57","294.86",null,null,null,null,"NA","NA"],
    [1379,"1379","Carrier M","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H2036","ALCOHOL AND/OR DRUG TREATMENT PROGRAM, PER DIEM","40","1",null,"1.8","100.2",null,null,null,null,"NA","NA"],
    [1380,"1380","Carrier M","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY, 60 MINUTES WITH PATIENT","39","0.97",null,"1.85","217.85",null,null,null,null,"NA","NA"],
    [1381,"1381","Carrier M","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0035","MENTAL HEALTH PARTIAL HOSPITALIZATION, TREATMENT, LESS THAN 24 HOURS","46","0.96",null,"0.52","78.26",null,null,null,null,"NA","NA"],
    [1382,"1382","Carrier M","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97156","FAMILY ADAPTIVE BEHAVIOR TREATMENT GUIDANCE, ADMINISTERED BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL (WITH OR WITHOUT THE PATIENT PRESENT),FACE- TO-FACE WITH GUARDIAN(S)/CAREGIVER(S), EACH 15 MINUTES","19","0.95",null,"3.79","990.32",null,null,null,null,"NA","NA"],
    [1383,"1383","Carrier M","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97153","ADAPTIVE BEHAVIOR TREATMENT BY PROTOCOL, ADMINISTERED BY TECHNICIAN UNDER THE DIRECTION OF A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, FACE-TO-FACE WITH ONE PATIENT, EACH 15 MINUTES","19","0.89",null,"-195.79","1784.84",null,null,null,null,"NA","NA"],
    [1384,"1384","Carrier M","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97151","BEHAVIOR IDENTIFICATION ASSESSMENT, ADMINISTERED BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, EACH 15 MINUTES OF THE PHYSICIANS OR OTHER QUALI FIED HEALTH CARE PROFESSIONALS TIME FACE-TO-FACE WITH PATIENT AND/OR GUARDIAN( S)/CAREGIVER(S) A","25","0.88",null,"-148.8","744.96",null,null,null,null,"NA","NA"],
    [1385,"1385","Carrier M","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97155","ADAPTIVE BEHAVIOR TREATMENT WITH PROTOCOL MODIFICATION, ADMINISTERED BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, WHICH MAY INCLUDE SIMULTANEOUS DIRECTION OF TECHNICIAN, FACE-TO-FACE WITH ONE PATIENT, EACH 15 MINUTES","23","0.87",null,"-161.74","1562.09",null,null,null,null,"NA","NA"],
    [1386,"1386","Carrier M","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90869","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT MOTOR THRESHOLD RE-DETERMINATION WITH DELIVERY AND MANAGEMENT","20","0.65",null,"3.6","102",null,null,null,null,"NA","NA"],
    [1387,"1387","Carrier M","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90867","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; INITIAL, INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, DELIVERY AND MANAGEMENT","26","0.62",null,"2.77","216.92",null,null,null,null,"NA","NA"],
    [1388,"1388","Carrier M","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90868","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT DELIVERY AND MANAGEMENT, PER SESSION","28","0.61",null,"2.57","294.86",null,null,null,null,"NA","NA"],
    [1389,"1389","Carrier A","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","13","1",null,"15.5","18.2",null,null,null,null,"NA","NA"],
    [1390,"1390","Carrier A","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97810","Acupuncture, 1 or more needles; without electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient","3","1",null,null,"46.5",null,null,null,null,"NA","NA"],
    [1391,"1391","Carrier A","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19350","Nipple/areola reconstruction","2","1",null,null,"50.5",null,null,null,null,"NA","NA"],
    [1392,"1392","Carrier A","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19303","Mastectomy, simple, complete","2","1",null,null,"50.5",null,null,null,null,"NA","NA"],
    [1393,"1393","Carrier A","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan","2","1",null,null,"276.9",null,null,null,null,"NA","NA"],
    [1394,"1394","Carrier A","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97811","Acupuncture, 1 or more needles; without electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with re-insertion of needle(s) (List separately in addition to code for primary procedure)","2","1",null,null,"1.1","168",null,null,null,"NA","NA"],
    [1395,"1395","Carrier A","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours","2","1",null,null,"29.5",null,null,null,null,"NA","NA"],
    [1396,"1396","Carrier A","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97156","Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes","2","1",null,null,"276.9","393.6",null,null,null,"NA","NA"],
    [1397,"1397","Carrier A","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97153","Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes","2","1",null,null,"276.9","466.29",null,null,null,"NA","NA"],
    [1398,"1398","Carrier A","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97155","Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes","2","1",null,null,"276.9","576",null,null,null,"NA","NA"],
    [1399,"1399","Carrier A","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","92507","Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual","17","0.82",null,null,"23.7",null,null,null,null,"NA","NA"],
    [1400,"1400","Carrier A","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H2036","Alcohol and/or other drug treatment program, per diem","8","0.75",null,null,"6.8",null,null,null,null,"NA","NA"],
    [1401,"1401","Carrier A","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90853","Group psychotherapy (other than of a multiple-family group)","2","0",null,"2.9","22.1",null,null,null,null,"NA","NA"],
    [1402,"1402","Carrier A","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15877","Suction assisted lipectomy; trunk","2","0",null,null,"50.5","461",null,null,null,"NA","NA"],
    [1403,"1403","Carrier A","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","13","1",null,"15.5","18.2",null,null,null,null,"NA","NA"],
    [1404,"1404","Carrier A","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97810","Acupuncture, 1 or more needles; without electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient","3","1",null,null,"46.5",null,null,null,null,"NA","NA"],
    [1405,"1405","Carrier A","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19350","Nipple/areola reconstruction","2","1",null,null,"50.5",null,null,null,null,"NA","NA"],
    [1406,"1406","Carrier A","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97156","Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes","2","1",null,null,"276.9",null,null,null,null,"NA","NA"],
    [1407,"1407","Carrier A","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97811","Acupuncture, 1 or more needles; without electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with re-insertion of needle(s) (List separately in addition to code for primary procedure)","2","1",null,null,"1.1",null,null,null,null,"NA","NA"],
    [1408,"1408","Carrier A","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19303","Mastectomy, simple, complete","2","1",null,null,"50.5",null,null,null,null,"NA","NA"],
    [1409,"1409","Carrier A","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97151","Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan","2","1",null,null,"276.9",null,null,null,null,"NA","NA"],
    [1410,"1410","Carrier A","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0035","Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours","2","1",null,null,"29.5",null,null,null,null,"NA","NA"],
    [1411,"1411","Carrier A","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97153","Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes","2","1",null,null,"276.9",null,null,null,null,"NA","NA"],
    [1412,"1412","Carrier A","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97155","Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes","2","1",null,null,"276.9",null,null,null,null,"NA","NA"],
    [1413,"1413","Carrier N","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","Mental Health Individual and Family Therapy","4","1",null,null,"108.25",null,null,null,null,"NA","NA"],
    [1414,"1414","Carrier N","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","S0201","Substance Abuse Partial Hospitalization Program","4","1",null,null,"24",null,null,null,null,"NA","NA"],
    [1415,"1415","Carrier N","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","S9480","Mental Health Intensive Outpatient Program","3","1",null,null,"24",null,null,null,null,"NA","NA"],
    [1416,"1416","Carrier N","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","H0015","Substance Abuse Intensive Outpatient Program","3","1",null,null,"24",null,null,null,null,"NA","NA"],
    [1417,"1417","Carrier N","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Transcranial Magnetic Stimulation (TMS)","2","1",null,null,"24.5",null,null,null,null,"NA","NA"],
    [1418,"1418","Carrier N","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","H0035","Psychiatric Treatment Partial Hospitalization","1","1",null,null,"24",null,null,null,null,"NA","NA"],
    [1419,"1419","Carrier N","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90837","Mental Health Individual and Family Therapy","4","1",null,null,"108.25",null,null,null,null,"NA","NA"],
    [1420,"1420","Carrier N","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","S0201","Substance Abuse Partial Hospitalization Program","4","1",null,null,"24",null,null,null,null,"NA","NA"],
    [1421,"1421","Carrier N","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","S9480","Mental Health Intensive Outpatient Program","3","1",null,null,"24",null,null,null,null,"NA","NA"],
    [1422,"1422","Carrier N","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H0015","Substance Abuse Intensive Outpatient Program","3","1",null,null,"24",null,null,null,null,"NA","NA"],
    [1423,"1423","Carrier N","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90868","Transcranial Magnetic Stimulation (TMS)","2","1",null,null,"24.5",null,null,null,null,"NA","NA"],
    [1424,"1424","Carrier N","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H0035","Psychiatric Treatment Partial Hospitalization","1","1",null,null,"24",null,null,null,null,"NA","NA"],
    [1425,"1425","Carrier B","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY WITH PATIENT AND FAMILY 60 MINUTES","10","1",null,"0","156.67","0.11",null,null,null,"NA","NA"],
    [1426,"1426","Carrier B","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96101","PSYHCOLOGICAL TESTING PER HOUR FACE TO FACE TIME WITH PATIENT","9","1",null,"0","187.72","192.35",null,null,null,"NA","NA"],
    [1427,"1427","Carrier B","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S9480","INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES PER DIEM","7","1",null,"27.2","158.19","0",null,null,null,"NA","NA"],
    [1428,"1428","Carrier B","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0004","BEHAVIORAL HEALTH COUNSELING AND THERAPY PER 15 MIN","6","1",null,"0","52.62","0",null,null,null,"NA","NA"],
    [1429,"1429","Carrier B","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90834","PSYCHOTHERAPY WITH PAIENT AND FAMILY 45  MINUTES","4","1",null,"104.43","21.63","0.25",null,null,null,"NA","NA"],
    [1430,"1430","Carrier B","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90870","ELECTROCONVULSIVE THERAPY; SINGLE SEIZURE","3","1",null,"0","80.11","0",null,null,null,"NA","NA"],
    [1431,"1431","Carrier B","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0015","INTENSIVE OUTPATIENT ALCOHOL AND/OR DRUG SERVICES ->=3HOURS A  DAY/3DAYS A WEEK","2","1",null,"0","118.37","0",null,null,null,"NA","NA"],
    [1432,"1432","Carrier B","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","906","INTENSIVE BEHAVIORAL HEALTH TREATMENT SERVICES","15","0.93",null,"0","95.29","0",null,null,null,"NA","NA"],
    [1433,"1433","Carrier B","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90836","PSYCHOTHERAPY  WITH PATIENT WITH  EVALUTATION/MANAGEMENT LASTING 45 MIN","29","0.9",null,"0","104.22","0.16",null,null,null,"NA","NA"],
    [1434,"1434","Carrier B","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","905","INTENSIVE BEHAVIORAL HEALTH TREATMENT SERVICES PER DIEM","5","0.8",null,"0","136.09","0",null,null,null,"NA","NA"],
    [1435,"1435","Carrier B","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY WITH PATIENT AND FAMILY 60 MINUTES","10","1",null,"0","156.67","0.11",null,null,null,"NA","NA"],
    [1436,"1436","Carrier B","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96101","PSYHCOLOGICAL TESTINGG PER HOUR FACE TO FACE TIME WITH PATIENT","9","1",null,"0","187.72","192.35",null,null,null,"NA","NA"],
    [1437,"1437","Carrier B","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S9480","INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES PER DIEM","7","1",null,"27.2","158.19","0",null,null,null,"NA","NA"],
    [1438,"1438","Carrier B","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0004","BEHAVIORAL HEALTH COUNSELING AND THERAPY PER 15 MIN","6","1",null,"0","52.62","0",null,null,null,"NA","NA"],
    [1439,"1439","Carrier B","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90834","PSYCHOTHERAPY WITH PAIENT AND FAMILY 45  MINUTES","4","1",null,"104.43","21.63","0.25",null,null,null,"NA","NA"],
    [1440,"1440","Carrier B","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90870","ELECTROCONVULSIVE THERAPY; SINGLE SEIZURE","3","1",null,"0","80.11","0",null,null,null,"NA","NA"],
    [1441,"1441","Carrier B","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0015","INTENSIVE OUTPATIENT ALCOHOL AND/OR DRUG SERVICES ->=3HOURS A  DAY/3DAYS A WEEK","2","1",null,"0","118.37","0",null,null,null,"NA","NA"],
    [1442,"1442","Carrier B","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99212","OFFICE/OUTPATIENT VISIT ESTABLISHED PATIENT","1","1",null,"0","289.85","0",null,null,null,"NA","NA"],
    [1443,"1443","Carrier B","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96130","PSYCHOLOGICAL TESTING  FACE TO FACE TIME WITH PATIENT FOR 1ST HOUR OF TREATMENT","1","1",null,"0","198.1","0",null,null,null,"NA","NA"],
    [1444,"1444","Carrier B","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0001","ALCOHOL AND/OR DRUG ASSESSMENT","1","1",null,"0","145.13","0",null,null,null,"NA","NA"],
    [1445,"1445","Carrier C","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY 60 MIN PATIENT","14129","0.99",null,"46.32","193.87",null,null,null,null,"NA","NA"],
    [1446,"1446","Carrier C","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90834","PSYCHOTHERAPY 45 MIN PATIENT","8109","0.99",null,"51.5","97.9",null,null,null,null,"NA","NA"],
    [1447,"1447","Carrier C","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90836","PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS","4544","0.99",null,"32.33","199.89",null,null,null,null,"NA","NA"],
    [1448,"1448","Carrier C","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90853","GROUP PSYCHOTHERAPY","1210","0.99",null,"74.93","113.09",null,null,null,null,"NA","NA"],
    [1449,"1449","Carrier C","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90833","PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS","206","0.98",null,null,"176.38",null,null,null,null,"NA","NA"],
    [1450,"1450","Carrier C","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","905","BH/INTENS OP/PSYCH","165","0.98",null,null,"130.21",null,null,null,null,"NA","NA"],
    [1451,"1451","Carrier C","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96130","PSYCHOLOGICAL TESTING EVAL BY PHYS OR QUAL PROF;  FIRST HOUR","323","0.95",null,"147.68","248.79",null,null,null,null,"NA","NA"],
    [1452,"1452","Carrier C","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES","301","0.91",null,"125.29","585.12",null,null,null,null,"NA","NA"],
    [1453,"1453","Carrier C","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96132","NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR","175","0.87",null,"65.84","442.04",null,null,null,null,"NA","NA"],
    [1454,"1454","Carrier C","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","BEHAV IDENTIFICATION ASSESSMNT, ADM BY PHYS OR QUAL PROF, EA 15 MINS","214","0.79",null,"53.58","648.05",null,null,null,null,"NA","NA"],
    [1455,"1455","Carrier C","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96150","ASSESS HLTH/BEHAVE INIT","16","1",null,null,"129.94",null,null,null,null,"NA","NA"],
    [1456,"1456","Carrier C","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99492","INIT PSYCHIATRIC COLLABORATIVE CARE MGMT, FIRST 70 MINS/FIRST CAL MONTH","13","1",null,null,"1047.05",null,null,null,null,"NA","NA"],
    [1457,"1457","Carrier C","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97803","MED NUTRIT THRPY REASSESS PER 15 MIN","7","1",null,null,"392.21",null,null,null,null,"NA","NA"],
    [1458,"1458","Carrier C","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97802","MED NUTRIT THRPY INIT ASSESS 15 MIN","7","1",null,null,"91.2",null,null,null,null,"NA","NA"],
    [1459,"1459","Carrier C","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96156","HEALTH BEHAVIOR ASSESSMENT, OR RE-ASSESSMENT","4","1",null,null,"637.48",null,null,null,null,"NA","NA"],
    [1460,"1460","Carrier C","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96101","PSYCHOLOGICAL TESTING BILLED PER HR BY PHD","2","1",null,null,"45.61",null,null,null,null,"NA","NA"],
    [1461,"1461","Carrier C","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95819","EEG AWAKE & ASLEEP INCLUDE HYPERVENTILATION &/OR","2","1",null,null,"137.98",null,null,null,null,"NA","NA"],
    [1462,"1462","Carrier C","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96127","BRIEF EMOTION/BEHAVIOR ASSES, W/SCORING AND DOC, PER STNDARD INSTRUMNT","2","1",null,null,"1061.95",null,null,null,null,"NA","NA"],
    [1463,"1463","Carrier C","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96125","COGNITIVE TEST BY HC PRO","2","1",null,null,"355.82",null,null,null,null,"NA","NA"],
    [1464,"1464","Carrier C","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","0362T","BHV ID SUPRT ASSMT EA 15","2","1",null,null,"811.09",null,null,null,null,"NA","NA"],
    [1465,"1465","Carrier C","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","128","ROOM AND BOARD","1","0","1",null,"94.45",null,null,null,null,"NA","NA"],
    [1466,"1466","Carrier C","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","J8999","ORAL PRESCRIPTION DRUG CHEMO","2","0","0.5",null,"765.04",null,null,null,null,"NA","NA"],
    [1467,"1467","Carrier C","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90868","TRANSCRANIAL MAG STIMJ TX DLVR & MGMT","144","0","0.02","48.06","462.93",null,null,null,null,"NA","NA"],
    [1468,"1468","Carrier C","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97151","BEHAV IDENTIFICATION ASSESSMNT, ADM BY PHYS OR QUAL PROF, EA 15 MINS","214","0","0.01","53.58","648.05",null,null,null,null,"NA","NA"],
    [1469,"1469","Carrier C","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90837","PSYCHOTHERAPY 60 MIN PATIENT","14129","0","0","46.32","193.87",null,null,null,null,"NA","NA"],
    [1470,"1470","Carrier C","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90834","PSYCHOTHERAPY 45 MIN PATIENT","8109","0","0","51.5","97.9",null,null,null,null,"NA","NA"],
    [1471,"1471","Carrier C","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90836","PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS","4544","0","0","32.33","199.89",null,null,null,null,"NA","NA"],
    [1472,"1472","Carrier D","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY 60 MIN PATIENT","832","1",null,"23.30319625","190.66",null,null,null,null,"NA","NA"],
    [1473,"1473","Carrier D","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90834","PSYCHOTHERAPY 45 MIN PATIENT","646","1",null,"37.90055668","89.01",null,null,null,null,"NA","NA"],
    [1474,"1474","Carrier D","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90836","PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS","453","1",null,"33.43685336","193.13",null,null,null,null,"NA","NA"],
    [1475,"1475","Carrier D","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90853","GROUP PSYCHOTHERAPY","110","1",null,"73.56166692","113.9",null,null,null,null,"NA","NA"],
    [1476,"1476","Carrier D","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES","38","1",null,"24.4785427","585.84",null,null,null,null,"NA","NA"],
    [1477,"1477","Carrier D","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","S9480","PSYCH SVC INTENSIVE OUTPT","15","1",null,null,"887.26",null,null,null,null,"NA","NA"],
    [1478,"1478","Carrier D","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96130","PSYCHOLOGICAL TESTING EVAL BY PHYS OR QUAL PROF;  FIRST HOUR","35","0.94",null,"16.85305825","192.17",null,null,null,null,"NA","NA"],
    [1479,"1479","Carrier D","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96132","NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR","82","0.93",null,"44.40416865","452.8",null,null,null,null,"NA","NA"],
    [1480,"1480","Carrier D","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","BEHAV IDENTIFICATION ASSESSMNT, ADM BY PHYS OR QUAL PROF, EA 15 MINS","68","0.84",null,"27.44527833","277.07",null,null,null,null,"NA","NA"],
    [1481,"1481","Carrier D","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","TRANSCRANIAL MAG STIMJ TX DLVR & MGMT","47","0.74",null,"71.99097414","349.24",null,null,null,null,"NA","NA"],
    [1482,"1482","Carrier D","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90853","GROUP PSYCHOTHERAPY","110","1",null,"73.56166692","113.9",null,null,null,null,"NA","NA"],
    [1483,"1483","Carrier D","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES","38","1",null,"24.4785427","585.84",null,null,null,null,"NA","NA"],
    [1484,"1484","Carrier D","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","S9480","PSYCH SVC INTENSIVE OUTPT","15","1",null,null,"887.26",null,null,null,null,"NA","NA"],
    [1485,"1485","Carrier D","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","905","BH/INTENS OP/PSYCH","14","1",null,null,"200.31",null,null,null,null,"NA","NA"],
    [1486,"1486","Carrier D","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H2014","SKILLS TRAIN AND DEV, 15 MIN","11","1",null,null,"693.3",null,null,null,null,"NA","NA"],
    [1487,"1487","Carrier D","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99201","OFFICE VISIT E&M NEW SELF LIMIT/MINOR 10","9","1",null,null,"1448.03",null,null,null,null,"NA","NA"],
    [1488,"1488","Carrier D","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90833","PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS","4","1",null,null,"194.34",null,null,null,null,"NA","NA"],
    [1489,"1489","Carrier D","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90870","ELECTROCONVULSIVE THERAPY","3","1",null,null,"395.82",null,null,null,null,"NA","NA"],
    [1490,"1490","Carrier D","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H0020","ALCOHOL AND/OR DRUG SERVICES","3","1",null,null,"651.14",null,null,null,null,"NA","NA"],
    [1491,"1491","Carrier D","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99214","OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS","3","1",null,null,"13.84",null,null,null,null,"NA","NA"],
    [1492,"1492","Carrier D","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90868","TRANSCRANIAL MAG STIMJ TX DLVR & MGMT","47","0","0.04","71.99097414","349.24",null,null,null,null,"NA","NA"],
    [1493,"1493","Carrier D","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","96132","NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR","82","0","0.01","44.40416865","452.8","0",null,null,null,"NA","NA"],
    [1494,"1494","Carrier E","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97153","ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN","51","1",null,null,"24.5","216",null,null,null,"NA","NA"],
    [1495,"1495","Carrier E","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0001","ALCOHOL AND/OR DRUG ASSESS","39","1",null,null,"21.2",null,null,null,null,"NA","NA"],
    [1496,"1496","Carrier E","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0020","ALCOHOL AND/OR DRUG SERVICES METHADONE ADMINISTRATION","34","1",null,null,"19.2",null,null,null,null,"NA","NA"],
    [1497,"1497","Carrier E","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN","20","1",null,null,"15.5","600",null,null,null,"NA","NA"],
    [1498,"1498","Carrier E","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90847","FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS","17","1",null,null,"21.5",null,null,null,null,"NA","NA"],
    [1499,"1499","Carrier E","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97156","FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN","16","1",null,null,"31.1",null,null,null,null,"NA","NA"],
    [1500,"1500","Carrier E","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97155","ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN","14","1",null,null,"33.6",null,null,null,null,"NA","NA"],
    [1501,"1501","Carrier E","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY W/PATIENT 60 MINUTES","305","0.99",null,null,"25.9",null,null,null,null,"NA","NA"],
    [1502,"1502","Carrier E","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVALUATION","735","0.97",null,null,"26.3",null,null,null,null,"NA","NA"],
    [1503,"1503","Carrier E","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90834","PSYCHOTHERAPY W/PATIENT 45 MINUTES","33","0.97",null,null,"26.5",null,null,null,null,"NA","NA"],
    [1504,"1504","Carrier E","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97153","ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN","51","1",null,null,"24.5",null,null,null,null,"NA","NA"],
    [1505,"1505","Carrier E","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0001","ALCOHOL AND/OR DRUG ASSESS","39","1",null,null,"21.2",null,null,null,null,"NA","NA"],
    [1506,"1506","Carrier E","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0020","ALCOHOL AND/OR DRUG SERVICES METHADONE ADMINISTRATION","34","1",null,null,"19.2",null,null,null,null,"NA","NA"],
    [1507,"1507","Carrier E","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97151","BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN","20","1",null,null,"15.5",null,null,null,null,"NA","NA"],
    [1508,"1508","Carrier E","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90847","FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS","17","1",null,null,"21.5",null,null,null,null,"NA","NA"],
    [1509,"1509","Carrier E","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97156","FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN","16","1",null,null,"31.1",null,null,null,null,"NA","NA"],
    [1510,"1510","Carrier E","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97155","ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN","14","1",null,null,"33.6",null,null,null,null,"NA","NA"],
    [1511,"1511","Carrier E","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90899","UNLISTED PSYCHIATRIC SERVICE/PROCEDURE","13","1",null,null,"7.3",null,null,null,null,"NA","NA"],
    [1512,"1512","Carrier E","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90853","GROUP PSYCHOTHERAPY","13","1",null,null,"53.5",null,null,null,null,"NA","NA"],
    [1513,"1513","Carrier E","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97152","BEHAVIOR ID SUPPORT ASSMT BY 1 TECH EA 15 MIN","10","1",null,null,"19.3",null,null,null,null,"NA","NA"],
    [1514,"1514","Carrier F","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S0201","Partial hospitalization services, less than 24 hours, per diem","16","0.88",null,"23","72",null,null,null,null,"NA","NA"],
    [1515,"1515","Carrier F","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","Mental health partial hospitalization, treatment, less than 24 hours","100","0.8",null,"24","66",null,null,null,null,"NA","NA"],
    [1516,"1516","Carrier F","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S9480","Intensive outpatient psychiatric services, per diem","40","0.8",null,"19","68",null,null,null,null,"NA","NA"],
    [1517,"1517","Carrier F","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","20","0.8",null,"3","55",null,null,null,null,"NA","NA"],
    [1518,"1518","Carrier F","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","28","0.79",null,"10","66","0",null,null,null,"NA","NA"],
    [1519,"1519","Carrier F","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","23","0.78",null,"10","62",null,null,null,null,"NA","NA"],
    [1520,"1520","Carrier F","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0015","Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education","41","0.71",null,"34","65",null,null,null,null,"NA","NA"],
    [1521,"1521","Carrier F","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","Psychotherapy, 60 minutes with patient","22","0.45",null,"32","91","18.3",null,null,null,"NA","NA"],
    [1522,"1522","Carrier F","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96136","Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; first 30 minutes","12","0.42",null,"42","90",null,null,null,null,"NA","NA"],
    [1523,"1523","Carrier F","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90853","Group psychotherapy (other than of a multiple-family group)","12","0.33",null,"23","76",null,null,null,null,"NA","NA"],
    [1524,"1524","Carrier F","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97156","Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes","11","1",null,"35","95",null,null,null,null,"NA","NA"],
    [1525,"1525","Carrier F","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97153","Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes","10","1",null,"23","84",null,null,null,null,"NA","NA"],
    [1526,"1526","Carrier F","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97151","Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan","9","1",null,"16","92",null,null,null,null,"NA","NA"],
    [1527,"1527","Carrier F","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0032","Mental health service plan development by nonphysician","6","1",null,null,"85",null,null,null,null,"NA","NA"],
    [1528,"1528","Carrier F","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H2019","Therapeutic behavioral services, per 15 minutes","6","1",null,null,"85",null,null,null,null,"NA","NA"],
    [1529,"1529","Carrier F","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97155","Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes","5","1",null,"35","108",null,null,null,null,"NA","NA"],
    [1530,"1530","Carrier F","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90836","Psychotherapy, 45 minutes with patient when performed with an evaluation and management service (List separately in addition to the code for primary procedure)","1","1",null,null,"98",null,null,null,null,"NA","NA"],
    [1531,"1531","Carrier F","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90840","Psychotherapy for crisis; each additional 30 minutes (List separately in addition to code for primary service)","1","1",null,null,"209",null,null,null,null,"NA","NA"],
    [1532,"1532","Carrier F","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90686","Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.5 mL dosage, for intramuscular use","1","1",null,null,"98",null,null,null,null,"NA","NA"],
    [1533,"1533","Carrier F","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43235","Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","1","1",null,null,"75",null,null,null,null,"NA","NA"],
    [1534,"1534","Carrier F","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90837","Psychotherapy, 60 minutes with patient","22","0","0.09","32","91",null,null,null,null,"NA","NA"],
    [1535,"1535","Carrier F","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","H0035","Mental health partial hospitalization, treatment, less than 24 hours","100","0","0.01","24","66",null,null,null,null,"NA","NA"],
    [1536,"1536","Carrier G","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","G0297","LOW DOSE CT SCAN FOR LUNG CANCER SCREENING","53","0.85",null,"25.2","55.7",null,null,null,null,"NA","NA"],
    [1537,"1537","Carrier G","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90870","ELECTROCONVULSIVE THERAPY","4","0.75",null,"25.2","212.7",null,null,null,null,"NA","NA"],
    [1538,"1538","Carrier G","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","THERAP REPETITIVE TMS TX SUBSEQ DELIVERY  AND  MNG","7","0.71",null,"48.6","112",null,null,null,null,"NA","NA"],
    [1539,"1539","Carrier G","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL and M","7","0.71",null,"48.6","112",null,null,null,null,"NA","NA"],
    [1540,"1540","Carrier G","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19325","BREAST AUGMENTATION WITH IMPLANT","7","0.71",null,null,"42.5",null,null,null,null,"NA","NA"],
    [1541,"1541","Carrier G","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV  and  MN","5","0.6",null,"48.6","107.6",null,null,null,null,"NA","NA"],
    [1542,"1542","Carrier G","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","55970","INTERSEX SURG MALE FEMALE","7","0.57",null,null,"64",null,null,null,null,"NA","NA"],
    [1543,"1543","Carrier G","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVALUATION","9","0.44",null,null,"80.5",null,null,null,null,"NA","NA"],
    [1544,"1544","Carrier G","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","80307","DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE","8","0.38",null,null,"72.5",null,null,null,null,"NA","NA"],
    [1545,"1545","Carrier G","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97530","THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN","5","0",null,null,"16.3",null,null,null,null,"NA","NA"],
    [1546,"1546","Carrier G","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81381","HLA I TYPING HIGH RESOLUTION 1 ALLELE/ALLELE GRP","3","1",null,null,"0",null,null,null,null,"NA","NA"],
    [1547,"1547","Carrier G","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H0004","BEHAVIORAL HEALTH CNSL AND THERAPY PER 15 MINUTES","2","1",null,null,"77.7",null,null,null,null,"NA","NA"],
    [1548,"1548","Carrier G","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96164","HEALTH BEHAVIOR IVNTJ GROUP F2F 1ST 30 MIN","2","1",null,null,"77.7",null,null,null,null,"NA","NA"],
    [1549,"1549","Carrier G","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H0035","MENTAL HEALTH PARTIAL HOSP TX  LT  24 HOURS","2","1",null,"29.7","25.6",null,null,null,null,"NA","NA"],
    [1550,"1550","Carrier G","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","92523","EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION","2","1",null,null,"175.3",null,null,null,null,"NA","NA"],
    [1551,"1551","Carrier G","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96165","HEALTH BEHAVIOR IVNTJ GROUP F2F EA ADDL 15 MIN","2","1",null,null,"77.7",null,null,null,null,"NA","NA"],
    [1552,"1552","Carrier G","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19350","NIPPLE/AREOLA RECONSTRUCTION","2","1",null,null,"110.7",null,null,null,null,"NA","NA"],
    [1553,"1553","Carrier G","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96133","NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR","2","1",null,null,"203.5",null,null,null,null,"NA","NA"],
    [1554,"1554","Carrier G","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","17380","ELECTROLYSIS EPILATION EACH 30 MINUTES","1","1",null,null,"99.8",null,null,null,null,"NA","NA"],
    [1555,"1555","Carrier G","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70551","MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL","1","1",null,null,"23.5",null,null,null,null,"NA","NA"],
    [1556,"1556","Carrier G","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","96132","NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP 1ST HOUR","1","0","1",null,"192.4",null,null,null,null,"NA","NA"],
    [1557,"1557","Carrier G","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","92522","EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE","1","0","1",null,"136.7",null,null,null,null,"NA","NA"],
    [1558,"1558","Carrier G","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","92610","EVAL ORAL AND PHARYNGEAL SWLNG FUNCJ","1","0","1",null,"136.7",null,null,null,null,"NA","NA"],
    [1559,"1559","Carrier G","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","92523","EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION","2","0","0.5",null,"175.3",null,null,null,null,"NA","NA"],
    [1560,"1560","Carrier G","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","96133","NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR","2","0","0.5",null,"203.5",null,null,null,null,"NA","NA"],
    [1561,"1561","Carrier G","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","H0035","MENTAL HEALTH PARTIAL HOSP TX  LT  24 HOURS","2","0","0.5","29.7","25.6",null,null,null,null,"NA","NA"],
    [1562,"1562","Carrier G","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","96138","PSYCL/NRPSYCL TST TECH 2 Plus  TST 1ST 30 MIN","3","0","0.33",null,"203.5",null,null,null,null,"NA","NA"],
    [1563,"1563","Carrier G","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","96121","NEUROBEHAVIORAL STATUS XM PHYS/QHP EA ADDL HOUR","3","0","0.33",null,"203.5",null,null,null,null,"NA","NA"],
    [1564,"1564","Carrier G","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","96139","PSYCL/NRPSYCL TST TECH 2 Plus  TST EA ADDL 30 MIN","3","0","0.33",null,"203.5",null,null,null,null,"NA","NA"],
    [1565,"1565","Carrier G","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","96116","NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR","3","0","0.33",null,"203.5",null,null,null,null,"NA","NA"],
    [1566,"1566","Carrier H","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","Therapeutic Repetitive Transcranial Magnetic Simulation (tms) Treatment; Including Cortical Mapping, Motor Threshold Determination, Delivery And Mgmt","153","0.91",null,null,"67",null,null,null,null,"NA","NA"],
    [1567,"1567","Carrier H","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","Therapeutic Repetitive Transcranial Magnetic Stimulation (tms) Treatment; Subsequent Motor Threshold Re-determination With Delivery And Management","155","0.86",null,"48","76",null,null,null,null,"NA","NA"],
    [1568,"1568","Carrier H","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Therapeutic Repetitive Transcranial Magnetic Simulation (tms) Treatment; Initial, Including Cortical Mapping, Motor Threshold Determination, Subsequent Delivery And Mgmt.","170","0.58",null,"48","77","146.3",null,null,null,"NA","NA"],
    [1569,"1569","Carrier H","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90867","Therapeutic Repetitive Transcranial Magnetic Simulation (tms) Treatment; Including Cortical Mapping, Motor Threshold Determination, Delivery And Mgmt","153","0.91",null,null,"67.34",null,null,null,null,"NA","NA"],
    [1570,"1570","Carrier H","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90869","Therapeutic Repetitive Transcranial Magnetic Stimulation (tms) Treatment; Subsequent Motor Threshold Re-determination With Delivery And Management","155","0.86",null,"48","76.46",null,null,null,null,"NA","NA"],
    [1571,"1571","Carrier H","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90868","Therapeutic Repetitive Transcranial Magnetic Simulation (tms) Treatment; Initial, Including Cortical Mapping, Motor Threshold Determination, Subsequent Delivery And Mgmt.","170","0.58",null,"48","77.34",null,null,null,null,"NA","NA"],
    [1572,"1572","Carrier H","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90867","Therapeutic Repetitive Transcranial Magnetic Simulation (tms) Treatment; Including Cortical Mapping, Motor Threshold Determination, Delivery And Mgmt","153","0","0.33",null,"67.34",null,null,null,null,"NA","NA"],
    [1573,"1573","Carrier H","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90869","Therapeutic Repetitive Transcranial Magnetic Stimulation (tms) Treatment; Subsequent Motor Threshold Re-determination With Delivery And Management","155","0","0.22","48","76.46",null,null,null,null,"NA","NA"],
    [1574,"1574","Carrier H","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90870","Electroconvulsive therapy (includes necessary monitoring)","5","0","0.2","17","92",null,null,null,null,"NA","NA"],
    [1575,"1575","Carrier H","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90868","Therapeutic Repetitive Transcranial Magnetic Simulation (tms) Treatment; Initial, Including Cortical Mapping, Motor Threshold Determination, Subsequent Delivery And Mgmt.","170","0","0.1","48","77.34",null,null,null,null,"NA","NA"],
    [1576,"1576","Carrier H","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","S0201","Partial hospitalization services, less than 24 hours, per diem","44","0","0.02","65","68",null,null,null,null,"NA","NA"],
    [1577,"1577","Carrier I","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours","10","1",null,"20.64","23.2",null,null,null,null,"NA","NA"],
    [1578,"1578","Carrier I","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","8","1",null,null,"37.06",null,null,null,null,"NA","NA"],
    [1579,"1579","Carrier I","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","8","1",null,null,"37.06",null,null,null,null,"NA","NA"],
    [1580,"1580","Carrier I","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","8","1",null,null,"37.06",null,null,null,null,"NA","NA"],
    [1581,"1581","Carrier I","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H2036","Alcohol and/or other drug treatment program, per diem","6","1",null,null,"57.31",null,null,null,null,"NA","NA"],
    [1582,"1582","Carrier I","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","7","0.86",null,null,"19.54",null,null,null,null,"NA","NA"],
    [1583,"1583","Carrier I","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","92507","Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual","12","0.83",null,"0.61","35.61",null,null,null,null,"NA","NA"],
    [1584,"1584","Carrier I","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97530","Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","2","0.5",null,null,"72.67",null,null,null,null,"NA","NA"],
    [1585,"1585","Carrier I","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97153","Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes","2","0.5",null,null,"20.86",null,null,null,null,"NA","NA"],
    [1586,"1586","Carrier I","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","81229","Cytogenomic constitutional (genome-wide) microarray analysis; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants for chromosomal abnormalities","2","0.5",null,null,"75.45",null,null,null,null,"NA","NA"],
    [1587,"1587","Carrier I","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97155","Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes","2","0.5",null,null,"20.86",null,null,null,null,"NA","NA"],
    [1588,"1588","Carrier I","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97156","Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes","2","0.5",null,null,"20.86",null,null,null,null,"NA","NA"],
    [1589,"1589","Carrier I","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","2","0.5",null,null,"72.02","352",null,null,null,"NA","NA"],
    [1590,"1590","Carrier I","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0035","Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours","10","1",null,"20.64","23.2",null,null,null,null,"NA","NA"],
    [1591,"1591","Carrier I","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","8","1",null,null,"37.06","1.6",null,null,null,"NA","NA"],
    [1592,"1592","Carrier I","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","8","1",null,null,"37.06",null,null,null,null,"NA","NA"],
    [1593,"1593","Carrier I","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","8","1",null,null,"37.06",null,null,null,null,"NA","NA"],
    [1594,"1594","Carrier I","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H2036","Alcohol and/or other drug treatment program, per diem","6","1",null,null,"57.31",null,null,null,null,"NA","NA"],
    [1595,"1595","Carrier I","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70553","Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences","1","1",null,null,"0",null,null,null,null,"NA","NA"],
    [1596,"1596","Carrier I","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","98943","Chiropractic manipulative treatment (CMT); extraspinal, 1 or more regions","1","1",null,null,"1.68",null,null,null,null,"NA","NA"],
    [1597,"1597","Carrier I","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97140","Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes","1","1",null,null,"0.38","15.5",null,null,null,"NA","NA"],
    [1598,"1598","Carrier I","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81244","FMR1 (fragile X mental retardation 1) (eg, fragile X mental retardation) gene analysis; characterization of alleles (eg, expanded size and promoter methylation status)","1","1",null,null,"75.45","23",null,null,null,"NA","NA"],
    [1599,"1599","Carrier I","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19303","Mastectomy, simple, complete","1","1",null,null,"46.29","23.5",null,null,null,"NA","NA"],
    [1600,"1600","Carrier I","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81321","PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis","1","1",null,null,"75.45",null,null,null,null,"NA","NA"],
    [1601,"1601","Carrier I","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97112","Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities","1","1",null,null,"0.38","20.8",null,null,null,"NA","NA"],
    [1602,"1602","Carrier I","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81323","PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant","1","1",null,null,"75.45","8.7",null,null,null,"NA","NA"],
    [1603,"1603","Carrier I","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97151","Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan","1","1",null,null,"20.86","10.6",null,null,null,"NA","NA"],
    [1604,"1604","Carrier I","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19350","Nipple/areola reconstruction","1","1",null,null,"46.29","21.1",null,null,null,"NA","NA"],
    [1605,"1605","Carrier I","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81243","FMR1 (fragile X mental retardation 1) (eg, fragile X mental retardation) gene analysis; evaluation to detect abnormal (eg, expanded) alleles","1","1",null,null,"75.45",null,null,null,null,"NA","NA"],
    [1606,"1606","Carrier I","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70551","Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material","1","1",null,null,"0","24",null,null,null,"NA","NA"],
    [1607,"1607","Carrier I","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70450","Computed tomography, head or brain; without contrast material","1","1",null,null,"0","10.6",null,null,null,"NA","NA"],
    [1608,"1608","Carrier I","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","92522","Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria);","1","1",null,null,"182.15",null,null,null,null,"NA","NA"],
    [1609,"1609","Carrier I","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","H0035","Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours","10","0","0","20.64","23.2",null,null,null,null,"NA","NA"],
    [1610,"1610","Carrier J","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","235","0.99",null,"28.44","17.34",null,null,null,null,"NA","NA"],
    [1611,"1611","Carrier J","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H2036","Alcohol and/or other drug treatment program, per diem","105","0.92",null,null,"42.57",null,null,null,null,"NA","NA"],
    [1612,"1612","Carrier J","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours","96","0.92",null,"35.94","60.64",null,null,null,null,"NA","NA"],
    [1613,"1613","Carrier J","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","66","0.85",null,"22.38","45.15",null,null,null,null,"NA","NA"],
    [1614,"1614","Carrier J","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","57","0.81",null,"25.39","38.91",null,null,null,null,"NA","NA"],
    [1615,"1615","Carrier J","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","76","0.79",null,"19.49","43.53",null,null,null,null,"NA","NA"],
    [1616,"1616","Carrier J","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97155","Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes","48","0.75",null,null,"74.9",null,null,null,null,"NA","NA"],
    [1617,"1617","Carrier J","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","92507","Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual","248","0.74",null,null,"57.33",null,null,null,null,"NA","NA"],
    [1618,"1618","Carrier J","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97156","Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes","49","0.74",null,null,"73.43",null,null,null,null,"NA","NA"],
    [1619,"1619","Carrier J","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","92523","Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language)","59","0.68",null,null,"70.31",null,null,null,null,"NA","NA"],
    [1620,"1620","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70553","Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences","5","1",null,null,"0","18.9",null,null,null,"NA","NA"],
    [1621,"1621","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81229","Cytogenomic constitutional (genome-wide) microarray analysis; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants for chromosomal abnormalities","5","1",null,null,"16.24",null,null,null,null,"NA","NA"],
    [1622,"1622","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70450","Computed tomography, head or brain; without contrast material","5","1",null,null,"4.23","19.3",null,null,null,"NA","NA"],
    [1623,"1623","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81243","FMR1 (fragile X mental retardation 1) (eg, fragile X mental retardation) gene analysis; evaluation to detect abnormal (eg, expanded) alleles","4","1",null,null,"20.3",null,null,null,null,"NA","NA"],
    [1624,"1624","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97814","Acupuncture, 1 or more needles; with electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with re-insertion of needle(s) (List separately in addition to code for primary procedure)","4","1",null,null,"6.39",null,null,null,null,"NA","NA"],
    [1625,"1625","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97813","Acupuncture, 1 or more needles; with electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient","4","1",null,null,"6.39",null,null,null,null,"NA","NA"],
    [1626,"1626","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","17380","Electrolysis epilation, each 30 minutes","3","1",null,null,"126.07",null,null,null,null,"NA","NA"],
    [1627,"1627","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","98943","Chiropractic manipulative treatment (CMT); extraspinal, 1 or more regions","3","1",null,null,"0.84",null,null,null,null,"NA","NA"],
    [1628,"1628","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","G0283","Electrical Stimulation (Unattended), To One Or More Areas For Indicati","3","1",null,null,"35.97","0.1",null,null,null,"NA","NA"],
    [1629,"1629","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81416","Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure)","2","1",null,null,"84.87",null,null,null,null,"NA","NA"],
    [1630,"1630","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58571","Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)","2","1",null,null,"72.28","15.3",null,null,null,"NA","NA"],
    [1631,"1631","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97124","Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion)","2","1",null,null,"0.05","11.1",null,null,null,"NA","NA"],
    [1632,"1632","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63650","Percutaneous implantation of neurostimulator electrode array, epidural","2","1",null,null,"130.19","28.7",null,null,null,"NA","NA"],
    [1633,"1633","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81415","Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis","2","1",null,null,"84.87",null,null,null,null,"NA","NA"],
    [1634,"1634","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64493","Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level","2","1",null,null,"211.34",null,null,null,null,"NA","NA"],
    [1635,"1635","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","0362T","Behavior identification supporting assessment, each 15 minutes of technicians' time face-to-face with a patient, requiring the following components: administration by the physician or other qualified health care professional who is on site; with the assistance of two or more technicians; for a patient who exhibits destructive behavior; completion in an environment that is customized to the patient's behavior.","2","1",null,null,"107.44",null,null,null,null,"NA","NA"],
    [1636,"1636","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64494","Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level (List separately in addition to code for primary procedure)","2","1",null,null,"211.34",null,null,null,null,"NA","NA"],
    [1637,"1637","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97164","Re-evaluation of physical therapy established plan of care, requiring these components: An examination including a review of history and use of standardized tests and measures is required; and Revised plan of care using a standardized patient assessment instrument and/or measurable assessment of functional outcome Typically, 20 minutes are spent face-to-face with the patient and/or family.","2","1",null,null,"185.21",null,null,null,null,"NA","NA"],
    [1638,"1638","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","17380","Electrolysis epilation, each 30 minutes","3","0","0.33",null,"126.07",null,null,null,null,"NA","NA"],
    [1639,"1639","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97152","Behavior identification-supporting assessment, administered by one technician under the direction of a physician or other qualified health care professional, face-to-face with the patient, each 15 minutes","11","0","0.09",null,"103.21",null,null,null,null,"NA","NA"],
    [1640,"1640","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97154","Group adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with two or more patients, each 15 minutes","12","0","0.08",null,"45.83",null,null,null,null,"NA","NA"],
    [1641,"1641","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","76","0","0.03","19.49","43.53",null,null,null,null,"NA","NA"],
    [1642,"1642","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97153","Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes","46","0","0.02",null,"77.58",null,null,null,null,"NA","NA"],
    [1643,"1643","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97151","Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan","46","0","0.02",null,"65.18",null,null,null,null,"NA","NA"],
    [1644,"1644","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97155","Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes","48","0","0.02",null,"74.9",null,null,null,null,"NA","NA"],
    [1645,"1645","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97156","Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes","49","0","0.02",null,"73.43",null,null,null,null,"NA","NA"],
    [1646,"1646","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","57","0","0.02","25.39","38.91",null,null,null,null,"NA","NA"],
    [1647,"1647","Carrier J","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","66","0","0.02","22.38","45.15",null,null,null,null,"NA","NA"],
    [1648,"1648","Carrier K","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","Psychological and Neuropsychological Test Administration","54","1",null,null,"19.82",null,null,null,null,"NA","NA"],
    [1649,"1649","Carrier K","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","SUD IOP Adult","104","0.99",null,"0.07","1.69",null,null,null,null,"NA","NA"],
    [1650,"1650","Carrier K","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","SUD Partial Adult","103","0.99",null,"1.38","15.18",null,null,null,null,"NA","NA"],
    [1651,"1651","Carrier K","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","MH IOP Adult","93","0.99",null,null,"9.08",null,null,null,null,"NA","NA"],
    [1652,"1652","Carrier K","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","MH Partial Adult","90","0.98",null,"0.4","2.48","35",null,null,null,"NA","NA"],
    [1653,"1653","Carrier K","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","SUD Detox Residential Adult","54","0.98",null,"0.66","4.09",null,null,null,null,"NA","NA"],
    [1654,"1654","Carrier K","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","MH Residential Adult","44","0.98",null,"1.92","14",null,null,null,null,"NA","NA"],
    [1655,"1655","Carrier K","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","SUD Residential Adult","116","0.97",null,"12.96","1.19",null,null,null,null,"NA","NA"],
    [1656,"1656","Carrier K","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","MH Partial Eating Disorder Adult","32","0.97",null,"6.9","12.18",null,null,null,null,"NA","NA"],
    [1657,"1657","Carrier K","2020","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","Psychological Testing","67","0.93",null,null,"25.38",null,null,null,null,"NA","NA"],
    [1658,"1658","Carrier K","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","Psychological and Neuropsychological Test Administration","54","1",null,null,"19.82",null,null,null,null,"NA","NA"],
    [1659,"1659","Carrier K","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","ABA Behavior Identification Assessments","27","1",null,null,"5.97",null,null,null,null,"NA","NA"],
    [1660,"1660","Carrier K","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","MH IOP Adolescent","26","1",null,null,"0.92",null,null,null,null,"NA","NA"],
    [1661,"1661","Carrier K","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","MH Residential Eating Disorder Adult","25","1",null,"2.99","24.64",null,null,null,null,"NA","NA"],
    [1662,"1662","Carrier K","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","ABA Direct Care Codes","25","1",null,null,"2.63",null,null,null,null,"NA","NA"],
    [1663,"1663","Carrier K","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","MH IOP Eating Disorder Adult","24","1",null,null,"7.84",null,null,null,null,"NA","NA"],
    [1664,"1664","Carrier K","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","ABA Qualified Health Professional Services","24","1",null,null,"2.73",null,null,null,null,"NA","NA"],
    [1665,"1665","Carrier K","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","MH Residential Adolescent","23","1",null,"0.05","6.66",null,null,null,null,"NA","NA"],
    [1666,"1666","Carrier K","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","MH Partial Eating Disorder Adolescent","14","1",null,"22.67","15.1",null,null,null,null,"NA","NA"],
    [1667,"1667","Carrier K","2020","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","SUD Residential Adolescent","13","1",null,"0.04","24.09",null,null,null,null,"NA","NA"],
    [1668,"1668","Carrier K","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NA","NA","MH Partial Adolescent","20","0","0.95",null,"40.45",null,null,null,null,"NA","NA"],
    [1669,"1669","Carrier K","2020","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NA","NA","Transcranial Magnetic Stimulation (TMS)","17","0","0.59",null,"44.03",null,null,null,null,"NA","NA"],
    [1670,"1670","Carrier M","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2311","POWER WHEELCHAIR ACCESSORY, ELECTRONIC CONNECTION BETWEEN WHEELCHAIR CONTROLLER AND TWO OR MORE POWER SEATING SYSTEM MOTORS, INCLUDING ALL RELATED ELECTRONICS, INDICATOR FEATURE, MECHANICAL FUNCTION SELECTION SWITCH, AND FIXEDMOUNTING HARDWARE","2","1",null,null,"72",null,"0","2",null,"NA","NA"],
    [1671,"1671","Carrier M","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0108","WHEELCHAIR COMPONENT OR ACCESSORY, NOT OTHERWISE SPECIFIED","2","1",null,null,"72",null,"0","2",null,"NA","NA"],
    [1672,"1672","Carrier M","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0861","POWER WHEELCHAIR, GROUP 3 STANDARD, MULTIPLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS","2","1",null,null,"72",null,"0","2",null,"NA","NA"],
    [1673,"1673","Carrier M","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","92700","UNLISTED OTORHINOLARYNGOLOGICAL SERVICE OR PROCEDURE","1","1",null,null,"48",null,"0","1",null,"NA","NA"],
    [1674,"1674","Carrier M","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0951","HEEL LOOP/HOLDER, WITH OR WITHOUT ANKLE STRAP, EACH","1","1",null,null,"48",null,"0","1",null,"NA","NA"],
    [1675,"1675","Carrier M","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0953","WHEELCHAIR ACCESSORY, LATERAL THIGH OR KNEE SUPPORT, ANY TYPE INCLUDING FIXED MOUNTING HARDWARE, EACH","1","1",null,null,"48",null,"0","1",null,"NA","NA"],
    [1676,"1676","Carrier M","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0955","WHEELCHAIR ACCESSORY, HEADREST, CUSHIONED, PREFABRICATED, INCLUDING FIXED HARDWARE, EACH","1","1",null,null,"48",null,"0","1",null,"NA","NA"],
    [1677,"1677","Carrier M","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0973","WHEELCHAIR ACCESSORY, ADJUSTABLE HEIGHT, DETACHABLE ARMREST, COMPLETE ASSEMBLY, EACH","1","1",null,null,"96",null,"0","1",null,"NA","NA"],
    [1678,"1678","Carrier M","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1012","WHEELCHAIR ACCESSORY, ADDITION TO POWER SEATING SYSTEM, CENTER MOUNT POWER ELEVATING LEG REST/PLATFORM, COMPLETE SYSTEM, ANY TYPE, EACH","1","1",null,null,"48",null,"0","1",null,"NA","NA"],
    [1679,"1679","Carrier M","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1007","WHEELCHAIR ACCESSORY, POWER SEATING SYSTEM, COMBINATION TILT AND RECLINE, WITH MECHANICAL SHEAR REDUCTION","3","0.67",null,null,"56",null,"0","3",null,"NA","NA"],
    [1680,"1680","Carrier M","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2311","POWER WHEELCHAIR ACCESSORY, ELECTRONIC CONNECTION BETWEEN WHEELCHAIR CONTROLLER AND TWO OR MORE POWER SEATING SYSTEM MOTORS, INCLUDING ALL RELATED ELECTRONICS, INDICATOR FEATURE, MECHANICAL FUNCTION SELECTION SWITCH, AND FIXEDMOUNTING HARDWARE","2","1",null,null,"72",null,"0","2",null,"NA","NA"],
    [1681,"1681","Carrier M","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0108","WHEELCHAIR COMPONENT OR ACCESSORY, NOT OTHERWISE SPECIFIED","2","1",null,null,"72",null,"0","2",null,"NA","NA"],
    [1682,"1682","Carrier M","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0861","POWER WHEELCHAIR, GROUP 3 STANDARD, MULTIPLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS","2","1",null,null,"72",null,"0","2",null,"NA","NA"],
    [1683,"1683","Carrier M","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","92700","UNLISTED OTORHINOLARYNGOLOGICAL SERVICE OR PROCEDURE","1","1",null,null,"48",null,"0","1",null,"NA","NA"],
    [1684,"1684","Carrier M","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0951","HEEL LOOP/HOLDER, WITH OR WITHOUT ANKLE STRAP, EACH","1","1",null,null,"48",null,"0","1",null,"NA","NA"],
    [1685,"1685","Carrier M","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0953","WHEELCHAIR ACCESSORY, LATERAL THIGH OR KNEE SUPPORT, ANY TYPE INCLUDING FIXED MOUNTING HARDWARE, EACH","1","1",null,null,"48",null,"0","1",null,"NA","NA"],
    [1686,"1686","Carrier M","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0955","WHEELCHAIR ACCESSORY, HEADREST, CUSHIONED, PREFABRICATED, INCLUDING FIXED HARDWARE, EACH","1","1",null,null,"48",null,"0","1",null,"NA","NA"],
    [1687,"1687","Carrier M","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0973","WHEELCHAIR ACCESSORY, ADJUSTABLE HEIGHT, DETACHABLE ARMREST, COMPLETE ASSEMBLY, EACH","1","1",null,null,"96",null,"0","1",null,"NA","NA"],
    [1688,"1688","Carrier M","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1012","WHEELCHAIR ACCESSORY, ADDITION TO POWER SEATING SYSTEM, CENTER MOUNT POWER ELEVATING LEG REST/PLATFORM, COMPLETE SYSTEM, ANY TYPE, EACH","1","1",null,null,"48",null,"0","1",null,"NA","NA"],
    [1689,"1689","Carrier M","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1007","WHEELCHAIR ACCESSORY, POWER SEATING SYSTEM, COMBINATION TILT AND RECLINE, WITH MECHANICAL SHEAR REDUCTION","3","0.67",null,null,"56",null,"0","3",null,"NA","NA"],
    [1690,"1690","Carrier M","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E2361","POWER WHEELCHAIR ACCESSORY, 22NF SEALED LEAD ACID BATTERY, EACH, (E.G. GEL CELL, ABSORBED GLASSMAT)","1","0","1",null,"96",null,"0","1",null,"NA","NA"],
    [1691,"1691","Carrier M","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E1007","WHEELCHAIR ACCESSORY, POWER SEATING SYSTEM, COMBINATION TILT AND RECLINE, WITH MECHANICAL SHEAR REDUCTION","1","0","0",null,"24",null,"0","1",null,"NA","NA"],
    [1692,"1692","Carrier M","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E2300","WHEELCHAIR ACCESSORY, POWER SEAT ELEVATION SYSTEM, ANY TYPE","1","0","0",null,"48",null,"0","1",null,"NA","NA"],
    [1693,"1693","Carrier M","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E2321","POWER WHEELCHAIR ACCESSORY, HAND CONTROL INTERFACE, REMOTE JOYSTICK, NONPROPORTIONAL, INCLUDING ALL RELATED ELECTRONICS, MECHANICAL STOP SWITCH, AND FIXED MOUNTING HARDWARE","1","0","0",null,"96",null,"0","1",null,"NA","NA"],
    [1694,"1694","Carrier M","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","K0841","POWER WHEELCHAIR, GROUP 2 STANDARD, MULTIPLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS","1","0","0",null,"24",null,"0","1",null,"NA","NA"],
    [1695,"1695","Carrier M","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","J9312","INJECTION, RITUXIMAB, 10 MG","12","1",null,null,"42",null,"0","12",null,"NA","NA"],
    [1696,"1696","Carrier M","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96416","CHEMOTHERAPY ADMINISTRATION, INTRAVENOUS INFUSION TECHNIQUE; INITIATION OF PROLONGED CHEMOTHERAPY INFUSION (MORE THAN 8 HOURS), REQUIRING USE OF A PORTABLE OR IMPLANTABLE PUMP","20","0.95",null,null,"32.4",null,"0","20",null,"NA","NA"],
    [1697,"1697","Carrier M","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43775","LAPAROSCOPY, SURGICAL, GASTRIC RESTRICTIVE PROCEDURE; LONGITUDINAL GASTRECTOMY (IE, SLEEVE GASTRECTOMY)","14","0.93",null,null,"96",null,"0","14",null,"NA","NA"],
    [1698,"1698","Carrier M","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22612","ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLE LEVEL ; LUMBAR (WITH LATERAL TRANSVERSE TECHNIQUE, WHEN PERFORMED)","9","0.78",null,null,"72",null,"0","9",null,"NA","NA"],
    [1699,"1699","Carrier M","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22633","ARTHRODESIS, COMBINED POSTERIOR OR POSTEROLATERAL TECHNIQUE WITH POSTERIOR INTERBODY TECHNIQUE INCLUDING LAMINECTOMY AND/OR DISCECTOMY SUFFICIENT TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION), SINGLE INTERSPACE AND SEGMENT; LUMBAR","10","0.6",null,null,"67.2",null,"0","10",null,"NA","NA"],
    [1700,"1700","Carrier M","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63047","LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA AND/OR NERVE ROOT(S) (EG; SPINAL OR LATERAL RECESS STENOSIS) SINGLE VERTEBRAL SEGMENT; LUMBAR","12","0.58",null,null,"196",null,"0","12",null,"NA","NA"],
    [1701,"1701","Carrier M","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20936","AUTOGRAFT FOR SPINE SURGERY ONLY (INCLUDES HARVESTING THE GRAFT); LOCAL (EG, RIBS, SPINOUS PROCESS, OR LAMINAR FRAGMENTS) OBTAINED FROM SAME INCISION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)","13","0.54",null,null,"42.5",null,"0","13",null,"NA","NA"],
    [1702,"1702","Carrier M","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","INSERTION OF INTERBODY BIOMECHANICAL DEVICE(S) (EG, SYNTHETIC CAGE, MESH) WITH INTEGRAL ANTERIOR INSTRUMENTATION FOR DEVICE ANCHORING (EG, SCREWS, FLANGES), WHEN PERFORMED, TO INTERVERTEBRAL DISC SPACE IN CONJUNCTION WITH INTERBODY ARTHRODESIS, EACH INTE","22","0.5",null,null,"41.5",null,"0","22",null,"NA","NA"],
    [1703,"1703","Carrier M","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20930","ALLOGRAFT, MORSELIZED, OR PLACEMENT OF OSTEOPROMOTIVE MATERIAL, FOR SPINE SURGERY ONLY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)","14","0.5",null,null,"34.3",null,"0","15",null,"NA","NA"],
    [1704,"1704","Carrier M","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22840","POSTERIOR NON-SEGMENTAL INSTRUMENTATION (EG, HARRINGTON ROD TECHNIQUE, PEDICLE FIXATION ACROSS ONE INTERSPACE, ATLANTOAXIAL TRANSARTICULAR SCREW FIXATION, SUBLAMINAR WIRING AT C1, FACET SCREW FIXATION) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PRO","13","0.46",null,null,"60.9",null,"0","13",null,"NA","NA"],
    [1705,"1705","Carrier M","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J9312","INJECTION, RITUXIMAB, 10 MG","12","1",null,null,"42",null,"0","12",null,"NA","NA"],
    [1706,"1706","Carrier M","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J9070","CYCLOPHOSPHAMIDE, 100 MG","9","1",null,null,"72",null,"0","9",null,"NA","NA"],
    [1707,"1707","Carrier M","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J9181","INJECTION, ETOPOSIDE, 10 MG","9","1",null,null,"56",null,"0","9",null,"NA","NA"],
    [1708,"1708","Carrier M","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22614","SPINE FUSION, EXTRA SEGMENT","8","1",null,null,"45",null,"0","8",null,"NA","NA"],
    [1709,"1709","Carrier M","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J9000","INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG","8","1",null,null,"63",null,"0","8",null,"NA","NA"],
    [1710,"1710","Carrier M","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96416","CHEMOTHERAPY ADMINISTRATION, INTRAVENOUS INFUSION TECHNIQUE; INITIATION OF PROLONGED CHEMOTHERAPY INFUSION (MORE THAN 8 HOURS), REQUIRING USE OF A PORTABLE OR IMPLANTABLE PUMP","20","0.95",null,null,"32.4",null,"0","20",null,"NA","NA"],
    [1711,"1711","Carrier M","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43775","LAPAROSCOPY, SURGICAL, GASTRIC RESTRICTIVE PROCEDURE; LONGITUDINAL GASTRECTOMY (IE, SLEEVE GASTRECTOMY)","14","0.93",null,null,"96",null,"0","14",null,"NA","NA"],
    [1712,"1712","Carrier M","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","20936","AUTOGRAFT FOR SPINE SURGERY ONLY (INCLUDES HARVESTING THE GRAFT); LOCAL (EG, RIBS, SPINOUS PROCESS, OR LAMINAR FRAGMENTS) OBTAINED FROM SAME INCISION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)","13","0.54",null,null,"42.5",null,"0","13",null,"NA","NA"],
    [1713,"1713","Carrier M","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22853","INSERTION OF INTERBODY BIOMECHANICAL DEVICE(S) (EG, SYNTHETIC CAGE, MESH) WITH INTEGRAL ANTERIOR INSTRUMENTATION FOR DEVICE ANCHORING (EG, SCREWS, FLANGES), WHEN PERFORMED, TO INTERVERTEBRAL DISC SPACE IN CONJUNCTION WITH INTERBODY ARTHRODESIS, EACH INTE","22","0.5",null,null,"41.5",null,"0","22",null,"NA","NA"],
    [1714,"1714","Carrier M","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","20930","ALLOGRAFT, MORSELIZED, OR PLACEMENT OF OSTEOPROMOTIVE MATERIAL, FOR SPINE SURGERY ONLY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)","14","0.5",null,null,"34.3",null,"0","14",null,"NA","NA"],
    [1715,"1715","Carrier M","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22853","INSERTION OF INTERBODY BIOMECHANICAL DEVICE(S) (EG, SYNTHETIC CAGE, MESH) WITH INTEGRAL ANTERIOR INSTRUMENTATION FOR DEVICE ANCHORING (EG, SCREWS, FLANGES), WHEN PERFORMED, TO INTERVERTEBRAL DISC SPACE IN CONJUNCTION WITH INTERBODY ARTHRODESIS, EACH INTE","11","0","0.64",null,"58.9",null,"0","11",null,"NA","NA"],
    [1716,"1716","Carrier M","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22840","POSTERIOR NON-SEGMENTAL INSTRUMENTATION (EG, HARRINGTON ROD TECHNIQUE, PEDICLE FIXATION ACROSS ONE INTERSPACE, ATLANTOAXIAL TRANSARTICULAR SCREW FIXATION, SUBLAMINAR WIRING AT C1, FACET SCREW FIXATION) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PRO","7","0","0.57",null,"61.7",null,"0","7",null,"NA","NA"],
    [1717,"1717","Carrier M","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","20930","ALLOGRAFT, MORSELIZED, OR PLACEMENT OF OSTEOPROMOTIVE MATERIAL, FOR SPINE SURGERY ONLY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)","7","0","0.43",null,"51.4",null,"0","7",null,"NA","NA"],
    [1718,"1718","Carrier M","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","20936","AUTOGRAFT FOR SPINE SURGERY ONLY (INCLUDES HARVESTING THE GRAFT); LOCAL (EG, RIBS, SPINOUS PROCESS, OR LAMINAR FRAGMENTS) OBTAINED FROM SAME INCISION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)","6","0","0.5",null,"72",null,"0","6",null,"NA","NA"],
    [1719,"1719","Carrier M","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63047","LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA AND/OR NERVE ROOT(S) (EG; SPINAL OR LATERAL RECESS STENOSIS) SINGLE VERTEBRAL SEGMENT; LUMBAR","5","0","0.6",null,"81.6",null,"0","5",null,"NA","NA"],
    [1720,"1720","Carrier M","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22633","ARTHRODESIS, COMBINED POSTERIOR OR POSTEROLATERAL TECHNIQUE WITH POSTERIOR INTERBODY TECHNIQUE INCLUDING LAMINECTOMY AND/OR DISCECTOMY SUFFICIENT TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION), SINGLE INTERSPACE AND SEGMENT; LUMBAR","4","0","0.75",null,"108",null,"0","4",null,"NA","NA"],
    [1721,"1721","Carrier M","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22558","ARTHRODESIS, ANTERIOR INTERBODY TECHNIQUE, INCLUDING MINIMAL DESKECTOMY TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION); LUMBAR","3","0","0.33",null,"72",null,"0","3",null,"NA","NA"],
    [1722,"1722","Carrier M","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22612","Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed)","3","0","0.33",null,"144",null,"0","3",null,"NA","NA"],
    [1723,"1723","Carrier M","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22216","REVISE, EXTRA SPINE SEGMENT","2","0","0.5",null,"156",null,"0","2",null,"NA","NA"],
    [1724,"1724","Carrier M","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22612","ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLE LEVEL ; LUMBAR (WITH LATERAL TRANSVERSE TECHNIQUE, WHEN PERFORMED)","2","0","0.5",null,"24",null,"0","2",null,"NA","NA"],
    [1725,"1725","Carrier M","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Internal","RMH","Residential Mental Health","8","1",null,null,"9",null,null,"8",null,"NA","NA"],
    [1726,"1726","Carrier M","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Internal","MEN","Mental Health","2","1",null,null,"0",null,null,"2",null,"NA","NA"],
    [1727,"1727","Carrier M","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Internal","REH","Rehabilitation","21","0.9",null,null,"6.9",null,null,"21",null,"NA","NA"],
    [1728,"1728","Carrier M","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Internal","RSA","Residential Substance Abuse","5","0.8",null,null,"14.4",null,null,"5",null,"NA","NA"],
    [1729,"1729","Carrier M","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Internal","DAA","Detoxification","2","0.5",null,null,"24",null,null,"2",null,"NA","NA"],
    [1730,"1730","Carrier M","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Internal","RMH","Residential Mental Health","8","1",null,null,"9",null,"0","8",null,"NA","NA"],
    [1731,"1731","Carrier M","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Internal","MEN","Mental Health","2","1",null,null,"0",null,"0","2",null,"NA","NA"],
    [1732,"1732","Carrier M","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Internal","REH","Rehabilitation","21","0.9",null,null,"6.9",null,"0","21",null,"NA","NA"],
    [1733,"1733","Carrier M","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Internal","RSA","Residential Substance Abuse","5","0.8",null,null,"14.4",null,"0","5",null,"NA","NA"],
    [1734,"1734","Carrier M","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Internal","DAA","Detoxification","2","0.5",null,null,"24",null,"0","2",null,"NA","NA"],
    [1735,"1735","Carrier M","2021","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Internal","REH","Rehabilitation","2","0","0",null,"12",null,"0","2",null,"NA","NA"],
    [1736,"1736","Carrier M","2021","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Internal","DAA","Detoxification","1","0","0",null,"48",null,"0","1",null,"NA","NA"],
    [1737,"1737","Carrier M","2021","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Internal","RSA","Residential Substance Abuse","1","0","0",null,"0",null,"0","1",null,"NA","NA"],
    [1738,"1738","Carrier M","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","66984","EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1 STAGE PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGATION AND ASPIRATION OR PHACOEMULSIFICATION); WITHOUT ENDOSCOPIC CYCLOPHOTOCOAGULATION","101","1",null,null,"0",null,"0","101",null,"NA","NA"],
    [1739,"1739","Carrier M","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S4016","FROZEN IN VITRO FERTILIZATION CYCLE, CASE RATE","58","1",null,null,"8.7",null,"0","58",null,"NA","NA"],
    [1740,"1740","Carrier M","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","89342","STORAGE, (PER YEAR); EMBRYO(S)","67","0.99",null,null,"30.8",null,"0","67",null,"NA","NA"],
    [1741,"1741","Carrier M","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","89258","CRYOPRESERVATION; EMBRYO","68","0.97",null,null,"30.4",null,"0","68",null,"NA","NA"],
    [1742,"1742","Carrier M","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S4011","IN VITRO FERTILIZATION; INCLUDING BUT NOT LIMITED TO IDENTIFICATION","73","0.75",null,null,"78.2",null,"0","73",null,"NA","NA"],
    [1743,"1743","Carrier M","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19318","BREAST REDUCTION","75","0.73",null,null,"22.4",null,"0","75",null,"NA","NA"],
    [1744,"1744","Carrier M","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","89253","ASSISTED EMBRYO HATCHING, MICROTECHNIQUES (ANY METHOD)","87","0.55",null,null,"54.9",null,"0","87",null,"NA","NA"],
    [1745,"1745","Carrier M","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S4022","ASSISTED OOCYTE FERTILIZATION, CASE RATE","82","0.37",null,null,"53.3",null,"0","82",null,"NA","NA"],
    [1746,"1746","Carrier M","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","89291","BIOPSY, OOCYTE POLAR BODY OR EMBRYO BLASTOMERE, MICROTECHNIQUE (FOR PRE-IMPLANTATION GENETIC DIAGNOSIS); GREATER THAN 5 EMBRYOS","49","0.04",null,null,"52.9",null,"0","49",null,"NA","NA"],
    [1747,"1747","Carrier M","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","89290","BIOPSY, OOCYTE POLAR BODY OR EMBRYO BLASTOMERE, MICROTECHNIQUE (FOR PRE-IMPLANTATION GENETIC DIAGNOSIS); LESS THAN OR EQUAL TO 5 EMBRYOS","48","0.04",null,null,"54",null,"0","48",null,"NA","NA"],
    [1748,"1748","Carrier M","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","66984","EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1 STAGE PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGATION AND ASPIRATION OR PHACOEMULSIFICATION); WITHOUT ENDOSCOPIC CYCLOPHOTOCOAGULATION","101","1",null,null,"0",null,"0","101",null,"NA","NA"],
    [1749,"1749","Carrier M","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S4016","FROZEN IN VITRO FERTILIZATION CYCLE, CASE RATE","58","1",null,null,"8.7",null,"0","58",null,"NA","NA"],
    [1750,"1750","Carrier M","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","36475","ENDOVENOUS ABLATION THERAPY OF INCOMPETENT VEIN, EXTREMITY, INCLUSIVE OF ALL IMAGING GUIDANCE AND MONITORING, PERCUTANEOUS, RADIOFREQUENCY; FIRST VEIN TREATED","44","1",null,null,"9.8",null,"0","44",null,"NA","NA"],
    [1751,"1751","Carrier M","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","89342","STORAGE, (PER YEAR); EMBRYO(S)","67","0.99",null,null,"30.8",null,"0","67",null,"NA","NA"],
    [1752,"1752","Carrier M","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","89258","CRYOPRESERVATION; EMBRYO","68","0.97",null,null,"30.4",null,"0","68",null,"NA","NA"],
    [1753,"1753","Carrier M","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58322","ARTIFICIAL INSEMINATION; INTRA-UTERINE","31","0.9",null,null,"37.9",null,"0","31",null,"NA","NA"],
    [1754,"1754","Carrier M","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S4011","IN VITRO FERTILIZATION; INCLUDING BUT NOT LIMITED TO IDENTIFICATION","73","0.75",null,null,"78.2",null,"0","73",null,"NA","NA"],
    [1755,"1755","Carrier M","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19318","BREAST REDUCTION","75","0.73",null,null,"22.4",null,"0","75",null,"NA","NA"],
    [1756,"1756","Carrier M","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","89253","ASSISTED EMBRYO HATCHING, MICROTECHNIQUES (ANY METHOD)","87","0.55",null,null,"54.9",null,"0","87",null,"NA","NA"],
    [1757,"1757","Carrier M","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S4022","ASSISTED OOCYTE FERTILIZATION, CASE RATE","82","0.37",null,null,"53.3",null,"0","82",null,"NA","NA"],
    [1758,"1758","Carrier M","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","S4022","ASSISTED OOCYTE FERTILIZATION, CASE RATE","52","0","0.02",null,"36",null,"0","52",null,"NA","NA"],
    [1759,"1759","Carrier M","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","89291","BIOPSY, OOCYTE POLAR BODY OR EMBRYO BLASTOMERE, MICROTECHNIQUE (FOR PRE-IMPLANTATION GENETIC DIAGNOSIS); GREATER THAN 5 EMBRYOS","47","0","0",null,"55.1",null,"0","47",null,"NA","NA"],
    [1760,"1760","Carrier M","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","89290","BIOPSY, OOCYTE POLAR BODY OR EMBRYO BLASTOMERE, MICROTECHNIQUE (FOR PRE-IMPLANTATION GENETIC DIAGNOSIS); LESS THAN OR EQUAL TO 5 EMBRYOS","46","0","0",null,"56.3",null,"0","46",null,"NA","NA"],
    [1761,"1761","Carrier M","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","89253","ASSISTED EMBRYO HATCHING, MICROTECHNIQUES (ANY METHOD)","39","0","0.05",null,"17.8",null,"0","39",null,"NA","NA"],
    [1762,"1762","Carrier M","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","19318","BREAST REDUCTION","20","0","0.2",null,"34.8",null,"0","20",null,"NA","NA"],
    [1763,"1763","Carrier M","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","S4011","IN VITRO FERTILIZATION; INCLUDING BUT NOT LIMITED TO IDENTIFICATION","18","0","0.06",null,"36",null,"0","18",null,"NA","NA"],
    [1764,"1764","Carrier M","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","30410","RHINOPLASTY, PRIMARY; COMPLETE, EXTERNAL PARTS INCLUDING BONY PYRAMID, LATERAL AND ALAR CARTILAGES, AND/OR ELEVATION OF NASAL TIP","8","0","0",null,"45",null,"0","8",null,"NA","NA"],
    [1765,"1765","Carrier M","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","31256","NASAL/SINUS ENDOSCOPY, SURGICAL, WITH MAXILLARY ANTROSTOMY;","7","0","0.43",null,"78.9",null,"0","7",null,"NA","NA"],
    [1766,"1766","Carrier M","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","15776","PUNCH GRAFT FOR HAIR TRANSPLANT; MORE THAN 15 PUNCH GRAFTS","6","0","0",null,"12",null,"0","6",null,"NA","NA"],
    [1767,"1767","Carrier M","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21139","REDUCTION FOREHEAD; CONTOURING ONLY CONTOURING AND SET BACK OF ANTERIOR FRONTAL SINUS WALL","6","0","0",null,"32",null,"0","6",null,"NA","NA"],
    [1768,"1768","Carrier M","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","MENTAL HEALTH PARTIAL HOSPITALIZATION, TREATMENT, LESS THAN 24 HOURS","50","1",null,null,"14.4",null,"0","50",null,"NA","NA"],
    [1769,"1769","Carrier M","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY, 60 MINUTES WITH PATIENT","48","1",null,null,"35.5",null,"0","48",null,"NA","NA"],
    [1770,"1770","Carrier M","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H2036","ALCOHOL AND/OR DRUG TREATMENT PROGRAM, PER DIEM","20","1",null,null,"10.8",null,"0","20",null,"NA","NA"],
    [1771,"1771","Carrier M","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97153","ADAPTIVE BEHAVIOR TREATMENT BY PROTOCOL, ADMINISTERED BY TECHNICIAN UNDER THE DIRECTION OF A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, FACE-TO-FACE WITH ONE PATIENT, EACH 15 MINUTES","18","1",null,null,"766.7",null,"0","18",null,"NA","NA"],
    [1772,"1772","Carrier M","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97155","ADAPTIVE BEHAVIOR TREATMENT WITH PROTOCOL MODIFICATION, ADMINISTERED BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, WHICH MAY INCLUDE SIMULTANEOUS DIRECTION OF TECHNICIAN, FACE-TO-FACE WITH ONE PATIENT, EACH 15 MINUTES","18","1",null,null,"766.7",null,"0","18",null,"NA","NA"],
    [1773,"1773","Carrier M","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97156","FAMILY ADAPTIVE BEHAVIOR TREATMENT GUIDANCE, ADMINISTERED BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL (WITH OR WITHOUT THE PATIENT PRESENT),FACE- TO-FACE WITH GUARDIAN(S)/CAREGIVER(S), EACH 15 MINUTES","18","1",null,null,"766.7",null,"0","18",null,"NA","NA"],
    [1774,"1774","Carrier M","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","BEHAVIOR IDENTIFICATION ASSESSMENT, ADMINISTERED BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, EACH 15 MINUTES OF THE PHYSICIANS OR OTHER QUALI FIED HEALTH CARE PROFESSIONALS TIME FACE-TO-FACE WITH PATIENT AND/OR GUARDIAN( S)/CAREGIVER(S) A","17","1",null,null,"21.2",null,"0","17",null,"NA","NA"],
    [1775,"1775","Carrier M","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT MOTOR THRESHOLD RE-DETERMINATION WITH DELIVERY AND MANAGEMENT","28","0.68",null,null,"105.4",null,"0","28",null,"NA","NA"],
    [1776,"1776","Carrier M","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; INITIAL, INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, DELIVERY AND MANAGEMENT","38","0.66",null,null,"135.2",null,"0","38",null,"NA","NA"],
    [1777,"1777","Carrier M","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT DELIVERY AND MANAGEMENT, PER SESSION","38","0.66",null,null,"135.2",null,"0","38",null,"NA","NA"],
    [1778,"1778","Carrier M","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0035","MENTAL HEALTH PARTIAL HOSPITALIZATION, TREATMENT, LESS THAN 24 HOURS","50","1",null,null,"14.4",null,"0","50",null,"NA","NA"],
    [1779,"1779","Carrier M","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY, 60 MINUTES WITH PATIENT","48","1",null,null,"35.5",null,"0","48",null,"NA","NA"],
    [1780,"1780","Carrier M","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H2036","ALCOHOL AND/OR DRUG TREATMENT PROGRAM, PER DIEM","20","1",null,null,"10.8",null,"0","20",null,"NA","NA"],
    [1781,"1781","Carrier M","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97153","ADAPTIVE BEHAVIOR TREATMENT BY PROTOCOL, ADMINISTERED BY TECHNICIAN UNDER THE DIRECTION OF A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, FACE-TO-FACE WITH ONE PATIENT, EACH 15 MINUTES","18","1",null,null,"766.7",null,"0","18",null,"NA","NA"],
    [1782,"1782","Carrier M","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97155","ADAPTIVE BEHAVIOR TREATMENT WITH PROTOCOL MODIFICATION, ADMINISTERED BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, WHICH MAY INCLUDE SIMULTANEOUS DIRECTION OF TECHNICIAN, FACE-TO-FACE WITH ONE PATIENT, EACH 15 MINUTES","18","1",null,null,"766.7",null,"0","18",null,"NA","NA"],
    [1783,"1783","Carrier M","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97156","FAMILY ADAPTIVE BEHAVIOR TREATMENT GUIDANCE, ADMINISTERED BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL (WITH OR WITHOUT THE PATIENT PRESENT),FACE- TO-FACE WITH GUARDIAN(S)/CAREGIVER(S), EACH 15 MINUTES","18","1",null,null,"766.7",null,"0","18",null,"NA","NA"],
    [1784,"1784","Carrier M","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97151","BEHAVIOR IDENTIFICATION ASSESSMENT, ADMINISTERED BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, EACH 15 MINUTES OF THE PHYSICIANS OR OTHER QUALI FIED HEALTH CARE PROFESSIONALS TIME FACE-TO-FACE WITH PATIENT AND/OR GUARDIAN( S)/CAREGIVER(S) A","17","1",null,null,"21.2",null,"0","17",null,"NA","NA"],
    [1785,"1785","Carrier M","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90869","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT MOTOR THRESHOLD RE-DETERMINATION WITH DELIVERY AND MANAGEMENT","28","0.68",null,null,"105.4",null,"0","28",null,"NA","NA"],
    [1786,"1786","Carrier M","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90867","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; INITIAL, INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, DELIVERY AND MANAGEMENT","38","0.66",null,null,"135.2",null,"0","38",null,"NA","NA"],
    [1787,"1787","Carrier M","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90868","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT DELIVERY AND MANAGEMENT, PER SESSION","38","0.66",null,null,"135.2",null,"0","38",null,"NA","NA"],
    [1788,"1788","Carrier M","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90867","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; INITIAL, INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, DELIVERY AND MANAGEMENT","13","0","0",null,"236.3",null,"0","13",null,"NA","NA"],
    [1789,"1789","Carrier M","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90868","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT DELIVERY AND MANAGEMENT, PER SESSION","13","0","0",null,"236.3",null,"0","13",null,"NA","NA"],
    [1790,"1790","Carrier M","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90869","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT MOTOR THRESHOLD RE-DETERMINATION WITH DELIVERY AND MANAGEMENT","9","0","0",null,"184",null,"0","9",null,"NA","NA"],
    [1791,"1791","Carrier M","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97152","BEHAVIOR IDENTIFICATIONSUPPORTING ASSESSMENT, ADMINISTERED BY ONE TECHNICIAN U NDER THE DIRECTION OF A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, FACE-TO-FACE WITH THE PATIENT, EACH 15 MINUTES","1","0","0",null,"72",null,"0","1",null,"NA","NA"],
    [1792,"1792","Carrier M","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97158","GROUP ADAPTIVE BEHAVIOR TREATMENT WITH PROTOCOL MODIFICATION, ADMINISTERED BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, FACE-TO-FACE WITH MULTIPLE PATIENTS, EACH 15 MINUTES","1","0","0",null,"3024",null,"0","1",null,"NA","NA"],
    [1793,"1793","Carrier A","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","4","1",null,null,"108.2401342",null,null,"4",null,"NA","NA"],
    [1794,"1794","Carrier A","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9276","Disposable sensor, CGM sys","1","0",null,null,"160.5394444",null,null,"1",null,"NA","NA"],
    [1795,"1795","Carrier A","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9277","External transmitter, CGM","1","0",null,null,"160.5394444",null,null,"1",null,"NA","NA"],
    [1796,"1796","Carrier A","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","4","1",null,null,"108.2401342",null,null,"4",null,"NA","NA"],
    [1797,"1797","Carrier A","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9276","Disposable sensor, CGM sys","1","0",null,null,"160.5394444",null,null,"1",null,"NA","NA"],
    [1798,"1798","Carrier A","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9277","External transmitter, CGM","1","0",null,null,"160.5394444",null,null,"1",null,"NA","NA"],
    [1799,"1799","Carrier A","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","9","1",null,null,"8.702746913",null,null,"9",null,"NA","NA"],
    [1800,"1800","Carrier A","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2599","Accessory for speech generating device, not otherwise classified","2","1",null,null,"105.9313889",null,null,"2",null,"NA","NA"],
    [1801,"1801","Carrier A","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]","196","0.97",null,null,"1.340782313",null,null,"196",null,"NA","NA"],
    [1802,"1802","Carrier A","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","14","0.86",null,null,"19.04505952",null,null,"14",null,"NA","NA"],
    [1803,"1803","Carrier A","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0748","Elec Osteogen Stim Spinal","3","0.33",null,null,"62.68567991",null,null,"3",null,"NA","NA"],
    [1804,"1804","Carrier A","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1399","Durable Medical Equipment Mi","11","0.18",null,null,"182.9355853",null,null,"11",null,"NA","NA"],
    [1805,"1805","Carrier A","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0781","External Ambulatory Infus Pu","4","0",null,null,"0.00438632",null,null,"4",null,"NA","NA"],
    [1806,"1806","Carrier A","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0978","Wheelchair Belt W/Airplane B","2","0",null,null,"0.010277779",null,null,"2",null,"NA","NA"],
    [1807,"1807","Carrier A","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0950","Tray","2","0",null,null,"0.010729166",null,null,"2",null,"NA","NA"],
    [1808,"1808","Carrier A","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1028","Wheelchair accessory, manual swingaway, retractable or removable mounting hardware","2","0",null,null,"0.010413334",null,null,"2",null,"NA","NA"],
    [1809,"1809","Carrier A","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2510","Speech generating device, synthesized speech, permitting multiple methods","2","0",null,null,"12.02839625",null,null,"2",null,"NA","NA"],
    [1810,"1810","Carrier A","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0960","Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","2","0",null,null,"0.010150973",null,null,"2",null,"NA","NA"],
    [1811,"1811","Carrier A","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0466","HOME VENT NON-INVASIVE INTER","2","0",null,"17.2175","92.87083333",null,"1","1",null,"NA","NA"],
    [1812,"1812","Carrier A","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","9","1",null,null,"8.702746913",null,null,"9",null,"NA","NA"],
    [1813,"1813","Carrier A","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2599","Accessory for speech generating device, not otherwise classified","2","1",null,null,"105.9313889",null,null,"2",null,"NA","NA"],
    [1814,"1814","Carrier A","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0601","Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]","196","0.97",null,null,"1.340782313",null,null,"196",null,"NA","NA"],
    [1815,"1815","Carrier A","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","14","0.86",null,null,"19.04505952",null,null,"14",null,"NA","NA"],
    [1816,"1816","Carrier A","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0748","Elec Osteogen Stim Spinal","3","0.33",null,null,"62.68567991",null,null,"3",null,"NA","NA"],
    [1817,"1817","Carrier A","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1399","Durable Medical Equipment Mi","11","0.18",null,null,"182.9355853",null,null,"11",null,"NA","NA"],
    [1818,"1818","Carrier A","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0781","External Ambulatory Infus Pu","4","0",null,null,"0.00438632",null,null,"4",null,"NA","NA"],
    [1819,"1819","Carrier A","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0978","Wheelchair Belt W/Airplane B","2","0",null,null,"0.010277779",null,null,"2",null,"NA","NA"],
    [1820,"1820","Carrier A","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0950","Tray","2","0",null,null,"0.010729166",null,null,"2",null,"NA","NA"],
    [1821,"1821","Carrier A","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1028","Wheelchair accessory, manual swingaway, retractable or removable mounting hardware","2","0",null,null,"0.010413334",null,null,"2",null,"NA","NA"],
    [1822,"1822","Carrier A","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2510","Speech generating device, synthesized speech, permitting multiple methods","2","0",null,null,"12.02839625",null,null,"2",null,"NA","NA"],
    [1823,"1823","Carrier A","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0960","Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","2","0",null,null,"0.010150973",null,null,"2",null,"NA","NA"],
    [1824,"1824","Carrier A","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0466","HOME VENT NON-INVASIVE INTER","2","0",null,"17.2175","92.87083333",null,"1","1",null,"NA","NA"],
    [1825,"1825","Carrier A","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","7","1",null,null,"52.77394383",null,null,"7",null,"NA","NA"],
    [1826,"1826","Carrier A","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22612","Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)","6","1",null,null,"67.90327581",null,null,"6",null,"NA","NA"],
    [1827,"1827","Carrier A","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63047","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","5","1",null,null,"70.2762026",null,null,"5",null,"NA","NA"],
    [1828,"1828","Carrier A","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","5","1",null,null,"70.46072986",null,null,"5",null,"NA","NA"],
    [1829,"1829","Carrier A","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","8","0.88",null,null,"66.6517052",null,null,"8",null,"NA","NA"],
    [1830,"1830","Carrier A","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96416","Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours), requiring use of a portable or implantable pump","10","0",null,null,"41.18195907",null,null,"10",null,"NA","NA"],
    [1831,"1831","Carrier A","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","J9250","Methotrexate Sodium Inj","6","0",null,null,"34.9061865",null,null,"6",null,"NA","NA"],
    [1832,"1832","Carrier A","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19364","Breast reconstruction; with free flap (eg, fTRAM, DIEP, SIEA, GAP flap)","5","0",null,null,"13.92645522",null,null,"5",null,"NA","NA"],
    [1833,"1833","Carrier A","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","69990","Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure)","5","0",null,null,"0.020715556",null,null,"5",null,"NA","NA"],
    [1834,"1834","Carrier A","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S2068","Breast DIEP flag reconstruct","5","0",null,null,"13.92634167",null,null,"5",null,"NA","NA"],
    [1835,"1835","Carrier A","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33929","Removal of a total replacement heart system (artificial heart) for heart transplantation (List separately in addition to code for primary procedure)","1","1",null,"3.79888889",null,null,"1",null,null,"NA","NA"],
    [1836,"1836","Carrier A","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33976","Insertion of ventricular assist device; extracorporeal, biventricular","1","1",null,"3.79888889",null,null,"1",null,null,"NA","NA"],
    [1837,"1837","Carrier A","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33927","Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy","1","1",null,"3.79888889",null,null,"1",null,null,"NA","NA"],
    [1838,"1838","Carrier A","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33945","Heart transplant, with or without recipient cardiectomy","1","1",null,"3.79888889",null,null,"1",null,null,"NA","NA"],
    [1839,"1839","Carrier A","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33979","Insertion of ventricular assist device, implantable intracorporeal, single ventricle","1","1",null,"3.79888889",null,null,"1",null,null,"NA","NA"],
    [1840,"1840","Carrier A","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33361","Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; percutaneous femoral artery approach","1","1",null,"0.004444445",null,null,"1",null,null,"NA","NA"],
    [1841,"1841","Carrier A","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","7","1",null,null,"52.77394383",null,null,"7",null,"NA","NA"],
    [1842,"1842","Carrier A","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22612","Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)","6","1",null,null,"67.90327581",null,null,"6",null,"NA","NA"],
    [1843,"1843","Carrier A","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63047","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","5","1",null,null,"70.2762026",null,null,"5",null,"NA","NA"],
    [1844,"1844","Carrier A","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22558","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","5","1",null,null,"70.46072986",null,null,"5",null,"NA","NA"],
    [1845,"1845","Carrier A","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22842","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)","4","1",null,null,"76.09473587",null,null,"4",null,"NA","NA"],
    [1846,"1846","Carrier A","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22585","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace (List separately in addition to code for primary procedure)","2","1",null,null,"57.4230399",null,null,"2",null,"NA","NA"],
    [1847,"1847","Carrier A","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63048","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure)","2","1",null,null,"57.4230399",null,null,"2",null,"NA","NA"],
    [1848,"1848","Carrier A","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","23472","Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder))","2","1",null,null,"12.81386847",null,null,"2",null,"NA","NA"],
    [1849,"1849","Carrier A","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22614","Arthrodesis, posterior or posterolateral technique, single level; each additional vertebral segment (List separately in addition to code for primary procedure)","2","1",null,null,"57.4230399",null,null,"2",null,"NA","NA"],
    [1850,"1850","Carrier A","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22856","Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); single interspace, cervical","1","1",null,null,"22.43535278",null,null,"1",null,"NA","NA"],
    [1851,"1851","Carrier A","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22800","Arthrodesis, posterior, for spinal deformity, with or without cast; up to 6 vertebral segments","1","1",null,null,"25.19059361",null,null,"1",null,"NA","NA"],
    [1852,"1852","Carrier A","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22633","Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar","1","1",null,null,"44.73411944",null,null,"1",null,"NA","NA"],
    [1853,"1853","Carrier A","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27132","Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft","1","1",null,null,"36.80007583",null,null,"1",null,"NA","NA"],
    [1854,"1854","Carrier A","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63252","Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar","1","1",null,null,"0.030555556",null,null,"1",null,"NA","NA"],
    [1855,"1855","Carrier A","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15769","Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia)","1","1",null,null,"71.77944444",null,null,"1",null,"NA","NA"],
    [1856,"1856","Carrier A","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33340","Percutaneous transcatheter closure of the left atrial appendage with endocardial implant, including fluoroscopy, transseptal puncture, catheter placement(s), left atrial angiography, left atrial appendage angiography, when performed, and radiological supervision and interpretation","1","1",null,null,"1.785277778",null,null,"1",null,"NA","NA"],
    [1857,"1857","Carrier A","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22630","Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; lumbar","1","1",null,null,"25.19059361",null,null,"1",null,"NA","NA"],
    [1858,"1858","Carrier A","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","20931","Allograft, structural, for spine surgery only (List separately in addition to code for primary procedure)","1","1",null,null,"16.89200917",null,null,"1",null,"NA","NA"],
    [1859,"1859","Carrier A","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","Room and board, Semi-Private, Psychiatric","4","1",null,"1.234166666","1.459653055",null,"1","3",null,"NA","NA"],
    [1860,"1860","Carrier A","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1002","Residential treatment, Substance Use Disorder","13","0.92",null,null,"62.60147669",null,null,"13",null,"NA","NA"],
    [1861,"1861","Carrier A","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0019","Alcohol And/Or Drug Services","1","0",null,"102.2166667",null,null,"1",null,null,"NA","NA"],
    [1862,"1862","Carrier A","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1001","Residential treatment, Psychiatric","1","0",null,null,"138.8416667",null,null,"1",null,"NA","NA"],
    [1863,"1863","Carrier A","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","Room and board, Semi-Private, Psychiatric","4","1",null,"1.234166666","1.459653055",null,"1","3",null,"NA","NA"],
    [1864,"1864","Carrier A","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1002","Residential treatment, Substance Use Disorder","13","0.92",null,null,"62.60147669",null,null,"13",null,"NA","NA"],
    [1865,"1865","Carrier A","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0019","Alcohol And/Or Drug Services","1","0",null,"102.2166667",null,null,"1",null,null,"NA","NA"],
    [1866,"1866","Carrier A","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1001","Residential treatment, Psychiatric","1","0",null,null,"138.8416667",null,null,"1",null,"NA","NA"],
    [1867,"1867","Carrier A","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0399","Home sleep test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation","145","0.94",null,null,"9.725153257",null,null,"145",null,"NA","NA"],
    [1868,"1868","Carrier A","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","ECHO, transthoracic w/doppler, complete","251","0.93",null,null,"6.987740448","720",null,"251","1","NA","NA"],
    [1869,"1869","Carrier A","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74176","CT abd & pelvis","226","0.93",null,null,"12.2330689",null,null,"226",null,"NA","NA"],
    [1870,"1870","Carrier A","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","MRI, lower extremity any joint; wo contr","211","0.92",null,"0.108611112","8.666618187",null,"1","210",null,"NA","NA"],
    [1871,"1871","Carrier A","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73221","MRI, any joint of upper extremity; wo co","114","0.87",null,"0.153055555","11.97213207","672","1","113","1","NA","NA"],
    [1872,"1872","Carrier A","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72148","MRI of lumbar spine","159","0.84",null,null,"12.34567115",null,null,"159",null,"NA","NA"],
    [1873,"1873","Carrier A","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97140","Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes","474","0.71",null,"40.14867806","40.97692555",null,"3","471",null,"NA","NA"],
    [1874,"1874","Carrier A","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","496","0.7",null,"40.14867806","37.51292904",null,"3","493",null,"NA","NA"],
    [1875,"1875","Carrier A","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97530","Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","246","0.69",null,"30.694312","39.348981",null,"3","243",null,"NA","NA"],
    [1876,"1876","Carrier A","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97112","Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities","258","0.68",null,"16.51276292","43.91067717","624","2","256","1","NA","NA"],
    [1877,"1877","Carrier A","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27130","Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft","22","1",null,null,"8.486309407",null,null,"22",null,"NA","NA"],
    [1878,"1878","Carrier A","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64494","Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level (List separately in addition to code for primary procedure)","18","1",null,null,"0.031796595",null,null,"18",null,"NA","NA"],
    [1879,"1879","Carrier A","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72157","MRI of thoracic spine","17","1",null,null,"1.824656863",null,null,"17",null,"NA","NA"],
    [1880,"1880","Carrier A","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","74174","ct angio abd&pelv w/o&w/dye","16","1",null,null,"7.785902778",null,null,"16",null,"NA","NA"],
    [1881,"1881","Carrier A","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70552","Contrast MRI of brain","15","1",null,null,"11.70940741",null,null,"15",null,"NA","NA"],
    [1882,"1882","Carrier A","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93303","ECHO, transthoracic, complete cng","14","1",null,null,"0.014484127",null,null,"14",null,"NA","NA"],
    [1883,"1883","Carrier A","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70543","MRI orb/fc/nck w/o cntrst flwd cntr","14","1",null,null,"12.11799603",null,null,"14",null,"NA","NA"],
    [1884,"1884","Carrier A","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29882","Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)","13","1",null,null,"41.81070067",null,null,"13",null,"NA","NA"],
    [1885,"1885","Carrier A","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","73720","MRI, lower extremity other than joint; w","13","1",null,null,"5.170683761",null,null,"13",null,"NA","NA"],
    [1886,"1886","Carrier A","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93312","ECHO, transesophageal, heart, compl","12","1",null,null,"0.0000694",null,null,"12",null,"NA","NA"],
    [1887,"1887","Carrier A","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29888","Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction","12","1",null,null,"34.0108765",null,null,"12",null,"NA","NA"],
    [1888,"1888","Carrier A","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70496","CTA, head, w/o cntrst flwd by cntrst","12","1",null,null,"7.942286325",null,null,"12",null,"NA","NA"],
    [1889,"1889","Carrier A","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64636","Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional facet joint (List separately in addition to code for primary procedure)","12","1",null,null,"32.99390504",null,null,"12",null,"NA","NA"],
    [1890,"1890","Carrier A","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","72148","MRI of lumbar spine","159","0","0.02",null,"12.34567115",null,null,"159",null,"NA","NA"],
    [1891,"1891","Carrier A","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64483","Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, single level","71","0","0.04","0.437153611","27.52914773",null,"1","70",null,"NA","NA"],
    [1892,"1892","Carrier A","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27096","Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or CT) including arthrography when performed","34","0","0.06",null,"28.75976059",null,null,"34",null,"NA","NA"],
    [1893,"1893","Carrier A","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64635","Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint","15","0","0.07",null,"28.19355546",null,null,"15",null,"NA","NA"],
    [1894,"1894","Carrier A","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63047","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","10","0","0.1","0.044166667","25.80615524",null,"1","9",null,"NA","NA"],
    [1895,"1895","Carrier A","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63030","Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar","8","0","0.13","0.195765222","109.3666737",null,"2","6",null,"NA","NA"],
    [1896,"1896","Carrier A","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63048","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure)","5","0","0.2",null,"29.84955181",null,null,"5",null,"NA","NA"],
    [1897,"1897","Carrier A","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","12","1",null,null,"18.82247263",null,null,"12",null,"NA","NA"],
    [1898,"1898","Carrier A","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H2036","Alcohol and/or other drug treatment program, per diem","5","1",null,null,"13.01069444",null,null,"5",null,"NA","NA"],
    [1899,"1899","Carrier A","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97530","Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","8","0.75",null,null,"101.5087823",null,null,"8",null,"NA","NA"],
    [1900,"1900","Carrier A","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97112","Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities","4","0.75",null,null,"46.18055993",null,null,"4",null,"NA","NA"],
    [1901,"1901","Carrier A","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71271","CT THORAX LW DOSE LNG CA SCR C-","31","0.74",null,null,"9.081451613",null,null,"31",null,"NA","NA"],
    [1902,"1902","Carrier A","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","6","0.67",null,null,"34.4736869",null,null,"6",null,"NA","NA"],
    [1903,"1903","Carrier A","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","6","0.67",null,null,"34.44148148",null,null,"6",null,"NA","NA"],
    [1904,"1904","Carrier A","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","6","0.67",null,null,"34.4736869",null,null,"6",null,"NA","NA"],
    [1905,"1905","Carrier A","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","92507","Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual","18","0.33",null,null,"65.46100057","648",null,"18","1","NA","NA"],
    [1906,"1906","Carrier A","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","92523","Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language)","4","0.25",null,null,"125.2505176",null,null,"4",null,"NA","NA"],
    [1907,"1907","Carrier A","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90834","Psychotherapy, 45 minutes with patient","4","0",null,"13.71211111","11.89154565",null,"1","3",null,"NA","NA"],
    [1908,"1908","Carrier A","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90853","Group psychotherapy (other than of a multiple-family group)","4","0",null,"13.71211028","4.345258982",null,"1","3",null,"NA","NA"],
    [1909,"1909","Carrier A","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77385","Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; simple","1","1",null,"0.010277777",null,null,"1",null,null,"NA","NA"],
    [1910,"1910","Carrier A","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","12","1",null,null,"18.82247263",null,null,"12",null,"NA","NA"],
    [1911,"1911","Carrier A","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H2036","Alcohol and/or other drug treatment program, per diem","5","1",null,null,"13.01069444",null,null,"5",null,"NA","NA"],
    [1912,"1912","Carrier A","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S9131","Physical therapy, in the home, per diem","2","1",null,null,"23.16153292",null,null,"2",null,"NA","NA"],
    [1913,"1913","Carrier A","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97124","Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion)","2","1",null,null,"1.439357917",null,null,"2",null,"NA","NA"],
    [1914,"1914","Carrier A","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70553","MRI of brain and further sequences","2","1",null,null,"44.52694444",null,null,"2",null,"NA","NA"],
    [1915,"1915","Carrier A","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70551","MRI of brain","2","1",null,null,"0",null,null,"2",null,"NA","NA"],
    [1916,"1916","Carrier A","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77301","Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications","3","1",null,"0.010277777","60.31208333",null,"1","2",null,"NA","NA"],
    [1917,"1917","Carrier A","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81229","Cytogenomic constitutional (genome-wide) microarray analysis; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants for chromosomal abnormalities","1","1",null,null,"0.009444446",null,null,"1",null,"NA","NA"],
    [1918,"1918","Carrier A","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97032","Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes","1","1",null,null,"0.178888889",null,null,"1",null,"NA","NA"],
    [1919,"1919","Carrier A","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77386","Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex","1","1",null,null,"23.92027778",null,null,"1",null,"NA","NA"],
    [1920,"1920","Carrier A","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97026","Application of a modality to 1 or more areas; infrared","1","1",null,null,"0.178888889",null,null,"1",null,"NA","NA"],
    [1921,"1921","Carrier A","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77338","Multi-leaf collimator (MLC) device(s) for intensity modulated radiation therapy (IMRT), design and construction per IMRT plan","2","1",null,"0.010277777","23.92027778",null,"1","1",null,"NA","NA"],
    [1922,"1922","Carrier A","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","G6015","RADIATION TX DELIVERY IMRT","2","1",null,"0.010555555","96.70388889",null,"1","1",null,"NA","NA"],
    [1923,"1923","Carrier A","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","71271","CT THORAX LW DOSE LNG CA SCR C-","31","0","0.03",null,"9.081451613",null,null,"31",null,"NA","NA"],
    [1924,"1924","Carrier N","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0784","EXT AMB INFUSN PUMP INSULIN","7","1",null,"96","56",null,"1","6","0","NA","NA"],
    [1925,"1925","Carrier N","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0766","ELEC STIM CANCER TREATMENT","2","1",null,"0","36",null,"0","2","0","NA","NA"],
    [1926,"1926","Carrier N","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L8619","COCH IMP EXT PROC/CONTR RPLC","1","1",null,"0","96",null,"0","1","0","NA","NA"],
    [1927,"1927","Carrier N","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L8685","IMPLT NROSTM PLS GEN SNG REC","1","1",null,"0","24",null,"0","1","0","NA","NA"],
    [1928,"1928","Carrier N","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L8680","IMPLT NEUROSTIM ELCTR EACH","1","1",null,"0","24",null,"0","1","0","NA","NA"],
    [1929,"1929","Carrier N","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L8614","COCHLEAR DEVICE","1","1",null,"0","168",null,"0","1","0","NA","NA"],
    [1930,"1930","Carrier N","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44145","PARTIAL REMOVAL OF COLON","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [1931,"1931","Carrier N","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15734","MUSCLE-SKIN GRAFT TRUNK","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [1932,"1932","Carrier N","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","21085","PREPARE FACE/ORAL PROSTHESIS","1","1",null,null,"24",null,null,"1",null,"NA","NA"],
    [1933,"1933","Carrier N","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58543","LSH UTERUS ABOVE 250 G","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [1934,"1934","Carrier N","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44207","L COLECTOMY/COLOPROCTOSTOMY","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [1935,"1935","Carrier N","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","32667","THORACOSCOPY W/W RESECT ADDL","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [1936,"1936","Carrier N","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","61304","OPEN SKULL FOR EXPLORATION","1","1",null,null,"24",null,null,"1",null,"NA","NA"],
    [1937,"1937","Carrier N","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","47379","LAPAROSCOPE PROCEDURE LIVER","1","1",null,null,"48",null,null,"1",null,"NA","NA"],
    [1938,"1938","Carrier N","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58954","TAH RAD DEBULK/LYMPH REMOVE","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [1939,"1939","Carrier N","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22633","ARTHRD CMBN 1NTRSPC LUMBAR","5","0.6",null,null,"91",null,null,"5",null,"NA","NA"],
    [1940,"1940","Carrier N","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","49560","Repair initial incisional or ventral hernia; reducible",null,"0",null,null,null,null,null,null,null,"NA","NA"],
    [1941,"1941","Carrier N","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44145","PARTIAL REMOVAL OF COLON","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [1942,"1942","Carrier N","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15734","MUSCLE-SKIN GRAFT TRUNK","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [1943,"1943","Carrier N","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","21085","PREPARE FACE/ORAL PROSTHESIS","1","1",null,null,"24",null,null,"1",null,"NA","NA"],
    [1944,"1944","Carrier N","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58543","LSH UTERUS ABOVE 250 G","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [1945,"1945","Carrier N","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44207","L COLECTOMY/COLOPROCTOSTOMY","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [1946,"1946","Carrier N","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","32667","THORACOSCOPY W/W RESECT ADDL","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [1947,"1947","Carrier N","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","61304","OPEN SKULL FOR EXPLORATION","1","1",null,null,"24",null,null,"1",null,"NA","NA"],
    [1948,"1948","Carrier N","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","47379","LAPAROSCOPE PROCEDURE LIVER","1","1",null,null,"48",null,null,"1",null,"NA","NA"],
    [1949,"1949","Carrier N","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58954","TAH RAD DEBULK/LYMPH REMOVE","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [1950,"1950","Carrier N","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63047","LAM FACETEC & FORAMOT LUMBAR","1","1",null,null,"24",null,null,"1",null,"NA","NA"],
    [1951,"1951","Carrier N","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","Substance Abuse Residential","3","1",null,null,null,null,"0","3","0","NA","NA"],
    [1952,"1952","Carrier N","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","Mental Health Inpatient","1","1",null,null,null,null,"0","1","0","NA","NA"],
    [1953,"1953","Carrier N","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","Substance Abuse Residential","3","1",null,null,null,null,"0","3","0","NA","NA"],
    [1954,"1954","Carrier N","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","Mental Health Inpatient","1","1",null,null,null,null,"0","1","0","NA","NA"],
    [1955,"1955","Carrier N","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","Q5103","INJECTION, INFLECTRA","15","1",null,"32","14",null,"3","12","0","NA","NA"],
    [1956,"1956","Carrier N","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95806","SLEEP STUDY UNATT&RESP EFFT","41","0.976",null,"0","7.6",null,"0","41","0","NA","NA"],
    [1957,"1957","Carrier N","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","92507","SPEECH/HEARING THERAPY","53","0.943",null,"120","167.1",null,"2","51","0","NA","NA"],
    [1958,"1958","Carrier N","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95810","POLYSOM 6/> YRS 4/> PARAM","28","0.929",null,"0","57.4",null,"0","28","0","NA","NA"],
    [1959,"1959","Carrier N","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64615","CHEMODENERV MUSC MIGRAINE","22","0.909",null,"0","38.2",null,"0","22","0","NA","NA"],
    [1960,"1960","Carrier N","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J0585","INJECTION,ONABOTULINUMTOXINA","40","0.85",null,"24","48",null,"1","39","0","NA","NA"],
    [1961,"1961","Carrier N","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64999","NERVOUS SYSTEM SURGERY","11","0.818",null,"0","113.5",null,"0","11","0","NA","NA"],
    [1962,"1962","Carrier N","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95811","POLYSOM 6/>YRS CPAP 4/> PARM","19","0.789",null,"0","73.3",null,"0","19","0","NA","NA"],
    [1963,"1963","Carrier N","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","MRI (eg, proton) ANY JOINT OF LOWER EXTREMITY","16","0.75",null,"0","69",null,"0","16","0","NA","NA"],
    [1964,"1964","Carrier N","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J1745","INFLIXIMAB NOT BIOSIMIL 10MG","14","0.429",null,"0","90.9",null,"0","14","0","NA","NA"],
    [1965,"1965","Carrier N","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","Q5103","INJECTION, INFLECTRA","15","1",null,"32","14",null,"3","12","0","NA","NA"],
    [1966,"1966","Carrier N","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","G0299","HHS/HOSPICE OF RN EA 15 MIN","10","1",null,"0","12",null,"0","10","0","NA","NA"],
    [1967,"1967","Carrier N","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95800","SLP STDY UNATTENDED","9","1",null,"0","0",null,"0","9","0","NA","NA"],
    [1968,"1968","Carrier N","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J9035","BEVACIZUMAB INJECTION","9","1",null,"0","2.7",null,"0","9","0","NA","NA"],
    [1969,"1969","Carrier N","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","Q5121","INJ. AVSOLA, 10 MG","7","1",null,"0","0",null,"0","7","0","NA","NA"],
    [1970,"1970","Carrier N","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","36475","ENDOVENOUS RF 1ST VEIN","6","1",null,"0","72",null,"0","6","0","NA","NA"],
    [1971,"1971","Carrier N","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J0178","AFLIBERCEPT INJECTION","6","1",null,"0","400",null,"0","6","0","NA","NA"],
    [1972,"1972","Carrier N","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","G0399","HOME SLEEP TEST/TYPE 3 PORTA","6","1",null,"0","0",null,"0","6","0","NA","NA"],
    [1973,"1973","Carrier N","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","S0122","INJ MENOTROPINS 75 IU","6","1",null,"0","0",null,"6","0","0","NA","NA"],
    [1974,"1974","Carrier N","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","S0126","INJ FOLLITROPIN ALFA 75 IU","6","1",null,"0","0",null,"6","0","0","NA","NA"],
    [1975,"1975","Carrier N","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","J1557","GAMMAPLEX INJECTION","3","0","0.33",null,"24",null,"0","1","0","NA","NA"],
    [1976,"1976","Carrier N","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","67904","REPAIR EYELID DEFECT","1","0","1",null,"24",null,"0","1","0","NA","NA"],
    [1977,"1977","Carrier N","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Transcranial Magnetic Stimulation (TMS)","4","1",null,null,"24",null,"0","4","0","NA","NA"],
    [1978,"1978","Carrier N","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","S9480","Mental Health Intensive Outpatient Program","3","1",null,null,"24",null,"0","3","0","NA","NA"],
    [1979,"1979","Carrier N","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","H0035","Psychiatric Treatment Partial Hospitalization","2","1",null,null,"24",null,"0","2","0","NA","NA"],
    [1980,"1980","Carrier N","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","H0015","Substance Abuse Intensive Outpatient Program","2","1",null,null,"24",null,"0","2","0","NA","NA"],
    [1981,"1981","Carrier N","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","Mental Health Individual and Family Therapy","1","1",null,null,"69.25",null,"0","1","0","NA","NA"],
    [1982,"1982","Carrier N","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90868","Transcranial Magnetic Stimulation (TMS)","4","1",null,null,"24",null,"0","4","0","NA","NA"],
    [1983,"1983","Carrier N","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","S9480","Mental Health Intensive Outpatient Program","3","1",null,null,"24",null,"0","3","0","NA","NA"],
    [1984,"1984","Carrier N","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H0035","Psychiatric Treatment Partial Hospitalization","2","1",null,null,"24",null,"0","2","0","NA","NA"],
    [1985,"1985","Carrier N","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H0015","Substance Abuse Intensive Outpatient Program","2","1",null,null,"24",null,"0","2","0","NA","NA"],
    [1986,"1986","Carrier N","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90837","Mental Health Individual and Family Therapy","1","1",null,null,"69.25",null,"0","1","0","NA","NA"],
    [1987,"1987","Carrier B","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9274","EXTERNAL AMBULATORY INSULIN DELIVERY SYSTEM","11","1",null,null,"87.54","0","1","10","0","NA","NA"],
    [1988,"1988","Carrier B","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9277","EXTERNAL TRANSMITTER CONTINOUS GLUCOSE MONITOR DAILY","83","0.94",null,"48.6","106.08","0","2","81","0","NA","NA"],
    [1989,"1989","Carrier B","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9276","DISPOSABLE SENSOR  FOR CONTINOUS GLUCOSE MONITORING SYSTEM DAILY","21","0.9",null,"72.62","85.73","0","1","20","0","NA","NA"],
    [1990,"1990","Carrier B","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","EXTERNAL AMBULATORY INFUSION PUMP, INSULIN","9","0.89",null,null,"79.04","0","0","9","0","NA","NA"],
    [1991,"1991","Carrier B","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9278","EXTERNAL RECEIVER  FOR CONTINOUS GLUCOSE MONITORING","29","0.86",null,null,"119.73","0","0","29","0","NA","NA"],
    [1992,"1992","Carrier B","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0553","CONTINOUS GLUCOSE MONITORING SYSTEM SUPPLIES MONTH AT A TIME","12","0.5",null,null,"157.41","0","0","12","0","NA","NA"],
    [1993,"1993","Carrier B","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0554","THERAPEUTIC CONTINOUS GLUCOSE MONITORING RECEIVER/MONITOR MONTHLY","7","0.29",null,null,"137.89","0","0","7","0","NA","NA"],
    [1994,"1994","Carrier B","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9274","EXTERNAL AMBULATORY INSULIN DELIVERY SYSTEM","11","1",null,null,"87.54","0","1","10","0","NA","NA"],
    [1995,"1995","Carrier B","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9277","EXTERNAL TRANSMITTER CONTINOUS GLUCOSE MONITOR DAILY","83","0.94",null,"48.6","106.08","0","2","81","0","NA","NA"],
    [1996,"1996","Carrier B","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9276","DISPOSABLE SENSOR  FOR CONTINOUS GLUCOSE MONITORING SYSTEM DAILY","21","0.9",null,"72.62","85.73","0","1","20","0","NA","NA"],
    [1997,"1997","Carrier B","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","EXTERNAL AMBULATORY INFUSION PUMP, INSULIN","9","0.89",null,null,"79.04","0","0","9","0","NA","NA"],
    [1998,"1998","Carrier B","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9278","EXTERNAL RECEIVER  FOR CONTINOUS GLUCOSE MONITORING","29","0.86",null,null,"119.73","0","0","29","0","NA","NA"],
    [1999,"1999","Carrier B","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0553","CONTINOUS GLUCOSE MONITORING SYSTEM SUPPLIES MONTH AT A TIME","12","0.5",null,null,"157.41","0","0","12","0","NA","NA"],
    [2000,"2000","Carrier B","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0554","THERAPEUTIC CONTINOUS GLUCOSE MONITORING RECEIVER/MONITOR MONTHLY","7","0.29",null,null,"137.89","0","0","7","0","NA","NA"],
    [2001,"2001","Carrier B","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2402","NEGATIVE PRESSURE WOUND PUMP","20","1",null,"21.48","148.93",null,"1","19","0","NA","NA"],
    [2002,"2002","Carrier B","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0935","PASSIVE MOTION EXERCISE DEVICE","12","1",null,null,"120.87",null,"0","12","0","NA","NA"],
    [2003,"2003","Carrier B","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0001","STANDARD WHEELCHAIR","9","1",null,"29.66","82.34",null,"4","5","0","NA","NA"],
    [2004,"2004","Carrier B","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","CONTINUOUS AIRWAY PRESSURE (CPAP) DEVICE","491","0.98",null,"43.82","101.64",null,"3","487","0","NA","NA"],
    [2005,"2005","Carrier B","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1390","PORTABLE OXYGEN CONCENTRATOR","152","0.97",null,"11.9","75.63",null,"13","138","0","NA","NA"],
    [2006,"2006","Carrier B","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0470","BI-PAP RESPIRATORY ASSIST DEVICE WITH OUT BACKUP","30","0.97",null,"60.75","123.58",null,"2","28","0","NA","NA"],
    [2007,"2007","Carrier B","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0471","BI-PAP RESPIRATORY ASSIST DEVICE WITH BACKUP","19","0.95",null,"69.86","85.64",null,"2","17","0","NA","NA"],
    [2008,"2008","Carrier B","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0781","AMBULATORY INFUSION PUMP 1 OR MULTIPLE CHANNELS PATIENT WEARS","72","0.88",null,null,"98.8","0.04","0","72","1","NA","NA"],
    [2009,"2009","Carrier B","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0466","HOME VENT TYPE USED NON-INVASIVE","17","0.82",null,"21.4","121.07",null,"1","16","0","NA","NA"],
    [2010,"2010","Carrier B","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0108","OTHER ACCESSORY","10","0.8",null,null,"143.61",null,"0","10","0","NA","NA"],
    [2011,"2011","Carrier B","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0001","STANDARD WHEELCHAIR","9","1",null,"29.66","82.34","0","4","5","0","NA","NA"],
    [2012,"2012","Carrier B","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1399","DURABLE MEDICAL EQUPMENT MISCELLANEOUS","5","1",null,null,"112.21","0","0","5","0","NA","NA"],
    [2013,"2013","Carrier B","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4222","SUPPLIES EXTERNAL DRUG INFUSION PUMP PER CASSETTE/BAG","4","1",null,null,"152.56","0","0","4","0","NA","NA"],
    [2014,"2014","Carrier B","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2510","SPEECH GENERATING DEVICE/SYNTHIZED SPEECH, PERMITTING MULTIPLE METHODS OF MESSAGE FORMULATION","3","1",null,null,"101.37","0","0","3","0","NA","NA"],
    [2015,"2015","Carrier B","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0007","EXTRA HEAVY-DUTY WHEELCHAIR","2","1",null,null,"84.45","0","0","2","0","NA","NA"],
    [2016,"2016","Carrier B","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4221","SUPPLIES-MAINTAINCE DRUG INFUSION CATHETERS PER WEEK","1","1",null,null,"69.45","0","0","1","0","NA","NA"],
    [2017,"2017","Carrier B","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","V5260","HEARING AID, DIGITAL, BINAURAL, ITE","1","1",null,null,"112.25","0","0","1","0","NA","NA"],
    [2018,"2018","Carrier B","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2359","POWER WHEELCHAIR ACCESSORY, GROUP 34 SEALED LEAD ACID BATTERY","1","1",null,null,"193.22","0","0","1","0","NA","NA"],
    [2019,"2019","Carrier B","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4425","OSTOMY POUCH, DRAINABLE USE ON BARRIAR WITH NON-LOCKING FLANGE W NON-LOCKING FLANGE-2 PIECE SYSTEM","1","1",null,null,"153.35","0","0","1","0","NA","NA"],
    [2020,"2020","Carrier B","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9279","MONITOR FEATURE/DEVICE, STAND-ALONE OR INTEGRAT, ANY TYPE, NOT OTHERWISE CLASSIFIED","1","1",null,null,"124.4","0","0","1","0","NA","NA"],
    [2021,"2021","Carrier B","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0466","HOME VENT TYPE USED NON-INVASIVE","17","0","0.06","21.4","121.07","0","1","16","0","NA","NA"],
    [2022,"2022","Carrier B","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0486","ORAL DEVICE/APPLIANCE TO REDUCE UP/AIRWAY COLLAPSIBILITY ADJUSTABLE ORTHOTIC","3","0","0.33","0","248.67","0","0","3","0","NA","NA"],
    [2023,"2023","Carrier B","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0652","PNEUMATIC COMPRESS SEGMENTAL W ITH GRADIENT PRESS","3","0","0.33","0","392.91","0","0","3","0","NA","NA"],
    [2024,"2024","Carrier B","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0668","SEGMENTAL PNEUMATIC-USE W/COMPRESSOR FULL ARM","2","0","0.5","0","408.82","0","0","2","0","NA","NA"],
    [2025,"2025","Carrier B","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44207","LAPORSCOPY REMOVAL OF PART OF THE COLON","11","1",null,"2.18","97.98","0","1","10","0","NA","NA"],
    [2026,"2026","Carrier B","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","TOTAL ABDOMINAL HYSTERECTOMY","9","1",null,null,"86.77","0","0","9","0","NA","NA"],
    [2027,"2027","Carrier B","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20936","AUTOGRAFT TO BONE DURING SPINAL SURGERY","16","0.94",null,null,"45.44","0","0","16","0","NA","NA"],
    [2028,"2028","Carrier B","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22840","INSTRUMENTATION  INSERTED TO CORRECT  A SPINAL SPACE","12","0.92",null,null,"32.84","0","0","12","0","NA","NA"],
    [2029,"2029","Carrier B","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22614","SPINAL FUSION TO JOIN TWO VERTEBRAE","9","0.89",null,null,"58.92","0","0","9","0","NA","NA"],
    [2030,"2030","Carrier B","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","cPT","22853","METALLIC  MESH BETWEEN VERTEBRAE","17","0.88",null,null,"44.27","0","0","17","0","NA","NA"],
    [2031,"2031","Carrier B","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20930","BONE GRAFT MATERIAL ATTACHED TO SPINE","16","0.88",null,null,"47.91","0","0","16","0","NA","NA"],
    [2032,"2032","Carrier B","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","SPINAL FUSION TO JOIN TWO VERTEBRAE IN LOW BACK","7","0.86",null,null,"61.72","0","0","7","0","NA","NA"],
    [2033,"2033","Carrier B","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22612","LUMBAR SPINE FUSION","9","0.78",null,null,"51.61","0","0","9","0","NA","NA"],
    [2034,"2034","Carrier B","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63047","SINGLE VERTEBRAE LAMINECTOMY   SURGERY","7","0.71",null,null,"49.16","0","0","7","0","NA","NA"],
    [2035,"2035","Carrier B","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44213","LAPAROSCOPIC PROCEDURE DONE DURING A PARTIAL COLECTOMY","6","1",null,"2.18","132.15","0","1","5","0","NA","NA"],
    [2036,"2036","Carrier B","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J9070","CYCLOPHOSPHAMIDE 100MG","4","1",null,null,"125.57","0","0","4","0","NA","NA"],
    [2037,"2037","Carrier B","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","52332","INSPECTION OF INSIDE OF BLADDER WITH A SCOPE","1","1",null,null,"65.9","0","0","1","0","NA","NA"],
    [2038,"2038","Carrier B","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","0538T","T-LYMPHOCYTES FROZEN FOR TRANSPORT","1","1",null,null,"29.18","0","0","1","0","NA","NA"],
    [2039,"2039","Carrier B","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","0539T","LABORTATORY RECEIPT AND PREP OF T-LYMPHOCYTES","1","1",null,null,"29.18","0","0","1","0","NA","NA"],
    [2040,"2040","Carrier B","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","49255","OMENTECTOMY/EPIPLOECTOMY-RESECTION OMENTUM","1","1",null,null,"42.68","0","0","1","0","NA","NA"],
    [2041,"2041","Carrier B","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","0569T","REPAIR OF MITRAL VLAVE DEFECT WITH PROTHESIS","1","1",null,null,"95.57","0","0","1","0","NA","NA"],
    [2042,"2042","Carrier B","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58548","LAPAROSCOPIC REMOVAL OF UTERUS, FALLOPIAN TUBES, OVARIES, AND LIGAMENTS","1","1",null,null,"71.63","0","0","1","0","NA","NA"],
    [2043,"2043","Carrier B","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","0570T","REPAIR OF TRICUSPIC VALVE WITH PROSTHIC DEVICE","1","1",null,null,"95.8","0","0","1","0","NA","NA"],
    [2044,"2044","Carrier B","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","61781","INTRACRANIAL SCAN PERFORMED DURING INTERCRANIAL SURGERY","1","1",null,"19.48",null,"0","1","0","0","NA","NA"],
    [2045,"2045","Carrier B","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22857","LUMBAR ARTIFICAL  DISKECTOMY","1","0","1","0","59.23","0","0","1","0","NA","NA"],
    [2046,"2046","Carrier B","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1001","BEHAVIORAL HEALTH ACCOMODATIONS-RESIDENTIAL TREATMENT  PSYCHIATRIC","4","1",null,"0","206.78","0","0","4","0","NA","NA"],
    [2047,"2047","Carrier B","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","126","SEMI-PRIVATE DETOXIFICATION BED INPATIENT","2","1",null,"0","2.45","0","0","2","0","NA","NA"],
    [2048,"2048","Carrier B","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1002","BEHAVIORAL HEALTH ACCOMODATIONS-RELATED TO CHEMICAL DEPENDANCY","1","1",null,"0","54","0","0","1","0","NA","NA"],
    [2049,"2049","Carrier B","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","SEMI-PRIVATE PYSCHIATRIC INPATIENT STAY","43","0.95",null,"0","26.15","0","0","41","0","NA","NA"],
    [2050,"2050","Carrier B","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1001","BEHAVIORAL HEALTH ACCOMODATIONS-RESIDENTIAL TREATMENT PSYCHIATRIC","4","1",null,"0","206.78","0","0","4","0","NA","NA"],
    [2051,"2051","Carrier B","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","126","SEMI-PRIVATE DETOXIFICATION BED INPATIENT","2","1",null,"0","2.45","0","0","2","0","NA","NA"],
    [2052,"2052","Carrier B","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1002","BEHAVIORAL HEALTH ACCOMODATIONS-RELATED TO CHEMICAL DEPENDANCY","1","1",null,"0","54","0","0","1","0","NA","NA"],
    [2053,"2053","Carrier B","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","SEMI-PRIVATE PYSCHIATRIC INPATIENT STAY","43","0.95",null,"0","26.15","0","0","41","0","NA","NA"],
    [2054,"2054","Carrier B","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","Q5101","INJ FILGRASTIM G-CSF BIOSIMULATOR","61","1",null,"15.6","56.91",null,"20","39","0","NA","NA"],
    [2055,"2055","Carrier B","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","551","SKILLED NURSE VISIT IN HOME","148","0.99",null,"64.88","101.9",null,"10","137","0","NA","NA"],
    [2056,"2056","Carrier B","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J3489","ZOLEDRONIC ACID 1MG","64","0.97",null,"13.66","52.46",null,"18","45","0","NA","NA"],
    [2057,"2057","Carrier B","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64483","ANESTHETIC AGEN AND/OR STERIOD INJECTION FOR TRANSFORAMINAL EPIDURAL INJECTION INTO A SINGLE LEVEL","79","0.9",null,null,"143.4",null,"0","79","0","NA","NA"],
    [2058,"2058","Carrier B","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95811","SLEEP STUDY GREATER THAN 6 YRS OLD WITH CPAP MACHINE","163","0.8",null,"71.41","152.17",null,"1","162","0","NA","NA"],
    [2059,"2059","Carrier B","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95810","SLEEP STUDY GREATER THAN 6 YRS OLD","180","0.78",null,"23.73","153.51",null,"1","179","0","NA","NA"],
    [2060,"2060","Carrier B","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","J0585","INJECTION,ONABOTULINUMTOXINA","113","0.76",null,"26.15","146.46",null,"4","105","0","NA","NA"],
    [2061,"2061","Carrier B","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99212","OFFICE/OUTPATIENT ESTABLISHED MEMBER LASTING 10-19 MIN","201","0.63",null,"70.64","124.25","0.05","16","181","4","NA","NA"],
    [2062,"2062","Carrier B","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0480","DEFINITIVE DRUG TEST OF CLASSES 1-7","63","0.4",null,null,"175.29",null,"0","63","0","NA","NA"],
    [2063,"2063","Carrier B","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0481","DEFINITIVE DRUG TEST OF CLASSES 8-14","64","0.39",null,null,"175.26",null,"0","64","0","NA","NA"],
    [2064,"2064","Carrier B","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","Q5118","INJECTION BEVACIZUMAB-BVCR BIOSIMILAR 10 MILLIGRAM (ZIRABEV)","26","1",null,"24.06","82.62","0","5","20","0","NA","NA"],
    [2065,"2065","Carrier B","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J9299","INJECTION NIVOLUMAB 1 MILLIGRAM","19","1",null,"4.06","113.87","0","6","13","0","NA","NA"],
    [2066,"2066","Carrier B","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J9022","INJECTION ATEZOLIZUMAB 10 MILLIGRAM","11","1",null,"10.01","76.68","0","3","8","0","NA","NA"],
    [2067,"2067","Carrier B","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81208","BCR/ABL1 GENETIC TEST FOR CHROMOSOME 22","3","1",null,null,"176.89","0","0","3","0","NA","NA"],
    [2068,"2068","Carrier B","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81257","HBA1/HBA2 GENETIC TEST FOR ALPHA THALASSEMIA","3","1",null,null,"69.44","0","0","3","0","NA","NA"],
    [2069,"2069","Carrier B","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J2182","INJECTION MEPOLIZUMAB 1MILLIGRAM","2","1",null,null,"129.42","0","0","2","0","NA","NA"],
    [2070,"2070","Carrier B","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81256","HFE GENE (HEMOCHROMATOSIS GENE) TEST FOR CHANGES","2","1",null,null,"97.74","0","0","2","0","NA","NA"],
    [2071,"2071","Carrier B","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J0694","INJECTION CEFOXITIN SODIUM 1 GRAM","1","1",null,null,"22.23","0","0","1","0","NA","NA"],
    [2072,"2072","Carrier B","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81261","IGH GENETIC TEST FOR LYMPHOID NEOPLASMS","1","1",null,null,"117.75","0","0","1","0","NA","NA"],
    [2073,"2073","Carrier B","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","G0491","DIALYSIS ACUTE KIDNEY WITHOUT END STAGE RENAL DISEASE","1","1",null,"5.65",null,"0","1","0","0","NA","NA"],
    [2074,"2074","Carrier B","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21209","OSTEOPLASTY FACIAL BONES; REDUCTION","1","0","1","0","270.06",null,"0","1","0","NA","NA"],
    [2075,"2075","Carrier B","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","77067","SCREENING MAMMOGRAPHY","3","0","1","0",null,null,"0","0","0","NA","NA"],
    [2076,"2076","Carrier B","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","99213","OFFICE/OUTPATIENT VISIT ESTABLISHED","1","0","1","0",null,null,"0","0","0","NA","NA"],
    [2077,"2077","Carrier B","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","83605","TEST FOR AMOUNTS OF LACTATE","1","0","1","0",null,null,"0","0","0","NA","NA"],
    [2078,"2078","Carrier B","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","88304","LEVEL III-SURGICAL PATH GROSS/MICROSCOPIC EXAM","1","0","1","0",null,null,"0","0","0","NA","NA"],
    [2079,"2079","Carrier B","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","23350","INJECTION  PROCEDURE TO THE SHOULDER JOINT","1","0","1","0",null,null,"0","0","0","NA","NA"],
    [2080,"2080","Carrier B","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","77065","DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED","1","0","1","0",null,null,"0","0","0","NA","NA"],
    [2081,"2081","Carrier B","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","11104","PUNCH BIOPSY SKIN SINGLE LESION","1","0","1","0",null,"1.17","0","0","1","NA","NA"],
    [2082,"2082","Carrier B","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","80053","COMPREHENSIVE METABOLIC PANEL","1","0","1","0",null,"0.07","0","0","1","NA","NA"],
    [2083,"2083","Carrier B","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90837","PSYCHO THERAPY FOR LESS THAN 60 MINUTES","1","0","1","0",null,"0.04","0","0","3","NA","NA"],
    [2084,"2084","Carrier B","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96101","PSYCHOLOGICAL TESTING PER HOUR FACE TO FACE TIME WITH PATIENT","10","1",null,"0","204.01","0","0","10","0","NA","NA"],
    [2085,"2085","Carrier B","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S9480","INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES PER DIEM","4","1",null,"0","113.31","0","0","3","0","NA","NA"],
    [2086,"2086","Carrier B","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","912","PARTIAL HOSPITALIZATION PSYCHIATRIC  PROGRAM","3","1",null,"0","159.13","0","0","3","0","NA","NA"],
    [2087,"2087","Carrier B","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S0201","PARTIAL HOSPITALZTION SERVICES <24 HR-PER DIEM","2","1",null,"0","74.53","0","0","2","0","NA","NA"],
    [2088,"2088","Carrier B","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","905","INTENSIVE BEHAVIORAL HEALTH TREATMENT SERVICES","2","1",null,"0","31.89","0","0","2","0","NA","NA"],
    [2089,"2089","Carrier B","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90870","ELECTRIC CONVULSIVE THERAPY","2","1",null,"0","445.4","0","0","2","0","NA","NA"],
    [2090,"2090","Carrier B","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0020","ALCOHOL AND/OR DRUG SERVICES;METHADONE ADMINISTRATION/SERVICE","1","1",null,"0","200.57","0","0","1","0","NA","NA"],
    [2091,"2091","Carrier B","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY SESSION UNDER 60 MINUTES","1","1",null,"0","98.12","0","0","1","0","NA","NA"],
    [2092,"2092","Carrier B","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0015","INTENSIVE  OUTPATIENT PROGRAM FOR  CHEMICAL DEPENDENCY TREATMENT","1","1",null,"0","136.87","0","0","1","0","NA","NA"],
    [2093,"2093","Carrier B","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","906","PROFESSIONAL FEE FOR PSYCHOLOGY","24","0.92",null,"0","176.91","0","0","24","0","NA","NA"],
    [2094,"2094","Carrier B","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96101","PSYCHOLOGICAL TESTING PER HOUR FACE TO FACE TIME WITH PATIENT","10","1",null,"0","204.01","0","0","10","0","NA","NA"],
    [2095,"2095","Carrier B","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S9480","INTENSIVE OUTPT PSYCH SERV PER DIEM","4","1",null,"0","113.31","0","0","3","0","NA","NA"],
    [2096,"2096","Carrier B","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","912","PARTIAL HOSPITALIZATION PSYCHIATRIC  PROGRAM","3","1",null,"0","159.13","0","0","3","0","NA","NA"],
    [2097,"2097","Carrier B","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90870","ELECTRIC CONVULSIVE THERAPY","2","1",null,"0","445.4","0","0","2","0","NA","NA"],
    [2098,"2098","Carrier B","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S0201","PARTIAL HOSPITALZTION SERVICES <24 HR-PER DIEM","2","1",null,"0","74.53","0","0","2","0","NA","NA"],
    [2099,"2099","Carrier B","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","905","INTENSIVE BEHAVIORAL HEALTH TREATMENT SERVICES","2","1",null,"0","31.89","0","0","2","0","NA","NA"],
    [2100,"2100","Carrier B","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0020","ALCOHOL AND/OR DRUG SERVICES;METHADONE ADMINISTRATION/SERVICE","1","1",null,"0","200.57","0","0","1","0","NA","NA"],
    [2101,"2101","Carrier B","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96130","PSYCHOLOGICAL TESTING EVALUATION SERVICES PHYSICIAN/QUALIFIED HEALTH PROFESSIONAL FOR THE FIRST HOUR","1","1",null,"0","236.25","0","0","1","0","NA","NA"],
    [2102,"2102","Carrier B","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY SESSION UNDER 60 MINUTES","1","1",null,"0","98.12","0","0","1","0","NA","NA"],
    [2103,"2103","Carrier B","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0015","INTENSIVE  OUTPATIENT PROGRAM FOR  CHEMICAL DEPENDENCY TREATMENT","1","1",null,"0","136.87","0","0","1","0","NA","NA"],
    [2104,"2104","Carrier C","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4230","INFUS SET INSULIN PUMP NON NEEDLE","473","0.992",null,"2","53",null,"411","62",null,"NA","NA"],
    [2105,"2105","Carrier C","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97802","MED NUTRIT THRPY INIT ASSESS 15 MIN","718","0.976",null,"1","20",null,"15","703",null,"NA","NA"],
    [2106,"2106","Carrier C","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS","2160","0.965",null,"5","19",null,"161","1999",null,"NA","NA"],
    [2107,"2107","Carrier C","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J9035","INJ BEVACIZUMAB 10 MG","128","0.961",null,"6","43",null,"55","73",null,"NA","NA"],
    [2108,"2108","Carrier C","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","120","ROOM AND BOARD","117","0.957",null,"11",null,null,"117","0",null,"NA","NA"],
    [2109,"2109","Carrier C","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A5500","DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE","260","0.931",null,"6","47",null,"7","253",null,"NA","NA"],
    [2110,"2110","Carrier C","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","G0108","DIAB MGMT TRN PER INDIV","85","0.929",null,"3","47",null,"25","60",null,"NA","NA"],
    [2111,"2111","Carrier C","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A9276","SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D","629","0.859",null,"6","99",null,"373","256",null,"NA","NA"],
    [2112,"2112","Carrier C","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0784","EXTERN AMBUL INSULIN INFUS PUMP","186","0.839",null,"19","85",null,"22","164",null,"NA","NA"],
    [2113,"2113","Carrier C","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","K0553","SUPPLY ALLOWANCE FOR THERAPEUTIC CONTINUOUS GLUCOSE MONITOR (CGM), INCLUDES ALL SUPPLIES AND ACCESSORIES","827","0.801",null,"7","83",null,"426","401",null,"NA","NA"],
    [2114,"2114","Carrier C","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95250","GLUCOSE MONITORING 72 HRS MD OR OTH QUAL, EQUIP PROV, REC/STORAGE GL","73","1",null,"1","7",null,"3","70",null,"NA","NA"],
    [2115,"2115","Carrier C","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A5501","DIABETIC CUSTOM MOLDED SHOE","23","1",null,null,"47",null,"0","23",null,"NA","NA"],
    [2116,"2116","Carrier C","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","11042","DEBRIDE SKIN & SUBQ TISSUE","16","1",null,"0","28",null,"1","15",null,"NA","NA"],
    [2117,"2117","Carrier C","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","11721","DEBRIDE NAIL(S) ANY METHOD(S) 6+","9","1",null,null,"75",null,"0","9",null,"NA","NA"],
    [2118,"2118","Carrier C","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L4205","REPAIR ORTHOTIC DEV LABOR PER 15 MIN","10","1",null,"0","20",null,"3","7",null,"NA","NA"],
    [2119,"2119","Carrier C","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","92014","COMPREHENSIVE EYE EXAM ESTABLISHED PT 1+ VISITS","9","1",null,"9","28",null,"2","7",null,"NA","NA"],
    [2120,"2120","Carrier C","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93924","NON-INVASIVE STUDY LE ARTERY POST T","9","1",null,"0","39",null,"2","7",null,"NA","NA"],
    [2121,"2121","Carrier C","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99204","OFFICE VISIT E&M NEW PT MODERATE MDM, 45-59 MINS","8","1",null,"25","42",null,"2","6",null,"NA","NA"],
    [2122,"2122","Carrier C","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","92134","OCT MACULAR/RETINA W/INTERP & REPORT; UNIL/BILAT","12","1",null,"10","30",null,"10","2",null,"NA","NA"],
    [2123,"2123","Carrier C","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","762","MISC SERVICES","22","1",null,"13",null,null,"22","0",null,"NA","NA"],
    [2124,"2124","Carrier C","2021","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","K0553","SUPPLY ALLOWANCE FOR THERAPEUTIC CONTINUOUS GLUCOSE MONITOR (CGM), INCLUDES ALL SUPPLIES AND ACCESSORIES","827","0","0.009","7","83",null,"426","401",null,"NA","NA"],
    [2125,"2125","Carrier C","2021","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A9276","SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D","629","0","0.006","6","99",null,"373","256",null,"NA","NA"],
    [2126,"2126","Carrier C","2021","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0784","EXTERN AMBUL INSULIN INFUS PUMP","186","0","0.022","19","85",null,"22","164",null,"NA","NA"],
    [2127,"2127","Carrier C","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L3660","SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND","559","0.998",null,null,"7",null,"0","559",null,"NA","NA"],
    [2128,"2128","Carrier C","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0603","DME ELECTRIC BREAST PUMP KIT PURCHASE","2191","0.995",null,"1","30",null,"2103","88",null,"NA","NA"],
    [2129,"2129","Carrier C","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0114","CRUTCHES METAL UNDERARM PAIR","658","0.994",null,"3","14",null,"41","617",null,"NA","NA"],
    [2130,"2130","Carrier C","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L4361","PNEUMATIC, WALKING BOOT","632","0.989",null,"1","12",null,"9","623",null,"NA","NA"],
    [2131,"2131","Carrier C","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A7034","NASAL APPLICATION DEVICE","3691","0.984",null,"2","8",null,"209","3482",null,"NA","NA"],
    [2132,"2132","Carrier C","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0439","STATIONARY LIQUID 02","539","0.974",null,"5","27",null,"226","313",null,"NA","NA"],
    [2133,"2133","Carrier C","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0143","WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT","690","0.973",null,"10","28",null,"354","336",null,"NA","NA"],
    [2134,"2134","Carrier C","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0604","DME ELECTRIC BREAST PUMP KIT RENTAL","1252","0.957",null,"2","28",null,"669","583",null,"NA","NA"],
    [2135,"2135","Carrier C","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0118","CRUTCH SUBSTITUTE, LOWER LEG PLATFORM, WITH OR WITHOUT WHEELS, EACH","574","0.953",null,"4","40",null,"290","284",null,"NA","NA"],
    [2136,"2136","Carrier C","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0601","CPAP DEVICE","4746","0.916",null,"4","43",null,"1485","3261",null,"NA","NA"],
    [2137,"2137","Carrier C","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L3260","POST-OP SHOE CANVAS","268","1",null,"0","7",null,"4","264",null,"NA","NA"],
    [2138,"2138","Carrier C","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L1846","KO W ADJ FLEX/EXT ROTAT MOLD","108","1",null,"0","7",null,"12","96",null,"NA","NA"],
    [2139,"2139","Carrier C","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0849","TRACTION EQUIP,CERVICAL,FREE STAND,TRACTION FORCE OTHER THAN MANDIBLE","75","1",null,"1","20",null,"2","73",null,"NA","NA"],
    [2140,"2140","Carrier C","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L7520","REPAIR PROSTH DEV LABOR PER 15 MIN","72","1",null,"5","45",null,"9","63",null,"NA","NA"],
    [2141,"2141","Carrier C","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0156","SEAT ATTACHMENT, WALKER","111","1",null,"2","26",null,"52","59",null,"NA","NA"],
    [2142,"2142","Carrier C","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L4386","WALKING BOOT, PREFAB, NONPNEUMATIC","46","1",null,"3","33",null,"1","45",null,"NA","NA"],
    [2143,"2143","Carrier C","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0484","OSCILLATORY POSITIVE EXPIRATORY PRESSURE DEV, NONELEC, ANY TYPE, EACH","47","1",null,"1","32",null,"10","37",null,"NA","NA"],
    [2144,"2144","Carrier C","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0100","CANES OF ANY MATERIAL","48","1",null,"0","13",null,"18","30",null,"NA","NA"],
    [2145,"2145","Carrier C","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4338","INDWELLING CATH LATEX","117","1",null,"1","6",null,"102","15",null,"NA","NA"],
    [2146,"2146","Carrier C","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0165","COMMODE CHAIR STATIONARY","42","1",null,"1","29",null,"28","14",null,"NA","NA"],
    [2147,"2147","Carrier C","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","K0739","REPAIR OR NONROUTN SVC DME OTHER THAN O2 EQUIP,REQ TECH SKILL,PER 15 MINS","215","0","0.005","11","87",null,"50","165","0","NA","NA"],
    [2148,"2148","Carrier C","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A6549","GRADIENT COMPRESSION STOCKING/SLEEVE NOS","165","0","0.012","34","89",null,"11","154","0","NA","NA"],
    [2149,"2149","Carrier C","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0766","ELECT STIMULATION DEV USED FOR CANCER TX, INCL ALL ACCESS, ANY TYPE","29","0","0.069","22","117.5",null,"5","24","0","NA","NA"],
    [2150,"2150","Carrier C","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L5700","REPLACE SOCKET BEL KNEE PT MODEL","20","0","0.05","13","133",null,"1","19","0","NA","NA"],
    [2151,"2151","Carrier C","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L5673","ADDTN TO LOW EXTRMTY BELOW/ABOVE KNEE,CUSTOM FAB,USE W/LOCKING MECH","19","0","0.053","0","80",null,"1","18","0","NA","NA"],
    [2152,"2152","Carrier C","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","B4105","IN-LINE CARTRIDGE CONTAINING DIGESTIVE ENZYME(S) ENTERAL FEEDING; EA","2","0","0.5",null,"74.5",null,"0","2","0","NA","NA"],
    [2153,"2153","Carrier C","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E1028","WHEELCHAIR ACCESS, MANUAL SWINGAWAY, MULT POWER OPTION, POSITION ACCESS","2","0","0",null,"311.5",null,"0","2","0","NA","NA"],
    [2154,"2154","Carrier C","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21089","UNLISTED MAXILLOFACIAL PROSTH PROC","1","0","1",null,"98",null,"0","1","0","NA","NA"],
    [2155,"2155","Carrier C","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","K0848","PWR WHEELCHAIR, GRP 3 STNDRD, SLING/SOLID SEAT/BACK,CAP UP TO/INCL 300 LBS","1","0","1",null,"306",null,"0","1","0","NA","NA"],
    [2156,"2156","Carrier C","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A4427","OSTOMY POUCH, DRAINABLE; USE ON BARRIER W LOCKING","1","0","1","74",null,null,"1","0","0","NA","NA"],
    [2157,"2157","Carrier C","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","367","SURGERY","72","1",null,null,"77",null,"0","72",null,"NA","NA"],
    [2158,"2158","Carrier C","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","59400","FULL ROUT OBSTE CARE,VAGINAL DELIV","120","0.983",null,"4","29",null,"6","114",null,"NA","NA"],
    [2159,"2159","Carrier C","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","120","ROOM AND BOARD","13731","0.976",null,"12","37",null,"13688","43",null,"NA","NA"],
    [2160,"2160","Carrier C","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","TOTAL ABDOM HYSTERECTOMY","34","0.971",null,"3","20",null,"17","17",null,"NA","NA"],
    [2161,"2161","Carrier C","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","59510","FULL ROUT OBSTE CARE,CESAREAN DELIV","97","0.949",null,"7","42",null,"13","84",null,"NA","NA"],
    [2162,"2162","Carrier C","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43644","LAP GASTRIC BYPASS/ROUX-EN-Y","33","0.909",null,null,"72",null,"0","33",null,"NA","NA"],
    [2163,"2163","Carrier C","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44204","COLECTOMY LAP PARTIAL W/ ANAST","51","0.882",null,"4","24",null,"8","43",null,"NA","NA"],
    [2164,"2164","Carrier C","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU","26","0.654",null,"23","160",null,"2","24",null,"NA","NA"],
    [2165,"2165","Carrier C","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS","31","0.645",null,"26","76",null,"7","24",null,"NA","NA"],
    [2166,"2166","Carrier C","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","128","ROOM AND BOARD","174","0.489",null,"13","53",null,"173","1",null,"NA","NA"],
    [2167,"2167","Carrier C","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","367","SURGERY","72","1",null,null,"77",null,"0","72",null,"NA","NA"],
    [2168,"2168","Carrier C","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","32663","THORACOSCOPY SURG W/ LOBECTOMY TOTAL/SEGMEN","10","1",null,"0","33",null,"1","9",null,"NA","NA"],
    [2169,"2169","Carrier C","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","55970","INTERSEX SURG MALE TO FEMALE","9","1",null,null,"67",null,"0","9",null,"NA","NA"],
    [2170,"2170","Carrier C","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33427","VAL-PLASTY MITRAL VAL W/BYPASS RAD CONS W/WO RING","8","1",null,null,"7",null,"0","8",null,"NA","NA"],
    [2171,"2171","Carrier C","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44620","CLOSE ENTEROSTOMY LARGE/SMALL INTESTINE","10","1",null,"3","22",null,"3","7",null,"NA","NA"],
    [2172,"2172","Carrier C","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","45380","COLONOSCOPY W/ BX SINGLE/MULT","9","1",null,"1","18",null,"2","7",null,"NA","NA"],
    [2173,"2173","Carrier C","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44207","LAP SURG; COLECT PART W/ANASTOM W/COLOPROCTOST","14","1",null,"2","8",null,"10","4",null,"NA","NA"],
    [2174,"2174","Carrier C","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58210","RAD ABD HYST W/ BILAT PEL LYMPHADENECTOMY","8","1",null,"10","42",null,"4","4",null,"NA","NA"],
    [2175,"2175","Carrier C","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33361","REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH","7","1",null,"13","128",null,"6","1",null,"NA","NA"],
    [2176,"2176","Carrier C","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","762","MISC SERVICES","23","1",null,"0",null,null,"23","0",null,"NA","NA"],
    [2177,"2177","Carrier C","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","120","ROOM AND BOARD","13731","0","0","12","37",null,"13688","43","0","NA","NA"],
    [2178,"2178","Carrier C","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","50220","NEPHREC W/ PART URETERECT OPEN W/ RIB RESECT","12","0","0.083","11","37",null,"2","10","0","NA","NA"],
    [2179,"2179","Carrier C","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","128","ROOM AND BOARD","174","0","0.023","13","53",null,"173","1","0","NA","NA"],
    [2180,"2180","Carrier C","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","126","ROOM AND BOARD","239","0.992",null,"51",null,null,"239","0",null,"NA","NA"],
    [2181,"2181","Carrier C","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","900","OTHER THERAPY SERV","368","0.97",null,"24","2",null,"367","1",null,"NA","NA"],
    [2182,"2182","Carrier C","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","128","ROOM AND BOARD","378","0.968",null,"25",null,null,"378","0",null,"NA","NA"],
    [2183,"2183","Carrier C","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","ROOM AND BOARD","867","0.967",null,"11","90",null,"863","4",null,"NA","NA"],
    [2184,"2184","Carrier C","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","126","ROOM AND BOARD","239","0.992",null,"51",null,null,"239","0",null,"NA","NA"],
    [2185,"2185","Carrier C","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","900","OTHER THERAPY SERV","368","0.97",null,"24","2",null,"367","1",null,"NA","NA"],
    [2186,"2186","Carrier C","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","128","ROOM AND BOARD","378","0.968",null,"25",null,null,"378","0",null,"NA","NA"],
    [2187,"2187","Carrier C","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","ROOM AND BOARD","867","0.967",null,"11","90",null,"863","4",null,"NA","NA"],
    [2188,"2188","Carrier C","2021","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","124","ROOM AND BOARD","867","0","0.002","11","90",null,"863","4",null,"NA","NA"],
    [2189,"2189","Carrier C","2021","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","900","OTHER THERAPY SERV","368","0","0.005","24","2",null,"367","1",null,"NA","NA"],
    [2190,"2190","Carrier C","2021","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","128","ROOM AND BOARD","378","0","0.003","25",null,null,"378","0",null,"NA","NA"],
    [2191,"2191","Carrier C","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","NA","MISC SERVICES","6340","0.988",null,"11","45",null,"6339","1",null,"NA","NA"],
    [2192,"2192","Carrier C","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","76380","CT SCAN LIMITED OR LOCALIZED F/U STUDY","2458","0.978",null,"3","17",null,"691","1767",null,"NA","NA"],
    [2193,"2193","Carrier C","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","COLONOSCOPY W/ BX SINGLE/MULT","10887","0.977",null,"2","11",null,"495","10392",null,"NA","NA"],
    [2194,"2194","Carrier C","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73218","MRI, UPPER EXTREMITY","3263","0.973",null,"4","17",null,"478","2785",null,"NA","NA"],
    [2195,"2195","Carrier C","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43235","UPPER GI ENDO DX (SEP PROC)","3180","0.969",null,"2","12",null,"407","2773",null,"NA","NA"],
    [2196,"2196","Carrier C","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97124","THERA PROC 1+ AREAS EA 15 MIN MASSAGE","11498","0.959",null,"2","5",null,"259","11239",null,"NA","NA"],
    [2197,"2197","Carrier C","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS","108237","0.95",null,"7","19",null,"11935","96302",null,"NA","NA"],
    [2198,"2198","Carrier C","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97802","MED NUTRIT THRPY INIT ASSESS 15 MIN","2884","0.949",null,"8","27",null,"138","2746",null,"NA","NA"],
    [2199,"2199","Carrier C","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES","14314","0.909",null,"10","24",null,"740","13574",null,"NA","NA"],
    [2200,"2200","Carrier C","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99202","OFFICE VISIT E&M NEW PT STRAIGHTFORWARD MDM, 15-29 MINS","3472","0.885",null,"14","44",null,"549","2923",null,"NA","NA"],
    [2201,"2201","Carrier C","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","76885","ECHOGRAPHY OF INFANT HIPS, DYNAMIC","217","1",null,"105","62",null,"10","207",null,"NA","NA"],
    [2202,"2202","Carrier C","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","S9098","HOME PHOTOTHERAPY VISIT","77","1",null,null,"32",null,"0","77",null,"NA","NA"],
    [2203,"2203","Carrier C","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96160","ADM OF HEALTH RISK ASSESS PATIENT FOCUS W/SCORE","76","1",null,null,"14",null,"0","76",null,"NA","NA"],
    [2204,"2204","Carrier C","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19083","BX BREAST W/ DEVICE IMAGING PERC; FIRST LESION, W/ US GUIDE","87","1",null,"3","19",null,"21","66",null,"NA","NA"],
    [2205,"2205","Carrier C","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","11102","TANGENTIAL BIOPSY OF SKIN; FIRST LESION","75","1",null,"1","12",null,"9","66",null,"NA","NA"],
    [2206,"2206","Carrier C","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","57420","COLPOSCOPY ENTIRE VAGINA W/CERVIX IF PRESENT;","53","1",null,"0","7",null,"4","49",null,"NA","NA"],
    [2207,"2207","Carrier C","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","31622","BRONCHOSCOPY RIGID/FLEX  W/WO CELL WASH (SEP PROC)","56","1",null,"8","35",null,"18","38",null,"NA","NA"],
    [2208,"2208","Carrier C","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","20670","REM IMPLANT SUPERFICIAL (SEP PROC)","50","1",null,"1","26",null,"13","37",null,"NA","NA"],
    [2209,"2209","Carrier C","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58301","REM IUD COMPLICATED W/DEVICE (NOT HEMOSTAT)","45","1",null,"6","21",null,"8","37",null,"NA","NA"],
    [2210,"2210","Carrier C","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","65855","TRABECULOPLASTY LASER SURG 1+ SESSIONS","48","1",null,"9","22",null,"15","33",null,"NA","NA"],
    [2211,"2211","Carrier C","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","53854","TRANSURETHRAL DESTRUCT PROSTAT TISSUE;BY RADIOFRQ WATER THERMOTHERPY","7","0","0.286",null,"166",null,"0","7","0","NA","NA"],
    [2212,"2212","Carrier C","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","15830","EXCISION, EXCESS SKIN & SUBQU TISSUE, ABDOMEN","6","0","0.333","25","121",null,"1","5","0","NA","NA"],
    [2213,"2213","Carrier C","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","42145","PALATOPHARYNGOPLASTY","5","0","0.4",null,"164",null,"0","5","0","NA","NA"],
    [2214,"2214","Carrier C","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43499","UNLISTED PROC ESOPHAGUS","3","0","0.333",null,"133",null,"0","3","0","NA","NA"],
    [2215,"2215","Carrier C","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","99201.276","REF PLASTIC SURGERY","2","0","0.5",null,"63",null,"0","2","0","NA","NA"],
    [2216,"2216","Carrier C","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","J7050","NORMAL SALINE SOL INFUS 250 ML","2","0","0.5",null,"242",null,"0","2","0","NA","NA"],
    [2217,"2217","Carrier C","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","77522","PROTON TRMT, SIMPLE W/COMP","5","0","0.4","28","309",null,"4","1","0","NA","NA"],
    [2218,"2218","Carrier C","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","66183","INSERTION ANT SEG AQUEOUS DEVICE W/O EXTRAOCULAR RES EXTERNAL APPROACH","2","0","0.5","48","289",null,"1","1","0","NA","NA"],
    [2219,"2219","Carrier C","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","85390","FIBRINOLYSINS OR COAGULOPATHY","1","0","1","140",null,null,"1","0","0","NA","NA"],
    [2220,"2220","Carrier C","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","99421","ONLINE DIGITAL EM SVC, EST PT, FOR UP TO 7 DAYS, CUMULATIVE TIME; 5-10 MINS","1","0","1","25",null,null,"1","0","0","NA","NA"],
    [2221,"2221","Carrier C","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90834","PSYCHOTHERAPY 45 MIN PATIENT","1237","0.993",null,"7","19",null,"4","1233",null,"NA","NA"],
    [2222,"2222","Carrier C","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90833","PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS","124","0.992",null,"47","57",null,"1","123",null,"NA","NA"],
    [2223,"2223","Carrier C","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90836","PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS","4188","0.991",null,"18","64",null,"46","4142",null,"NA","NA"],
    [2224,"2224","Carrier C","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90853","GROUP PSYCHOTHERAPY","1067","0.99",null,"445","32",null,"13","1054",null,"NA","NA"],
    [2225,"2225","Carrier C","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96130","PSYCHOLOGICAL TESTING EVAL BY PHYS OR QUAL PROF;  FIRST HOUR","401","0.983",null,"29","44",null,"5","396",null,"NA","NA"],
    [2226,"2226","Carrier C","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY 60 MIN PATIENT","20864","0.981",null,"30","39",null,"220","20644",null,"NA","NA"],
    [2227,"2227","Carrier C","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96132","NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR","176","0.926",null,"50","105",null,"9","167",null,"NA","NA"],
    [2228,"2228","Carrier C","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES","631","0.859",null,"41","106",null,"49","582",null,"NA","NA"],
    [2229,"2229","Carrier C","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","TRANSCRANIAL MAG STIMJ TX DLVR & MGMT","167","0.832",null,null,"85",null,"0","167",null,"NA","NA"],
    [2230,"2230","Carrier C","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90792","PSYCHIATRIC DIAGNOSTIC EVALUATION W/MEDICAL SERVICES","129","0.791",null,"110","81",null,"3","126",null,"NA","NA"],
    [2231,"2231","Carrier C","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","S9480","PSYCH SVC INTENSIVE OUTPT","36","1",null,"111","101",null,"1","35",null,"NA","NA"],
    [2232,"2232","Carrier C","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96156","HEALTH BEHAVIOR ASSESSMENT, OR RE-ASSESSMENT","12","1",null,null,"26",null,"0","12",null,"NA","NA"],
    [2233,"2233","Carrier C","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90832","PSYCHOTHERAPY 30 MIN PATIENT","7","1",null,"1","132",null,"1","6",null,"NA","NA"],
    [2234,"2234","Carrier C","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97803","MED NUTRIT THRPY REASSESS PER 15 MIN","6","1",null,null,"15",null,"0","6",null,"NA","NA"],
    [2235,"2235","Carrier C","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97802","MED NUTRIT THRPY INIT ASSESS 15 MIN","5","1",null,null,"110",null,"0","5",null,"NA","NA"],
    [2236,"2236","Carrier C","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99214.101","REF MENTAL HEALTH INTERNAL (FOR MH PROVIDERS ONLY)","3","1",null,null,"220",null,"0","3",null,"NA","NA"],
    [2237,"2237","Carrier C","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96137","PSYCHOLOGICAL OR NEUROPSYCHOLOGICAL TEST BY PHYS,2 OR MORE;ADDL 30 MINS","2","1",null,null,"159",null,"0","2",null,"NA","NA"],
    [2238,"2238","Carrier C","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96158","HEALTH BEHAVIOR INTERVENTION, INDIVIDUAL, FACE-TO-FACE; INITIAL 30 MINS","2","1",null,null,"2",null,"0","2",null,"NA","NA"],
    [2239,"2239","Carrier C","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90807","IND PSYCHOTHERAPY OFFICE 45-50 MIN W/ E & M","1","1",null,null,"281",null,"0","1",null,"NA","NA"],
    [2240,"2240","Carrier C","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","126","ROOM AND BOARD","1","1",null,"0",null,null,"1","0",null,"NA","NA"],
    [2241,"2241","Carrier C","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90837","PSYCHOTHERAPY 60 MIN PATIENT","20864","0","0.001","30","39",null,"220","20644","0","NA","NA"],
    [2242,"2242","Carrier C","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90836","PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS","4188","0","0.001","18","64",null,"46","4142","0","NA","NA"],
    [2243,"2243","Carrier C","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","96132","NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR","176","0","0.006","50","105",null,"9","167","0","NA","NA"],
    [2244,"2244","Carrier C","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90792","PSYCHIATRIC DIAGNOSTIC EVALUATION W/MEDICAL SERVICES","129","0","0.031","110","82",null,"3","126","0","NA","NA"],
    [2245,"2245","Carrier C","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97153","ADAPTIVE BEHAV TX BY PROTOCOL, ADM BY TECH/SUP BY PHYS, EA 15 MINS","49","0","0.02","30","201",null,"1","48","0","NA","NA"],
    [2246,"2246","Carrier C","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","99201","OFFICE VISIT E&M NEW SELF LIMIT/MINOR 10","24","0","0.042",null,"257",null,"0","24","0","NA","NA"],
    [2247,"2247","Carrier C","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","99215","OFFICE VISIT E&M EST PT, HIGH MDM, 40-54 MINS","2","0","0.5","123","113",null,"1","1","0","NA","NA"],
    [2248,"2248","Carrier D","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS","566","0.991",null,"5","16",null,"38","528",null,"NA","NA"],
    [2249,"2249","Carrier D","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4230","INFUS SET INSULIN PUMP NON NEEDLE","88","0.989",null,"3","59",null,"73","15",null,"NA","NA"],
    [2250,"2250","Carrier D","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97802","MED NUTRIT THRPY INIT ASSESS 15 MIN","165","0.988",null,"3","22",null,"8","157",null,"NA","NA"],
    [2251,"2251","Carrier D","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A5500","DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE","73","0.986",null,"1","38",null,"1","72",null,"NA","NA"],
    [2252,"2252","Carrier D","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J9035","INJ BEVACIZUMAB 10 MG","64","0.984",null,"9","28",null,"15","49",null,"NA","NA"],
    [2253,"2253","Carrier D","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","120","ROOM AND BOARD","44","0.977",null,"14",null,null,"44","0",null,"NA","NA"],
    [2254,"2254","Carrier D","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J0178","INJ AFLIBERCEPT (EYLEA) 1 MG","53","0.925",null,"15","47",null,"13","40",null,"NA","NA"],
    [2255,"2255","Carrier D","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A9276","SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D","293","0.802",null,"8","114",null,"163","130",null,"NA","NA"],
    [2256,"2256","Carrier D","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0784","EXTERN AMBUL INSULIN INFUS PUMP","85","0.741",null,"29","129",null,"8","77",null,"NA","NA"],
    [2257,"2257","Carrier D","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","K0553","SUPPLY ALLOWANCE FOR THERAPEUTIC CONTINUOUS GLUCOSE MONITOR (CGM), INCLUDES ALL SUPPLIES AND ACCESSORIES","391","0.706",null,"12","97",null,"212","179",null,"NA","NA"],
    [2258,"2258","Carrier D","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","G0108","DIAB MGMT TRN PER INDIV","26","1",null,"3","38",null,"5","21",null,"NA","NA"],
    [2259,"2259","Carrier D","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99202","OFFICE VISIT E&M NEW PT STRAIGHTFORWARD MDM, 15-29 MINS","16","1",null,"1","24",null,"2","14",null,"NA","NA"],
    [2260,"2260","Carrier D","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95249","GLUCOSE MONITORING 72 HRS, PT PROVIDED EQUIP, TRAINING AND RECORDING","10","1",null,null,"27",null,"0","10",null,"NA","NA"],
    [2261,"2261","Carrier D","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","NA","OTHER THERAPY SERV","10","1",null,"0","23",null,"1","9",null,"NA","NA"],
    [2262,"2262","Carrier D","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99201","OFFICE VISIT E&M NEW SELF LIMIT/MINOR 10","9","1",null,null,"46",null,"0","9",null,"NA","NA"],
    [2263,"2263","Carrier D","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95250","GLUCOSE MONITORING 72 HRS MD OR OTH QUAL, EQUIP PROV, REC/STORAGE GL","7","1",null,null,"17",null,"0","7",null,"NA","NA"],
    [2264,"2264","Carrier D","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","11719","TRIMMING NONDYSTROPHIC NAILS ANY NUMBER","6","1",null,null,"49",null,"0","6",null,"NA","NA"],
    [2265,"2265","Carrier D","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A5513","FOR DIAB ONLY MX DNSITY INSRT CSTM MOLD CSTM EA","6","1",null,null,"29",null,"0","6",null,"NA","NA"],
    [2266,"2266","Carrier D","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A9274","EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA","12","1",null,"4","61",null,"9","3",null,"NA","NA"],
    [2267,"2267","Carrier D","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","NA","MISC SERVICES","17","1",null,"16",null,null,"17","0",null,"NA","NA"],
    [2268,"2268","Carrier D","2021","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","K0553","SUPPLY ALLOWANCE FOR THERAPEUTIC CONTINUOUS GLUCOSE MONITOR (CGM), INCLUDES ALL SUPPLIES AND ACCESSORIES","391","0","0.01","12","97",null,"212","179","0","NA","NA"],
    [2269,"2269","Carrier D","2021","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A9276","SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D","293","0","0.01","8","114",null,"163","130","0","NA","NA"],
    [2270,"2270","Carrier D","2021","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0784","EXTERN AMBUL INSULIN INFUS PUMP","85","0","0.047","29","129",null,"8","77","0","NA","NA"],
    [2271,"2271","Carrier D","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L3908","WRIST SPLINT W/WO COCK-UP","235","0.996",null,null,"15",null,"0","235",null,"NA","NA"],
    [2272,"2272","Carrier D","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0603","DME ELECTRIC BREAST PUMP KIT PURCHASE","731","0.995",null,"1","45",null,"692","39",null,"NA","NA"],
    [2273,"2273","Carrier D","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0114","CRUTCHES METAL UNDERARM PAIR","364","0.992",null,"0","17",null,"3","361",null,"NA","NA"],
    [2274,"2274","Carrier D","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L4361","PNEUMATIC, WALKING BOOT","335","0.991",null,null,"15",null,"0","335",null,"NA","NA"],
    [2275,"2275","Carrier D","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A7034","NASAL APPLICATION DEVICE","877","0.986",null,"2","21",null,"28","849",null,"NA","NA"],
    [2276,"2276","Carrier D","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L3660","SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND","281","0.986",null,null,"21",null,"0","281",null,"NA","NA"],
    [2277,"2277","Carrier D","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0439","STATIONARY LIQUID 02","205","0.981",null,"5","38",null,"88","117",null,"NA","NA"],
    [2278,"2278","Carrier D","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0143","WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT","196","0.98",null,"3","35",null,"97","99",null,"NA","NA"],
    [2279,"2279","Carrier D","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0604","DME ELECTRIC BREAST PUMP KIT RENTAL","293","0.966",null,"2","33",null,"138","155",null,"NA","NA"],
    [2280,"2280","Carrier D","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0601","CPAP DEVICE","1843","0.96",null,"3","40",null,"357","1486",null,"NA","NA"],
    [2281,"2281","Carrier D","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L1833","WARRIOR WRAP WITH HINGES/FLEX STOP","97","1",null,"0","13",null,"1","96",null,"NA","NA"],
    [2282,"2282","Carrier D","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L3670","SHLDER IMMOB W/ABDUCTION PILLOW","91","1",null,"1","16",null,"2","89",null,"NA","NA"],
    [2283,"2283","Carrier D","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L1830","KO IMMOBILIZER CANVAS LONGIT","78","1",null,null,"20",null,"0","78",null,"NA","NA"],
    [2284,"2284","Carrier D","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L1812","KNEE ORTHOSIS, ELAST W/JOINTS, PREFAB,OFF-THE-SHELF","44","1",null,null,"17",null,"0","44",null,"NA","NA"],
    [2285,"2285","Carrier D","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L4205","REPAIR ORTHOTIC DEV LABOR PER 15 MIN","45","1",null,"5","40",null,"4","41",null,"NA","NA"],
    [2286,"2286","Carrier D","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L4387","WALKING BOOT, PREFAB, NONPNEUMATIC","33","1",null,null,"12",null,"0","33",null,"NA","NA"],
    [2287,"2287","Carrier D","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0570","DME NEBULIZE HOME/PORTABLE","49","1",null,"3","27",null,"22","27",null,"NA","NA"],
    [2288,"2288","Carrier D","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","V2624","POLISHING ARTIFICAL EYE","24","1",null,null,"41",null,"0","24",null,"NA","NA"],
    [2289,"2289","Carrier D","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L0650","LSO SAGITTAL-CORONAL CONTROL, SACROCOCCYG JUCT TO T-9 VERT, PREFAB","22","1",null,null,"29",null,"0","22",null,"NA","NA"],
    [2290,"2290","Carrier D","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4388","DRAINABLE PCH W EX WEAR BARR","69","1",null,"3","29",null,"55","14",null,"NA","NA"],
    [2291,"2291","Carrier D","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0601","CPAP DEVICE","1843","0","0.001","3","40",null,"357","1486","0","NA","NA"],
    [2292,"2292","Carrier D","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0114","CRUTCHES METAL UNDERARM PAIR","364","0","0.003","0","17",null,"3","361","0","NA","NA"],
    [2293,"2293","Carrier D","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","K0739","REPAIR OR NONROUTN SVC DME OTHER THAN O2 EQUIP,REQ TECH SKILL,PER 15 MINS","52","0","0.019","19","119",null,"14","38","0","NA","NA"],
    [2294,"2294","Carrier D","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0760","OSTEOGEN U/S STIMLTOR","31","0","0.032","24","149",null,"7","24","0","NA","NA"],
    [2295,"2295","Carrier D","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0652","PNEUMATIC COMPRESS SEGMNT W GRAD","21","0","0.048","114","188",null,"1","20","0","NA","NA"],
    [2296,"2296","Carrier D","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","K0823","POWER WC, GROUP 2 STD, CAPTAINS, PT WT UP TO/INCLUDE 300 LBS","3","0","0.333",null,"138",null,"0","3","0","NA","NA"],
    [2297,"2297","Carrier D","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E8000","GAIT TRAINER, PEDIATRIC SIZE, POSTERIOR SUPPORT INCL ALL ACCESSORIES & COMP","1","0","1",null,"100",null,"0","1","0","NA","NA"],
    [2298,"2298","Carrier D","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","59400","FULL ROUT OBSTE CARE,VAGINAL DELIV","23","1",null,"0","78",null,"3","20",null,"NA","NA"],
    [2299,"2299","Carrier D","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","367","SURGERY","12","1",null,null,"83",null,"0","12",null,"NA","NA"],
    [2300,"2300","Carrier D","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96416","CHEMO ADMIN IV INFUS >8 HRS W/PORT/IMPLANTED PUMP","12","1",null,"12","32",null,"2","10",null,"NA","NA"],
    [2301,"2301","Carrier D","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","TOTAL ABDOM HYSTERECTOMY","13","1",null,"5","16",null,"4","9",null,"NA","NA"],
    [2302,"2302","Carrier D","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","120","ROOM AND BOARD","5942","0.969",null,"17","72",null,"5906","36",null,"NA","NA"],
    [2303,"2303","Carrier D","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","59510","FULL ROUT OBSTE CARE,CESAREAN DELIV","31","0.968",null,"1","22",null,"8","23",null,"NA","NA"],
    [2304,"2304","Carrier D","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU","25","0.88",null,null,"187",null,"0","25",null,"NA","NA"],
    [2305,"2305","Carrier D","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43644","LAP GASTRIC BYPASS/ROUX-EN-Y","22","0.864",null,null,"72",null,"0","22",null,"NA","NA"],
    [2306,"2306","Carrier D","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43775","LAP SLEEVE GASTRECTOMY","22","0.546",null,null,"109",null,"0","22",null,"NA","NA"],
    [2307,"2307","Carrier D","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","128","ROOM AND BOARD","72","0.361",null,"27",null,null,"72","0",null,"NA","NA"],
    [2308,"2308","Carrier D","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","59400","FULL ROUT OBSTE CARE,VAGINAL DELIV","23","1",null,"1","79",null,"3","20",null,"NA","NA"],
    [2309,"2309","Carrier D","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","367","SURGERY","12","1",null,null,"83",null,"0","12",null,"NA","NA"],
    [2310,"2310","Carrier D","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96416","CHEMO ADMIN IV INFUS >8 HRS W/PORT/IMPLANTED PUMP","12","1",null,"12","32",null,"2","10",null,"NA","NA"],
    [2311,"2311","Carrier D","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58150","TOTAL ABDOM HYSTERECTOMY","13","1",null,"5","16",null,"4","9",null,"NA","NA"],
    [2312,"2312","Carrier D","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44207","LAP SURG; COLECT PART W/ANASTOM W/COLOPROCTOST","11","1",null,"7","41",null,"2","9",null,"NA","NA"],
    [2313,"2313","Carrier D","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44204","COLECTOMY LAP PARTIAL W/ ANAST","11","1",null,"0","3",null,"3","8",null,"NA","NA"],
    [2314,"2314","Carrier D","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33405","REPLACE PROSTH AORTIC VALVE, OPEN, W/BYPASS NON-HOMO","9","1",null,"3","17",null,"1","8",null,"NA","NA"],
    [2315,"2315","Carrier D","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","32650","THORACOSCOPY SURG W/ PLEURODESIS (MECHANICA","10","1",null,"1","2",null,"3","7",null,"NA","NA"],
    [2316,"2316","Carrier D","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19364","BREAST RECONSTRUCTION; WITH FREE FLAP","9","1",null,"10","100",null,"2","7",null,"NA","NA"],
    [2317,"2317","Carrier D","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99221","INITIAL HOSPITAL CARE,LEVL I","9","1",null,"1","23",null,"3","6",null,"NA","NA"],
    [2318,"2318","Carrier D","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","120","ROOM AND BOARD","5942","0","0","17","72",null,"5906","36","0","NA","NA"],
    [2319,"2319","Carrier D","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43775","LAP SLEEVE GASTRECTOMY","22","0","0.091",null,"109",null,"0","22","0","NA","NA"],
    [2320,"2320","Carrier D","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","128","ROOM AND BOARD","72","0","0.042","27",null,null,"72","0","0","NA","NA"],
    [2321,"2321","Carrier D","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","912","OTHER THERAPY SERV","1","1",null,null,"10",null,"0","1",null,"NA","NA"],
    [2322,"2322","Carrier D","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","900","OTHER THERAPY SERV","237","0.987",null,"13",null,null,"237","0",null,"NA","NA"],
    [2323,"2323","Carrier D","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","ROOM AND BOARD","445","0.984",null,"9",null,null,"445","0",null,"NA","NA"],
    [2324,"2324","Carrier D","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","126","ROOM AND BOARD","146","0.98",null,"28",null,null,"146","0",null,"NA","NA"],
    [2325,"2325","Carrier D","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","128","ROOM AND BOARD","373","0.979",null,"51",null,null,"373","0",null,"NA","NA"],
    [2326,"2326","Carrier D","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","912","OTHER THERAPY SERV","1","1",null,null,"10",null,"0","1",null,"NA","NA"],
    [2327,"2327","Carrier D","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","900","OTHER THERAPY SERV","237","0.987",null,"13",null,null,"237","0",null,"NA","NA"],
    [2328,"2328","Carrier D","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","ROOM AND BOARD","445","0.984",null,"9",null,null,"445","0",null,"NA","NA"],
    [2329,"2329","Carrier D","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","126","ROOM AND BOARD","146","0.98",null,"28",null,null,"146","0",null,"NA","NA"],
    [2330,"2330","Carrier D","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","128","ROOM AND BOARD","373","0.979",null,"51",null,null,"373","0",null,"NA","NA"],
    [2331,"2331","Carrier D","2021","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","124","ROOM AND BOARD","445","0","0.002","9",null,null,"445","0",null,"NA","NA"],
    [2332,"2332","Carrier D","2021","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","128","ROOM AND BOARD","373","0","0.003","51",null,null,"373","0",null,"NA","NA"],
    [2333,"2333","Carrier D","2021","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","900","OTHER THERAPY SERV","237","0","0.004","13",null,null,"237","0",null,"NA","NA"],
    [2334,"2334","Carrier D","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","76380","CT SCAN LIMITED OR LOCALIZED F/U STUDY","1369","0.995",null,"2","13",null,"437","932",null,"NA","NA"],
    [2335,"2335","Carrier D","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","COLONOSCOPY W/ BX SINGLE/MULT","2194","0.993",null,"7","13",null,"222","1972",null,"NA","NA"],
    [2336,"2336","Carrier D","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73218","MRI, UPPER EXTREMITY","1862","0.99",null,"3","14",null,"315","1547",null,"NA","NA"],
    [2337,"2337","Carrier D","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS","24318","0.988",null,"5","19",null,"2303","22015",null,"NA","NA"],
    [2338,"2338","Carrier D","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97124","THERA PROC 1+ AREAS EA 15 MIN MASSAGE","1760","0.983",null,"34","11",null,"38","1722",null,"NA","NA"],
    [2339,"2339","Carrier D","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","762","MISC SERVICES","2761","0.982",null,"15",null,null,"2761","0",null,"NA","NA"],
    [2340,"2340","Carrier D","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES","2679","0.981",null,"6","15",null,"114","2565",null,"NA","NA"],
    [2341,"2341","Carrier D","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99202","OFFICE VISIT E&M NEW PT STRAIGHTFORWARD MDM, 15-29 MINS","663","0.977",null,"6","31",null,"90","573",null,"NA","NA"],
    [2342,"2342","Carrier D","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71250","COMPUTED TOMOGRAPHY, THORAX, DIAGNOSTIC; W/O CONTRAST MATERIAL","651","0.836",null,"12","47",null,"136","515",null,"NA","NA"],
    [2343,"2343","Carrier D","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72158","MRI LUMBAR W/WO CONTRST SPINE","884","0.396",null,"26","120",null,"149","735",null,"NA","NA"],
    [2344,"2344","Carrier D","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93241","EXT ECG RECORD >48 HRS UP TO 7 DAYS BY CONT RHYTHM, INCL REC/SCAN W/INTERP & REP","142","1",null,"1","22",null,"9","133",null,"NA","NA"],
    [2345,"2345","Carrier D","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","94010","SPIROMETRY W/GRAPHIC RECORD/VITAL CAPACITY/FLOW","121","1",null,"7","11",null,"9","112",null,"NA","NA"],
    [2346,"2346","Carrier D","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","66984","EXTRACAPSULAR CAT REM W/ INSERT LENS PROSTHESIS; W/O ECP","127","1",null,"1","31",null,"16","111",null,"NA","NA"],
    [2347,"2347","Carrier D","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","17311","MOHS HD, NCK, HND, FEET, GEN 1ST STGE UP TO 5 BLCK","134","1",null,"2","14",null,"34","100",null,"NA","NA"],
    [2348,"2348","Carrier D","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93797","OPEN CARDIAC REHAB W/O CONT EKG MONITORING","84","1",null,"13","122",null,"7","77",null,"NA","NA"],
    [2349,"2349","Carrier D","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93242","EXT ECG RECORD >48 HRS UP TO 7 DAYS BY CONT RHYTHM RECORDING/STORAGE","71","1",null,"11","36",null,"5","66",null,"NA","NA"],
    [2350,"2350","Carrier D","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","26540","REPAIR COLLAT LIGAMENT METACARPOPHALANGEAL/IP JNT","75","1",null,"9","23",null,"19","56",null,"NA","NA"],
    [2351,"2351","Carrier D","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93270","EVENT MONITOR - HOOKUP RECORD & DISCON ONLY","85","1",null,"3","13",null,"31","54",null,"NA","NA"],
    [2352,"2352","Carrier D","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97597","DEBRIDEMENT, OPEN WOUND, ASSESSMENT, ONGOING CARE, PER SESSION,  FIRST 20 SQ CM OR LESS","70","1",null,"2","21",null,"22","48",null,"NA","NA"],
    [2353,"2353","Carrier D","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77412","RAD TX DELIVERY CUSTOM BLOCK 5 MEV","90","1",null,"3","16",null,"46","44",null,"NA","NA"],
    [2354,"2354","Carrier D","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43644","LAP GASTRIC BYPASS/ROUX-EN-Y","4","0","0.25",null,"171",null,"0","4","0","NA","NA"],
    [2355,"2355","Carrier D","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","77522","PROTON TRMT, SIMPLE W/COMP","4","0","0.25","98","131",null,"1","3","0","NA","NA"],
    [2356,"2356","Carrier D","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","29916","ARTHROSCOPY HIP W/LABRAL REPAIR","4","0","0.25","4","77",null,"1","3","0","NA","NA"],
    [2357,"2357","Carrier D","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","53854","TRANSURETHRAL DESTRUCT PROSTAT TISSUE;BY RADIOFRQ WATER THERMOTHERPY","3","0","0.333",null,"87",null,"0","3","0","NA","NA"],
    [2358,"2358","Carrier D","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","11606","EXC MALIG LES TRUNK ARMS/LEGS >4.0 CM","4","0","0.25","35","82",null,"2","2","0","NA","NA"],
    [2359,"2359","Carrier D","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","67908","REP BLEPHAROPTOSIS CONJU","2","0","0.5",null,"202",null,"0","2","0","NA","NA"],
    [2360,"2360","Carrier D","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","77280","THERAPEUTIC RADIOLOGY FIELD SIMPLE","3","0","0.333","2","142",null,"2","1","0","NA","NA"],
    [2361,"2361","Carrier D","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43210","EGD, FLEX, TRNSORAL; W EG FUNDOPLASTY, PARTIAL /COMPLETE, INC DUODENOSCOSPY","1","0","1",null,"105",null,"0","1","0","NA","NA"],
    [2362,"2362","Carrier D","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27299","UNLISTED PROC PELVIS/HIP JNT","1","0","1",null,"125",null,"0","1","0","NA","NA"],
    [2363,"2363","Carrier D","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","88381","MICRODISSECTION; MANUAL","1","0","1","44",null,null,"1","0","0","NA","NA"],
    [2364,"2364","Carrier D","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90853","GROUP PSYCHOTHERAPY","153","1",null,null,"26",null,"0","153",null,"NA","NA"],
    [2365,"2365","Carrier D","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90834","PSYCHOTHERAPY 45 MIN PATIENT","248","0.992",null,null,"6",null,"0","248",null,"NA","NA"],
    [2366,"2366","Carrier D","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90836","PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS","641","0.988",null,"13","48",null,"8","633",null,"NA","NA"],
    [2367,"2367","Carrier D","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY 60 MIN PATIENT","2794","0.987",null,"8","25",null,"38","2756",null,"NA","NA"],
    [2368,"2368","Carrier D","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96130","PSYCHOLOGICAL TESTING EVAL BY PHYS OR QUAL PROF;  FIRST HOUR","64","0.953",null,"1","65",null,"2","62",null,"NA","NA"],
    [2369,"2369","Carrier D","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96132","NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR","81","0.926",null,"13","199",null,"4","77",null,"NA","NA"],
    [2370,"2370","Carrier D","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS","23","0.913",null,null,"139",null,"1","22",null,"NA","NA"],
    [2371,"2371","Carrier D","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90792","PSYCHIATRIC DIAGNOSTIC EVALUATION W/MEDICAL SERVICES","26","0.885",null,null,"96",null,"0","26",null,"NA","NA"],
    [2372,"2372","Carrier D","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES","120","0.883",null,"44","127",null,"12","108",null,"NA","NA"],
    [2373,"2373","Carrier D","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","TRANSCRANIAL MAG STIMJ TX DLVR & MGMT","77","0.831",null,null,"86",null,"0","77",null,"NA","NA"],
    [2374,"2374","Carrier D","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90853","GROUP PSYCHOTHERAPY","153","1",null,null,"26",null,"0","153",null,"NA","NA"],
    [2375,"2375","Carrier D","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90870","ECT (W/ MONITORING) SINGLE SEIZURE","13","1",null,null,"109",null,"0","13",null,"NA","NA"],
    [2376,"2376","Carrier D","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H0020","ALCOHOL AND/OR DRUG SERVICES","13","1",null,null,"106",null,"0","13",null,"NA","NA"],
    [2377,"2377","Carrier D","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90833","PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS","7","1",null,null,"14",null,"0","7",null,"NA","NA"],
    [2378,"2378","Carrier D","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90806.102","REF MENTAL HEALTH EXTERNAL","5","1",null,null,"63",null,"0","5",null,"NA","NA"],
    [2379,"2379","Carrier D","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96156","HEALTH BEHAVIOR ASSESSMENT, OR RE-ASSESSMENT","2","1",null,null,"65",null,"0","2",null,"NA","NA"],
    [2380,"2380","Carrier D","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90832","PSYCHOTHERAPY 30 MIN PATIENT","1","1",null,null,"317",null,"0","1",null,"NA","NA"],
    [2381,"2381","Carrier D","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96116","NEUROBEHAVIORAL STATUS EXAM, PHYS OR QUAL PROF, FIRST HOUR","1","1",null,null,"308",null,"0","1",null,"NA","NA"],
    [2382,"2382","Carrier D","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96138","PSYCHOLOGICAL OR NEUROPSYCHOLOGICAL TEST BY TECH,2 OR MORE;FIRST 30 MINS","1","1",null,null,"74",null,"0","1",null,"NA","NA"],
    [2383,"2383","Carrier D","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96159","HEALTH BEHAVIOR INTERVENTION, INDIVIDUAL, FACE-TO-FACE; EA ADDL 15 MINS","1","1",null,null,"8",null,"0","1",null,"NA","NA"],
    [2384,"2384","Carrier D","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90837","PSYCHOTHERAPY 60 MIN PATIENT","2794","0","0","8","25",null,"38","2756","0","NA","NA"],
    [2385,"2385","Carrier D","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","96132","NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR","81","0","0.025","13","199",null,"4","77","0","NA","NA"],
    [2386,"2386","Carrier D","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90868","TRANSCRANIAL MAG STIMJ TX DLVR & MGMT","77","0","0.039",null,"86",null,"0","77","0","NA","NA"],
    [2387,"2387","Carrier D","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","S9480","PSYCH SVC INTENSIVE OUTPT","6","0","0.167","1","358",null,"1","5","0","NA","NA"],
    [2388,"2388","Carrier D","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","G2082","VISIT FOR EVAL/MGMT EST PT REQ SUPERVISOIN MD, UP TO 56 MG OF ESKETAMINE NASAL, SELF ADMIM","5","0","0.2",null,"74",null,"0","5","0","NA","NA"],
    [2389,"2389","Carrier E","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4230","INFUS INSULIN PUMP NON NEEDL","37","1",null,"93.8","55.3",null,"1","36",null,"NA","NA"],
    [2390,"2390","Carrier E","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4232","SYRINGE W/NEEDLE INSULIN 3CC","21","1",null,null,"97.1",null,null,"21",null,"NA","NA"],
    [2391,"2391","Carrier E","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","EXT AMB INFUSN PUMP INSULIN","19","1",null,null,"114.6",null,null,"19",null,"NA","NA"],
    [2392,"2392","Carrier E","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9276","SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D","6","1",null,null,"28.9",null,null,"6",null,"NA","NA"],
    [2393,"2393","Carrier E","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A6257","TRANSPARENT FILM STERL 16 SQ IN OR LESS EA DRESS","1","1",null,null,"23.9",null,null,"1",null,"NA","NA"],
    [2394,"2394","Carrier E","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0553","SUPPLY ALLOW FOR TX CGM1 MO SPL = 1 U OF SERVICE","158","0.96",null,null,"27.7",null,null,"158",null,"NA","NA"],
    [2395,"2395","Carrier E","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0554","RECEIVER DEDICATED FOR USE W/THERAPEUTIC GCM SYS","36","0.81",null,null,"35.4","33.7",null,"33","3","NA","NA"],
    [2396,"2396","Carrier E","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95250","Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous","51","0.33",null,null,"27.4",null,null,"51",null,"NA","NA"],
    [2397,"2397","Carrier E","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4230","INFUS INSULIN PUMP NON NEEDL","37","1",null,"93.8","55.3",null,"1","36",null,"NA","NA"],
    [2398,"2398","Carrier E","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4232","SYRINGE W/NEEDLE INSULIN 3CC","21","1",null,null,"97.1",null,null,"21",null,"NA","NA"],
    [2399,"2399","Carrier E","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","EXT AMB INFUSN PUMP INSULIN","19","1",null,null,"114.6",null,null,"19",null,"NA","NA"],
    [2400,"2400","Carrier E","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9276","SENSOR;INVSV DISP INTRSTL CONT GLU MON SYS 1U=1D","6","1",null,null,"28.9",null,null,"6",null,"NA","NA"],
    [2401,"2401","Carrier E","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A6257","TRANSPARENT FILM STERL 16 SQ IN OR LESS EA DRESS","1","1",null,null,"23.9",null,null,"1",null,"NA","NA"],
    [2402,"2402","Carrier E","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0553","SUPPLY ALLOW FOR TX CGM1 MO SPL = 1 U OF SERVICE","158","0.96",null,null,"27.7",null,null,"158",null,"NA","NA"],
    [2403,"2403","Carrier E","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0554","RECEIVER DEDICATED FOR USE W/THERAPEUTIC GCM SYS","36","0.81",null,null,"35.4","33.7",null,"33","3","NA","NA"],
    [2404,"2404","Carrier E","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95250","Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous","51","0.33",null,null,"27.4",null,null,"51",null,"NA","NA"],
    [2405,"2405","Carrier E","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0570","NEBULIZER WITH COMPRESSOR","78","1",null,"9.5","8.7","74.3","11","66","1","NA","NA"],
    [2406,"2406","Carrier E","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0202","PHOTOTHERAPY LIGHT W/ PHOTOM","34","1",null,"0.6","26.5","22.5","4","28","2","NA","NA"],
    [2407,"2407","Carrier E","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","B9002","ENTERAL NUTRITION INFUSION PUMP ANY TYPE","42","1",null,null,"16","22.9",null,"33","9","NA","NA"],
    [2408,"2408","Carrier E","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0143","WALKER FOLDING WHEELED W/O S","161","0.99",null,"0.4","14.5","13.2","1","156","4","NA","NA"],
    [2409,"2409","Carrier E","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1390","OXYGEN CONCENTRATOR","191","0.98",null,"5.8","26.8","17.5","22","145","24","NA","NA"],
    [2410,"2410","Carrier E","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0001","STANDARD WHEELCHAIR","34","0.97",null,null,"35.7","0",null,"32","2","NA","NA"],
    [2411,"2411","Carrier E","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A5500","DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE","78","0.97",null,null,"52.1","33.2",null,"44","34","NA","NA"],
    [2412,"2412","Carrier E","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0730","TENS DEVICE 4/MORE LEADS MULTI NERVE STIMULATION","84","0.94",null,null,"45.7","52.6",null,"82","2","NA","NA"],
    [2413,"2413","Carrier E","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0604","BREAST PUMP HEAVY DUTY HOSP GRADE PISTON OP","141","0.92",null,"3.6","24.4","36","14","125","2","NA","NA"],
    [2414,"2414","Carrier E","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A6530","GRADIENT COMPRESSION STK BELW KNEE 18-30 MMHG EA","38","0.63",null,null,"117.7","35.3",null,"29","9","NA","NA"],
    [2415,"2415","Carrier E","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0570","NEBULIZER WITH COMPRESSOR","78","1",null,"9.5","8.7","74.3","11","66","1","NA","NA"],
    [2416,"2416","Carrier E","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0691","UV LIGHT TX SYS BULB/LAMP TIMER; TX 2 SQ FT/LESS","26","1",null,null,"20.1","30.9",null,"25","1","NA","NA"],
    [2417,"2417","Carrier E","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A7005","NONDISPOSABLE NEBULIZER SET","22","1",null,"0.7","21","0.1","1","20","1","NA","NA"],
    [2418,"2418","Carrier E","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0202","PHOTOTHERAPY LIGHT W/ PHOTOM","34","1",null,"0.6","26.5","22.5","4","28","2","NA","NA"],
    [2419,"2419","Carrier E","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2402","NEG PRESS WOUND THERAPY PUMP","26","1",null,"3","13.9","28","3","21","2","NA","NA"],
    [2420,"2420","Carrier E","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8015","EXT BREASTPROSTHESIS GARMENT","18","1",null,null,"62.7","20.2",null,"14","4","NA","NA"],
    [2421,"2421","Carrier E","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","B9002","ENTERAL NUTRITION INFUSION PUMP ANY TYPE","42","1",null,null,"16","22.9",null,"33","9","NA","NA"],
    [2422,"2422","Carrier E","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L1846","KNEE ORTHOSIS DOUBLE UPRIGHT THIGH & CALF CUSTOM","19","1",null,null,"291.8","57.9",null,"2","17","NA","NA"],
    [2423,"2423","Carrier E","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A6212","FOAM DRESS STERL PAD SZ 16 SQ/> W/ADHES BORDR EA","26","1",null,null,"65.7",null,null,"26",null,"NA","NA"],
    [2424,"2424","Carrier E","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0693","UV LT TX SYS PANL W/BULBS/LAMPS TIMER 6 FT PANEL","21","1",null,null,"19.9",null,null,"21",null,"NA","NA"],
    [2425,"2425","Carrier E","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","A6530","GRADIENT COMPRESSION STK BELW KNEE 18-30 MMHG EA","37","0","0.03",null,"92.3",null,null,"37",null,"NA","NA"],
    [2426,"2426","Carrier E","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","D0303","D0303NON-TRAUMATIC BRAIN INJURY WITH MOTOR >26.15 & MOTOR <35.05.,COMORBIDITY IN TIER 3","1","1",null,null,null,"0",null,null,"1","NA","NA"],
    [2427,"2427","Carrier E","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","50360","RENAL ALLOTRANSPLANTATION, IMPLANTATION OF GRAFT","3","1",null,null,"20.2","35.1",null,"1","2","NA","NA"],
    [2428,"2428","Carrier E","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99223","INITIAL HOSPITAL CARE/DAY 70 MINUTES","2","1",null,null,"0.1",null,null,"2",null,"NA","NA"],
    [2429,"2429","Carrier E","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","D0106","D0106STROKE WITH MOTOR >30.05 & MOTOR <34.25.,COMORBIDITY IN TIER 3","1","1",null,null,"25.2",null,null,"1",null,"NA","NA"],
    [2430,"2430","Carrier E","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","D0102","D0102STROKE WITH MOTOR >44.45 & MOTOR <51.05 & COGNITIVE >18.5.,COMORBIDITY IN TIER 3","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [2431,"2431","Carrier E","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","C0302","C0302NON-TRAUMATIC BRAIN INJURY WITH MOTOR >35.05 & MOTOR <41.05.,COMORBIDITY IN TIER 2","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [2432,"2432","Carrier E","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A0502","A0502NON-TRAUMATIC SPINAL CORD INJURY WITH MOTOR >40.15 & MOTOR <51.35.,WITHOUT COMORBI","1","1",null,null,"0.1",null,null,"1",null,"NA","NA"],
    [2433,"2433","Carrier E","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A0302","AMBULANCE BASIC EMERGENY ALL","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [2434,"2434","Carrier E","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A0301","A0301NON-TRAUMATIC BRAIN INJURY WITH MOTOR >41.05.,WITHOUT COMORBIDITIES","1","1",null,null,"2",null,null,"1",null,"NA","NA"],
    [2435,"2435","Carrier E","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A0106","A0106STROKE WITH MOTOR >30.05 & MOTOR <34.25.,WITHOUT COMORBIDITIES","1","1",null,null,"52.1",null,null,"1",null,"NA","NA"],
    [2436,"2436","Carrier E","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","D0303","D0303NON-TRAUMATIC BRAIN INJURY WITH MOTOR >26.15 & MOTOR <35.05.,COMORBIDITY IN TIER 3","1","1",null,null,null,"0",null,null,"1","NA","NA"],
    [2437,"2437","Carrier E","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","50360","RENAL ALLOTRANSPLANTATION, IMPLANTATION OF GRAFT","3","1",null,null,"20.2","35.1",null,"1","2","NA","NA"],
    [2438,"2438","Carrier E","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99223","INITIAL HOSPITAL CARE/DAY 70 MINUTES","2","1",null,null,"0.1",null,null,"2",null,"NA","NA"],
    [2439,"2439","Carrier E","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","D0106","D0106STROKE WITH MOTOR >30.05 & MOTOR <34.25.,COMORBIDITY IN TIER 3","1","1",null,null,"25.2",null,null,"1",null,"NA","NA"],
    [2440,"2440","Carrier E","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","D0102","D0102STROKE WITH MOTOR >44.45 & MOTOR <51.05 & COGNITIVE >18.5.,COMORBIDITY IN TIER 3","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [2441,"2441","Carrier E","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","C0302","C0302NON-TRAUMATIC BRAIN INJURY WITH MOTOR >35.05 & MOTOR <41.05.,COMORBIDITY IN TIER 2","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [2442,"2442","Carrier E","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A0502","A0502NON-TRAUMATIC SPINAL CORD INJURY WITH MOTOR >40.15 & MOTOR <51.35.,WITHOUT COMORBI","1","1",null,null,"0.1",null,null,"1",null,"NA","NA"],
    [2443,"2443","Carrier E","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A0302","AMBULANCE BASIC EMERGENY ALL","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [2444,"2444","Carrier E","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A0301","A0301NON-TRAUMATIC BRAIN INJURY WITH MOTOR >41.05.,WITHOUT COMORBIDITIES","1","1",null,null,"2",null,null,"1",null,"NA","NA"],
    [2445,"2445","Carrier E","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A0106","A0106STROKE WITH MOTOR >30.05 & MOTOR <34.25.,WITHOUT COMORBIDITIES","1","1",null,null,"52.1",null,null,"1",null,"NA","NA"],
    [2446,"2446","Carrier E","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99238","HOSPITAL DISCHARGE DAY MANAGEMENT 30 MIN/<","1","1",null,null,null,"92.6",null,null,"1","NA","NA"],
    [2447,"2447","Carrier E","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","21126","REFERRAL PORTLAND, REFERRALS EXTERNAL","1","1",null,null,null,"30.9",null,null,"1","NA","NA"],
    [2448,"2448","Carrier E","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","128","ROOM & BOARD, SEMIPRIVATE TWO-BED - REHABILITATION","3","1",null,null,"19.2","53.4",null,"2","1","NA","NA"],
    [2449,"2449","Carrier E","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","126","ROOM & BOARD, SEMIPRIVATE TWO-BED - DETOXIFICATION","9","1",null,null,"80.2","49.1",null,"5","4","NA","NA"],
    [2450,"2450","Carrier E","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","194","SUBACUTE CARE, LEVEL IV","7","1",null,null,null,"45.5",null,null,"7","NA","NA"],
    [2451,"2451","Carrier E","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1001","BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC","11","1",null,null,null,"39.4",null,null,"11","NA","NA"],
    [2452,"2452","Carrier E","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC","48","1",null,null,"14.2","8.2",null,"24","24","NA","NA"],
    [2453,"2453","Carrier E","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1002","BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP","29","0.93",null,"127.5","75.2","62.4","1","6","22","NA","NA"],
    [2454,"2454","Carrier E","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90832","PSYCHOTHERAPY W/PATIENT 30 MINUTES","5","0.8",null,null,"32.2","58.5",null,"3","2","NA","NA"],
    [2455,"2455","Carrier E","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99238","HOSPITAL DISCHARGE DAY MANAGEMENT 30 MIN/<","1","1",null,null,null,"92.6",null,null,"1","NA","NA"],
    [2456,"2456","Carrier E","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","21126","REFERRAL PORTLAND, REFERRALS EXTERNAL","1","1",null,null,null,"30.9",null,null,"1","NA","NA"],
    [2457,"2457","Carrier E","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","128","ROOM & BOARD, SEMIPRIVATE TWO-BED - REHABILITATION","3","1",null,null,"19.2","53.4",null,"2","1","NA","NA"],
    [2458,"2458","Carrier E","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","126","ROOM & BOARD, SEMIPRIVATE TWO-BED - DETOXIFICATION","9","1",null,null,"80.2","49.1",null,"5","4","NA","NA"],
    [2459,"2459","Carrier E","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","194","SUBACUTE CARE, LEVEL IV","7","1",null,null,null,"45.5",null,null,"7","NA","NA"],
    [2460,"2460","Carrier E","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1001","BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC","11","1",null,null,null,"39.4",null,null,"11","NA","NA"],
    [2461,"2461","Carrier E","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC","48","1",null,null,"14.2","8.2",null,"24","24","NA","NA"],
    [2462,"2462","Carrier E","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1002","BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP","29","0.93",null,"127.5","75.2","62.4","1","6","22","NA","NA"],
    [2463,"2463","Carrier E","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90832","PSYCHOTHERAPY W/PATIENT 30 MINUTES","5","0.8",null,null,"32.2","58.5",null,"3","2","NA","NA"],
    [2464,"2464","Carrier E","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45385","COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ","101","1",null,null,"21.6","3.8",null,"99","2","NA","NA"],
    [2465,"2465","Carrier E","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99203","OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES","433","1",null,"5.6","39.2","35.2","8","399","26","NA","NA"],
    [2466,"2466","Carrier E","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97162","PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS","99","0.99",null,"0.5","34.2","31.9","3","92","4","NA","NA"],
    [2467,"2467","Carrier E","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45378","COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD","120","0.98",null,null,"27.8","10",null,"119","1","NA","NA"],
    [2468,"2468","Carrier E","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97161","PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS","919","0.98",null,"3.4","38.6","26.8","13","866","40","NA","NA"],
    [2469,"2469","Carrier E","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","98940","CHIROPRACTIC MANIPULATIVE TX SPINAL 1-2 REGIONS","194","0.97",null,null,"45.1",null,null,"194",null,"NA","NA"],
    [2470,"2470","Carrier E","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97810","ACUPUNCTURE 1/> NDLES W/O ELEC STIMJ INIT 15 MIN","372","0.96",null,null,"42.6","1",null,"371","1","NA","NA"],
    [2471,"2471","Carrier E","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99213","OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN","103","0.96",null,null,"35.2","43.8",null,"98","5","NA","NA"],
    [2472,"2472","Carrier E","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99204","OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES","95","0.96",null,"7.9","37.5","20.3","4","85","6","NA","NA"],
    [2473,"2473","Carrier E","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99211","OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP","123","0.9",null,"3.2","36.6","24","4","118","1","NA","NA"],
    [2474,"2474","Carrier E","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97110","THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES","76","1",null,"0.8","35.4","4.9","3","72","1","NA","NA"],
    [2475,"2475","Carrier E","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70551","MRI BRAIN NO CONTRAST","30","1",null,"6.3","44.7","27.3","17","12","1","NA","NA"],
    [2476,"2476","Carrier E","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","45385","COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ","101","1",null,null,"21.6","3.8",null,"99","2","NA","NA"],
    [2477,"2477","Carrier E","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","73721","MRI RIGHT KNEE NO CONTRAST","36","1",null,"6.3","38.6","0.4","28","6","2","NA","NA"],
    [2478,"2478","Carrier E","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","74177","CT ABD AND PELVIS W CONTRAST","28","1",null,"13.4","50.2","7","19","1","8","NA","NA"],
    [2479,"2479","Carrier E","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S9131","PT IN THE HOME PER DIEM","59","1",null,null,"9.3",null,null,"59",null,"NA","NA"],
    [2480,"2480","Carrier E","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","87635","IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ","36","1",null,null,"24.9",null,null,"36",null,"NA","NA"],
    [2481,"2481","Carrier E","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97813","ACUPUNCTURE 1/> NDLS W/ELEC STIMJ 1ST 15 MIN","35","1",null,null,"43.5",null,null,"35",null,"NA","NA"],
    [2482,"2482","Carrier E","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","98941","CHIROPRACTIC MANIPULATIVE TX SPINAL 3-4 REGIONS","28","1",null,null,"44.9",null,null,"28",null,"NA","NA"],
    [2483,"2483","Carrier E","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70553","MRI BRAIN WO/W CONTRAST","60","1",null,"10.5","35.9",null,"37","23",null,"NA","NA"],
    [2484,"2484","Carrier E","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97810","ACUPUNCTURE 1/> NDLES W/O ELEC STIMJ INIT 15 MIN","372","0","0.01",null,"42.6","1",null,"371","1","NA","NA"],
    [2485,"2485","Carrier E","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21126","REFERRAL PORTLAND, REFERRALS EXTERNAL","37","0","0.03","2.6","73.2","56.7","3","29","5","NA","NA"],
    [2486,"2486","Carrier E","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","99202","OFFICE/OUTPATIENT NEW SF MDM 15-29 MINUTES","62","0","0.02","46.9","43.5",null,"3","59",null,"NA","NA"],
    [2487,"2487","Carrier E","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90834","PSYCHOTHERAPY W/PATIENT 45 MINUTES","31","1",null,null,"56.7","69.8",null,"30","1","NA","NA"],
    [2488,"2488","Carrier E","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90832","PSYCHOTHERAPY W/PATIENT 30 MINUTES","27","1",null,null,"35.8","0.8",null,"26","1","NA","NA"],
    [2489,"2489","Carrier E","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0001","ALCOHOL AND/OR DRUG ASSESS","25","1",null,null,"43.9","6.4",null,"24","1","NA","NA"],
    [2490,"2490","Carrier E","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90899","UNLISTED PSYCHIATRIC SERVICE/PROCEDURE","21","1",null,null,"45.2","6.3",null,"20","1","NA","NA"],
    [2491,"2491","Carrier E","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0020","ALCOHOL AND/OR DRUG SERVICES METHADONE ADMINISTRATION","35","1",null,null,"39.9","14",null,"15","20","NA","NA"],
    [2492,"2492","Carrier E","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN","22","1",null,null,"37.6",null,null,"22",null,"NA","NA"],
    [2493,"2493","Carrier E","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97155","ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN","19","1",null,null,"64.7",null,null,"19",null,"NA","NA"],
    [2494,"2494","Carrier E","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY W/PATIENT 60 MINUTES","459","0.99",null,null,"50.9","44.6",null,"456","3","NA","NA"],
    [2495,"2495","Carrier E","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVALUATION","1322","0.98",null,null,"39.8","61.3",null,"1311","11","NA","NA"],
    [2496,"2496","Carrier E","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97153","ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN","52","0.98",null,null,"62.4",null,null,"52",null,"NA","NA"],
    [2497,"2497","Carrier E","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90834","PSYCHOTHERAPY W/PATIENT 45 MINUTES","31","1",null,null,"56.7","69.8",null,"30","1","NA","NA"],
    [2498,"2498","Carrier E","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90832","PSYCHOTHERAPY W/PATIENT 30 MINUTES","27","1",null,null,"35.8","0.8",null,"26","1","NA","NA"],
    [2499,"2499","Carrier E","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0001","ALCOHOL AND/OR DRUG ASSESS","25","1",null,null,"43.9","6.4",null,"24","1","NA","NA"],
    [2500,"2500","Carrier E","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90899","UNLISTED PSYCHIATRIC SERVICE/PROCEDURE","21","1",null,null,"45.2","6.3",null,"20","1","NA","NA"],
    [2501,"2501","Carrier E","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","912","BEHAVIORAL HEALTH TREATMENTS/SVCS, PARTIAL HOSPITAL - LESS INTENSIVE","8","1",null,null,"47.5","79.7",null,"6","2","NA","NA"],
    [2502,"2502","Carrier E","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0020","ALCOHOL AND/OR DRUG SERVICES METHADONE ADMINISTRATION","35","1",null,null,"39.9","14",null,"15","20","NA","NA"],
    [2503,"2503","Carrier E","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97151","BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN","22","1",null,null,"37.6",null,null,"22",null,"NA","NA"],
    [2504,"2504","Carrier E","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97155","ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN","19","1",null,null,"64.7",null,null,"19",null,"NA","NA"],
    [2505,"2505","Carrier E","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97156","FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN","18","1",null,null,"44.7",null,null,"18",null,"NA","NA"],
    [2506,"2506","Carrier E","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0005","ALCOHOL AND/OR DRUG SERVICES GROUP COUNSELING BY CLINICIAN","6","1",null,null,"39.3",null,null,"6",null,"NA","NA"],
    [2507,"2507","Carrier E","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVALUATION","1322","0","0.001",null,"39.8","61.3",null,"1311","11","NA","NA"],
    [2508,"2508","Carrier F","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","Test Strips","28","0.61",null,"5.76","32.61",null,"6","22",null,"NA","NA"],
    [2509,"2509","Carrier F","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","Test Strips","28","0.61",null,"5.76","32.61",null,"6","22",null,"NA","NA"],
    [2510,"2510","Carrier F","2021","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NA","NA","Test Strips","28","0","0","5.76","32.61",null,"6","22",null,"NA","NA"],
    [2511,"2511","Carrier F","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0486","Oral device/appliance used to reduce upper airway collapsibility, adjustable or nonadjustable, custom fabricated, includes fitting and adjustment","7","1",null,null,"112",null,"0","7",null,"NA","NA"],
    [2512,"2512","Carrier F","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9276","Sensor; invasive (e.g., subcutaneous), disposable, for use with interstitial continuous glucose monitoring system, 1 unit = 1 day supply","33","0.91",null,"19","122",null,"4","29",null,"NA","NA"],
    [2513,"2513","Carrier F","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L1852","Knee orthosis (KO), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","10","0.9",null,null,"133",null,"0","10",null,"NA","NA"],
    [2514,"2514","Carrier F","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9277","Transmitter; external, for use with interstitial continuous glucose monitoring system","18","0.89",null,"36","114",null,"3","15",null,"NA","NA"],
    [2515,"2515","Carrier F","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0747","Osteogenesis stimulator, electrical, noninvasive, other than spinal applications","8","0.86",null,null,"111",null,"0","8",null,"NA","NA"],
    [2516,"2516","Carrier F","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4230","Infusion set for external insulin pump, nonneedle cannula type","10","0.8",null,"26","159",null,"2","8",null,"NA","NA"],
    [2517,"2517","Carrier F","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","External ambulatory infusion pump, insulin","13","0.69",null,"28","150",null,"5","8",null,"NA","NA"],
    [2518,"2518","Carrier F","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1399","Durable medical equipment, miscellaneous","8","0.63",null,"52","153",null,"1","7",null,"NA","NA"],
    [2519,"2519","Carrier F","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0603","Breast pump, electric (AC and/or DC), any type","13","0.15",null,null,"186",null,"0","13",null,"NA","NA"],
    [2520,"2520","Carrier F","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","Continuous positive airway pressure (CPAP) device","8","0.13",null,null,"110",null,"0","8",null,"NA","NA"],
    [2521,"2521","Carrier F","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0486","Oral device/appliance used to reduce upper airway collapsibility, adjustable or nonadjustable, custom fabricated, includes fitting and adjustment","7","1",null,null,"112",null,"0","7",null,"NA","NA"],
    [2522,"2522","Carrier F","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L1846","Knee orthosis (KO), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","6","1",null,"23","88",null,"1","5",null,"NA","NA"],
    [2523,"2523","Carrier F","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L2820","Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","5","1",null,null,"116",null,"0","5",null,"NA","NA"],
    [2524,"2524","Carrier F","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L1970","Ankle-foot orthosis (AFO), plastic with ankle joint, custom fabricated","5","1",null,"63","107",null,"1","4",null,"NA","NA"],
    [2525,"2525","Carrier F","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A6550","Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","4","1",null,null,"119",null,"0","4",null,"NA","NA"],
    [2526,"2526","Carrier F","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A7000","Canister, disposable, used with suction pump, each","4","1",null,null,"119",null,"0","4",null,"NA","NA"],
    [2527,"2527","Carrier F","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2402","Negative pressure wound therapy electrical pump, stationary or portable","4","1",null,null,"118",null,"0","4",null,"NA","NA"],
    [2528,"2528","Carrier F","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0766","Electrical stimulation device used for cancer treatment, includes all accessories, any type","4","1",null,"50","104",null,"1","3",null,"NA","NA"],
    [2529,"2529","Carrier F","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L0650","Lumbar-sacral orthosis (LSO), sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to T-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf","4","1",null,"63","112",null,"1","3",null,"NA","NA"],
    [2530,"2530","Carrier F","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L1851","Knee orthosis (KO), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","4","1",null,null,"108",null,"0","4",null,"NA","NA"],
    [2531,"2531","Carrier F","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L2999","Lower extremity orthoses, not otherwise specified","2","0","0.5",null,"99",null,"0","2",null,"NA","NA"],
    [2532,"2532","Carrier F","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L2755","Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","2","0","0.5",null,"99",null,"0","2",null,"NA","NA"],
    [2533,"2533","Carrier F","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","B4152","Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","1","0","1",null,"122",null,"0","1",null,"NA","NA"],
    [2534,"2534","Carrier F","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","11","0.82",null,"24","94",null,"1","10",null,"NA","NA"],
    [2535,"2535","Carrier F","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22633","Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace, lumbar;","14","0.71",null,"25","54",null,"3","11",null,"NA","NA"],
    [2536,"2536","Carrier F","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","27","0.7",null,"24","61",null,"3","24",null,"NA","NA"],
    [2537,"2537","Carrier F","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","121","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Medical/Surgical/GYN","244","0.67",null,"30","65",null,"57","187",null,"NA","NA"],
    [2538,"2538","Carrier F","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20930","Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for primary procedure)","18","0.67",null,"25","57",null,"2","16",null,"NA","NA"],
    [2539,"2539","Carrier F","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63047","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","15","0.67",null,"23","48",null,"3","12",null,"NA","NA"],
    [2540,"2540","Carrier F","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22614","Arthrodesis, posterior or posterolateral technique, single interspace; each additional interspace (List separately in addition to code for primary procedure)","12","0.67",null,"25","56",null,"2","10",null,"NA","NA"],
    [2541,"2541","Carrier F","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","14","0.64",null,"24","65",null,"2","12",null,"NA","NA"],
    [2542,"2542","Carrier F","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20936","Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar fragments) obtained from same incision (List separately in addition to code for primary procedure)","16","0.63",null,"25","55",null,"2","14",null,"NA","NA"],
    [2543,"2543","Carrier F","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22842","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)","17","0.59",null,"25","34",null,"3","14",null,"NA","NA"],
    [2544,"2544","Carrier F","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58150","Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);","8","1",null,"33","46",null,"3","5",null,"NA","NA"],
    [2545,"2545","Carrier F","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","32663","Thoracoscopy, surgical; with lobectomy (single lobe)","6","1",null,"17","85",null,"2","4",null,"NA","NA"],
    [2546,"2546","Carrier F","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22214","Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar","5","1",null,"25","96",null,"1","4",null,"NA","NA"],
    [2547,"2547","Carrier F","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33427","Valvuloplasty, mitral valve, with cardiopulmonary bypass; radical reconstruction, with or without ring","5","1",null,"42","67",null,"1","4",null,"NA","NA"],
    [2548,"2548","Carrier F","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","20937","Autograft for spine surgery only (includes harvesting the graft); morselized (through separate skin or fascial incision) (List separately in addition to code for primary procedure)","4","1",null,"76","110",null,"1","3",null,"NA","NA"],
    [2549,"2549","Carrier F","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","61781","Stereotactic computer-assisted (navigational) procedure; cranial, intradural (List separately in addition to code for primary procedure)","4","1",null,"6","89",null,"1","3",null,"NA","NA"],
    [2550,"2550","Carrier F","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15769","Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia)","3","1",null,null,"95",null,"0","3",null,"NA","NA"],
    [2551,"2551","Carrier F","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19364","Breast reconstruction; with free flap (eg, fTRAM, DIEP, SIEA, GAP flap)","3","1",null,"29","105",null,"1","2",null,"NA","NA"],
    [2552,"2552","Carrier F","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22216","Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; each additional vertebral segment (List separately in addition to primary procedure)","3","1",null,"25","64",null,"1","2",null,"NA","NA"],
    [2553,"2553","Carrier F","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22600","Arthrodesis, posterior or posterolateral technique, single interspace; cervical below C2 segment","3","1",null,"24","96",null,"1","2",null,"NA","NA"],
    [2554,"2554","Carrier F","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43848","Revision, open, of gastric restrictive procedure for morbid obesity, other than adjustable gastric restrictive device (separate procedure)","2","0","1",null,"86",null,"0","2",null,"NA","NA"],
    [2555,"2555","Carrier F","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","49255","Omentectomy, epiploectomy, resection of omentum (separate procedure)","2","0","1","5","27",null,"1","1",null,"NA","NA"],
    [2556,"2556","Carrier F","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","49205","Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor greater than 10.0 cm diameter","1","0","1","5",null,null,"1","0",null,"NA","NA"],
    [2557,"2557","Carrier F","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","44005","Enterolysis (freeing of intestinal adhesion) (separate procedure)","1","0","1","5",null,null,"1","0",null,"NA","NA"],
    [2558,"2558","Carrier F","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","96549","Unlisted chemotherapy procedure","1","0","1","6",null,null,"1","0",null,"NA","NA"],
    [2559,"2559","Carrier F","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0018","Behavioral health; short-term residential (nonhospital residential treatment program), without room and board, per diem","1","1",null,"26",null,null,"1","0",null,"NA","NA"],
    [2560,"2560","Carrier F","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43239","Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple","538","0.95",null,"33","111",null,"75","463",null,"NA","NA"],
    [2561,"2561","Carrier F","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43235","Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","471","0.94",null,"35","112",null,"70","401",null,"NA","NA"],
    [2562,"2562","Carrier F","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64483","Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, single level","140","0.91",null,"34","113",null,"18","122",null,"NA","NA"],
    [2563,"2563","Carrier F","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","92250","Fundus photography with interpretation and report","134","0.9",null,"33","109",null,"26","108",null,"NA","NA"],
    [2564,"2564","Carrier F","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","66984","Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); without endoscopic cyclophotocoagulation","138","0.89",null,"34","112",null,"40","98",null,"NA","NA"],
    [2565,"2565","Carrier F","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","29881","Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed","83","0.89",null,"30","105",null,"9","74",null,"NA","NA"],
    [2566,"2566","Carrier F","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27130","Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft","114","0.82",null,"28","119",null,"15","99",null,"NA","NA"],
    [2567,"2567","Carrier F","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","128","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation","4","0.25",null,"21",null,null,"4","0",null,"NA","NA"],
    [2568,"2568","Carrier F","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","Mental health partial hospitalization, treatment, less than 24 hours","2","0",null,"26","5",null,"1","1",null,"NA","NA"],
    [2569,"2569","Carrier F","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric","1","0",null,null,"5",null,"0","1",null,"NA","NA"],
    [2570,"2570","Carrier F","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27096","Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or CT) including arthrography when performed","57","1",null,"36","110",null,"5","52",null,"NA","NA"],
    [2571,"2571","Carrier F","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","36471","Injection of sclerosant; multiple incompetent veins (other than telangiectasia), same leg","29","1",null,null,"102",null,"0","29",null,"NA","NA"],
    [2572,"2572","Carrier F","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43238","Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s), (includes endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures)","23","1",null,"30","105",null,"4","19",null,"NA","NA"],
    [2573,"2573","Carrier F","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","69990","Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure)","20","1",null,"47","115",null,"1","19",null,"NA","NA"],
    [2574,"2574","Carrier F","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","36482","Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; first vein treated","14","1",null,null,"98",null,"0","14",null,"NA","NA"],
    [2575,"2575","Carrier F","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64633","Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, single facet joint","12","1",null,"75","120",null,"1","11",null,"NA","NA"],
    [2576,"2576","Carrier F","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","66982","Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device, suture support for intraocular lens, or primary posterior capsulorrhexis) or performed on patients in the amblyogenic developmental stage; without endoscopic cyclophotocoagulation","14","1",null,"16","104",null,"4","10",null,"NA","NA"],
    [2577,"2577","Carrier F","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93460","Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","14","1",null,"34","96",null,"5","9",null,"NA","NA"],
    [2578,"2578","Carrier F","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43242","Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examined distal to the anastomosis)","11","1",null,"17","112",null,"3","8",null,"NA","NA"],
    [2579,"2579","Carrier F","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","31267","Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus","11","1",null,"30","113",null,"4","7",null,"NA","NA"],
    [2580,"2580","Carrier F","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0018","Behavioral health; short-term residential (nonhospital residential treatment program), without room and board, per diem","1","1",null,"26",null,null,"1","0",null,"NA","NA"],
    [2581,"2581","Carrier F","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","128","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation","4","0.25",null,"21",null,null,"4","0",null,"NA","NA"],
    [2582,"2582","Carrier F","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64718","Neuroplasty and/or transposition; ulnar nerve at elbow","4","0","0.25",null,"79",null,"0","4",null,"NA","NA"],
    [2583,"2583","Carrier F","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","77065","Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral","3","0","0.33","24","156",null,"1","2",null,"NA","NA"],
    [2584,"2584","Carrier F","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","55970","Intersex surgery; male to female","2","0","0.5",null,"108",null,"0","2",null,"NA","NA"],
    [2585,"2585","Carrier F","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","54520","Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach","2","0","0.5",null,"108",null,"0","2",null,"NA","NA"],
    [2586,"2586","Carrier F","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","67971","Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; up to two-thirds of eyelid, 1 stage or first stage","2","0","0.5",null,"171",null,"0","2",null,"NA","NA"],
    [2587,"2587","Carrier F","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43999","Unlisted procedure, stomach","1","0","1",null,"91",null,"0","1",null,"NA","NA"],
    [2588,"2588","Carrier F","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","67917","Repair of ectropion; extensive (eg, tarsal strip operations)","1","0","1",null,"223",null,"0","1",null,"NA","NA"],
    [2589,"2589","Carrier F","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27329","Radical resection of tumor (eg, sarcoma), soft tissue of thigh or knee area; less than 5 cm","1","0","1","27",null,null,"1","0",null,"NA","NA"],
    [2590,"2590","Carrier F","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S9480","Intensive outpatient psychiatric services, per diem","31","0.94",null,"15","60",null,"5","26",null,"NA","NA"],
    [2591,"2591","Carrier F","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97153","Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes","20","0.9",null,"18","65",null,"1","19",null,"NA","NA"],
    [2592,"2592","Carrier F","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0015","Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education","49","0.86",null,"166","40",null,"10","39",null,"NA","NA"],
    [2593,"2593","Carrier F","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","Mental health partial hospitalization, treatment, less than 24 hours","108","0.85",null,"24","66",null,"20","88",null,"NA","NA"],
    [2594,"2594","Carrier F","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97156","Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes","25","0.84",null,"29","91",null,"5","20",null,"NA","NA"],
    [2595,"2595","Carrier F","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan","25","0.84",null,"27","66",null,"7","18",null,"NA","NA"],
    [2596,"2596","Carrier F","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S0201","Partial hospitalization services, less than 24 hours, per diem","19","0.79",null,"33","82",null,"2","17",null,"NA","NA"],
    [2597,"2597","Carrier F","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","29","0.72",null,"17","48",null,"1","28",null,"NA","NA"],
    [2598,"2598","Carrier F","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","25","0.68",null,"17","48",null,"1","24",null,"NA","NA"],
    [2599,"2599","Carrier F","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","16","0.63",null,"17","58",null,"1","15",null,"NA","NA"],
    [2600,"2600","Carrier F","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90870","Electroconvulsive therapy (includes necessary monitoring)","2","1",null,null,"62",null,"0","2",null,"NA","NA"],
    [2601,"2601","Carrier F","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99442","Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion","2","1",null,null,"0",null,"0","2",null,"NA","NA"],
    [2602,"2602","Carrier F","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","0373T","Adaptive behavior treatment with protocol modification, each 15 minutes of technicians' time face-to-face with a patient, requiring the following components: administration by the physician or other qualified health care professional who is on site; with the assistance of two or more technicians; for a patient who exhibits destructive behavior; completion in an environment that is customized to the patient's behavior.","1","1",null,null,"95",null,"0","1",null,"NA","NA"],
    [2603,"2603","Carrier F","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90887","Interpretation or explanation of results of psychiatric, other medical examinations and procedures, or other accumulated data to family or other responsible persons, or advising them how to assist patient","1","1",null,null,"23",null,"0","1",null,"NA","NA"],
    [2604,"2604","Carrier F","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96372","Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular","1","1",null,null,"16",null,"0","1",null,"NA","NA"],
    [2605,"2605","Carrier F","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99213","Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using time for code selection, 20-29 minutes of total time is spent on the date of the encounter.","1","1",null,null,"0",null,"0","1",null,"NA","NA"],
    [2606,"2606","Carrier F","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99443","Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 21-30 minutes of medical discussion","1","1",null,null,"0",null,"0","1",null,"NA","NA"],
    [2607,"2607","Carrier F","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0012","Alcohol and/or drug services; subacute detoxification (residential addiction program outpatient)","1","1",null,null,"28",null,"0","1",null,"NA","NA"],
    [2608,"2608","Carrier F","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S0013","Esketamine, nasal spray, 1 mg","1","1",null,"25",null,null,"1","0",null,"NA","NA"],
    [2609,"2609","Carrier F","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97158","Group adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, face-to-face with multiple patients, each 15 minutes","23","0.87",null,"35","77",null,"8","15",null,"NA","NA"],
    [2610,"2610","Carrier F","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","H0035","Mental health partial hospitalization, treatment, less than 24 hours","120","0","0.008","25","48",null,"17","103",null,"NA","NA"],
    [2611,"2611","Carrier F","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97156","Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes","85","0","0.012","32","99",null,"19","66",null,"NA","NA"],
    [2612,"2612","Carrier F","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97155","Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes","80","0","0.013","32","103",null,"20","60",null,"NA","NA"],
    [2613,"2613","Carrier G","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A5514","DIAB ONLY MX DEN INSRT DIRECT CARV CUSTOM FAB EA","3","1",null,null,"15.4",null,null,"3",null,"NA","NA"],
    [2614,"2614","Carrier G","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A9274","EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA","1","1",null,null,"140.3",null,null,"1",null,"NA","NA"],
    [2615,"2615","Carrier G","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0784","EXTERNAL AMBULATORY INFUSION PUMP INSULIN","23","0.83",null,"23.9","39.6",null,"5","18",null,"NA","NA"],
    [2616,"2616","Carrier G","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4230","INFUS SET EXT INSULIN PUMP NONNDLE CANNULA TYPE","5","0.8",null,"6.4","69.2",null,"1","4",null,"NA","NA"],
    [2617,"2617","Carrier G","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4232","SYRINGE W/NDLE EXTERNAL INSULIN PUMP STERILE 3CC","4","0.75",null,"6.4","62.1",null,"1","3",null,"NA","NA"],
    [2618,"2618","Carrier G","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A5500","DIAB ONLY FIT CSTM PREP AND SPL SHOE MX DNSITY INSRT","2","0",null,null,null,null,null,"2",null,"NA","NA"],
    [2619,"2619","Carrier G","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L3000","FT INSRT MOLD PT MDL UCB TYPE BERKLY SHELL EA","1","0",null,null,null,null,null,"1",null,"NA","NA"],
    [2620,"2620","Carrier G","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A5514","DIAB ONLY MX DEN INSRT DIRECT CARV CUSTOM FAB EA","3","1",null,null,"15.4",null,null,"3",null,"NA","NA"],
    [2621,"2621","Carrier G","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A9274","EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA","1","1",null,null,"140.3",null,null,"1",null,"NA","NA"],
    [2622,"2622","Carrier G","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0784","EXTERNAL AMBULATORY INFUSION PUMP INSULIN","23","0.83",null,"23.9","39.6",null,"5","18",null,"NA","NA"],
    [2623,"2623","Carrier G","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4230","INFUS SET EXT INSULIN PUMP NONNDLE CANNULA TYPE","5","0.8",null,"6.4","69.2",null,"1","4",null,"NA","NA"],
    [2624,"2624","Carrier G","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4232","SYRINGE W/NDLE EXTERNAL INSULIN PUMP STERILE 3CC","4","0.75",null,"6.4","62.1",null,"1","3",null,"NA","NA"],
    [2625,"2625","Carrier G","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A5500","DIAB ONLY FIT CSTM PREP AND SPL SHOE MX DNSITY INSRT","2","0",null,null,null,null,null,"2",null,"NA","NA"],
    [2626,"2626","Carrier G","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L3000","FT INSRT MOLD PT MDL UCB TYPE BERKLY SHELL EA","1","0",null,null,null,null,null,"1",null,"NA","NA"],
    [2627,"2627","Carrier G","2021","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0784","EXTERNAL AMBULATORY INFUSION PUMP INSULIN","23","0","0.174","23.9","39.6",null,"5","18",null,"NA","NA"],
    [2628,"2628","Carrier G","2021","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A4230","INFUS SET EXT INSULIN PUMP NONNDLE CANNULA TYPE","5","0","0.2","6.4","69.2",null,"1","4",null,"NA","NA"],
    [2629,"2629","Carrier G","2021","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A4232","SYRINGE W/NDLE EXTERNAL INSULIN PUMP STERILE 3CC","4","0","0.25","6.4","62.1",null,"1","3",null,"NA","NA"],
    [2630,"2630","Carrier G","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L1970","AFO PLASTIC WITH ANKLE JOINT CUSTOM FABRICATED","9","0.89",null,null,"53.2",null,null,"9",null,"NA","NA"],
    [2631,"2631","Carrier G","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0784","EXTERNAL AMBULATORY INFUSION PUMP INSULIN","23","0.83",null,"23.9","39.6",null,"5","18",null,"NA","NA"],
    [2632,"2632","Carrier G","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","V2624","POLISHING/RESURFACING OF OCULAR PROSTHESIS","9","0.78",null,null,"35",null,null,"9",null,"NA","NA"],
    [2633,"2633","Carrier G","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0486","ORL DEVC/APPL RDUC UP AIRWAY COLLAPSIBILITY CSTM","9","0.44",null,null,"104.2",null,null,"9",null,"NA","NA"],
    [2634,"2634","Carrier G","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0667","SEG PNEUMAT APPLINC W/PNEUMAT COMPRS FULL LEG","8","0.38",null,null,"85.7",null,null,"8",null,"NA","NA"],
    [2635,"2635","Carrier G","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A6550","WND CARE SET NEG PRSS WND TX ELEC PUMP SPL","11","0.36",null,"69.8","52.1",null,"3","8",null,"NA","NA"],
    [2636,"2636","Carrier G","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E2402","NEG PRESS WOUND THERAPY ELEC PUMP STATION/PRTBLE","11","0.36",null,"69.8","52.1",null,"3","8",null,"NA","NA"],
    [2637,"2637","Carrier G","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A7000","CANISTER DISPOSABLE USED WITH SUCTION PUMP EACH","11","0.36",null,"69.8","52.1",null,"3","8",null,"NA","NA"],
    [2638,"2638","Carrier G","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0652","PNEUMAT COMPRS SEG HOM MDL W/CALBRTD GRADNT PRSS","12","0.33",null,null,"78.5",null,null,"12",null,"NA","NA"],
    [2639,"2639","Carrier G","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L3000","FT INSRT MOLD PT MDL UCB TYPE BERKLY SHELL EA","13","0",null,null,"28",null,"1","12",null,"NA","NA"],
    [2640,"2640","Carrier G","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A7048","VACUUM DRAINAGE COLLECTION UNIT  AND  TUBING KIT EA","2","1",null,"17.4",null,null,"2",null,null,"NA","NA"],
    [2641,"2641","Carrier G","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72141","MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL","1","1",null,"50.1",null,null,"1",null,null,"NA","NA"],
    [2642,"2642","Carrier G","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72148","MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL","1","1",null,"50.1",null,null,"1",null,null,"NA","NA"],
    [2643,"2643","Carrier G","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A5514","DIAB ONLY MX DEN INSRT DIRECT CARV CUSTOM FAB EA","3","1",null,null,"15.4",null,null,"3",null,"NA","NA"],
    [2644,"2644","Carrier G","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A0425","GROUND MILEAGE PER STATUTE MILE","1","1",null,null,"91.3",null,null,"1",null,"NA","NA"],
    [2645,"2645","Carrier G","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A0428","AMBULANCE SERVICE BLS NONEMERGENCY TRANSPORT","1","1",null,null,"91.3",null,null,"1",null,"NA","NA"],
    [2646,"2646","Carrier G","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A9270","NONCOVERED ITEM OR SERVICE","1","1",null,null,"120",null,null,"1",null,"NA","NA"],
    [2647,"2647","Carrier G","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A9274","EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA","1","1",null,null,"140.3",null,null,"1",null,"NA","NA"],
    [2648,"2648","Carrier G","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0143","WALKER FOLDING WHEELED ADJUSTABLE/FIXED HEIGHT","1","1",null,null,"28.1",null,null,"1",null,"NA","NA"],
    [2649,"2649","Carrier G","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0261","HOS BED SEMI-ELEC ANY TYPE SIDE RAIL W/O MATTRSS","1","1",null,null,"213",null,null,"1",null,"NA","NA"],
    [2650,"2650","Carrier G","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0652","PNEUMAT COMPRS SEG HOM MDL W/CALBRTD GRADNT PRSS","12","0","0.25",null,"78.5",null,null,"12",null,"NA","NA"],
    [2651,"2651","Carrier G","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0466","HOME VENTILATOR ANY TYPE USED W/NON-INVASV INTF","4","0","0.5",null,"72.3",null,null,"4",null,"NA","NA"],
    [2652,"2652","Carrier G","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A4232","SYRINGE W/NDLE EXTERNAL INSULIN PUMP STERILE 3CC","4","0","0.25","6.4","62.1",null,"1","3",null,"NA","NA"],
    [2653,"2653","Carrier G","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0241","BATHTUB WALL RAIL EACH","2","0","0.5",null,"4.4",null,null,"2",null,"NA","NA"],
    [2654,"2654","Carrier G","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0245","TUB STOOL OR BENCH","2","0","0.5",null,"4.4",null,null,"2",null,"NA","NA"],
    [2655,"2655","Carrier G","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A0425","GROUND MILEAGE PER STATUTE MILE","1","0","1",null,"91.3",null,null,"1",null,"NA","NA"],
    [2656,"2656","Carrier G","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A0428","AMBULANCE SERVICE BLS NONEMERGENCY TRANSPORT","1","0","1",null,"91.3",null,null,"1",null,"NA","NA"],
    [2657,"2657","Carrier G","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0143","WALKER FOLDING WHEELED ADJUSTABLE/FIXED HEIGHT","1","0","1",null,"28.1",null,null,"1",null,"NA","NA"],
    [2658,"2658","Carrier G","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E1815","DYN ADJ ANKLE EXT/FLEX DEVC INCL SOFT INTF MATL","1","0","1",null,"126.8",null,null,"1",null,"NA","NA"],
    [2659,"2659","Carrier G","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0935","CONTINUOUS PASSIVE MOT EXERCISE DEVC KNEE ONLY","2","0","0.5",null,"168.6",null,"1","1",null,"NA","NA"],
    [2660,"2660","Carrier G","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","38724","CERVICAL LYMPHADEC MODIFIED RADICAL NECK DSJ","12","1",null,"9.8","57.1",null,"5","7",null,"NA","NA"],
    [2661,"2661","Carrier G","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44204","LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS","10","1",null,"6.7","123.2",null,"4","6",null,"NA","NA"],
    [2662,"2662","Carrier G","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","120","Room & Board - Semiprivate - 2 Beds - General","25","0.96",null,"78.1","0",null,"22","3",null,"NA","NA"],
    [2663,"2663","Carrier G","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","69990","MICROSURG TQS REQ USE OPERATING MICROSCOPE","18","0.94",null,"15.6","82.8",null,"8","10",null,"NA","NA"],
    [2664,"2664","Carrier G","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44207","LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST","11","0.91",null,null,"27",null,null,"11",null,"NA","NA"],
    [2665,"2665","Carrier G","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","61510","CRANIEC TREPHINE BONE FLP BRAIN TUMOR SUPRTENTOR","11","0.91",null,"13","64.4",null,"6","5",null,"NA","NA"],
    [2666,"2666","Carrier G","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","61781","STRTCTC CPTR ASSTD PX CRANIAL INTRADURAL","16","0.88",null,"5.3","69.6",null,"7","9",null,"NA","NA"],
    [2667,"2667","Carrier G","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD","16","0.81",null,"66.2","64.1",null,"3","13",null,"NA","NA"],
    [2668,"2668","Carrier G","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20936","AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION","14","0.79",null,"26.3","68.3",null,"3","11",null,"NA","NA"],
    [2669,"2669","Carrier G","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20930","ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED","15","0.73",null,"26.3","66.5",null,"3","12",null,"NA","NA"],
    [2670,"2670","Carrier G","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","200","Intensive Care - General","7","1",null,"0",null,null,"7",null,null,"NA","NA"],
    [2671,"2671","Carrier G","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","110","Room & Board - Private - General","3","1",null,"11",null,null,"3",null,null,"NA","NA"],
    [2672,"2672","Carrier G","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","113","Room & Board - Private - Pediatric","1","1",null,"46.2",null,null,"1",null,null,"NA","NA"],
    [2673,"2673","Carrier G","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","122","Room & Board - Semiprivate - 2 Beds - OB","1","1",null,"49.5",null,null,"1",null,null,"NA","NA"],
    [2674,"2674","Carrier G","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","127","Room & Board - Semiprivate - 2 Beds - Oncology","1","1",null,null,null,null,"1",null,null,"NA","NA"],
    [2675,"2675","Carrier G","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","11646","EXCISION MALIGNANT LESION F/E/E/N/L  GT 4.0 CM","1","1",null,"14.7",null,null,"1",null,null,"NA","NA"],
    [2676,"2676","Carrier G","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","11042","DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM OR LT","2","1",null,null,"97.1",null,null,"2",null,"NA","NA"],
    [2677,"2677","Carrier G","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","11045","DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM","2","1",null,null,"97.1",null,null,"2",null,"NA","NA"],
    [2678,"2678","Carrier G","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","206","Intensive Care - Intermediate  (ICU)","5","1",null,"0","167",null,"4","1",null,"NA","NA"],
    [2679,"2679","Carrier G","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","214","Coronary Care - Intermediate Coronary Care Unit (CCU)","4","1",null,"17.9","0",null,"3","1",null,"NA","NA"],
    [2680,"2680","Carrier G","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","121","Room & Board - Semiprivate - 2 Beds - Medical/Surgical/GYN","5","0","0.8","189.61",null,null,"5",null,null,"NA","NA"],
    [2681,"2681","Carrier G","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","113","Room & Board - Private - Pediatric","1","0","1","46.2",null,null,"1",null,null,"NA","NA"],
    [2682,"2682","Carrier G","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","122","Room & Board - Semiprivate - 2 Beds - OB","1","0","1","49.5",null,null,"1",null,null,"NA","NA"],
    [2683,"2683","Carrier G","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","J7512","PREDNISONE IMMEDIATE RLSE/DELAYED RLSE ORAL 1 MG","1","0","1","4.8",null,null,"1",null,null,"NA","NA"],
    [2684,"2684","Carrier G","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","J9181","INJECTION ETOPOSIDE 10 MG","1","0","1","4.8",null,null,"1",null,null,"NA","NA"],
    [2685,"2685","Carrier G","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","J9312","INJECTION RITUXIMAB 10 MG","1","0","1","4.8",null,null,"1",null,null,"NA","NA"],
    [2686,"2686","Carrier G","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","15740","FLAP ISLAND PEDICLE ANATOMIC NAMED AXIAL ARTERY","4","0","0.5",null,"127.8",null,null,"4",null,"NA","NA"],
    [2687,"2687","Carrier G","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","58571","LAPS TOTAL HYSTERECT 250 GM OR LT  W/RMVL TUBE/OVARY","1","0","1",null,"120",null,null,"1",null,"NA","NA"],
    [2688,"2688","Carrier G","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","61580","CRANIOFACIAL ANT CRANIAL FOSSA W/O ORBITAL EXNTJ","1","0","1",null,"195.3",null,null,"1",null,"NA","NA"],
    [2689,"2689","Carrier G","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","61600","RESCJ/EXC LES BASE ANT CRANIAL FOSSA EXTRADURAL","1","0","1",null,"195.3",null,null,"1",null,"NA","NA"],
    [2690,"2690","Carrier G","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99231","SBSQ HOSPITAL CARE/DAY 15 MINUTES","1","1",null,"24",null,null,"1",null,null,"NA","NA"],
    [2691,"2691","Carrier G","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","120","Room & Board - Semiprivate - 2 Beds - General","1","1",null,"57.5",null,null,"1",null,null,"NA","NA"],
    [2692,"2692","Carrier G","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90792","PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES","1","1",null,"24",null,null,"1",null,null,"NA","NA"],
    [2693,"2693","Carrier G","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99238","HOSPITAL DISCHARGE DAY MANAGEMENT 30 MIN OR LT","1","1",null,"24",null,null,"1",null,null,"NA","NA"],
    [2694,"2694","Carrier G","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","57335","VAGINOPLASTY INTERSEX STATE","2","1",null,null,"169.3",null,null,"2",null,"NA","NA"],
    [2695,"2695","Carrier G","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44204","LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS","2","1",null,null,"169.3",null,null,"2",null,"NA","NA"],
    [2696,"2696","Carrier G","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44955","APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX","1","1",null,null,"95.7",null,null,"1",null,"NA","NA"],
    [2697,"2697","Carrier G","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","Room & Board - Semiprivate - 2 Beds - Psychiatric","3","1",null,"24","0",null,"2","1",null,"NA","NA"],
    [2698,"2698","Carrier G","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15570","FRMJ DIRECT/TUBED PEDICLE W/WO TRANSFER TRUNK","1","0",null,null,null,null,null,"1",null,"NA","NA"],
    [2699,"2699","Carrier G","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15877","SUCTION ASSISTED LIPECTOMY TRUNK","1","0",null,null,null,null,null,"1",null,"NA","NA"],
    [2700,"2700","Carrier G","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","120","Room & Board - Semiprivate - 2 Beds - General","1","1",null,"57.5",null,null,"1",null,null,"NA","NA"],
    [2701,"2701","Carrier G","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90792","PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES","1","1",null,"24",null,null,"1",null,null,"NA","NA"],
    [2702,"2702","Carrier G","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99231","SBSQ HOSPITAL CARE/DAY 15 MINUTES","1","1",null,"24",null,null,"1",null,null,"NA","NA"],
    [2703,"2703","Carrier G","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99238","HOSPITAL DISCHARGE DAY MANAGEMENT 30 MIN OR LT","1","1",null,"24",null,null,"1",null,null,"NA","NA"],
    [2704,"2704","Carrier G","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44204","LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS","2","1",null,null,"338.6",null,null,"2",null,"NA","NA"],
    [2705,"2705","Carrier G","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","57335","VAGINOPLASTY INTERSEX STATE","2","1",null,null,"338.6",null,null,"2",null,"NA","NA"],
    [2706,"2706","Carrier G","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44955","APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX","1","1",null,null,"95.7",null,null,"1",null,"NA","NA"],
    [2707,"2707","Carrier G","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","Room & Board - Semiprivate - 2 Beds - Psychiatric","3","1",null,"48","0",null,"2","1",null,"NA","NA"],
    [2708,"2708","Carrier G","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15570","FRMJ DIRECT/TUBED PEDICLE W/WO TRANSFER TRUNK","1","0",null,null,null,null,null,"1",null,"NA","NA"],
    [2709,"2709","Carrier G","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15877","SUCTION ASSISTED LIPECTOMY TRUNK","1","0",null,null,null,null,null,"1",null,"NA","NA"],
    [2710,"2710","Carrier G","2021","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","120","Room & Board - Semiprivate - 2 Beds - General","1","0","1","57.5",null,null,"1",null,null,"NA","NA"],
    [2711,"2711","Carrier G","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","61782","STRTCTC CPTR ASSTD PX EXTRADURAL CRANIAL","2","0.5",null,null,"18.4",null,null,"2",null,"NA","NA"],
    [2712,"2712","Carrier G","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","31299","UNLISTED PROCEDURE ACCESSORY SINUSES","2","0.5",null,null,"18.4",null,null,"2",null,"NA","NA"],
    [2713,"2713","Carrier G","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43235","ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC","2","0.5",null,"14.9",null,null,"1","1",null,"NA","NA"],
    [2714,"2714","Carrier G","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","49320","LAPS ABD PRTM and OMENTUM DX W/WO SPEC BR/WA SPX","2","0.5",null,"14.9",null,null,"1","1",null,"NA","NA"],
    [2715,"2715","Carrier G","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63266","LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL THORACIC","1","0",null,"43.6",null,null,"1",null,null,"NA","NA"],
    [2716,"2716","Carrier G","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","31622","BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX","2","0",null,null,null,null,null,"2",null,"NA","NA"],
    [2717,"2717","Carrier G","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","47120","HEPATECTOMY RESCJ PARTIAL LOBECTOMY","1","0",null,null,null,null,null,"1",null,"NA","NA"],
    [2718,"2718","Carrier G","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","39561","RESCJ DIAPHRAGM W/COMPLEX REPAIR","1","0",null,null,null,null,null,"1",null,"NA","NA"],
    [2719,"2719","Carrier G","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","69990","MICROSURG TQS REQ USE OPERATING MICROSCOPE","2","0",null,"43.6","20.6",null,"1","1",null,"NA","NA"],
    [2720,"2720","Carrier G","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","33518","CORONARY ARTERY BYP W/VEIN  and  ARTERY GRAFT 2 VEIN","2","0",null,null,null,null,"1","1",null,"NA","NA"],
    [2721,"2721","Carrier G","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44186","LAPAROSCOPY SURGICAL JEJUNOSTOMY","1","1",null,"14.9",null,null,"1",null,null,"NA","NA"],
    [2722,"2722","Carrier G","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99222","INITIAL HOSPITAL CARE/DAY 50 MINUTES","1","1",null,"0",null,null,"1",null,null,"NA","NA"],
    [2723,"2723","Carrier G","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99223","INITIAL HOSPITAL CARE/DAY 70 MINUTES","1","1",null,"0",null,null,"1",null,null,"NA","NA"],
    [2724,"2724","Carrier G","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","31040","PTERYGOMAXILLARY FOSSA SURGERY ANY APPROACH","1","1",null,null,"37.8",null,null,"1",null,"NA","NA"],
    [2725,"2725","Carrier G","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","31241","NASAL/SINUS NDSC W/LIG SPHENOPALATINE ARTERY","1","1",null,null,"37.8",null,null,"1",null,"NA","NA"],
    [2726,"2726","Carrier G","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","31255","NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY","1","1",null,null,"37.8",null,null,"1",null,"NA","NA"],
    [2727,"2727","Carrier G","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","31256","NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY","1","1",null,null,"37.8",null,null,"1",null,"NA","NA"],
    [2728,"2728","Carrier G","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","31257","NASAL/SINUS NDSC TOTAL WITH SPHENOIDOTOMY","1","1",null,null,"37.8",null,null,"1",null,"NA","NA"],
    [2729,"2729","Carrier G","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","31259","NASAL/SINUS NDSC TOT W/SPHENDT W/SPHEN TISS RMVL","1","1",null,null,"37.8",null,null,"1",null,"NA","NA"],
    [2730,"2730","Carrier G","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","31276","NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS","1","1",null,null,"37.8",null,null,"1",null,"NA","NA"],
    [2731,"2731","Carrier G","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","H0011","ALCOHOL  and / DRUG SERVICES; ACUTE DTOX RES PROG IP","15","1",null,"10.4",null,null,"15",null,null,"NA","NA"],
    [2732,"2732","Carrier G","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97153","ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN","12","0.92",null,null,"105.5",null,null,"12",null,"NA","NA"],
    [2733,"2733","Carrier G","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97155","ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN","12","0.92",null,null,"105.5",null,null,"12",null,"NA","NA"],
    [2734,"2734","Carrier G","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","H0018","BHVAL HEALTH; SHORT-TERM RES W/O ROOM and BOARD-DIEM","13","0.92",null,"17.7","22",null,"11","2",null,"NA","NA"],
    [2735,"2735","Carrier G","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71271","COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-","110","0.86",null,"37.1","95.8",null,"4","106",null,"NA","NA"],
    [2736,"2736","Carrier G","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV  and  MN","15","0.67",null,null,"77",null,null,"15",null,"NA","NA"],
    [2737,"2737","Carrier G","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL and M","17","0.65",null,null,"71.9",null,"1","16",null,"NA","NA"],
    [2738,"2738","Carrier G","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90833","PSYCHOTHERAPY W/PATIENT W/E and M SRVCS 30 MIN","11","0.64",null,null,"53.4",null,null,"11",null,"NA","NA"],
    [2739,"2739","Carrier G","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","THERAP REPETITIVE TMS TX SUBSEQ DELIVERY  AND  MNG","19","0.63",null,null,"71.9",null,"1","18",null,"NA","NA"],
    [2740,"2740","Carrier G","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVALUATION","17","0.47",null,"47.3","69.1",null,"3","14",null,"NA","NA"],
    [2741,"2741","Carrier G","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","126","Room & Board - Semiprivate - 2 Beds - Detoxification","4","1",null,"24.3",null,null,"4",null,null,"NA","NA"],
    [2742,"2742","Carrier G","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","912","Behavioral Health Treatments_Services - Partial hospitalizat","2","1",null,"35.5",null,null,"2",null,null,"NA","NA"],
    [2743,"2743","Carrier G","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","905","Behavioral Health Treatments/Services -IOP Psychiatric","1","1",null,"96",null,null,"1",null,null,"NA","NA"],
    [2744,"2744","Carrier G","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81381","HLA I TYPING HIGH RESOLUTION 1 ALLELE/ALLELE GRP","2","1",null,null,null,null,null,"2",null,"NA","NA"],
    [2745,"2745","Carrier G","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","906","Behavioral Health Treatments/Services - IOP Chemical Depende","1","1",null,null,"55.2",null,null,"1",null,"NA","NA"],
    [2746,"2746","Carrier G","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70551","MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL","1","1",null,null,"71.4",null,null,"1",null,"NA","NA"],
    [2747,"2747","Carrier G","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81380","HLA CLASS I TYPING HIGH RESOLUTION ONE LOCUS EA","1","1",null,null,null,null,null,"1",null,"NA","NA"],
    [2748,"2748","Carrier G","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","906","Behavioral Health Treatments_Services - Intensive outpatient","1","1",null,null,"48",null,null,"1",null,"NA","NA"],
    [2749,"2749","Carrier G","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90846","FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [2750,"2750","Carrier G","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","92521","EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER)","1","1",null,null,"6.9",null,null,"1",null,"NA","NA"],
    [2751,"2751","Carrier G","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","126","Room & Board - Semiprivate - 2 Beds - Detoxification","4","0","0.25","24.3",null,null,"4",null,null,"NA","NA"],
    [2752,"2752","Carrier G","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","71271","COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-","110","0","0.009","37.1","95.8",null,"4","106",null,"NA","NA"],
    [2753,"2753","Carrier G","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVALUATION","17","0","0.059","47.3","69.1",null,"3","14",null,"NA","NA"],
    [2754,"2754","Carrier G","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","G0283","E-STIM 1 OR GT  AREAS OTH THAN WND CARE PART TX PLAN","1","0","1",null,"74.6",null,null,"1",null,"NA","NA"],
    [2755,"2755","Carrier H","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","Test Strips","146","0.72",null,"5.9","21.91",null,"29","117",null,"NA","NA"],
    [2756,"2756","Carrier H","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","Test Strips","146","0.72",null,"5.9","21.91",null,"29","117",null,"NA","NA"],
    [2757,"2757","Carrier H","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0486","Oral Device/appliance Cusfab","329","0.99",null,"3.71","0.15",null,"0","329",null,"NA","NA"],
    [2758,"2758","Carrier H","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2620","Positioning Wheelchair Back Cushion, Planar Back With Lateral Supports, Width","18","0.95",null,"100.36","4.18",null,"0","18",null,"NA","NA"],
    [2759,"2759","Carrier H","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0005","Ultralightweight Wheelchair","25","0.92",null,"75.84","3.16",null,"0","25",null,"NA","NA"],
    [2760,"2760","Carrier H","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S1040","Cranial Remolding Orthosis, Rigid, With Soft Interface Material, Custom Fabricated, Includes Fitting And Adjustment(s)","47","0.88",null,"69.23","2.88",null,"0","47",null,"NA","NA"],
    [2761,"2761","Carrier H","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0652","Pneumatic Compressor, Segmental Home Model With Calibrated Gradient Pr","20","0.85",null,"56.35","2.35",null,"0","20",null,"NA","NA"],
    [2762,"2762","Carrier H","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0108","Wheelchair Component Or Accessory, Not Otherwise Specified","83","0.8",null,"78","3.25",null,"0","83",null,"NA","NA"],
    [2763,"2763","Carrier H","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L1846","Ko, Double Upright, Thigh And Calf, With Adjustable Flexion And Extens","21","0.62",null,"68.31","2.85",null,"0","21",null,"NA","NA"],
    [2764,"2764","Carrier H","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0748","Osteogenic Stimulator, Noninvasive, Spinal Applications","36","0.48",null,"81.23","3.38",null,"0","36",null,"NA","NA"],
    [2765,"2765","Carrier H","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0747","Osteogenesis Stimulator (non-invasive)","38","0.43",null,"79.35","3.31",null,"0","38",null,"NA","NA"],
    [2766,"2766","Carrier H","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0760","Osteogenesis Stimulator Low Intensity Ultrasound Noninvasive","33","0.04",null,"85.03","3.54",null,"0","33",null,"NA","NA"],
    [2767,"2767","Carrier H","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8680","Implantable Neurostimulator Electrode Each","15","1",null,"24","98.82",null,"1","14",null,"NA","NA"],
    [2768,"2768","Carrier H","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L2755","Addition To Lower Extremity Orthosis Carbon Graphite Lamination","12","1",null,null,"60",null,"0","12",null,"NA","NA"],
    [2769,"2769","Carrier H","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1233","Wheelchair, Pediatric Size, Tilt-in-space, Rigid, Adj, Wo Seating","5","1",null,null,"67.2",null,"0","5",null,"NA","NA"],
    [2770,"2770","Carrier H","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2617","Custom Fabricated Wheelchair Back Cushion, Any Size, Including Any Type","5","1",null,null,"68",null,"0","5",null,"NA","NA"],
    [2771,"2771","Carrier H","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2609","Custom Fabricated Wheelchair Seat Cushion, Any Size","5","1",null,null,"82.29",null,"0","5",null,"NA","NA"],
    [2772,"2772","Carrier H","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S1040","Cranial Remolding Orthosis, Rigid, With Soft Interface Material, Custom Fabricated, Includes Fitting And Adjustment(s)","5","1",null,null,"84",null,"0","5",null,"NA","NA"],
    [2773,"2773","Carrier H","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1002","Wheelchair Accessory, Power Seating System, Tilt Only","4","1",null,null,"110.4",null,"0","4",null,"NA","NA"],
    [2774,"2774","Carrier H","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2310","Power Wheelchair Accessory, Electronic Connection Between Wheelchair Controller A& One Power Seating System Motor, Incl All Related Electronics, Indicator Feature, Mechanical","3","1",null,null,"56",null,"0","3",null,"NA","NA"],
    [2775,"2775","Carrier H","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1234","Wheelchair, Pediatric Size, Tilt-in-space, Folding, Adj, Wo Seating","3","1",null,null,"88",null,"0","3",null,"NA","NA"],
    [2776,"2776","Carrier H","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8619","Cochlear Implant External Speech Processor And Controller, Integrated System, Replacement","2","1",null,null,"84",null,"0","2",null,"NA","NA"],
    [2777,"2777","Carrier H","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","K0005","Ultralightweight Wheelchair","25","0","1",null,"75.84",null,"0","25",null,"NA","NA"],
    [2778,"2778","Carrier H","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0652","Pneumatic Compressor, Segmental Home Model With Calibrated Gradient Pr","20","0","1",null,"56.35",null,"0","20",null,"NA","NA"],
    [2779,"2779","Carrier H","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E2620","Positioning Wheelchair Back Cushion, Planar Back With Lateral Supports, Width","18","0","1",null,"100.36",null,"0","18",null,"NA","NA"],
    [2780,"2780","Carrier H","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L8619","Cochlear Implant External Speech Processor And Controller, Integrated System, Replacement","9","0","1",null,"80",null,"0","9",null,"NA","NA"],
    [2781,"2781","Carrier H","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0766","Electrical Stimulation Device Used For Cancer Treatment, Includes All Accessories, Any Type","8","0","0.5","9.6","57.6",null,"2","6",null,"NA","NA"],
    [2782,"2782","Carrier H","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0986","Manual Wheelchair Accessory, Push-rim Activated Power Assist, Each","5","0","1",null,"76",null,"0","5",null,"NA","NA"],
    [2783,"2783","Carrier H","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L5856","Addition To Lower Extremity Prosthesis, Endoskeletal Knee-shin System,","5","0","1","24","100.8",null,"1","4",null,"NA","NA"],
    [2784,"2784","Carrier H","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0766","Electrical Stimulation Device Used For Cancer Treatment, Includes All Accessories, Any Type","1","0","1",null,"72",null,"0","1",null,"NA","NA"],
    [2785,"2785","Carrier H","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0747","Osteogenesis Stimulator (non-invasive)","1","0","1",null,"120",null,"0","1",null,"NA","NA"],
    [2786,"2786","Carrier H","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L1846","Ko, Double Upright, Thigh And Calf, With Adjustable Flexion And Extens","1","0","1",null,"96",null,"0","1",null,"NA","NA"],
    [2787,"2787","Carrier H","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27130","Replacement Hip Total Simple","29","0.97",null,"0","70.59",null,"1","28",null,"NA","NA"],
    [2788,"2788","Carrier H","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43775","Laps Gstrc Rstrictiv Px Longitudinal Gastrectomy","55","0.91",null,null,"80.28",null,"0","55",null,"NA","NA"],
    [2789,"2789","Carrier H","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43644","Laparoscopy, Surg, Gastric Restrictive Procedure; W Gastric Bypass And Roux-en-y Gastroenterostomy (roux Limb <= 150 Cm)","44","0.91",null,null,"98.77",null,"0","44",null,"NA","NA"],
    [2790,"2790","Carrier H","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22551","Arthrodesis, Anterior Interbody, Including Disc Space Preparation, Discectomy, Osteophytectomy And Decompression Of Spinal Cord And/or Nerve Roots; Cervical Below C2","35","0.89",null,"33.6","87.27",null,"2","33",null,"NA","NA"],
    [2791,"2791","Carrier H","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63047","Laminectomy W Facetectomy-lumbar","29","0.87",null,"0","79.76",null,"1","28",null,"NA","NA"],
    [2792,"2792","Carrier H","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","Arthrod,interbdy Tech;lumbar,allogf","53","0.82",null,"24","78.48",null,"2","51",null,"NA","NA"],
    [2793,"2793","Carrier H","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27447","Replacement Knee Total","25","0.82",null,"24","83",null,"1","24",null,"NA","NA"],
    [2794,"2794","Carrier H","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22633","Arthrodesis, Combined Posterior Or Posterolateral Technique Wi/ Posterior Interbody Technique Incl Laminectomy And/or Discectomy Sufficient To Prepare Interspace, Lumbar","43","0.77",null,"40","73.67",null,"2","41",null,"NA","NA"],
    [2795,"2795","Carrier H","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22630","Arthrodesis Post Interbody-lumbar","10","0.7",null,null,"93.82",null,"0","10",null,"NA","NA"],
    [2796,"2796","Carrier H","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22612","Arthrodesis, Posterior Or Posterolateral Technique, Single Interspace; Lumbar (with Lateral Transverse Technique, When Performed)","11","0.64",null,"24","86.77",null,"1","10",null,"NA","NA"],
    [2797,"2797","Carrier H","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","75894","Transcatheter Therapy Embolize Any Meth","8","1",null,"24","51.43",null,"1","7",null,"NA","NA"],
    [2798,"2798","Carrier H","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33361","Transcatheter Aortic Valve Replacement (tavr/tavi) With Prosthetic Valve; Percutaneous Femoral Artery Approach","7","1",null,"24","75.43",null,"1","6",null,"NA","NA"],
    [2799,"2799","Carrier H","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63048","Laminectomy, Facetectomy & Foraminotomy (unilateral Or Bilateral W/ Decompression Of Spinal Cord, Cauda Equina And/or Nerve Root[s], Single Vertebral Segment; Each Addtl","6","1",null,null,"133.71",null,"0","6",null,"NA","NA"],
    [2800,"2800","Carrier H","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63045","Laminectomy W Facetectomy-cervical","6","1",null,"24","72",null,"1","5",null,"NA","NA"],
    [2801,"2801","Carrier H","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27134","Revis.tot.hip Arthropl;both Compnts","5","1",null,null,"72",null,"0","5",null,"NA","NA"],
    [2802,"2802","Carrier H","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22802","Arthrod,post,spin.deform,gft;7+vert","4","1",null,null,"54",null,"0","4",null,"NA","NA"],
    [2803,"2803","Carrier H","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22600","Arthrodesis, Posterior Or Posterolateral Technique, Single Interspace; Cervical Below C2 Segment","4","1",null,"24","56",null,"1","3",null,"NA","NA"],
    [2804,"2804","Carrier H","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43235","Esophagogastroduodenoscopy Flexible, Transoral; Diagnostic, Including Collection Of Specimen(s) By Brushing Or Washing, When Performed (separate Procedure)","3","1",null,null,"78",null,"0","3",null,"NA","NA"],
    [2805,"2805","Carrier H","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22552","Arthrodesis, Anterior Interbody, Incl Disc Space Prep, Discectomy, Osteophytectomy & Decompression Of Spinal Cord &/or Nerve Roots; Cervical Below C2 Each Additional Interspac","3","1",null,"24","84",null,"1","2",null,"NA","NA"],
    [2806,"2806","Carrier H","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22585","Arthrodesis, Anterior/-lateral,ea Add.in","3","1",null,"0","48",null,"1","2",null,"NA","NA"],
    [2807,"2807","Carrier H","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22558","Arthrod,interbdy Tech;lumbar,allogf","53","0","1","24","78",null,"2","51",null,"NA","NA"],
    [2808,"2808","Carrier H","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43644","Laparoscopy, Surg, Gastric Restrictive Procedure; W Gastric Bypass And Roux-en-y Gastroenterostomy (roux Limb <= 150 Cm)","44","0","1","0","98.77",null,"0","44",null,"NA","NA"],
    [2809,"2809","Carrier H","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22551","Arthrodesis, Anterior Interbody, Including Disc Space Preparation, Discectomy, Osteophytectomy And Decompression Of Spinal Cord And/or Nerve Roots; Cervical Below C2","35","0","1","34","87",null,"2","33",null,"NA","NA"],
    [2810,"2810","Carrier H","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27130","Replacement Hip Total Simple","29","0","1","0","70.59",null,"1","28",null,"NA","NA"],
    [2811,"2811","Carrier H","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63047","Laminectomy W Facetectomy-lumbar","29","0","1","0","80",null,"1","28",null,"NA","NA"],
    [2812,"2812","Carrier H","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27447","Replacement Knee Total","25","0","1","24","83",null,"1","24",null,"NA","NA"],
    [2813,"2813","Carrier H","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22630","Arthrodesis Post Interbody-lumbar","10","0","1","0","93.82",null,"0","10",null,"NA","NA"],
    [2814,"2814","Carrier H","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22533","Arthrodesis, Lateral Extracavitary Technique, Including Minimal Diskectomy To Prepare Interspace; Lumbar","9","0","1","24","87",null,"1","8",null,"NA","NA"],
    [2815,"2815","Carrier H","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","55970","Intersex Op Male To Female","7","0","1","0","76",null,"0","7",null,"NA","NA"],
    [2816,"2816","Carrier H","2021","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22614","Arthrodesis, Posterior Or Posterolateral Technique, Single Interspace; Each Additional Interspace (list Separately In Addition To Code For Primary Procedure)","5","0","1","24","192",null,"1","4",null,"NA","NA"],
    [2817,"2817","Carrier H","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","128","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation","13","0.46",null,"27","17.09",null,"6","7",null,"NA","NA"],
    [2818,"2818","Carrier H","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric","2","0",null,"25","23.12",null,"1","1",null,"NA","NA"],
    [2819,"2819","Carrier H","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","128","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation","13","0.46",null,"27","17.09",null,"6","7",null,"NA","NA"],
    [2820,"2820","Carrier H","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0399","Home Sleep Test W/type Iii Portable Monitor","3845","0.97",null,null,"3",null,"0","3845",null,"NA","NA"],
    [2821,"2821","Carrier H","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","Echocardiography, Transthoracic, Real-time W/ Image Documentation (2d), Includes M-mode Recording, When Performed","7010","0.95",null,"0","3.34",null,"2","7008",null,"NA","NA"],
    [2822,"2822","Carrier H","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","Mri Brain; W/o Contrast & W/contrast & A","3549","0.95",null,"0","6",null,"4","3545",null,"NA","NA"],
    [2823,"2823","Carrier H","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74176","Ct Abd & Pelvis W/o Contrast","6673","0.94",null,"0.18","5.09",null,"22","6651",null,"NA","NA"],
    [2824,"2824","Carrier H","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43235","Esophagogastroduodenoscopy Flexible, Transoral; Diagnostic, Including Collection Of Specimen(s) By Brushing Or Washing, When Performed (separate Procedure)","2927","0.9",null,"0.69","49",null,"154","2773",null,"NA","NA"],
    [2825,"2825","Carrier H","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","Magnetic Resonance Imaging, Any Jnt-lowe","6052","0.89",null,"0","7",null,"4","6048",null,"NA","NA"],
    [2826,"2826","Carrier H","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43239","Esophagogastroduodenoscopy Flexible, Transoral; With Biopsy, Single Or Multiple","3284","0.89",null,"0.59","49",null,"186","3098",null,"NA","NA"],
    [2827,"2827","Carrier H","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72141","Mri,spin.canal,cerv;w/o Contrst Mat","2394","0.86",null,"0","10.3",null,"3","2391",null,"NA","NA"],
    [2828,"2828","Carrier H","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72148","Mri,spin.canal,lumb;w/o Cntrst Matl","4276","0.85",null,"1","9",null,"6","4270",null,"NA","NA"],
    [2829,"2829","Carrier H","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73221","Mri, Any Joint Of Upper Extremity","3078","0.85",null,"0","8",null,"2","3076",null,"NA","NA"],
    [2830,"2830","Carrier H","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29888","Arthroscopically Aided Anter,cruciate Li","142","1",null,"18","72.81",null,"4","138",null,"NA","NA"],
    [2831,"2831","Carrier H","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95806","Sleep Study, Unattended, Simultaneous Recording Of, Heart Rate, Oxygen Saturation, Respiratory Airflow, And Respiratory Effort (eg Thoracoabdominal Movement)","80","1",null,null,"104.59",null,"0","80",null,"NA","NA"],
    [2832,"2832","Carrier H","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77371","Radiation Treatment Delivery, Sterotactic Radiosurgery (srs), Complete Course Of Treatment Of Cranial Lesion(s) Consisting Of 1 Session; Multi-source Cobalt 60 Based","63","1",null,null,"20",null,"0","63",null,"NA","NA"],
    [2833,"2833","Carrier H","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29874","Arthroscop Knee W Remov Loose Body","58","1",null,"8","73",null,"3","55",null,"NA","NA"],
    [2834,"2834","Carrier H","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29875","Arthroscopy,knee,surg;synovec,limited-se","50","1",null,"10","74",null,"5","45",null,"NA","NA"],
    [2835,"2835","Carrier H","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","78472","Card Bld Pool Image; 1 Rest W/motn","34","1",null,null,"0",null,"0","34",null,"NA","NA"],
    [2836,"2836","Carrier H","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95800","Slp Stdy Unatnd W/hrt Rate/o2 Sat/resp/slp Time","32","1",null,null,"0",null,"0","32",null,"NA","NA"],
    [2837,"2837","Carrier H","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77386","Intensity Modulated Radiation Treatment Delivery (imrt), Includes Guidance And Tracking, When Performed; Complex","41","1",null,"53","91",null,"10","31",null,"NA","NA"],
    [2838,"2838","Carrier H","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29876","Arthroscopy, Knee, Surgical; With Lateral Release","27","1",null,"88","68",null,"0","28",null,"NA","NA"],
    [2839,"2839","Carrier H","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29879","Arthroscopy, Knee, Surgical; Abrasion Arthroplasty (includes Chondroplasty Where Necessary) Or Multiple Drilling Or Microfracture","28","1",null,"24","95",null,"1","27",null,"NA","NA"],
    [2840,"2840","Carrier H","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","29881","Arthroscopy, Knee, With Meniscectomy Including Debridement/shaving Of Articular Cartilage, Same Or Separate Compartment(s), When Performed","501","0","1","17","74",null,"23","478",null,"NA","NA"],
    [2841,"2841","Carrier H","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","77402","Radiation Treatment Delivery, >= 1 Mev; Simple","329","0","1",null,"4",null,"0","329",null,"NA","NA"],
    [2842,"2842","Carrier H","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","29880","Arthroscopy, Knee, With Meniscectomy Including Debridement/shaving Of Articular Cartilage, Same Or Separate Compartment(s), When Performed","137","0","1","0","73",null,"1","136",null,"NA","NA"],
    [2843,"2843","Carrier H","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","29877","Arthroscopy,knee,surg;debride/shave A.ca","119","0","1","21","77",null,"8","111",null,"NA","NA"],
    [2844,"2844","Carrier H","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","31255","Nasal/sinus Endoscopy,surgical; With Ethmoidectomy,total (anterior And Posterior)","99","0","1","16","63",null,"3","96",null,"NA","NA"],
    [2845,"2845","Carrier H","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","75572","Ct Heart Contrast Eval Cardiac Structure&morph","53","0","1",null,"0",null,"0","53",null,"NA","NA"],
    [2846,"2846","Carrier H","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","29883","Arthroscop Knee W Tot Meniscus Rep","53","0","1",null,"70",null,"0","53",null,"NA","NA"],
    [2847,"2847","Carrier H","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","72147","Mri,spinal Canal/contents,thorac;w/cntrs","51","0","1",null,"0",null,"0","51",null,"NA","NA"],
    [2848,"2848","Carrier H","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63042","Laminotomy W Dec Nrv Rts;reex;lumb","49","0","1","19","77",null,"5","44",null,"NA","NA"],
    [2849,"2849","Carrier H","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27446","Arthropls,knee,cond/plat;medor Lat","34","0","1",null,"83",null,"0","34",null,"NA","NA"],
    [2850,"2850","Carrier H","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC SIMULATION (TMS) TREATMENT; INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, DELIVERY AND MGMT","196","0.82",null,"24","64",null,"1","153",null,"NA","NA"],
    [2851,"2851","Carrier H","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT MOTOR THRESHOLD RE-DETERMINATION WITH DELIVERY AND MANAGEMENT","150","0.79",null,"24","65",null,"1","149",null,"NA","NA"],
    [2852,"2852","Carrier H","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC SIMULATION (TMS) TREATMENT; INITIAL, INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, SUBSEQUENT DELIVERY AND MGMT.","251","0.69",null,"24","68",null,"1","171",null,"NA","NA"],
    [2853,"2853","Carrier H","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90867","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC SIMULATION (TMS) TREATMENT; INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, DELIVERY AND MGMT","196","0.82",null,"24","64",null,"1","153",null,"NA","NA"],
    [2854,"2854","Carrier H","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90869","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT MOTOR THRESHOLD RE-DETERMINATION WITH DELIVERY AND MANAGEMENT","150","0.79",null,"24","65",null,"1","149",null,"NA","NA"],
    [2855,"2855","Carrier H","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90868","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC SIMULATION (TMS) TREATMENT; INITIAL, INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, SUBSEQUENT DELIVERY AND MGMT.","251","0.69",null,"24","68",null,"1","171",null,"NA","NA"],
    [2856,"2856","Carrier H","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90868","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC SIMULATION (TMS) TREATMENT; INITIAL, INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, SUBSEQUENT DELIVERY AND MGMT.","251","0","0.05","24","68",null,"1","171",null,"NA","NA"],
    [2857,"2857","Carrier H","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90867","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC SIMULATION (TMS) TREATMENT; INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, DELIVERY AND MGMT","196","0","0.09","24","64",null,"1","153",null,"NA","NA"],
    [2858,"2858","Carrier H","2021","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90869","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT MOTOR THRESHOLD RE-DETERMINATION WITH DELIVERY AND MANAGEMENT","150","0","0.13","24","65",null,"1","149",null,"NA","NA"],
    [2859,"2859","Carrier I","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","11","0.91",null,null,"70.35487886",null,null,"11",null,"NA","NA"],
    [2860,"2860","Carrier I","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4232","Syringe W/Needle Insulin 3cc","1","0",null,null,"0.002192501",null,null,"1",null,"NA","NA"],
    [2861,"2861","Carrier I","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4230","Infus Insulin Pump Non Needl","1","0",null,null,"0.002075832",null,null,"1",null,"NA","NA"],
    [2862,"2862","Carrier I","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4231","Infusion Insulin Pump Needle","1","0",null,null,"0.00213611",null,null,"1",null,"NA","NA"],
    [2863,"2863","Carrier I","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","11","0.91",null,null,"70.35487886",null,null,"11",null,"NA","NA"],
    [2864,"2864","Carrier I","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4232","Syringe W/Needle Insulin 3cc","1","0",null,null,"0.002192501",null,null,"1",null,"NA","NA"],
    [2865,"2865","Carrier I","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4230","Infus Insulin Pump Non Needl","1","0",null,null,"0.002075832",null,null,"1",null,"NA","NA"],
    [2866,"2866","Carrier I","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4231","Infusion Insulin Pump Needle","1","0",null,null,"0.00213611",null,null,"1",null,"NA","NA"],
    [2867,"2867","Carrier I","2021","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0784","Ext Amb Infusn Pump Insulin","11","0","0.09",null,"70.35487886",null,null,"11",null,"NA","NA"],
    [2868,"2868","Carrier I","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0562","Humidifier, heated, used with positive airway pressure device","1","1",null,null,"51.8439325",null,null,"1",null,"NA","NA"],
    [2869,"2869","Carrier I","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]","239","0.98",null,null,"2.043918472",null,null,"239",null,"NA","NA"],
    [2870,"2870","Carrier I","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","13","0.85",null,null,"4.681773504",null,null,"13",null,"NA","NA"],
    [2871,"2871","Carrier I","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","3","0.67",null,null,"9.361759259",null,null,"3",null,"NA","NA"],
    [2872,"2872","Carrier I","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0760","Osteogen Ultrasound Stimltor","4","0.25",null,null,"96.94006944",null,null,"4",null,"NA","NA"],
    [2873,"2873","Carrier I","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2624","Adj skin pro/pos cus<22in","1","0",null,"0.086358331",null,null,"1",null,null,"NA","NA"],
    [2874,"2874","Carrier I","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0971","Wheelchair Anti-Tipping Devi","1","0",null,"0.086472221",null,null,"1",null,null,"NA","NA"],
    [2875,"2875","Carrier I","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0973","Wheelchair Adjustabl Height","1","0",null,"0.086313055",null,null,"1",null,null,"NA","NA"],
    [2876,"2876","Carrier I","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2620","WC planar back cush wd <22in","1","0",null,"0.086410277",null,null,"1",null,null,"NA","NA"],
    [2877,"2877","Carrier I","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0961","Wheelchair Brake Extension","1","0",null,"0.086274166",null,null,"1",null,null,"NA","NA"],
    [2878,"2878","Carrier I","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2300","Power wheelchair accessory, power seat elevation system","2","0",null,null,"12.06875",null,null,"2",null,"NA","NA"],
    [2879,"2879","Carrier I","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0748","Elec Osteogen Stim Spinal","1","0",null,null,"26.89350917",null,null,"1",null,"NA","NA"],
    [2880,"2880","Carrier I","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0486","Oral device/appliance cusfab","1","0",null,null,"0.070833334",null,null,"1",null,"NA","NA"],
    [2881,"2881","Carrier I","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0562","Humidifier, heated, used with positive airway pressure device","1","1",null,null,"51.8439325",null,null,"1",null,"NA","NA"],
    [2882,"2882","Carrier I","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0601","Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]","239","0.98",null,null,"2.043918472",null,null,"239",null,"NA","NA"],
    [2883,"2883","Carrier I","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","13","0.85",null,null,"4.681773504",null,null,"13",null,"NA","NA"],
    [2884,"2884","Carrier I","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","3","0.67",null,null,"9.361759259",null,null,"3",null,"NA","NA"],
    [2885,"2885","Carrier I","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0760","Osteogen Ultrasound Stimltor","4","0.25",null,null,"96.94006944",null,null,"4",null,"NA","NA"],
    [2886,"2886","Carrier I","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2624","Adj skin pro/pos cus<22in","1","0",null,"0.086358331",null,null,"1",null,null,"NA","NA"],
    [2887,"2887","Carrier I","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0971","Wheelchair Anti-Tipping Devi","1","0",null,"0.086472221",null,null,"1",null,null,"NA","NA"],
    [2888,"2888","Carrier I","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0973","Wheelchair Adjustabl Height","1","0",null,"0.086313055",null,null,"1",null,null,"NA","NA"],
    [2889,"2889","Carrier I","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2620","WC planar back cush wd <22in","1","0",null,"0.086410277",null,null,"1",null,null,"NA","NA"],
    [2890,"2890","Carrier I","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0961","Wheelchair Brake Extension","1","0",null,"0.086274166",null,null,"1",null,null,"NA","NA"],
    [2891,"2891","Carrier I","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2300","Power wheelchair accessory, power seat elevation system","2","0",null,null,"12.06875",null,null,"2",null,"NA","NA"],
    [2892,"2892","Carrier I","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0748","Elec Osteogen Stim Spinal","1","0",null,null,"26.89350917",null,null,"1",null,"NA","NA"],
    [2893,"2893","Carrier I","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0486","Oral device/appliance cusfab","1","0",null,null,"0.070833334",null,null,"1",null,"NA","NA"],
    [2894,"2894","Carrier I","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63012","Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (Gill type procedure)","2","1",null,null,"3.670543426",null,null,"2",null,"NA","NA"],
    [2895,"2895","Carrier I","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","3","0.67",null,null,"7.384826028",null,null,"3",null,"NA","NA"],
    [2896,"2896","Carrier I","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","3","0.67",null,null,"7.384826028",null,null,"3",null,"NA","NA"],
    [2897,"2897","Carrier I","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22633","Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar","2","0.5",null,null,"36.49746347",null,null,"2",null,"NA","NA"],
    [2898,"2898","Carrier I","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","69990","Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure)","3","0",null,null,"1.091204352",null,null,"3",null,"NA","NA"],
    [2899,"2899","Carrier I","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","52005","Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","3","0",null,null,"0.058389166",null,null,"3",null,"NA","NA"],
    [2900,"2900","Carrier I","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","62141","Cranioplasty for skull defect; larger than 5 cm diameter","2","0",null,null,"0.081991667",null,null,"2",null,"NA","NA"],
    [2901,"2901","Carrier I","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","52332","Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type)","2","0",null,null,"0.046121806",null,null,"2",null,"NA","NA"],
    [2902,"2902","Carrier I","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);","2","0",null,null,"0.002916667",null,null,"2",null,"NA","NA"],
    [2903,"2903","Carrier I","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","61512","Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, supratentorial","2","0",null,null,"1.593333334",null,null,"2",null,"NA","NA"],
    [2904,"2904","Carrier I","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44207","Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)","2","0",null,null,"2.85989861",null,null,"2",null,"NA","NA"],
    [2905,"2905","Carrier I","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","61781","Stereotactic computer-assisted (navigational) procedure; cranial, intradural (List separately in addition to code for primary procedure)","3","0",null,"0.086944445","1.593333334",null,"1","2",null,"NA","NA"],
    [2906,"2906","Carrier I","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15750","Flap; neurovascular pedicle","2","0",null,"0.087222221","0.005827778",null,"1","1",null,"NA","NA"],
    [2907,"2907","Carrier I","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15769","Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia)","1","1",null,"24.15111111",null,null,"1",null,null,"NA","NA"],
    [2908,"2908","Carrier I","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63012","Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (Gill type procedure)","2","1",null,null,"3.670543426",null,null,"2",null,"NA","NA"],
    [2909,"2909","Carrier I","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22630","Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; lumbar","1","1",null,null,"0.106666667",null,null,"1",null,"NA","NA"],
    [2910,"2910","Carrier I","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27130","Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft","1","1",null,null,"19.34411111",null,null,"1",null,"NA","NA"],
    [2911,"2911","Carrier I","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27446","Arthroplasty, knee, condyle and plateau; medial OR lateral compartment","1","1",null,null,"11.44515194",null,null,"1",null,"NA","NA"],
    [2912,"2912","Carrier I","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27487","Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component","1","1",null,null,"21.71432139",null,null,"1",null,"NA","NA"],
    [2913,"2913","Carrier I","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33361","Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; percutaneous femoral artery approach","1","1",null,null,"1.821111113",null,null,"1",null,"NA","NA"],
    [2914,"2914","Carrier I","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33362","Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open femoral artery approach","1","1",null,null,"1.821111113",null,null,"1",null,"NA","NA"],
    [2915,"2915","Carrier I","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","47135","Liver allotransplantation, orthotopic, partial or whole, from cadaver or living donor, any age","1","1",null,null,"17.83",null,null,"1",null,"NA","NA"],
    [2916,"2916","Carrier I","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","49560","Repair initial incisional or ventral hernia; reducible","1","1",null,null,"240.5268472",null,null,"1",null,"NA","NA"],
    [2917,"2917","Carrier I","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15734","Muscle, myocutaneous, or fasciocutaneous flap; trunk","1","1",null,null,"240.5268508",null,null,"1",null,"NA","NA"],
    [2918,"2918","Carrier I","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43644","Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy (roux limb 150 cm or less)","1","1",null,null,"2.738888887",null,null,"1",null,"NA","NA"],
    [2919,"2919","Carrier I","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1002","Residential treatment, Substance Use Disorder","14","1",null,null,"43.07273148",null,null,"14",null,"NA","NA"],
    [2920,"2920","Carrier I","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","Room and board, Semi-Private, Psychiatric","2","1",null,null,"21.58013889",null,null,"2",null,"NA","NA"],
    [2921,"2921","Carrier I","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1001","Residential treatment, Psychiatric","1","1",null,null,"88.88666667",null,null,"1",null,"NA","NA"],
    [2922,"2922","Carrier I","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","126","Room and board, Semi Private Detoxification","1","1",null,null,"0.2019675",null,null,"1",null,"NA","NA"],
    [2923,"2923","Carrier I","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1002","Residential treatment, Substance Use Disorder","14","1",null,null,"43.07273148",null,null,"14",null,"NA","NA"],
    [2924,"2924","Carrier I","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","Room and board, Semi-Private, Psychiatric","2","1",null,null,"21.58013889",null,null,"2",null,"NA","NA"],
    [2925,"2925","Carrier I","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1001","Residential treatment, Psychiatric","1","1",null,null,"88.88666667",null,null,"1",null,"NA","NA"],
    [2926,"2926","Carrier I","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","126","Room and board, Semi Private Detoxification","1","1",null,null,"0.2019675",null,null,"1",null,"NA","NA"],
    [2927,"2927","Carrier I","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","MRI of brain and further sequences","132","0.94",null,null,"14.74452149",null,null,"132",null,"NA","NA"],
    [2928,"2928","Carrier I","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","ECHO, transthoracic w/doppler, complete","211","0.93",null,null,"9.101342806",null,null,"211",null,"NA","NA"],
    [2929,"2929","Carrier I","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0399","Home sleep test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation","156","0.93",null,null,"6.463750842",null,null,"156",null,"NA","NA"],
    [2930,"2930","Carrier I","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74176","CT abd & pelvis","223","0.89",null,null,"16.77075072",null,null,"223",null,"NA","NA"],
    [2931,"2931","Carrier I","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72148","MRI of lumbar spine","140","0.85",null,"0.280555558","7.621059028","672","1","139","1","NA","NA"],
    [2932,"2932","Carrier I","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","MRI, lower extremity any joint; wo contr","148","0.85",null,null,"13.98278651",null,null,"148",null,"NA","NA"],
    [2933,"2933","Carrier I","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","270","0.74",null,null,"30.39479178",null,null,"270",null,"NA","NA"],
    [2934,"2934","Carrier I","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97140","Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes","256","0.72",null,null,"33.19778745",null,null,"256",null,"NA","NA"],
    [2935,"2935","Carrier I","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97530","Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","196","0.68",null,null,"28.1757568",null,null,"196",null,"NA","NA"],
    [2936,"2936","Carrier I","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97112","Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities","139","0.62",null,null,"38.76119208",null,null,"139",null,"NA","NA"],
    [2937,"2937","Carrier I","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93303","ECHO, transthoracic, complete cng","31","1",null,null,"2.592382155",null,null,"31",null,"NA","NA"],
    [2938,"2938","Carrier I","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","71271","CT THORAX LW DOSE LNG CA SCR C-","27","1",null,null,"0.000164609",null,null,"27",null,"NA","NA"],
    [2939,"2939","Carrier I","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27447","Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)","24","1",null,null,"28.47179523",null,null,"24",null,"NA","NA"],
    [2940,"2940","Carrier I","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70491","Contrast CAT scan of neck tissue","19","1",null,null,"7.380423977",null,null,"19",null,"NA","NA"],
    [2941,"2941","Carrier I","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","98943","Chiropractic manipulative treatment (CMT); extraspinal, 1 or more regions","17","1",null,null,"0.124270915",null,null,"17",null,"NA","NA"],
    [2942,"2942","Carrier I","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70543","MRI orb/fc/nck w/o cntrst flwd cntr","14","1",null,null,"24.03807407",null,null,"14",null,"NA","NA"],
    [2943,"2943","Carrier I","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72157","MRI of thoracic spine","11","1",null,null,"2.040023148",null,null,"11",null,"NA","NA"],
    [2944,"2944","Carrier I","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93312","ECHO, transesophageal, heart, compl","9","1",null,null,"0.000185185",null,null,"9",null,"NA","NA"],
    [2945,"2945","Carrier I","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93308","ECHO, transthoracic, heart, limited","8","1",null,null,"3.355902778",null,null,"8",null,"NA","NA"],
    [2946,"2946","Carrier I","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64635","Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint","7","1",null,null,"25.14872683",null,null,"7",null,"NA","NA"],
    [2947,"2947","Carrier I","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","G0398","Home sleep study test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation","7","1",null,null,"15.69222222",null,null,"7",null,"NA","NA"],
    [2948,"2948","Carrier I","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95805","Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness","7","1",null,null,"0.000119048",null,null,"7",null,"NA","NA"],
    [2949,"2949","Carrier I","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70480","CT, orbit, sella or pos fos wo contrast","7","1",null,null,"0.081825397",null,null,"7",null,"NA","NA"],
    [2950,"2950","Carrier I","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29888","Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction","7","1",null,null,"13.32367756",null,null,"7",null,"NA","NA"],
    [2951,"2951","Carrier I","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","70460","Contrast CAT scan of head/brain","2","0.5",null,null,"73.52277778",null,null,"2",null,"NA","NA"],
    [2952,"2952","Carrier I","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","62321","Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging guidance (ie, fluoroscopy or CT)","6","0.17",null,null,"12.31216825",null,null,"6",null,"NA","NA"],
    [2953,"2953","Carrier I","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64405","Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve","13","0.15",null,null,"38.698896",null,null,"13",null,"NA","NA"],
    [2954,"2954","Carrier I","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27096","Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or CT) including arthrography when performed","16","0.06",null,null,"23.89125918",null,null,"16",null,"NA","NA"],
    [2955,"2955","Carrier I","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","72148","MRI of lumbar spine","140","0.01",null,"0.280555558","7.621059028","672","1","139","1","NA","NA"],
    [2956,"2956","Carrier I","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","70553","MRI of brain and further sequences","132","0.01",null,null,"14.74452149",null,null,"132",null,"NA","NA"],
    [2957,"2957","Carrier I","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","7","1",null,null,"19.33206349",null,null,"7",null,"NA","NA"],
    [2958,"2958","Carrier I","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","8","1",null,"62.71416666","39.60111111",null,"1","7",null,"NA","NA"],
    [2959,"2959","Carrier I","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","7","1",null,"62.71416666","46.20037037",null,"1","6",null,"NA","NA"],
    [2960,"2960","Carrier I","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H2036","Alcohol and/or other drug treatment program, per diem","5","1",null,null,"35.11915778",null,null,"5",null,"NA","NA"],
    [2961,"2961","Carrier I","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","6","1",null,"62.71416666","45.77027778",null,"1","5",null,"NA","NA"],
    [2962,"2962","Carrier I","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours","11","0.91",null,null,"51.78626263",null,null,"11",null,"NA","NA"],
    [2963,"2963","Carrier I","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71271","CT THORAX LW DOSE LNG CA SCR C-","6","0.83",null,null,"10.37777778",null,null,"6",null,"NA","NA"],
    [2964,"2964","Carrier I","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","92507","Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual","17","0.82",null,null,"34.68305429",null,null,"17",null,"NA","NA"],
    [2965,"2965","Carrier I","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","92526","Treatment of swallowing dysfunction and/or oral function for feeding","9","0.56",null,null,"59.48722672",null,null,"9",null,"NA","NA"],
    [2966,"2966","Carrier I","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19303","Mastectomy, simple, complete","4","0.5",null,null,"80.90268519",null,null,"4",null,"NA","NA"],
    [2967,"2967","Carrier I","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19350","Nipple/areola reconstruction","4","0.5",null,null,"80.90268519",null,null,"4",null,"NA","NA"],
    [2968,"2968","Carrier I","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77386","Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex","1","1",null,"0.003902779",null,null,"1",null,null,"NA","NA"],
    [2969,"2969","Carrier I","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","7","1",null,null,"19.33206349",null,null,"7",null,"NA","NA"],
    [2970,"2970","Carrier I","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","8","1",null,"62.71416666","39.60111111",null,"1","7",null,"NA","NA"],
    [2971,"2971","Carrier I","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","7","1",null,"62.71416666","46.20037037",null,"1","6",null,"NA","NA"],
    [2972,"2972","Carrier I","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H2036","Alcohol and/or other drug treatment program, per diem","5","1",null,null,"35.11915778",null,null,"5",null,"NA","NA"],
    [2973,"2973","Carrier I","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","6","1",null,"62.71416666","45.77027778",null,"1","5",null,"NA","NA"],
    [2974,"2974","Carrier I","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70553","MRI of brain and further sequences","3","1",null,null,"0.00037037",null,null,"3",null,"NA","NA"],
    [2975,"2975","Carrier I","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","17999","Unlisted procedure, skin, mucous membrane and subcutaneous tissue","3","1",null,null,"63.60092593",null,null,"3",null,"NA","NA"],
    [2976,"2976","Carrier I","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","54520","Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach","2","1",null,null,"21.31138889",null,null,"2",null,"NA","NA"],
    [2977,"2977","Carrier I","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","17380","Electrolysis epilation, each 30 minutes","1","1",null,null,"45.00833334",null,null,"1",null,"NA","NA"],
    [2978,"2978","Carrier I","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19325","Breast augmentation with implant","1","1",null,null,"3.03138889",null,null,"1",null,"NA","NA"],
    [2979,"2979","Carrier I","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","92523","Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language)","1","1",null,null,"0.075277778",null,null,"1",null,"NA","NA"],
    [2980,"2980","Carrier J","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","91","0.92",null,null,"61.06683382",null,null,"91",null,"NA","NA"],
    [2981,"2981","Carrier J","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4230","Infus Insulin Pump Non Needl","8","0",null,null,"18.08044733",null,null,"8",null,"NA","NA"],
    [2982,"2982","Carrier J","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9277","External transmitter, CGM","8","0",null,null,"17.18122456",null,null,"8",null,"NA","NA"],
    [2983,"2983","Carrier J","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4232","Syringe W/Needle Insulin 3cc","8","0",null,null,"18.08048913",null,null,"8",null,"NA","NA"],
    [2984,"2984","Carrier J","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9276","Disposable sensor, CGM sys","7","0",null,null,"20.0444625",null,null,"7",null,"NA","NA"],
    [2985,"2985","Carrier J","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0553","Supply allowance for therapeutic continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 Unit Of Service \t2017-07-01 00:00:00.000\t2199-12-31 23:59:59.000\tADD","2","0",null,null,"10.04166667",null,null,"2",null,"NA","NA"],
    [2986,"2986","Carrier J","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0554","Receiver (monitor), dedicated, for use with therapeutic glucose continueous monitor system","1","0",null,null,"0.094166667",null,null,"1",null,"NA","NA"],
    [2987,"2987","Carrier J","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9274","Ext amb insuline delivery sys","1","0",null,null,"0.004824166",null,null,"1",null,"NA","NA"],
    [2988,"2988","Carrier J","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","91","0.92",null,null,"61.06683382",null,null,"91",null,"NA","NA"],
    [2989,"2989","Carrier J","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4230","Infus Insulin Pump Non Needl","8","0",null,null,"18.08044733",null,null,"8",null,"NA","NA"],
    [2990,"2990","Carrier J","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9277","External transmitter, CGM","8","0",null,null,"17.18122456",null,null,"8",null,"NA","NA"],
    [2991,"2991","Carrier J","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4232","Syringe W/Needle Insulin 3cc","8","0",null,null,"18.08048913",null,null,"8",null,"NA","NA"],
    [2992,"2992","Carrier J","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9276","Disposable sensor, CGM sys","7","0",null,null,"20.0444625",null,null,"7",null,"NA","NA"],
    [2993,"2993","Carrier J","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0553","Supply allowance for therapeutic continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 Unit Of Service \t2017-07-01 00:00:00.000\t2199-12-31 23:59:59.000\tADD","2","0",null,null,"10.04166667",null,null,"2",null,"NA","NA"],
    [2994,"2994","Carrier J","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0554","Receiver (monitor), dedicated, for use with therapeutic glucose continueous monitor system","1","0",null,null,"0.094166667",null,null,"1",null,"NA","NA"],
    [2995,"2995","Carrier J","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9274","Ext amb insuline delivery sys","1","0",null,null,"0.004824166",null,null,"1",null,"NA","NA"],
    [2996,"2996","Carrier J","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","176","0.97",null,"46.34777778","1.666598413",null,"1","175",null,"NA","NA"],
    [2997,"2997","Carrier J","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]","3483","0.96",null,"46.34777778","2.304491152","612","1","3482","2","NA","NA"],
    [2998,"2998","Carrier J","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","74","0.86",null,"33.63027778","10.69826984",null,"4","70",null,"NA","NA"],
    [2999,"2999","Carrier J","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0748","Elec Osteogen Stim Spinal","8","0.38",null,null,"136.7358895",null,null,"8",null,"NA","NA"],
    [3000,"3000","Carrier J","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0466","HOME VENT NON-INVASIVE INTER","7","0.29",null,"33.63027778","111.8903704",null,"4","3",null,"NA","NA"],
    [3001,"3001","Carrier J","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1399","Durable Medical Equipment Mi","20","0.25",null,"71.13215972","122.0365107",null,"2","18",null,"NA","NA"],
    [3002,"3002","Carrier J","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0760","Osteogen Ultrasound Stimltor","25","0.2",null,null,"110.5392436",null,null,"25",null,"NA","NA"],
    [3003,"3003","Carrier J","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0747","Elec Osteogen Stim Not Spine","19","0.16",null,null,"130.5461698",null,null,"19",null,"NA","NA"],
    [3004,"3004","Carrier J","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0971","Wheelchair Anti-Tipping Devi","7","0",null,null,"40.98090317",null,null,"7",null,"NA","NA"],
    [3005,"3005","Carrier J","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0978","Wheelchair Belt W/Airplane B","6","0",null,null,"47.79669463",null,null,"6",null,"NA","NA"],
    [3006,"3006","Carrier J","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0973","Wheelchair Adjustabl Height","6","0",null,null,"30.69141032",null,null,"6",null,"NA","NA"],
    [3007,"3007","Carrier J","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0562","Humidifier, heated, used with positive airway pressure device","1","1",null,"46.34777778",null,"576","1",null,"1","NA","NA"],
    [3008,"3008","Carrier J","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0561","Humidifier, non-heated, used with positive airway pressure device","1","1",null,"46.34777778",null,null,"1",null,null,"NA","NA"],
    [3009,"3009","Carrier J","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2599","Accessory for speech generating device, not otherwise classified","4","1",null,null,"140.6114583",null,null,"4",null,"NA","NA"],
    [3010,"3010","Carrier J","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","176","0.97",null,"46.34777778","1.666598413",null,"1","175",null,"NA","NA"],
    [3011,"3011","Carrier J","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0601","Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]","3483","0.96",null,"46.34777778","2.304491152","612","1","3482","2","NA","NA"],
    [3012,"3012","Carrier J","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","74","0.86",null,"33.63027778","10.69826984",null,"4","70",null,"NA","NA"],
    [3013,"3013","Carrier J","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0748","Elec Osteogen Stim Spinal","8","0.38",null,null,"136.7358895",null,null,"8",null,"NA","NA"],
    [3014,"3014","Carrier J","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0466","HOME VENT NON-INVASIVE INTER","7","0.29",null,"33.63027778","111.8903704",null,"4","3",null,"NA","NA"],
    [3015,"3015","Carrier J","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1399","Durable Medical Equipment Mi","20","0.25",null,"71.13215972","122.0365107",null,"2","18",null,"NA","NA"],
    [3016,"3016","Carrier J","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0760","Osteogen Ultrasound Stimltor","25","0.2",null,null,"110.5392436",null,null,"25",null,"NA","NA"],
    [3017,"3017","Carrier J","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0601","Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]","3483","0","0","46.34777778","2.304491152","612","1","3482","2","NA","NA"],
    [3018,"3018","Carrier J","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","44","0.93",null,null,"46.52218632",null,null,"44",null,"NA","NA"],
    [3019,"3019","Carrier J","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22612","Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)","21","0.9",null,null,"39.50508894",null,null,"21",null,"NA","NA"],
    [3020,"3020","Carrier J","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22633","Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar","20","0.9",null,null,"41.60779043",null,null,"20",null,"NA","NA"],
    [3021,"3021","Carrier J","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63047","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","25","0.88",null,null,"57.31271103","480",null,"25","1","NA","NA"],
    [3022,"3022","Carrier J","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","32","0.88",null,null,"47.11753477",null,null,"32",null,"NA","NA"],
    [3023,"3023","Carrier J","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);","33","0.21",null,"1.428810834","32.52842918",null,"4","29",null,"NA","NA"],
    [3024,"3024","Carrier J","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44207","Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)","24","0.08",null,"0.002777777","8.561956111",null,"1","23",null,"NA","NA"],
    [3025,"3025","Carrier J","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44204","Laparoscopy, surgical; colectomy, partial, with anastomosis","28","0.07",null,"0.006783332","16.29482006",null,"2","26",null,"NA","NA"],
    [3026,"3026","Carrier J","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96416","Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours), requiring use of a portable or implantable pump","20","0",null,"0.005555556","6.504863889",null,"1","19",null,"NA","NA"],
    [3027,"3027","Carrier J","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","33405","Replacement, aortic valve, open, with cardiopulmonary bypass; with prosthetic valve other than homograft or stentless valve","21","0",null,"16.85067514","22.84802685",null,"6","15",null,"NA","NA"],
    [3028,"3028","Carrier J","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22558","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","19","1",null,null,"48.37969797",null,null,"19",null,"NA","NA"],
    [3029,"3029","Carrier J","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27130","Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft","12","1",null,null,"70.4370587",null,null,"12",null,"NA","NA"],
    [3030,"3030","Carrier J","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","23472","Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder))","11","1",null,null,"38.07345989",null,null,"11",null,"NA","NA"],
    [3031,"3031","Carrier J","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22830","Exploration of spinal fusion","7","1",null,null,"55.4825526",null,null,"7",null,"NA","NA"],
    [3032,"3032","Carrier J","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22634","Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; each additional interspace and segment (List separately in addition to code for primary procedure)","5","1",null,null,"52.86069182",null,null,"5",null,"NA","NA"],
    [3033,"3033","Carrier J","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22843","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in addition to code for primary procedure)","5","1",null,null,"19.04977232",null,null,"5",null,"NA","NA"],
    [3034,"3034","Carrier J","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63042","Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumbar","4","1",null,null,"72.86497719",null,null,"4",null,"NA","NA"],
    [3035,"3035","Carrier J","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22216","Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; each additional vertebral segment (List separately in addition to primary procedure)","4","1",null,null,"15.81222586",null,null,"4",null,"NA","NA"],
    [3036,"3036","Carrier J","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22585","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace (List separately in addition to code for primary procedure)","4","1",null,null,"50.71772813",null,null,"4",null,"NA","NA"],
    [3037,"3037","Carrier J","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22214","Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar","3","1",null,null,"24.99000422",null,null,"3",null,"NA","NA"],
    [3038,"3038","Carrier J","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22610","Arthrodesis, posterior or posterolateral technique, single level; thoracic (with lateral transverse technique, when performed)","3","1",null,null,"17.87529292",null,null,"3",null,"NA","NA"],
    [3039,"3039","Carrier J","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43279","Laparoscopy, surgical, esophagomyotomy (Heller type), with fundoplasty, when performed","3","1",null,null,"121.1876852",null,null,"3",null,"NA","NA"],
    [3040,"3040","Carrier J","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22846","Anterior instrumentation; 4 to 7 vertebral segments (List separately in addition to code for primary procedure)","3","1",null,null,"54.81630383",null,null,"3",null,"NA","NA"],
    [3041,"3041","Carrier J","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","23470","Arthroplasty, glenohumeral joint; hemiarthroplasty","3","1",null,null,"8.043526852",null,null,"3",null,"NA","NA"],
    [3042,"3042","Carrier J","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22802","Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 vertebral segments","3","1",null,null,"41.49119243",null,null,"3",null,"NA","NA"],
    [3043,"3043","Carrier J","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63045","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; cervical","3","1",null,"5.107969833","0.384678611",null,"2","1",null,"NA","NA"],
    [3044,"3044","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","NA","Room and board, Semi Private Detoxification","4","1",null,null,"46.05034722",null,null,"4",null,"NA","NA"],
    [3045,"3045","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","56805","Clitoroplasty for intersex state","3","1",null,null,"128.3168519",null,null,"3",null,"NA","NA"],
    [3046,"3046","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","54520","Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach","3","1",null,null,"128.3168519",null,null,"3",null,"NA","NA"],
    [3047,"3047","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","54125","Amputation of penis; complete","2","1",null,null,"26.24138889",null,null,"2",null,"NA","NA"],
    [3048,"3048","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","53430","Urethroplasty, reconstruction of female urethra","2","1",null,null,"26.1616358",null,null,"2",null,"NA","NA"],
    [3049,"3049","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","57110","Vaginectomy, complete removal of vaginal wall;","1","1",null,null,"71.76638889",null,null,"1",null,"NA","NA"],
    [3050,"3050","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","56800","Plastic repair of introitus","1","1",null,null,"332.4677778",null,null,"1",null,"NA","NA"],
    [3051,"3051","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","57292","Construction of artificial vagina; with graft","1","1",null,null,"332.4677778",null,null,"1",null,"NA","NA"],
    [3052,"3052","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","57291","Construction of artificial vagina; without graft","1","1",null,null,"26.95916667",null,null,"1",null,"NA","NA"],
    [3053,"3053","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","53410","Urethroplasty, 1-stage reconstruction of male anterior urethra","1","1",null,null,"71.76638889",null,null,"1",null,"NA","NA"],
    [3054,"3054","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","NA","Alcohol and/or other drug treatment program, per diem","1","1",null,null,"18.8475",null,null,"1",null,"NA","NA"],
    [3055,"3055","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","55180","Scrotoplasty; complicated","1","1",null,null,"71.76638889",null,null,"1",null,"NA","NA"],
    [3056,"3056","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","NA","Room and board, Semi-Private, Psychiatric","32","0.94",null,"8.061203704","269.5459427",null,"3","29",null,"NA","NA"],
    [3057,"3057","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","NA","Residential treatment, Substance Use Disorder","238","0.93",null,null,"50.64727495",null,null,"238",null,"NA","NA"],
    [3058,"3058","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","NA","Residential treatment, Psychiatric","47","0.72",null,"28.53694444","241.0093836",null,"3","44",null,"NA","NA"],
    [3059,"3059","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","13121","Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm","2","0.5",null,null,"70.93978211",null,null,"2",null,"NA","NA"],
    [3060,"3060","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","NA","Crisis Intervention Mental H","1","0",null,"0.005361943",null,null,"1",null,null,"NA","NA"],
    [3061,"3061","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15002","Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; first 100 sq cm or 1% of body area of infants and children","1","0",null,null,"48.62139917",null,null,"1",null,"NA","NA"],
    [3062,"3062","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64859","Suture of each additional major peripheral nerve (List separately in addition to code for primary procedure)","1","0",null,null,"48.62139917",null,null,"1",null,"NA","NA"],
    [3063,"3063","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15240","Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less","1","0",null,null,"48.62139917",null,null,"1",null,"NA","NA"],
    [3064,"3064","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","NA","Alcohol And/Or Drug Services","1","0",null,null,"0.003226944",null,null,"1",null,"NA","NA"],
    [3065,"3065","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15273","Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","1","0",null,null,"48.62139917",null,null,"1",null,"NA","NA"],
    [3066,"3066","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15274","Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)","1","0",null,null,"48.62139917",null,null,"1",null,"NA","NA"],
    [3067,"3067","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15277","Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","1","0",null,null,"48.62139917",null,null,"1",null,"NA","NA"],
    [3068,"3068","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64910","Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve","1","0",null,null,"48.62139917",null,null,"1",null,"NA","NA"],
    [3069,"3069","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15574","Formation of direct or tubed pedicle, with or without transfer; forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands or feet","1","0",null,null,"48.62139917",null,null,"1",null,"NA","NA"],
    [3070,"3070","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15750","Flap; neurovascular pedicle","1","0",null,null,"48.62139917",null,null,"1",null,"NA","NA"],
    [3071,"3071","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15100","Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)","1","0",null,null,"48.62139917",null,null,"1",null,"NA","NA"],
    [3072,"3072","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15757","Free skin flap with microvascular anastomosis","1","0",null,null,"48.62139917",null,null,"1",null,"NA","NA"],
    [3073,"3073","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","14301","Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm","1","0",null,null,"48.62139917",null,null,"1",null,"NA","NA"],
    [3074,"3074","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","29125","Application of short arm splint (forearm to hand); static","1","0",null,null,"48.62139917",null,null,"1",null,"NA","NA"],
    [3075,"3075","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","31587","Laryngoplasty, cricoid split, without graft placement","1","0",null,null,"246.25",null,null,"1",null,"NA","NA"],
    [3076,"3076","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64856","Suture of major peripheral nerve, arm or leg, except sciatic; including transposition","1","0",null,null,"48.62139917",null,null,"1",null,"NA","NA"],
    [3077,"3077","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","51102","Aspiration of bladder; with insertion of suprapubic catheter","1","0",null,null,"48.62139917",null,null,"1",null,"NA","NA"],
    [3078,"3078","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64874","Suture of nerve; requiring extensive mobilization, or transposition of nerve (List separately in addition to code for nerve suture)","1","0",null,null,"48.62139917",null,null,"1",null,"NA","NA"],
    [3079,"3079","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97606","Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (DME), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area greater than 50 square centimeters","1","0",null,null,"48.62139917",null,null,"1",null,"NA","NA"],
    [3080,"3080","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","13122","Repair, complex, scalp, arms, and/or legs; each additional 5 cm or less (List separately in addition to code for primary procedure)","1","0",null,null,"48.62139917",null,null,"1",null,"NA","NA"],
    [3081,"3081","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","14040","Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less","1","0",null,null,"48.62139917",null,null,"1",null,"NA","NA"],
    [3082,"3082","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","14302","Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof (List separately in addition to code for primary procedure)","1","0",null,null,"48.62139917",null,null,"1",null,"NA","NA"],
    [3083,"3083","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","14041","Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cm","1","0",null,null,"48.62139917",null,null,"1",null,"NA","NA"],
    [3084,"3084","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15003","Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; each additional 100 sq cm, or part thereof, or each additional 1% of body area of infants and children (List separately in addition to code for primary procedure)","1","0",null,null,"48.62139917",null,null,"1",null,"NA","NA"],
    [3085,"3085","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15101","Split-thickness autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)","1","0",null,null,"48.62139917",null,null,"1",null,"NA","NA"],
    [3086,"3086","Carrier J","2021","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","55970","Intersex surgery; male to female","1","0",null,null,"261.6",null,null,"1",null,"NA","NA"],
    [3087,"3087","Carrier J","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","126","Room and board, Semi Private Detoxification","4","1",null,null,"46.05034722",null,null,"4",null,"NA","NA"],
    [3088,"3088","Carrier J","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","56805","Clitoroplasty for intersex state","3","1",null,null,"128.3168519",null,null,"3",null,"NA","NA"],
    [3089,"3089","Carrier J","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","54520","Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach","3","1",null,null,"128.3168519",null,null,"3",null,"NA","NA"],
    [3090,"3090","Carrier J","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","54125","Amputation of penis; complete","2","1",null,null,"26.24138889",null,null,"2",null,"NA","NA"],
    [3091,"3091","Carrier J","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","53430","Urethroplasty, reconstruction of female urethra","2","1",null,null,"26.1616358",null,null,"2",null,"NA","NA"],
    [3092,"3092","Carrier J","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","57110","Vaginectomy, complete removal of vaginal wall;","1","1",null,null,"71.76638889",null,null,"1",null,"NA","NA"],
    [3093,"3093","Carrier J","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","56800","Plastic repair of introitus","1","1",null,null,"332.4677778",null,null,"1",null,"NA","NA"],
    [3094,"3094","Carrier J","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","57292","Construction of artificial vagina; with graft","1","1",null,null,"332.4677778",null,null,"1",null,"NA","NA"],
    [3095,"3095","Carrier J","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","57291","Construction of artificial vagina; without graft","1","1",null,null,"26.95916667",null,null,"1",null,"NA","NA"],
    [3096,"3096","Carrier J","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","53410","Urethroplasty, 1-stage reconstruction of male anterior urethra","1","1",null,null,"71.76638889",null,null,"1",null,"NA","NA"],
    [3097,"3097","Carrier J","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H2036","Alcohol and/or other drug treatment program, per diem","1","1",null,null,"18.8475",null,null,"1",null,"NA","NA"],
    [3098,"3098","Carrier J","2021","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","55180","Scrotoplasty; complicated","1","1",null,null,"71.76638889",null,null,"1",null,"NA","NA"],
    [3099,"3099","Carrier J","2021","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","1001","Residential treatment, Psychiatric","47","0","0.02","28.53694444","241.0093836",null,"3","44",null,"NA","NA"],
    [3100,"3100","Carrier J","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0399","Home sleep test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation","1717","0.96",null,null,"4.55158774",null,null,"1717",null,"NA","NA"],
    [3101,"3101","Carrier J","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","MRI of brain and further sequences","1535","0.95",null,"0.0875","9.113422664",null,"3","1532",null,"NA","NA"],
    [3102,"3102","Carrier J","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","ECHO, transthoracic w/doppler, complete","2782","0.94",null,"0.087222221","6.260145469","660","1","2781","10","NA","NA"],
    [3103,"3103","Carrier J","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74176","CT abd & pelvis","3024","0.94",null,"3.520114943","9.638329536",null,"29","2995",null,"NA","NA"],
    [3104,"3104","Carrier J","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","MRI, lower extremity any joint; wo contr","2511","0.88",null,"0.239722222","11.00589676","648","1","2510","5","NA","NA"],
    [3105,"3105","Carrier J","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72148","MRI of lumbar spine","1845","0.86",null,"1.048194444","8.480348817","672","2","1843","2","NA","NA"],
    [3106,"3106","Carrier J","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","5525","0.74",null,"9.454080013","39.65143342","610.5","19","5506","16","NA","NA"],
    [3107,"3107","Carrier J","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97140","Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes","5040","0.73",null,"17.5520936","42.13966487","591","19","5021","8","NA","NA"],
    [3108,"3108","Carrier J","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97530","Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","4657","0.73",null,"24.91352116","39.53006852","810.6666667","12","4645","9","NA","NA"],
    [3109,"3109","Carrier J","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97112","Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities","3679","0.71",null,"48.72115167","43.90158338","568","11","3668","3","NA","NA"],
    [3110,"3110","Carrier J","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63685","Insertion or replacement of spinal neurostimulator pulse generator or receiver, direct or inductive coupling","23","1",null,null,"31.10083644","600",null,"23","1","NA","NA"],
    [3111,"3111","Carrier J","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77435","Stereotactic body radiation therapy, treatment management, per treatment course, to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions","18","1",null,"11.74046296","59.41540741","600","3","15","1","NA","NA"],
    [3112,"3112","Carrier J","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","23472","Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder))","31","1",null,"31.7586825","37.73359205",null,"1","30",null,"NA","NA"],
    [3113,"3113","Carrier J","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72147","Contrast MRI of thoracic spine","29","1",null,null,"2.430747127",null,null,"29",null,"NA","NA"],
    [3114,"3114","Carrier J","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63042","Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumbar","30","1",null,"51.48078611","32.48858983",null,"2","28",null,"NA","NA"],
    [3115,"3115","Carrier J","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64492","Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; third and any additional level(s) (List separately in addition to code for primary procedure)","25","1",null,null,"3.868942683",null,null,"25",null,"NA","NA"],
    [3116,"3116","Carrier J","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","78472","Nuclear scan, cardiac blood pool","22","1",null,null,"0.000113636",null,null,"22",null,"NA","NA"],
    [3117,"3117","Carrier J","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","22","1",null,null,"60.95812965",null,null,"22",null,"NA","NA"],
    [3118,"3118","Carrier J","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77373","Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions","17","1",null,"11.74046296","60.40331349",null,"3","14",null,"NA","NA"],
    [3119,"3119","Carrier J","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77432","Stereotactic radiation treatment management of cranial lesion(s) (complete course of treatment consisting of 1 session)","13","1",null,"1.974444444","86.46290404",null,"2","11",null,"NA","NA"],
    [3120,"3120","Carrier J","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64405","Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve","93","0","0.04","0.221404167","54.87779854","648","2","91","1","NA","NA"],
    [3121,"3121","Carrier J","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64493","Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level","309","0","0.03","23.44836431","15.21216818",null,"2","307",null,"NA","NA"],
    [3122,"3122","Carrier J","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64479","Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or thoracic, single level","153","0","0.02",null,"14.66959782",null,null,"153",null,"NA","NA"],
    [3123,"3123","Carrier J","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22856","Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); single interspace, cervical","40","0","0.03",null,"42.60520565",null,null,"40",null,"NA","NA"],
    [3124,"3124","Carrier J","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64520","Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic)","21","0","0.05",null,"15.36934318",null,null,"21",null,"NA","NA"],
    [3125,"3125","Carrier J","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","78459","MYOCRD IMG PET METAB EVAL SINGLE STUDY","8","0","0.13",null,"28.07048611",null,null,"8",null,"NA","NA"],
    [3126,"3126","Carrier J","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63020","Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical","7","0","0.14",null,"46.31105176",null,null,"7",null,"NA","NA"],
    [3127,"3127","Carrier J","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63655","Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural","5","0","0.2",null,"75.65615687",null,null,"5",null,"NA","NA"],
    [3128,"3128","Carrier J","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","23470","Arthroplasty, glenohumeral joint; hemiarthroplasty","5","0","0.2",null,"80.84910755",null,null,"5",null,"NA","NA"],
    [3129,"3129","Carrier J","2021","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","62290","Injection procedure for discography, each level; lumbar","4","0","0.25",null,"44.09172875",null,null,"4",null,"NA","NA"],
    [3130,"3130","Carrier J","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","187","1",null,"7.529548055","32.13749977",null,"9","178",null,"NA","NA"],
    [3131,"3131","Carrier J","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H2036","Alcohol and/or other drug treatment program, per diem","99","0.97",null,null,"43.77723558",null,null,"99",null,"NA","NA"],
    [3132,"3132","Carrier J","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19303","Mastectomy, simple, complete","35","0.94",null,null,"83.99884921","696",null,"35","1","NA","NA"],
    [3133,"3133","Carrier J","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19350","Nipple/areola reconstruction","34","0.94",null,"243.6577778","85.11815657",null,"1","33",null,"NA","NA"],
    [3134,"3134","Carrier J","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours","115","0.91",null,"54.67930556","62.02926565",null,"2","113",null,"NA","NA"],
    [3135,"3135","Carrier J","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","78","0.9",null,"25.81089712","47.67570908","552","9","69","1","NA","NA"],
    [3136,"3136","Carrier J","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71271","CT THORAX LW DOSE LNG CA SCR C-","198","0.9",null,null,"3.088960078",null,null,"198",null,"NA","NA"],
    [3137,"3137","Carrier J","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","52","0.9",null,"22.35729512","44.10535269",null,"7","45",null,"NA","NA"],
    [3138,"3138","Carrier J","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","82","0.89",null,"25.81089663","44.54946906",null,"9","73",null,"NA","NA"],
    [3139,"3139","Carrier J","2021","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","92507","Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual","282","0.73",null,"314.7020528","67.41074406",null,"1","281",null,"NA","NA"],
    [3140,"3140","Carrier J","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","187","1",null,"7.529548055","32.13749977",null,"9","178",null,"NA","NA"],
    [3141,"3141","Carrier J","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70553","MRI of brain and further sequences","12","1",null,null,"0.026828704",null,null,"12",null,"NA","NA"],
    [3142,"3142","Carrier J","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","17380","Electrolysis epilation, each 30 minutes","7","1",null,null,"268.1345238",null,null,"7",null,"NA","NA"],
    [3143,"3143","Carrier J","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","17999","Unlisted procedure, skin, mucous membrane and subcutaneous tissue","5","1",null,null,"103.4391667",null,null,"5",null,"NA","NA"],
    [3144,"3144","Carrier J","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81243","FMR1 (fragile X mental retardation 1) (eg, fragile X mental retardation) gene analysis; evaluation to detect abnormal (eg, expanded) alleles","4","1",null,null,"26.46513889",null,null,"4",null,"NA","NA"],
    [3145,"3145","Carrier J","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81229","Cytogenomic constitutional (genome-wide) microarray analysis; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants for chromosomal abnormalities","4","1",null,null,"25.55006944",null,null,"4",null,"NA","NA"],
    [3146,"3146","Carrier J","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","98943","Chiropractic manipulative treatment (CMT); extraspinal, 1 or more regions","4","1",null,null,"7.354965972",null,null,"4",null,"NA","NA"],
    [3147,"3147","Carrier J","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19325","Breast augmentation with implant","3","1",null,null,"88.2137037",null,null,"3",null,"NA","NA"],
    [3148,"3148","Carrier J","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95810","Polysomnography; Age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","4","1",null,"0.289444445","0",null,"1","3",null,"NA","NA"],
    [3149,"3149","Carrier J","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77373","Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions","2","1",null,null,"32.12763889",null,null,"2",null,"NA","NA"],
    [3150,"3150","Carrier J","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","56625","Vulvectomy simple; complete","2","1",null,null,"81.96222222",null,null,"2",null,"NA","NA"],
    [3151,"3151","Carrier J","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","78608","Brain imaging, PET, metabolic eval","2","1",null,null,"13.57888889",null,null,"2",null,"NA","NA"],
    [3152,"3152","Carrier J","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81415","Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis","2","1",null,null,"17.92347222",null,null,"2",null,"NA","NA"],
    [3153,"3153","Carrier J","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81416","Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure)","2","1",null,null,"17.92347222",null,null,"2",null,"NA","NA"],
    [3154,"3154","Carrier J","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","54520","Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach","2","1",null,null,"119.01875",null,null,"2",null,"NA","NA"],
    [3155,"3155","Carrier J","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","55175","Scrotoplasty; simple","2","1",null,null,"119.01875",null,null,"2",null,"NA","NA"],
    [3156,"3156","Carrier J","2021","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","Q3014","Telehealth originating site facility fee","2","1",null,null,"50.49276014",null,null,"2",null,"NA","NA"],
    [3157,"3157","Carrier K","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","External ambulatory infusion pump, insulin","6","1",null,null,"7.03",null,"0","6","0","NA","NA"],
    [3158,"3158","Carrier K","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9274","External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories","1","1",null,null,"23.5",null,"0","1","0","NA","NA"],
    [3159,"3159","Carrier K","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0607","Home blood glucose monitor","1","1",null,null,"23.5",null,"0","1","0","NA","NA"],
    [3160,"3160","Carrier K","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0553","Supply allowance for therapeutic continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 Unit of Service�","2","0.5",null,null,"85.5",null,"0","2","0","NA","NA"],
    [3161,"3161","Carrier K","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0554","Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system","2","0.5",null,null,"85.5",null,"0","2","0","NA","NA"],
    [3162,"3162","Carrier K","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","External ambulatory infusion pump, insulin","6","1",null,null,"7.03",null,"0","6","0","NA","NA"],
    [3163,"3163","Carrier K","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9274","External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories","1","1",null,null,"23.5",null,"0","1","0","NA","NA"],
    [3164,"3164","Carrier K","2021","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0607","Home blood glucose monitor","1","1",null,null,"23.5",null,"0","1","0","NA","NA"],
    [3165,"3165","Carrier K","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0748","Osteogenesis stimulator, electrical, noninvasive, spinal applications�","3","1",null,null,"40.5",null,"0","3","0","NA","NA"],
    [3166,"3166","Carrier K","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0739","Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","2","1",null,null,"84.9",null,"0","2","0","NA","NA"],
    [3167,"3167","Carrier K","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5301","Below knee, molded socket, shin, sach foot, endoskeletal system","2","1",null,null,"104.7",null,"0","2","0","NA","NA"],
    [3168,"3168","Carrier K","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5620","Addition to lower extremity, test socket, below knee","2","1",null,null,"104.7",null,"0","2","0","NA","NA"],
    [3169,"3169","Carrier K","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5629","Addition to lower extremity, below knee, acrylic socket","2","1",null,null,"104.7",null,"0","2","0","NA","NA"],
    [3170,"3170","Carrier K","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5637","Addition to lower extremity, below knee, total contact","2","1",null,null,"104.7",null,"0","2","0","NA","NA"],
    [3171,"3171","Carrier K","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5645","Addition to lower extremity, below knee, flexible inner socket, external frame�","2","1",null,null,"104.7",null,"0","2","0","NA","NA"],
    [3172,"3172","Carrier K","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5671","Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","2","1",null,null,"104.7",null,"0","2","0","NA","NA"],
    [3173,"3173","Carrier K","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5673","Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","2","1",null,null,"104.7",null,"0","2","0","NA","NA"],
    [3174,"3174","Carrier K","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1399","Durable medical equipment, miscellaneous","3","0",null,null,"140.8",null,"0","3","0","NA","NA"],
    [3175,"3175","Carrier K","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0748","Osteogenesis stimulator, electrical, noninvasive, spinal applications�","3","1",null,null,"40.5",null,"0","3","0","NA","NA"],
    [3176,"3176","Carrier K","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5301","Below knee, molded socket, shin, sach foot, endoskeletal system","2","1",null,null,"104.7",null,"0","2","0","NA","NA"],
    [3177,"3177","Carrier K","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5620","Addition to lower extremity, test socket, below knee","2","1",null,null,"104.7",null,"0","2","0","NA","NA"],
    [3178,"3178","Carrier K","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5629","Addition to lower extremity, below knee, acrylic socket","2","1",null,null,"104.7",null,"0","2","0","NA","NA"],
    [3179,"3179","Carrier K","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5637","Addition to lower extremity, below knee, total contact","2","1",null,null,"104.7",null,"0","2","0","NA","NA"],
    [3180,"3180","Carrier K","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5645","Addition to lower extremity, below knee, flexible inner socket, external frame�","2","1",null,null,"104.7",null,"0","2","0","NA","NA"],
    [3181,"3181","Carrier K","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5671","Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","2","1",null,null,"104.7",null,"0","2","0","NA","NA"],
    [3182,"3182","Carrier K","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5673","Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","2","1",null,null,"104.7",null,"0","2","0","NA","NA"],
    [3183,"3183","Carrier K","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5910","Addition, endoskeletal system, below knee, alignable system","2","1",null,null,"104.7",null,"0","2","0","NA","NA"],
    [3184,"3184","Carrier K","2021","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5940","Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","2","1",null,null,"104.7",null,"0","2","0","NA","NA"],
    [3185,"3185","Carrier K","2021","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E1399","Durable medical equipment, miscellaneous","1","0","1",null,"325.44",null,"0","1","0","NA","NA"],
    [3186,"3186","Carrier K","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19364","Breast reconstruction; with free flap (eg, fTRAM, DIEP, SIEA, GAP flap)","3","1",null,null,"37.3",null,"0","3","0","NA","NA"],
    [3187,"3187","Carrier K","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","11970","Replacement of tissue expander with permanent implant","2","1",null,null,"22",null,"0","2","0","NA","NA"],
    [3188,"3188","Carrier K","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","11971","Removal of tissue expander without insertion of implant","2","1",null,null,"56",null,"0","2","0","NA","NA"],
    [3189,"3189","Carrier K","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19380","Revision of reconstructed breast (eg, significant removal of tissue, re-advancement and/or re-inset of flaps in autologous reconstruction or significant capsular revision combined with soft tissue excision in implant-based reconstruction)","2","1",null,null,"22",null,"0","2","0","NA","NA"],
    [3190,"3190","Carrier K","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","49999","Unlisted procedure, abdomen, peritoneum and omentum�","2","1",null,null,"115",null,"0","2","0","NA","NA"],
    [3191,"3191","Carrier K","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","14302","Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof (List separately in addition to code for primary procedure)","2","0.5",null,null,"108.8",null,"0","2","0","NA","NA"],
    [3192,"3192","Carrier K","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15240","Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less","2","0.5",null,null,"108.8",null,"0","2","0","NA","NA"],
    [3193,"3193","Carrier K","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15241","Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)","2","0.5",null,null,"108.8",null,"0","2","0","NA","NA"],
    [3194,"3194","Carrier K","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","52332","Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type)","2","0.5",null,null,"118.3",null,"0","2","0","NA","NA"],
    [3195,"3195","Carrier K","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","53430","Urethroplasty, reconstruction of female urethra","2","0.5",null,null,"108.5",null,"0","2","0","NA","NA"],
    [3196,"3196","Carrier K","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19364","Breast reconstruction; with free flap (eg, fTRAM, DIEP, SIEA, GAP flap)","3","1",null,null,"37.3",null,"0","3","0","NA","NA"],
    [3197,"3197","Carrier K","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","11970","Replacement of tissue expander with permanent implant","2","1",null,null,"22",null,"0","2","0","NA","NA"],
    [3198,"3198","Carrier K","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","11971","Removal of tissue expander without insertion of implant","2","1",null,null,"56",null,"0","2","0","NA","NA"],
    [3199,"3199","Carrier K","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19380","Unlisted procedure, abdomen, peritoneum and omentum�","2","1",null,null,"22",null,"0","2","0","NA","NA"],
    [3200,"3200","Carrier K","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","49999","Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type)","2","1",null,null,"115",null,"0","2","0","NA","NA"],
    [3201,"3201","Carrier K","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43239","Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple","55","1",null,"9.7","3.66",null,"4","51","0","NA","NA"],
    [3202,"3202","Carrier K","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43235","Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","53","1",null,"12.9","3.8",null,"3","50","0","NA","NA"],
    [3203,"3203","Carrier K","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","81479","Unlisted molecular pathology procedure�","53","0.96",null,null,"10.28",null,"0","53","0","NA","NA"],
    [3204,"3204","Carrier K","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","81420","Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21","35","0.94",null,null,"9.8",null,"0","35","0","NA","NA"],
    [3205,"3205","Carrier K","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45378","Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)�","126","0.91",null,"0.2","15.1",null,"1","125","0","NA","NA"],
    [3206,"3206","Carrier K","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45385","Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique�","85","0.91",null,"0.2","15.11",null,"1","84","0","NA","NA"],
    [3207,"3207","Carrier K","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45384","Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","65","0.91",null,"0.2","16.4",null,"1","64","0","NA","NA"],
    [3208,"3208","Carrier K","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","Colonoscopy, flexible; with biopsy, single or multiple","111","0.9",null,"25.1","17.01",null,"2","109","0","NA","NA"],
    [3209,"3209","Carrier K","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95811","Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist","29","0.59",null,"48.9","36.8",null,"2","27","0","NA","NA"],
    [3210,"3210","Carrier K","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95810","Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","36","0.5",null,"42.3","52.9",null,"1","34","0","NA","NA"],
    [3211,"3211","Carrier K","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43239","Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple","55","1",null,"9.7","3.66",null,"4","51","0","NA","NA"],
    [3212,"3212","Carrier K","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43235","Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","53","1",null,"12.9","3.8",null,"3","50","0","NA","NA"],
    [3213,"3213","Carrier K","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43249","Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter)�","20","1",null,null,"1.3",null,"0","20","0","NA","NA"],
    [3214,"3214","Carrier K","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43248","Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire","11","1",null,null,"0.2",null,"0","11","0","NA","NA"],
    [3215,"3215","Carrier K","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81374","HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each�","10","1",null,null,"0.17",null,"0","10","0","NA","NA"],
    [3216,"3216","Carrier K","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81162","BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, detection of large gene rearrangements)�","10","1",null,null,"0.12",null,"0","10","0","NA","NA"],
    [3217,"3217","Carrier K","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64490","Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level�","9","1",null,null,"5.7",null,"0","9","0","NA","NA"],
    [3218,"3218","Carrier K","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","52356","Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, Gibbons or double-J type)","13","1",null,"11.3","2.1",null,"5","8","0","NA","NA"],
    [3219,"3219","Carrier K","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81241","F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant","7","1",null,null,"4.2",null,"0","7","0","NA","NA"],
    [3220,"3220","Carrier K","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93656","Comprehensive electrophysiologic evaluation including transseptal catheterizations, insertion and repositioning of multiple electrode catheters with intracardiac catheter ablation of atrial fibrillation by pulmonary vein isolation, including intracardiac electrophysiologic 3-dimensional mapping, intracardiac echocardiography including imaging supervision and interpretation, induction or attempted induction of an arrhythmia including left or right atrial pacing/recording, right ventricular pacing/recording, and His bundle recording, when performed�","7","1",null,"25","45.6",null,"1","6","0","NA","NA"],
    [3221,"3221","Carrier L","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1028","Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory","4","1",null,null,"117.2",null,"0","4","0","NA","NA"],
    [3222,"3222","Carrier L","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2402","Negative pressure wound therapy electrical pump, stationary or portable","2","0.5",null,null,"106.8",null,"0","2","0","NA","NA"],
    [3223,"3223","Carrier L","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S1040","Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s)�","2","0.5",null,null,"46.4",null,"0","2","0","NA","NA"],
    [3224,"3224","Carrier L","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1399","Durable medical equipment, miscellaneous","4","0",null,null,"100",null,"0","4","0","NA","NA"],
    [3225,"3225","Carrier L","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9999","Miscellaneous dme supply or accessory, not otherwise specified","3","0",null,null,"139.4",null,"0","3","0","NA","NA"],
    [3226,"3226","Carrier L","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0486","Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","2","0",null,null,"124.7",null,"0","2","0","NA","NA"],
    [3227,"3227","Carrier L","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20930","SP BONE ALGRFT MORSEL ADD-ON","6","1",null,"29",null,"0","6","0","0","NA","NA"],
    [3228,"3228","Carrier L","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20936","SP BONE AGRFT LOCAL ADD-ON","6","1",null,"29",null,"0","6","0","0","NA","NA"],
    [3229,"3229","Carrier L","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22556","ARTHRD ANT NTRBD MIN DSC THC","6","1",null,"29",null,"0","6","0","0","NA","NA"],
    [3230,"3230","Carrier L","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22610","ARTHRD PST TQ 1NTRSPC THRC","6","1",null,"29",null,"0","6","0","0","NA","NA"],
    [3231,"3231","Carrier L","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22840","INSERT SPINE FIXATION DEVICE","6","1",null,"29",null,"0","6","0","0","NA","NA"],
    [3232,"3232","Carrier L","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","INSJ BIOMECHANICAL DEVICE","6","1",null,"29",null,"0","6","0","0","NA","NA"],
    [3233,"3233","Carrier L","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63064","DECOMPRESS SPINAL CORD THRC","6","1",null,"29",null,"0","6","0","0","NA","NA"],
    [3234,"3234","Carrier L","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s)","4","0.75",null,"19.3","47.3",null,"1","3",null,"NA","NA"],
    [3235,"3235","Carrier L","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15734","Muscle, myocutaneous, or fasciocutaneous flap; trunk","2","1",null,null,"41.4",null,null,"2",null,"NA","NA"],
    [3236,"3236","Carrier L","2021","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","49560","Repair initial incisional or ventral hernia; reducible","2","1",null,null,"41.4",null,null,"2",null,"NA","NA"],
    [3237,"3237","Carrier L","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","20930","SP BONE ALGRFT MORSEL ADD-ON","6","1",null,"29",null,"0","6","0","0","NA","NA"],
    [3238,"3238","Carrier L","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","20936","SP BONE AGRFT LOCAL ADD-ON","6","1",null,"29",null,"0","6","0","0","NA","NA"],
    [3239,"3239","Carrier L","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22556","ARTHRD ANT NTRBD MIN DSC THC","6","1",null,"29",null,"0","6","0","0","NA","NA"],
    [3240,"3240","Carrier L","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22610","ARTHRD PST TQ 1NTRSPC THRC","6","1",null,"29",null,"0","6","0","0","NA","NA"],
    [3241,"3241","Carrier L","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22840","INSERT SPINE FIXATION DEVICE","6","1",null,"29",null,"0","6","0","0","NA","NA"],
    [3242,"3242","Carrier L","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22853","INSJ BIOMECHANICAL DEVICE","6","1",null,"29",null,"0","6","0","0","NA","NA"],
    [3243,"3243","Carrier L","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63064","DECOMPRESS SPINAL CORD THRC","6","1",null,"29",null,"0","6","0","0","NA","NA"],
    [3244,"3244","Carrier L","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15734","Muscle, myocutaneous, or fasciocutaneous flap; trunk","2","1",null,null,"41.4",null,null,"2",null,"NA","NA"],
    [3245,"3245","Carrier L","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","49560","Repair initial incisional or ventral hernia; reducible","2","1",null,null,"41.4",null,null,"2",null,"NA","NA"],
    [3246,"3246","Carrier L","2021","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","49568","Implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection","2","1",null,null,"41.4",null,null,"2",null,"NA","NA"],
    [3247,"3247","Carrier L","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45378","Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","192","0.84",null,"0.2","16.1",null,"6","186","0","NA","NA"],
    [3248,"3248","Carrier L","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","Colonoscopy, flexible; with biopsy, single or multiple","185","0.83",null,"6.7","17.9",null,"7","178","0","NA","NA"],
    [3249,"3249","Carrier L","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45385","Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","138","0.804",null,"11.6","19.6",null,"4","134","0","NA","NA"],
    [3250,"3250","Carrier L","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45384","Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","86","0.81",null,null,"19.2",null,"0","86","0","NA","NA"],
    [3251,"3251","Carrier L","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","81479","Unlisted molecular pathology procedure","74","0.93",null,null,"9.7",null,"0","74","0","NA","NA"],
    [3252,"3252","Carrier L","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43239","Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple","66","0.98",null,"0.4","4.2",null,"7","59","0","NA","NA"],
    [3253,"3253","Carrier L","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43235","Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","64","0.98",null,"0.2","4.4",null,"6","58","0","NA","NA"],
    [3254,"3254","Carrier L","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95810","Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","62","0.61",null,"22.8","43.2",null,"1","61","0","NA","NA"],
    [3255,"3255","Carrier L","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95811","Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist","49","0.63",null,"48","47.4",null,"1","48","0","NA","NA"],
    [3256,"3256","Carrier L","2021","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","81420","Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21","27","0.96",null,null,"7.7",null,"0","27","0","NA","NA"],
    [3257,"3257","Carrier L","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","45378","Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","1","1",null,"0","346.08",null,"0","1","0","NA","NA"],
    [3258,"3258","Carrier L","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","45380","Colonoscopy, flexible; with biopsy, single or multiple","1","1",null,"0","684.48",null,"0","1","0","NA","NA"],
    [3259,"3259","Carrier L","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81479","Unlisted molecular pathology procedure","1","1",null,"0","344.88",null,"0","1","0","NA","NA"],
    [3260,"3260","Carrier L","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29827","SHO ARTHRS SRG RT8TR CUF RPR",null,"0",null,null,null,null,null,null,null,"NA","NA"],
    [3261,"3261","Carrier L","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29822","SHO ARTHRS SRG LMTD DBRDMT",null,"0",null,null,null,null,null,null,null,"NA","NA"],
    [3262,"3262","Carrier L","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","25390","SHORTEN RADIUS OR ULNA",null,"0",null,null,null,null,null,null,null,"NA","NA"],
    [3263,"3263","Carrier L","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27279","ARTHRODESIS SACROILIAC JOINT",null,"0",null,null,null,null,null,null,null,"NA","NA"],
    [3264,"3264","Carrier L","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27447","TOTAL KNEE ARTHROPLASTY",null,"0",null,null,null,null,null,null,null,"NA","NA"],
    [3265,"3265","Carrier L","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29828","SHO ARTHRS SRG BICP TENODSIS",null,"0",null,null,null,null,null,null,null,"NA","NA"],
    [3266,"3266","Carrier L","2021","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29846","WRIST ARTHROSCOPY/SURGERY",null,"0",null,null,null,null,null,null,null,"NA","NA"],
    [3267,"3267","Carrier L","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","External ambulatory infusion pump, insulin","9","1",null,"13.7","16.4",null,"1","8","0","NA","NA"],
    [3268,"3268","Carrier L","2021","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0553","Supply allowance for therapeutic continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 Unit of Service","1","1",null,null,"0.1",null,"0","1","0","NA","NA"],
    [3269,"3269","Carrier L","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1028","Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory","4","1",null,null,"117.2",null,"0","4","0","NA","NA"],
    [3270,"3270","Carrier L","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1399","Durable medical equipment, miscellaneous","4","0",null,null,"100",null,"0","4","0","NA","NA"],
    [3271,"3271","Carrier L","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9999","Miscellaneous dme supply or accessory, not otherwise specified","3","0",null,null,"139.4",null,"0","3","0","NA","NA"],
    [3272,"3272","Carrier L","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0486","Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","2","0",null,null,"124.7",null,"0","2","0","NA","NA"],
    [3273,"3273","Carrier L","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2402","Negative pressure wound therapy electrical pump, stationary or portable","2","0.5",null,null,"106.8",null,"0","2","0","NA","NA"],
    [3274,"3274","Carrier L","2021","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S1040","Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s)�","2","0.5",null,null,"46.4",null,"0","2","0","NA","NA"],
    [3275,"3275","Carrier M","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20930","ALLOGRAFT, MORSELIZED, OR PLACEMENT OF OSTEOPROMOTIVE MATERIAL, FOR SPINE SURGERY ONLY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)","12","0.5",null,null,"167",null,"0","12",null,"NA","NA"],
    [3276,"3276","Carrier M","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44207","LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST","12","1",null,null,"21.2",null,"0","12",null,"NA","NA"],
    [3277,"3277","Carrier M","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43644","LAPS GSTR RSTCV PX W/BYP ROUX-EN-Y LIMB <150 CM","11","0.5455",null,"70.3","53.1",null,"1","10",null,"NA","NA"],
    [3278,"3278","Carrier M","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43775","LAPAROSCOPY, SURGICAL, GASTRIC RESTRICTIVE PROCEDURE; LONGITUDINAL GASTRECTOMY (IE, SLEEVE GASTRECTOMY)","10","0.8",null,null,"57.4",null,"0","10",null,"NA","NA"],
    [3279,"3279","Carrier M","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","TOTAL HYSTERECTOMY (CORPUS AND CERVIX), WITH OR WITHOUT REMOVAL OF TUBE(S), WITH OR WITHOUT REMOVAL OF OVARY(S);","10","1",null,"92.4","11.2",null,"1","9",null,"NA","NA"],
    [3280,"3280","Carrier M","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22842","POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG","10","0.8",null,"63.4","88.5",null,"1","9",null,"NA","NA"],
    [3281,"3281","Carrier M","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95720","ELECTROENCEPHALOGRAM (EEG), CONTINUOUS RECORDING, PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL REVIEW OF RECORDED EVENTS, ANALYSIS OF SPIKE AND SEIZURE DETECTION, EACH INCREMENT OF GREATER THAN 12 HOURS, UP TO 26 HOURS OF EEG RECORDING, INTERPRE","10","0.6",null,null,"44.2",null,"0","10",null,"NA","NA"],
    [3282,"3282","Carrier M","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44213","LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLECTOMY","8","1",null,null,"17.1",null,"0","8",null,"NA","NA"],
    [3283,"3283","Carrier M","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27130","ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT","8","0.625",null,null,"45.5",null,"0","8",null,"NA","NA"],
    [3284,"3284","Carrier M","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20936","AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION","7","0.7143",null,null,"149",null,"0","7",null,"NA","NA"],
    [3285,"3285","Carrier M","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44207","LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST","12","1",null,null,"21.2",null,"0","12",null,"NA","NA"],
    [3286,"3286","Carrier M","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58150","TOTAL HYSTERECTOMY (CORPUS AND CERVIX), WITH OR WITHOUT REMOVAL OF TUBE(S), WITH OR WITHOUT REMOVAL OF OVARY(S);","10","1",null,"92.4","11.2",null,"1","9",null,"NA","NA"],
    [3287,"3287","Carrier M","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44213","LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLECTOMY","8","1",null,null,"17.1",null,"0","8",null,"NA","NA"],
    [3288,"3288","Carrier M","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44204","LAPAROSCOPY, SURGICAL;COLECTOMY, PARTIAL, WITH ANASTOMOSIS","7","1",null,null,"6.2",null,"0","7",null,"NA","NA"],
    [3289,"3289","Carrier M","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J9208","INJECTION, IFOSFAMIDE, 1 GRAM","7","1",null,null,"102.3",null,"0","7",null,"NA","NA"],
    [3290,"3290","Carrier M","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22614","ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLE INTERSPACE; EACH ADDITIONAL INTERSPACE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)","7","1",null,null,"100.7",null,"0","7",null,"NA","NA"],
    [3291,"3291","Carrier M","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96416","CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP","6","1",null,null,"50.8",null,"0","6",null,"NA","NA"],
    [3292,"3292","Carrier M","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","45330","SIGMOIDOSCOPY, FLEXIBLE; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)","6","1",null,null,"20.7",null,"0","6",null,"NA","NA"],
    [3293,"3293","Carrier M","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","55866","LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT","5","1",null,"6.5","3.3",null,"1","4",null,"NA","NA"],
    [3294,"3294","Carrier M","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J9181","INJECTION, ETOPOSIDE, 10 MG","5","1",null,null,"124.1",null,"0","5",null,"NA","NA"],
    [3295,"3295","Carrier M","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43644","LAPS GSTR RSTCV PX W/BYP ROUX-EN-Y LIMB <150 CM","11","0","0.55","70.3","53.1",null,"1","10",null,"NA","NA"],
    [3296,"3296","Carrier M","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22633","ARTHRODESIS, COMBINED POSTERIOR OR POSTEROLATERAL TECHNIQUE WITH POSTERIOR INTERBODY TECHNIQUE INCLUDING LAMINECTOMY AND/OR DISCECTOMY SUFFICIENT TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION), SINGLE INTERSPACE; LUMBAR","6","0","0.33","63.4","63.8",null,"1","5",null,"NA","NA"],
    [3297,"3297","Carrier M","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43775","LAPAROSCOPY, SURGICAL, GASTRIC RESTRICTIVE PROCEDURE; LONGITUDINAL GASTRECTOMY (IE, SLEEVE GASTRECTOMY)","10","0","0.8",null,"57.4",null,"0","10",null,"NA","NA"],
    [3298,"3298","Carrier M","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22842","POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG","10","0","0.8","63.4","88.5",null,"1","9",null,"NA","NA"],
    [3299,"3299","Carrier M","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","20930","ALLOGRAFT, MORSELIZED, OR PLACEMENT OF OSTEOPROMOTIVE MATERIAL, FOR SPINE SURGERY ONLY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)","12","0","0.5",null,"167",null,"0","12",null,"NA","NA"],
    [3300,"3300","Carrier M","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63053","LAMINECTOMY, FACETECTOMY, OR FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA AND/OR NERVE ROOT(S) (EG, SPINAL OR LATERAL RECESS STENOSIS)), DURING POSTERIOR INTERBODY ARTHRODESIS, LUMBAR; EACH ADDITIONAL SEGMENT (LIS","1","0","0",null,"25.3",null,"0","1",null,"NA","NA"],
    [3301,"3301","Carrier M","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22840","POSTERIOR NON-SEGMENTAL INSTRUMENTATION (EG, HARRINGTON ROD TECHNIQUE, PEDICLE FIXATION ACROSS ONE INTERSPACE, ATLANTOAXIAL TRANSARTICULAR SCREW FIXATION, SUBLAMINAR WIRING AT C1, FACET SCREW FIXATION) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PRO","4","0","0.5",null,"91.9",null,"0","4",null,"NA","NA"],
    [3302,"3302","Carrier M","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27279","ARTHRODESIS, SACROILIAC JOINT, PERCUTANEOUS OR MINIMALLY INVASIVE (INDIRECT VISUALIZATION), WITH IMAGE GUIDANCE, INCLUDES OBTAINING BONE GRAFT WHEN PERFORMED, AND PLACEMENT OF TRANSFIXING DEVICE","1","0","0",null,"24",null,"0","1",null,"NA","NA"],
    [3303,"3303","Carrier M","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27130","ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT","8","0","0.63",null,"45.5",null,"0","8",null,"NA","NA"],
    [3304,"3304","Carrier M","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","20931","ALLOGRAFT, STRUCTURAL, FOR SPINE SURGERY ONLY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)","2","0","0.5",null,"273.7",null,"0","2",null,"NA","NA"],
    [3305,"3305","Carrier M","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","J0585","Botox","141","0.89",null,"26","42",null,"2","139",null,"NA","NA"],
    [3306,"3306","Carrier M","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","66984","EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1 STAGE PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGATION AND ASPIRATION OR PHACOEMULSIFICATION); WITHOUT ENDOSCOPIC CYCLOPHOTOCOAGULATION","98","1",null,"4","27.4",null,"1","97",null,"NA","NA"],
    [3307,"3307","Carrier M","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","89253","ASSTD EMBRYO HATCHING MICROTQS ANY METH","94","0.57",null,null,"107.8",null,"0","94",null,"NA","NA"],
    [3308,"3308","Carrier M","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","89258","CRYOPRSRV EMBRYO","89","0.75",null,null,"94.4",null,"0","89",null,"NA","NA"],
    [3309,"3309","Carrier M","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","89342","STORAGE, (PER YEAR); EMBRYO(S)","81","0.78",null,null,"81.3",null,"0","81",null,"NA","NA"],
    [3310,"3310","Carrier M","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19318","BREAST REDUCTION","81","0.7",null,null,"69.5",null,"0","81",null,"NA","NA"],
    [3311,"3311","Carrier M","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","S4022","ASST OOCYTE FERT CASE RATE","73","0.42",null,null,"91.5",null,"0","73",null,"NA","NA"],
    [3312,"3312","Carrier M","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","S4016","FROZEN IVF CASE RATE","66","0.89",null,null,"55.8",null,"0","66",null,"NA","NA"],
    [3313,"3313","Carrier M","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY, 60 MINUTES WITH PATIENT","62","0.98",null,null,"2414.3",null,"0","62",null,"NA","NA"],
    [3314,"3314","Carrier M","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","S4011","IVF PACKAGE","61","0.67",null,null,"98",null,"0","61",null,"NA","NA"],
    [3315,"3315","Carrier M","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","66984","EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1 STAGE PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGATION AND ASPIRATION OR PHACOEMULSIFICATION); WITHOUT ENDOSCOPIC CYCLOPHOTOCOAGULATION","98","1",null,"4","27.4",null,"1","97",null,"NA","NA"],
    [3316,"3316","Carrier M","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","36475","ENDOVENOUS ABLATION THERAPY OF INCOMPETENT VEIN, EXTREMITY, INCLUSIVE OF ALL IMAGING GUIDANCE AND MONITORING, PERCUTANEOUS, RADIOFREQUENCY; FIRST VEIN TREATED","52","1",null,null,"55.4",null,"0","52",null,"NA","NA"],
    [3317,"3317","Carrier M","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58558","HYSTEROSCOPY, SURGICAL; WITH SAMPLING (BIOPSY) OF ENDOMETRIUM AND/OR POLYPECTOMY, WITH OR WITHOUT D & C","33","1",null,"19.1","78.8",null,"1","32",null,"NA","NA"],
    [3318,"3318","Carrier M","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","36478","ENDOVENOUS ABLATION THERAPY OF INCOMPETENT VEIN, EXTREMITY, INCLUSIVE OF ALL IMAGING GUIDANCE AND MONITORING, PERCUTANEOUS,LASER, FIRST VEIN TREATED","16","1",null,null,"51.8",null,"0","16",null,"NA","NA"],
    [3319,"3319","Carrier M","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","66982","EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1-STAGE PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGATION AND ASPIRATION OR PHACOEMULSIFICATION), COMPLEX, REQUIRING DEVICES OR TECHNIQUES NOT GENERALLY USED IN ROUTIN","15","1",null,null,"10.8",null,"0","15",null,"NA","NA"],
    [3320,"3320","Carrier M","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19380","REVJ RECONSTRUCTED BREAST","13","1",null,null,"24.1",null,"0","13",null,"NA","NA"],
    [3321,"3321","Carrier M","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19357","TISSUE EXPANDER PLACEMENT IN BREAST RECONSTRUCTION, INCLUDING SUBSEQUENT EXPANSION(S)","13","1",null,null,"7.8",null,"0","13",null,"NA","NA"],
    [3322,"3322","Carrier M","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15823","BLEPHAROPLASTY, UPPER EYELID; WITH EXCESSIVE SKIN WEIGHTING DOWN LID","12","1",null,null,"24.9",null,"0","12",null,"NA","NA"],
    [3323,"3323","Carrier M","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","36471","NJX SCLEROSING SOLUTION MULTIPLE VEINS SAME LEG","11","1",null,null,"54.4",null,"0","11",null,"NA","NA"],
    [3324,"3324","Carrier M","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99354","PROLNG SVC O/P 1ST HOUR","10","1",null,"33.9","61.6",null,"2","8",null,"NA","NA"],
    [3325,"3325","Carrier M","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27447","ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS","61","0","0.67",null,"38.1",null,"0","61",null,"NA","NA"],
    [3326,"3326","Carrier M","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","89258","CRYOPRSRV EMBRYO","89","0","0.75",null,"94.4",null,"0","89",null,"NA","NA"],
    [3327,"3327","Carrier M","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27130","ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT","54","0","0.76",null,"39.3",null,"0","54",null,"NA","NA"],
    [3328,"3328","Carrier M","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","S4011","IVF PACKAGE","61","0","0.67",null,"98",null,"0","61",null,"NA","NA"],
    [3329,"3329","Carrier M","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","89342","STORAGE, (PER YEAR); EMBRYO(S)","81","0","0.78",null,"81.3",null,"0","81",null,"NA","NA"],
    [3330,"3330","Carrier M","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","31267","NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS","30","0","0.53","1.9","60.6",null,"1","29",null,"NA","NA"],
    [3331,"3331","Carrier M","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","19318","BREAST REDUCTION","81","0","0.7",null,"69.5",null,"0","81",null,"NA","NA"],
    [3332,"3332","Carrier M","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","31276","NASAL/SINUS NDSC W/FRONTAL SINUS EXPLORATION","27","0","0.59","9.7","79.2",null,"2","25",null,"NA","NA"],
    [3333,"3333","Carrier M","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","S4015","COMPLETE IVF NOS CASE RATE","26","0","0.73",null,"205.6",null,"0","26",null,"NA","NA"],
    [3334,"3334","Carrier M","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","89253","ASSTD EMBRYO HATCHING MICROTQS ANY METH","94","0","0.57",null,"107.8",null,"0","94",null,"NA","NA"],
    [3335,"3335","Carrier M","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Internal","NA","MENTAL HEALTH RESIDENTIAL TREATMENT FACILITY","47","0.91",null,"26.8","249.3",null,"4","43",null,"NA","NA"],
    [3336,"3336","Carrier M","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Internal","NA","CHEMICAL DEPENDENCY RESIDENTIAL TREATMENT FACILITY","7","1",null,"11.4","24.4",null,"4","3",null,"NA","NA"],
    [3337,"3337","Carrier M","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Internal","NA","MENTAL HEALTH INPATIENT","2","1",null,null,"96",null,"0","2",null,"NA","NA"],
    [3338,"3338","Carrier M","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Internal","NA","DETOXIFICATION","1","1",null,null,"0.1",null,"0","1",null,"NA","NA"],
    [3339,"3339","Carrier M","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Internal","NA","CHEMICAL DEPENDENCY RESIDENTIAL TREATMENT FACILITY","7","1",null,"11.4","24.4",null,"4","3",null,"NA","NA"],
    [3340,"3340","Carrier M","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Internal","NA","MENTAL HEALTH INPATIENT","2","1",null,null,"96",null,"0","2",null,"NA","NA"],
    [3341,"3341","Carrier M","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Internal","NA","DETOXIFICATION","1","1",null,null,"0.1",null,"0","1",null,"NA","NA"],
    [3342,"3342","Carrier M","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Internal","NA","MENTAL HEALTH RESIDENTIAL TREATMENT FACILITY","47","0.91",null,"26.8","249.3",null,"4","43",null,"NA","NA"],
    [3343,"3343","Carrier M","2022","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Internal","NA","MENTAL HEALTH INPATIENT","2","0","1",null,"96",null,"0","2",null,"NA","NA"],
    [3344,"3344","Carrier M","2022","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Internal","NA","CHEMICAL DEPENDENCY RESIDENTIAL TREATMENT FACILITY","7","0","1","11.4","24.4",null,"4","3",null,"NA","NA"],
    [3345,"3345","Carrier M","2022","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Internal","NA","DETOXIFICATION","1","0","1",null,"0.1",null,"0","1",null,"NA","NA"],
    [3346,"3346","Carrier M","2022","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Internal","NA","MENTAL HEALTH RESIDENTIAL TREATMENT FACILITY","47","0","0.91","26.8","249.3",null,"4","43",null,"NA","NA"],
    [3347,"3347","Carrier M","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","MH PARTIAL HOSP TX UNDER 24H","93","0.98",null,"9.8","328.8",null,"2","91",null,"NA","NA"],
    [3348,"3348","Carrier M","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","BEHAVIOR IDENTIFICATION ASSESSMENT, ADMINISTERED BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, EACH 15 MINUTES OF THE PHYSICIANS OR OTHER QUALI FIED HEALTH CARE PROFESSIONALS TIME FACE-TO-FACE WITH PATIENT AND/OR GUARDIAN( S)/CAREGIVER(S) A","75","0.99",null,null,"491.7",null,"0","75",null,"NA","NA"],
    [3349,"3349","Carrier M","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97153","ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN","66","0.88",null,null,"803.1",null,"0","66",null,"NA","NA"],
    [3350,"3350","Carrier M","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97155","ADAPTIVE BEHAVIOR TREATMENT WITH PROTOCOL MODIFICATION, ADMINISTERED BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, WHICH MAY INCLUDE SIMULTANEOUS DIRECTION OF TECHNICIAN, FACE-TO-FACE WITH ONE PATIENT, EACH 15 MINUTES","65","0.92",null,null,"740.1",null,"0","65",null,"NA","NA"],
    [3351,"3351","Carrier M","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97156","FAMILY ADAPTIVE BEHAVIOR TREATMENT GUIDANCE, ADMINISTERED BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL (WITH OR WITHOUT THE PATIENT PRESENT),FACE- TO-FACE WITH GUARDIAN(S)/CAREGIVER(S), EACH 15 MINUTES","60","0.98",null,null,"636.2",null,"0","60",null,"NA","NA"],
    [3352,"3352","Carrier M","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H2036","ALCOHOL AND/OR DRUG TREATMENT PROGRAM, PER DIEM","46","0.87",null,"81.2","109.1",null,"2","44",null,"NA","NA"],
    [3353,"3353","Carrier M","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY, 60 MINUTES WITH PATIENT","42","0.93",null,null,"730.4",null,"0","42",null,"NA","NA"],
    [3354,"3354","Carrier M","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT DELIVERY AND MANAGEMENT, PER SESSION","38","0.61",null,null,"239.9",null,"0","38",null,"NA","NA"],
    [3355,"3355","Carrier M","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; INITIAL, INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, DELIVERY AND MANAGEMENT","35","0.57",null,null,"204",null,"0","35",null,"NA","NA"],
    [3356,"3356","Carrier M","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT MOTOR THRESHOLD RE-DETERMINATION WITH DELIVERY AND MANAGEMENT","18","0.56",null,null,"285.2",null,"0","18",null,"NA","NA"],
    [3357,"3357","Carrier M","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90832","PSYCHOTHERAPY, 30 MINUTES WITH PATIENT","5","1",null,null,"10.9",null,"0","5",null,"NA","NA"],
    [3358,"3358","Carrier M","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99215","OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH REQUIRES A MEDICALLY APPROPRIATE HISTORY AND/OR EXAMINATION AND HIGH LEVEL OF MEDICAL DECISION MAKING. WHEN USING TIME FOR CODESELECTION, 40-54 MINUTES OF","2","1",null,null,"127.4",null,"0","2",null,"NA","NA"],
    [3359,"3359","Carrier M","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96131","PSYCHOLOGICAL TST EVAL SVC PHYS/QHP EA ADDL HOUR","2","1",null,null,"22.8",null,"0","2",null,"NA","NA"],
    [3360,"3360","Carrier M","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90847","FAMILY PSYCHOTHERAPY W/PATIENT PRESENT","2","1",null,null,"176.6",null,"0","2",null,"NA","NA"],
    [3361,"3361","Carrier M","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96137","PSYCL/NRPSYCL TST PHYS/QHP 2+ TST EA ADDL 30 MIN","2","1",null,null,"22.8",null,"0","2",null,"NA","NA"],
    [3362,"3362","Carrier M","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96130","PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR","2","1",null,null,"22.8",null,"0","2",null,"NA","NA"],
    [3363,"3363","Carrier M","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90846","FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT","2","1",null,null,"2.1",null,"0","2",null,"NA","NA"],
    [3364,"3364","Carrier M","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96136","PSYL/NRPSYCL TST PHYS/QHP 2+ TST 1ST 30 MIN","2","1",null,null,"22.8",null,"0","2",null,"NA","NA"],
    [3365,"3365","Carrier M","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90839","PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES","1","1",null,null,"23.2",null,"0","1",null,"NA","NA"],
    [3366,"3366","Carrier M","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90853","GROUP MEDICAL PSYCHOTHERAPY (OTHER THAN OF A MULTIPLE-FAMILY GROUP)","1","1",null,null,"24",null,"0","1",null,"NA","NA"],
    [3367,"3367","Carrier M","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90868","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT DELIVERY AND MANAGEMENT, PER SESSION","38","0","0.61",null,"239.9",null,"0","38",null,"NA","NA"],
    [3368,"3368","Carrier M","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90867","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; INITIAL, INCLUDING CORTICAL MAPPING, MOTOR THRESHOLD DETERMINATION, DELIVERY AND MANAGEMENT","35","0","0.57",null,"204",null,"0","35",null,"NA","NA"],
    [3369,"3369","Carrier M","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","99205","OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES A MEDICALLY APPROPRIATE HISTORY AND/OR EXAMINATION AND HIGH LEVEL OF MEDICAL DECISION MAKING. WHEN USING TIME FOR CODE SELECTION, 60-74 MINUTES OF TOTAL T","1","0","0",null,"115.6",null,"0","1",null,"NA","NA"],
    [3370,"3370","Carrier M","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90836","PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 45 MIN","2","0","0.5",null,"58.6",null,"0","2",null,"NA","NA"],
    [3371,"3371","Carrier M","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90832","PSYCHOTHERAPY, 30 MINUTES WITH PATIENT","5","0","1",null,"10.9",null,"0","5",null,"NA","NA"],
    [3372,"3372","Carrier M","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97154","GROUP ADAPTIVE BHV TX BY PROTOCOL TECH EA 15 MIN","3","0","0.67",null,"1527.7",null,"0","3",null,"NA","NA"],
    [3373,"3373","Carrier M","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVALUATION","14","0","0.86",null,"124.3",null,"0","14",null,"NA","NA"],
    [3374,"3374","Carrier M","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97151","BEHAVIOR IDENTIFICATION ASSESSMENT, ADMINISTERED BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, EACH 15 MINUTES OF THE PHYSICIANS OR OTHER QUALI FIED HEALTH CARE PROFESSIONALS TIME FACE-TO-FACE WITH PATIENT AND/OR GUARDIAN( S)/CAREGIVER(S) A","75","0","0.99",null,"491.7",null,"0","75",null,"NA","NA"],
    [3375,"3375","Carrier M","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","96130","PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR","2","0","1",null,"22.8",null,"0","2",null,"NA","NA"],
    [3376,"3376","Carrier M","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97158","GRP ADAPT BHV PRTCL MODIFCAJ PHYS/QHP EA 15 MIN","3","0","0.33",null,"1527.7",null,"0","3",null,"NA","NA"],
    [3377,"3377","Carrier M","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0486","ORAL DEVICE/APPLIANCE USED TO REDUCE UPPER AIRWAY COLLAPSIBILITY, ADJUSTABLE OR NON-ADJUSTABLE, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT","2","0",null,null,"59.7",null,"0","2",null,"NA","NA"],
    [3378,"3378","Carrier M","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5652","SUCTION SUSP AK/KNEE DISART","1","1",null,null,"28.3",null,"0","1",null,"NA","NA"],
    [3379,"3379","Carrier M","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5649","ISCH CONTAINMT/NARROW M-L SO","1","1",null,null,"28.2",null,"0","1",null,"NA","NA"],
    [3380,"3380","Carrier M","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5845","KNEE-SHIN SYS STANCE FLEXION","1","1",null,null,"28.3",null,"0","1",null,"NA","NA"],
    [3381,"3381","Carrier M","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L8480","PROS SOCK SINGLE PLY AK","1","1",null,null,"28.2",null,"0","1",null,"NA","NA"],
    [3382,"3382","Carrier M","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5981","FLEX-WALK SYS LOW EXT PROSTH","1","1",null,null,"22",null,"0","1",null,"NA","NA"],
    [3383,"3383","Carrier M","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L8460","SHRINKER ABOVE KNEE","1","1",null,null,"28.2",null,"0","1",null,"NA","NA"],
    [3384,"3384","Carrier M","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5950","ENDO AK ULTRA-LIGHT MATERIAL","1","1",null,null,"28.2",null,"0","1",null,"NA","NA"],
    [3385,"3385","Carrier M","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5650","TOT CONTACT AK/KNEE DISART S","1","1",null,null,"28.2",null,"0","1",null,"NA","NA"],
    [3386,"3386","Carrier M","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5920","ENDO AK/HIP ALIGNABLE SYSTEM","1","1",null,null,"28.2",null,"0","1",null,"NA","NA"],
    [3387,"3387","Carrier M","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5652","SUCTION SUSP AK/KNEE DISART","1","1",null,null,"28.3",null,"0","1",null,"NA","NA"],
    [3388,"3388","Carrier M","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8480","PROS SOCK SINGLE PLY AK","1","1",null,null,"28.2",null,"0","1",null,"NA","NA"],
    [3389,"3389","Carrier M","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5649","ISCH CONTAINMT/NARROW M-L SO","1","1",null,null,"28.2",null,"0","1",null,"NA","NA"],
    [3390,"3390","Carrier M","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5845","KNEE-SHIN SYS STANCE FLEXION","1","1",null,null,"28.3",null,"0","1",null,"NA","NA"],
    [3391,"3391","Carrier M","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5968","MULTIAXIAL ANKLE W DORSIFLEX","1","1",null,null,"21.9",null,"0","1",null,"NA","NA"],
    [3392,"3392","Carrier M","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5981","FLEX-WALK SYS LOW EXT PROSTH","1","1",null,null,"22",null,"0","1",null,"NA","NA"],
    [3393,"3393","Carrier M","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8460","SHRINKER ABOVE KNEE","1","1",null,null,"28.2",null,"0","1",null,"NA","NA"],
    [3394,"3394","Carrier M","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5950","ENDO AK ULTRA-LIGHT MATERIAL","1","1",null,null,"28.2",null,"0","1",null,"NA","NA"],
    [3395,"3395","Carrier M","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5650","TOT CONTACT AK/KNEE DISART S","1","1",null,null,"28.2",null,"0","1",null,"NA","NA"],
    [3396,"3396","Carrier M","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5920","ENDO AK/HIP ALIGNABLE SYSTEM","1","1",null,null,"28.2",null,"0","1",null,"NA","NA"],
    [3397,"3397","Carrier M","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L5652","SUCTION SUSP AK/KNEE DISART","1","0","1",null,"28.3",null,"0","1",null,"NA","NA"],
    [3398,"3398","Carrier M","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L5649","ISCH CONTAINMT/NARROW M-L SO","1","0","1",null,"28.2",null,"0","1",null,"NA","NA"],
    [3399,"3399","Carrier M","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L5845","KNEE-SHIN SYS STANCE FLEXION","1","0","1",null,"28.3",null,"0","1",null,"NA","NA"],
    [3400,"3400","Carrier M","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L8480","PROS SOCK SINGLE PLY AK","1","0","1",null,"28.2",null,"0","1",null,"NA","NA"],
    [3401,"3401","Carrier M","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L5981","FLEX-WALK SYS LOW EXT PROSTH","1","0","1",null,"22",null,"0","1",null,"NA","NA"],
    [3402,"3402","Carrier M","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L8460","SHRINKER ABOVE KNEE","1","0","1",null,"28.2",null,"0","1",null,"NA","NA"],
    [3403,"3403","Carrier M","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L5950","ENDO AK ULTRA-LIGHT MATERIAL","1","0","1",null,"28.2",null,"0","1",null,"NA","NA"],
    [3404,"3404","Carrier M","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L5650","TOT CONTACT AK/KNEE DISART S","1","0","1",null,"28.2",null,"0","1",null,"NA","NA"],
    [3405,"3405","Carrier M","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L5920","ENDO AK/HIP ALIGNABLE SYSTEM","1","0","1",null,"28.2",null,"0","1",null,"NA","NA"],
    [3406,"3406","Carrier M","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","373","0.563",null,"4.74","12.95",null,"92","281",null,"OZEMPIC/RYBELSUS","NA"],
    [3407,"3407","Carrier M","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","242","0.756",null,"4.13","9.56",null,"65","177",null,"DEPO-TESTOSTERONE/TESTOSTERONE","NA"],
    [3408,"3408","Carrier M","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","197","0.898",null,"10.16","9.46",null,"30","167",null,"FIRST-OMEPRAZOLE/OMEPRAZOLE/PRILOSEC","NA"],
    [3409,"3409","Carrier M","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","147","0.748",null,"2.89","15.68",null,"45","102",null,"ADDERALL/AMPHETAMINE-DEXTROAMPHET/AMPHETAMINE-DEXTROAMPHETAMINE/AMPHETAMINE/DEXTROAMPHETAMINE/MYDAYIS","NA"],
    [3410,"3410","Carrier M","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","147","0.714",null,"3.12","10.5",null,"19","128",null,"PROTOPIC/TACROLIMUS","NA"],
    [3411,"3411","Carrier M","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","146","0.87",null,"3.78","12.45",null,"52","94",null,"HYDROCODONE/HYDROCODONE-ACETAMINOPHEN/HYDROCODONE-APAP/HYDROCODONE/ACETAMINOPHEN","NA"],
    [3412,"3412","Carrier M","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","132","0.932",null,"0.53","6.9",null,"26","106",null,"PANTOPRAZOLE","NA"],
    [3413,"3413","Carrier M","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","121","0.777",null,"7.89","16.15",null,"27","94",null,"DULAGLUTIDE/TRULICITY","NA"],
    [3414,"3414","Carrier M","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","121","0.876",null,"7.95","40.74",null,"25","96",null,"HUMIRA","NA"],
    [3415,"3415","Carrier M","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","115","0.817",null,"0.29","7.44",null,"25","90",null,"ABSORICA/ACCUTANE/AMNESTEEM/CLARAVIS/ISOTRETINOIN/MYORISAN/ZENATANE","NA"],
    [3416,"3416","Carrier M","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","25","1",null,"7.74","18.09",null,"9","16",null,"SKYRIZI","NA"],
    [3417,"3417","Carrier M","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","22","1",null,"1.77","18.81",null,"6","16",null,"GABAPENTIN","NA"],
    [3418,"3418","Carrier M","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","20","1",null,"8.38","15.88",null,"6","14",null,"OMEPRAZOLE/PANTOPRAZOLE/RABEPRAZOLE","NA"],
    [3419,"3419","Carrier M","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","14","1",null,"5.34","2.62",null,"4","10",null,"JANUMET","NA"],
    [3420,"3420","Carrier M","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","14","1",null,"0","16.31",null,"1","13",null,"AKLIEF","NA"],
    [3421,"3421","Carrier M","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","9","1",null,null,"16.86",null,"0","9",null,"HIZENTRA","NA"],
    [3422,"3422","Carrier M","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","9","1",null,"2.66","0.04",null,"8","1",null,"CAPECITABINE","NA"],
    [3423,"3423","Carrier M","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,"0","0",null,"2","5",null,"ZALEPLON","NA"],
    [3424,"3424","Carrier M","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,"0","0.01",null,"4","3",null,"RAMELTEON","NA"],
    [3425,"3425","Carrier M","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","6","1",null,"0.92","19.02",null,"1","5",null,"PROLIA","NA"],
    [3426,"3426","Carrier M","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","5","0","1",null,"41.37",null,"0","5",null,"STELARA","NA"],
    [3427,"3427","Carrier M","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3","0","1",null,"60.18",null,"0","3",null,"ANDROGEL/TESTOSTERONE","NA"],
    [3428,"3428","Carrier M","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3","0","1","0.71","42.43",null,"1","2",null,"HUMIRA","NA"],
    [3429,"3429","Carrier M","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3","0","1","2.2",null,null,"3","0",null,"ELIQUIS","NA"],
    [3430,"3430","Carrier M","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2","0","1","52.62","2.72",null,"1","1",null,"TESTOSTERONE","NA"],
    [3431,"3431","Carrier M","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2","0","1","13.85",null,null,"2","0",null,"WEGOVY","NA"],
    [3432,"3432","Carrier M","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2","0","1","0.54",null,null,"2","0",null,"ARMODAFINIL","NA"],
    [3433,"3433","Carrier M","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2","0","1","5.08","5.18",null,"1","1",null,"GRALISE","NA"],
    [3434,"3434","Carrier M","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2","0","1",null,"35.61",null,"0","2",null,"SIMPONI","NA"],
    [3435,"3435","Carrier M","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2","0","1","0.26","19.75",null,"1","1",null,"COSENTYX","NA"],
    [3436,"3436","Carrier F","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","121","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Medical/Surgical/GYN","140","0.7",null,"19","53",null,"31","109",null,"NA","NA"],
    [3437,"3437","Carrier F","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","17","0.9412",null,"26","70",null,"2","15",null,"NA","NA"],
    [3438,"3438","Carrier F","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20936","Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar fragments) obtained from same incision (List separately in addition to code for primary procedure)","14","0.9286",null,"16","71",null,"2","12",null,"NA","NA"],
    [3439,"3439","Carrier F","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20930","Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for primary procedure)","11","1",null,"26","65",null,"2","9",null,"NA","NA"],
    [3440,"3440","Carrier F","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","11","0.9091",null,"29","69",null,"1","10",null,"NA","NA"],
    [3441,"3441","Carrier F","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);","9","1",null,"17","57",null,"3","6",null,"NA","NA"],
    [3442,"3442","Carrier F","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63048","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional vertebral segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure)","9","0.7778",null,"19","73",null,"3","6",null,"NA","NA"],
    [3443,"3443","Carrier F","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","760","Ancillary Services - Specialty Services-General Classification","7","0.8571",null,"1","26",null,"1","6",null,"NA","NA"],
    [3444,"3444","Carrier F","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22612","Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed)","6","0.8333",null,null,"67",null,"0","6",null,"NA","NA"],
    [3445,"3445","Carrier F","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22614","Arthrodesis, posterior or posterolateral technique, single interspace; each additional interspace (List separately in addition to code for primary procedure)","6","1",null,"17","52",null,"2","4",null,"NA","NA"],
    [3446,"3446","Carrier F","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","20930","Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for primary procedure)","11","1",null,"26","65",null,"2","9",null,"NA","NA"],
    [3447,"3447","Carrier F","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58150","Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);","9","1",null,"17","57",null,"3","6",null,"NA","NA"],
    [3448,"3448","Carrier F","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22614","Arthrodesis, posterior or posterolateral technique, single interspace; each additional interspace (List separately in addition to code for primary procedure)","6","1",null,"17","52",null,"2","4",null,"NA","NA"],
    [3449,"3449","Carrier F","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44207","Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)","6","1",null,null,"32",null,"0","6",null,"NA","NA"],
    [3450,"3450","Carrier F","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","55866","Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed","6","1",null,"14","31",null,"1","5",null,"NA","NA"],
    [3451,"3451","Carrier F","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19364","Breast reconstruction; with free flap (eg, fTRAM, DIEP, SIEA, GAP flap)","5","1",null,null,"80",null,"0","5",null,"NA","NA"],
    [3452,"3452","Carrier F","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22558","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","5","1",null,null,"57",null,"0","5",null,"NA","NA"],
    [3453,"3453","Carrier F","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","69990","Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure)","5","1",null,"13","41",null,"2","3",null,"NA","NA"],
    [3454,"3454","Carrier F","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22600","Arthrodesis, posterior or posterolateral technique, single interspace; cervical below C2 segment","4","1",null,"17","45",null,"2","2",null,"NA","NA"],
    [3455,"3455","Carrier F","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","38770","Pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure)","4","1",null,"14","49",null,"1","3",null,"NA","NA"],
    [3456,"3456","Carrier F","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","121","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Medical/Surgical/GYN","140","0","0.0071","19","53",null,"31","109",null,"NA","NA"],
    [3457,"3457","Carrier F","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43239","Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple","505","0.9267",null,"14","48",null,"72","433",null,"NA","NA"],
    [3458,"3458","Carrier F","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43235","Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","431","0.9188",null,"16","49",null,"69","362",null,"NA","NA"],
    [3459,"3459","Carrier F","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","66984","Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); without endoscopic cyclophotocoagulation","132","0.9394",null,"21","61",null,"11","121",null,"NA","NA"],
    [3460,"3460","Carrier F","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64483","Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, single level","131","0.9389",null,"16","46",null,"14","117",null,"NA","NA"],
    [3461,"3461","Carrier F","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45378","Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","116","0.6638",null,"13","40",null,"8","108",null,"NA","NA"],
    [3462,"3462","Carrier F","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","Colonoscopy, flexible; with biopsy, single or multiple","104","0.6923",null,"17","36",null,"7","97",null,"NA","NA"],
    [3463,"3463","Carrier F","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using time for code selection, 30-39 minutes of total time is spent on the date of the encounter.","102","0.3627",null,"29","76",null,"31","71",null,"NA","NA"],
    [3464,"3464","Carrier F","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","92250","Fundus photography with interpretation and report","91","0.967",null,"10","70",null,"20","71",null,"NA","NA"],
    [3465,"3465","Carrier F","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27130","Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft","91","0.8791",null,"32","73",null,"7","84",null,"NA","NA"],
    [3466,"3466","Carrier F","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27447","Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)","83","0.9157",null,"22","67",null,"3","80",null,"NA","NA"],
    [3467,"3467","Carrier F","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27096","Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or CT) including arthrography when performed","50","1",null,"18","37",null,"5","45",null,"NA","NA"],
    [3468,"3468","Carrier F","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29877","Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)","14","1",null,"14","80",null,"2","12",null,"NA","NA"],
    [3469,"3469","Carrier F","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","31276","Nasal/sinus endoscopy, surgical, with frontal sinus exploration, including removal of tissue from frontal sinus, when performed","13","1",null,"15","65",null,"3","10",null,"NA","NA"],
    [3470,"3470","Carrier F","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77067","Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed","12","1",null,null,"81",null,"0","12",null,"NA","NA"],
    [3471,"3471","Carrier F","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","G0260","Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography","10","1",null,null,"89",null,"0","10",null,"NA","NA"],
    [3472,"3472","Carrier F","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29824","Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (Mumford procedure)","9","1",null,null,"59",null,"0","9",null,"NA","NA"],
    [3473,"3473","Carrier F","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","20930","Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for primary procedure)","8","1",null,"24","98",null,"1","7",null,"NA","NA"],
    [3474,"3474","Carrier F","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","31287","Nasal/sinus endoscopy, surgical, with sphenoidotomy;","7","1",null,null,"59",null,"0","7",null,"NA","NA"],
    [3475,"3475","Carrier F","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43242","Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examined distal to the anastomosis)","7","1",null,"25","75",null,"2","5",null,"NA","NA"],
    [3476,"3476","Carrier F","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63650","Percutaneous implantation of neurostimulator electrode array, epidural","7","1",null,null,"83",null,"0","7",null,"NA","NA"],
    [3477,"3477","Carrier F","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27784","Open treatment of proximal fibula or shaft fracture, includes internal fixation, when performed","1","0","1","43",null,null,"1","0",null,"NA","NA"],
    [3478,"3478","Carrier F","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27759","Treatment of tibial shaft fracture (with or without fibular fracture) by intramedullary implant, with or without interlocking screws and/or cerclage","1","0","1","43",null,null,"1","0",null,"NA","NA"],
    [3479,"3479","Carrier F","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43254","Esophagogastroduodenoscopy, flexible, transoral; with endoscopic mucosal resection","1","0","1",null,"52",null,"0","1",null,"NA","NA"],
    [3480,"3480","Carrier F","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64910","Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve","2","0","0.5",null,"74",null,"0","2",null,"NA","NA"],
    [3481,"3481","Carrier F","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","67036","Vitrectomy, mechanical, pars plana approach;","2","0","0.5","24","119",null,"1","1",null,"NA","NA"],
    [3482,"3482","Carrier F","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","15877","Suction assisted lipectomy; trunk","4","0","0.25",null,"97",null,"0","4",null,"NA","NA"],
    [3483,"3483","Carrier F","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","99245","Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded.","9","0","0.2222","20","100",null,"7","2",null,"NA","NA"],
    [3484,"3484","Carrier F","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","58563","Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)","7","0","0.1429",null,"85",null,"0","7",null,"NA","NA"],
    [3485,"3485","Carrier F","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","19350","Nipple/areola reconstruction","14","0","0.0714",null,"101",null,"0","14",null,"NA","NA"],
    [3486,"3486","Carrier F","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","99212","Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using time for code selection, 10-19 minutes of total time is spent on the date of the encounter.","22","0","0.0455","29","85",null,"9","13",null,"NA","NA"],
    [3487,"3487","Carrier F","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","128","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation","10","0.7",null,"29","68",null,"3","7",null,"NA","NA"],
    [3488,"3488","Carrier F","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0017","Behavioral health; residential (hospital residential treatment program), without room and board, per diem","4","0.75",null,"14","83",null,"2","2",null,"NA","NA"],
    [3489,"3489","Carrier F","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric","2","0.5",null,"69","112",null,"1","1",null,"NA","NA"],
    [3490,"3490","Carrier F","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0046","Mental health services, not otherwise specified","1","1",null,"69",null,null,"1","0",null,"NA","NA"],
    [3491,"3491","Carrier F","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0018","Behavioral health; short-term residential (nonhospital residential treatment program), without room and board, per diem","1","1",null,null,"24",null,"0","1",null,"NA","NA"],
    [3492,"3492","Carrier F","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0011","Alcohol and/or drug services; acute detoxification (residential addiction program inpatient)","1","1",null,null,"26",null,"0","1",null,"NA","NA"],
    [3493,"3493","Carrier F","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0011","Alcohol and/or drug services; acute detoxification (residential addiction program inpatient)","1","1",null,null,"26",null,"0","1",null,"NA","NA"],
    [3494,"3494","Carrier F","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0046","Mental health services, not otherwise specified","1","1",null,"69",null,null,"1","0",null,"NA","NA"],
    [3495,"3495","Carrier F","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0018","Behavioral health; short-term residential (nonhospital residential treatment program), without room and board, per diem","1","1",null,null,"24",null,"0","1",null,"NA","NA"],
    [3496,"3496","Carrier F","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0017","Behavioral health; residential (hospital residential treatment program), without room and board, per diem","4","0.75",null,"14","83",null,"2","2",null,"NA","NA"],
    [3497,"3497","Carrier F","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","128","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation","10","0.7",null,"29","68",null,"3","7",null,"NA","NA"],
    [3498,"3498","Carrier F","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric","2","0.5",null,"69","112",null,"1","1",null,"NA","NA"],
    [3499,"3499","Carrier F","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","Mental health partial hospitalization, treatment, less than 24 hours","143","0.8741",null,"27","51",null,"16","127",null,"NA","NA"],
    [3500,"3500","Carrier F","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0015","Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education","56","0.6964",null,"23","60",null,"3","53",null,"NA","NA"],
    [3501,"3501","Carrier F","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S9480","Intensive outpatient psychiatric services, per diem","41","0.8293",null,"18","51",null,"6","35",null,"NA","NA"],
    [3502,"3502","Carrier F","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan","32","0.8125",null,"23","79",null,"2","30",null,"NA","NA"],
    [3503,"3503","Carrier F","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","30","0.7",null,"18","65",null,"7","23",null,"NA","NA"],
    [3504,"3504","Carrier F","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97156","Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes","30","0.8333",null,"23","76",null,"2","28",null,"NA","NA"],
    [3505,"3505","Carrier F","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","27","0.6296",null,"15","59",null,"5","22",null,"NA","NA"],
    [3506,"3506","Carrier F","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S0201","Partial hospitalization services, less than 24 hours, per diem","25","0.76",null,"26","49",null,"6","19",null,"NA","NA"],
    [3507,"3507","Carrier F","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H2019","Therapeutic behavioral services, per 15 minutes","24","0.75",null,"0","73",null,"1","23",null,"NA","NA"],
    [3508,"3508","Carrier F","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97153","Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes","23","0.8696",null,null,"76",null,"0","23",null,"NA","NA"],
    [3509,"3509","Carrier F","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96132","Neuropsychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, family member(s) or caregiver(s), when performed; first hour","4","1",null,null,"46",null,"0","4",null,"NA","NA"],
    [3510,"3510","Carrier F","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96133","Neuropsychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, family member(s) or caregiver(s), when performed; each additional hour (List separately in addition to code for primary procedure)","3","1",null,null,"43",null,"0","3",null,"NA","NA"],
    [3511,"3511","Carrier F","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","0373T","Adaptive behavior treatment with protocol modification, each 15 minutes of technicians' time face-to-face with a patient, requiring the following components: administration by the physician or other qualified health care professional who is on site; with the assistance of two or more technicians; for a patient who exhibits destructive behavior; completion in an environment that is customized to the patient's behavior.","2","1",null,null,"103",null,"0","2",null,"NA","NA"],
    [3512,"3512","Carrier F","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96137","Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; each additional 30 minutes (List separately in addition to code for primary procedure)","2","1",null,null,"54",null,"0","2",null,"NA","NA"],
    [3513,"3513","Carrier F","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97154","Group adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with two or more patients, each 15 minutes","2","1",null,null,"51",null,"0","2",null,"NA","NA"],
    [3514,"3514","Carrier F","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H2012","Behavioral health day treatment, per hour","2","1",null,null,"22",null,"0","2",null,"NA","NA"],
    [3515,"3515","Carrier F","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90833","Psychotherapy, 30 minutes with patient when performed with an evaluation and management service (List separately in addition to the code for primary procedure)","1","1",null,null,"19",null,"0","1",null,"NA","NA"],
    [3516,"3516","Carrier F","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96116","Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face-to-face time with the patient and time interpreting test results and preparing the report; first hour","1","1",null,null,"74",null,"0","1",null,"NA","NA"],
    [3517,"3517","Carrier F","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96138","Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; first 30 minutes","1","1",null,null,"74",null,"0","1",null,"NA","NA"],
    [3518,"3518","Carrier F","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96139","Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; each additional 30 minutes (List separately in addition to code for primary procedure)","1","1",null,null,"74",null,"0","1",null,"NA","NA"],
    [3519,"3519","Carrier F","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9276","Sensor; invasive (e.g., subcutaneous), disposable, for use with nondurable medical equipment interstitial continuous glucose monitoring system (CGM), one unit = 1 day supply","39","0.6667",null,null,"93",null,"0","39",null,"NA","NA"],
    [3520,"3520","Carrier F","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9277","Transmitter; external, for use with nondurable medical equipment interstitial continuous glucose monitoring system (CGM)","29","0.7931",null,null,"91",null,"0","29",null,"NA","NA"],
    [3521,"3521","Carrier F","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","Continuous positive airway pressure (CPAP) device","22","0.4091",null,null,"74",null,"0","22",null,"NA","NA"],
    [3522,"3522","Carrier F","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A7000","Canister, disposable, used with suction pump, each","15","0.8667",null,"13","102",null,"2","13",null,"NA","NA"],
    [3523,"3523","Carrier F","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2402","Negative pressure wound therapy electrical pump, stationary or portable","15","0.9333",null,"13","102",null,"2","13",null,"NA","NA"],
    [3524,"3524","Carrier F","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A6550","Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","14","0.9286",null,"13","100",null,"2","12",null,"NA","NA"],
    [3525,"3525","Carrier F","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0108","Wheelchair component or accessory, not otherwise specified","9","0.5556",null,null,"54",null,"0","9",null,"NA","NA"],
    [3526,"3526","Carrier F","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","External ambulatory infusion pump, insulin","9","0.8889",null,null,"48",null,"0","9",null,"NA","NA"],
    [3527,"3527","Carrier F","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A7035","Headgear used with positive airway pressure device","8","0.125",null,null,"71",null,"0","8",null,"NA","NA"],
    [3528,"3528","Carrier F","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L1852","Knee orthosis (KO), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","8","0.875",null,"21","50",null,"1","7",null,"NA","NA"],
    [3529,"3529","Carrier F","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S9342","Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem","7","1",null,"1","93",null,"1","6",null,"NA","NA"],
    [3530,"3530","Carrier F","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L2820","Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","6","1",null,null,"90",null,"0","6",null,"NA","NA"],
    [3531,"3531","Carrier F","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","G0249","Provision of test materials and equipment for home INR monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets Medicare coverage criteria; includes: provision of materials for use in the home and reporting of test results to physician; testing not occurring more frequently than once a week; testing materials, billing units of service include four tests","5","1",null,null,"98",null,"0","5",null,"NA","NA"],
    [3532,"3532","Carrier F","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L0464","Thoracic-lumbar-sacral orthosis (TLSO), triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment","5","1",null,"4.3","52",null,"1","4",null,"NA","NA"],
    [3533,"3533","Carrier F","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L1833","Knee orthosis (KO), adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","5","1",null,null,"90",null,"0","5",null,"NA","NA"],
    [3534,"3534","Carrier F","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","V2624","Polishing/resurfacing of ocular prosthesis","5","1",null,null,"87",null,"0","5",null,"NA","NA"],
    [3535,"3535","Carrier F","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1392","Portable oxygen concentrator, rental","4","1",null,"13","70",null,"2","2",null,"NA","NA"],
    [3536,"3536","Carrier F","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L2330","Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","4","1",null,null,"82",null,"0","4",null,"NA","NA"],
    [3537,"3537","Carrier F","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","B4153","Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","3","1",null,null,"82",null,"0","3",null,"NA","NA"],
    [3538,"3538","Carrier F","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0748","Osteogenesis stimulator, electrical, noninvasive, spinal applications","3","1",null,null,"97",null,"0","3",null,"NA","NA"],
    [3539,"3539","Carrier F","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L3913","Hand-finger orthosis (HFO), without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","2","0","0.5",null,"142",null,"0","2",null,"NA","NA"],
    [3540,"3540","Carrier F","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0240","Bath/shower chair, with or without wheels, any size","2","0","0.5",null,"73",null,"0","2",null,"NA","NA"],
    [3541,"3541","Carrier F","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","B4153","Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","3","0","0.3333",null,"82",null,"0","3",null,"NA","NA"],
    [3542,"3542","Carrier F","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0667","Segmental pneumatic appliance for use with pneumatic compressor, full leg","4","0","0.25","0","112",null,"2","2",null,"NA","NA"],
    [3543,"3543","Carrier F","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0652","Pneumatic compressor, segmental home model with calibrated gradient pressure","4","0","0.25","0","112",null,"2","2",null,"NA","NA"],
    [3544,"3544","Carrier F","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","S9342","Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem","7","0","0.1429","1","93",null,"1","6",null,"NA","NA"],
    [3545,"3545","Carrier F","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","Test Strips","23","0.6086",null,"9.2","24",null,"3","20",null,"NA","NA"],
    [3546,"3546","Carrier F","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","Test Strips","23","0.6086",null,"9.2","24",null,"3","20",null,"NA","NA"],
    [3547,"3547","Carrier H","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","121","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Medical/Surgical/GYN","109","0.67",null,"16.4","48.7",null,"18","91",null,"NA","NA"],
    [3548,"3548","Carrier H","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43644","Laparoscopy, Surg, Gastric Restrictive Procedure; W Gastric Bypass And Roux-En-Y Gastroent","61","0.75",null,"24","40.1",null,"1","60",null,"NA","NA"],
    [3549,"3549","Carrier H","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","Total Abdominal Hysterectomy (Corpus And Cervix), With Or Without Removal Of Tube(S), With","49","0.69",null,"28.8","45.2",null,"7","42",null,"NA","NA"],
    [3550,"3550","Carrier H","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43775","Laps Gstrc Rstrictiv Px Longitudinal Gastrectomy","47","0.94",null,null,"47.5",null,"0","47",null,"NA","NA"],
    [3551,"3551","Carrier H","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22614","Arthrodesis, Posterior Or Posterolateral Technique, Single Interspace; Each Additional Int","42","0.86",null,"12","66.2",null,"2","40",null,"NA","NA"],
    [3552,"3552","Carrier H","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22552","Arthrodesis, Anterior Interbody, Incl Disc Space Prep, Discectomy, Osteophytectomy & Decom","21","0.86",null,null,"50.5",null,"0","21",null,"NA","NA"],
    [3553,"3553","Carrier H","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22634","Arthrodesis, Combined Posterior Or Posterolateral Technique With Posterior Interbody Techn","14","1",null,"24","54.5",null,"1","13",null,"NA","NA"],
    [3554,"3554","Carrier H","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19328","Removal Of Intact Breast Implant","14","0.07",null,null,"24",null,"0","14",null,"NA","NA"],
    [3555,"3555","Carrier H","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22585","Arthrodesis, Anterior/-Lateral,Ea Add.In","14","0.64",null,null,"64.8",null,"0","14",null,"NA","NA"],
    [3556,"3556","Carrier H","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43235","Esophagogastroduodenoscopy Flexible, Transoral; Diagnostic, Including Collection Of Specim","14","0.43",null,"0","68",null,"1","13",null,"NA","NA"],
    [3557,"3557","Carrier H","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22634","Arthrodesis, Combined Posterior Or Posterolateral Technique With Posterior Interbody Techn","14","1",null,"24","54.5",null,"1","13",null,"NA","NA"],
    [3558,"3558","Carrier H","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27130","Replacement Hip Total Simple","13","1",null,"0","40",null,"1","12",null,"NA","NA"],
    [3559,"3559","Carrier H","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","75894","Transcatheter Therapy Embolize Any Meth","7","1",null,"0","48",null,"4","3",null,"NA","NA"],
    [3560,"3560","Carrier H","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33340","Percutaneous Transcatheter Closure Of The Left Atrial Appendage With Endocardial Implant,","6","1",null,null,"40",null,"0","6",null,"NA","NA"],
    [3561,"3561","Carrier H","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33361","Transcatheter Aortic Valve Replacement (Tavr/Tavi) With Prosthetic Valve; Percutaneous Fem","5","1",null,null,"28.8",null,"0","5",null,"NA","NA"],
    [3562,"3562","Carrier H","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22633","Arthrodesis, Combined Posterior Or Posterolateral Technique Wi/ Posterior Interbody Techni","5","1",null,"24","0",null,"1","4",null,"NA","NA"],
    [3563,"3563","Carrier H","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","42950","Pharyngoplasty","4","1",null,null,"54",null,"0","4",null,"NA","NA"],
    [3564,"3564","Carrier H","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22632","Arthrodesis, Each Additional Interspace","4","1",null,null,"54",null,"0","4",null,"NA","NA"],
    [3565,"3565","Carrier H","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","50365","Renal Homotxplnt,Implnt Gft;W/Recipnt Ne","3","1",null,null,"8",null,"0","3",null,"NA","NA"],
    [3566,"3566","Carrier H","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43644","Laparoscopy, Surg, Gastric Restrictive Procedure; W Gastric Bypass And Roux-En-Y Gastroent","61","0","1","24","40.1",null,"1","60",null,"NA","NA"],
    [3567,"3567","Carrier H","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43775","Laps Gstrc Rstrictiv Px Longitudinal Gastrectomy","47","0","1",null,"47.5",null,"0","47",null,"NA","NA"],
    [3568,"3568","Carrier H","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22634","Arthrodesis, Combined Posterior Or Posterolateral Technique With Posterior Interbody Techn","14","0","1","24","54.5",null,"1","13",null,"NA","NA"],
    [3569,"3569","Carrier H","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43235","Esophagogastroduodenoscopy Flexible, Transoral; Diagnostic, Including Collection Of Specim","14","0","1","0","68",null,"1","13",null,"NA","NA"],
    [3570,"3570","Carrier H","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43659","Unlisted Laparoscopy Procedure, Stomach","11","0","1","0","37.7",null,"2","9",null,"NA","NA"],
    [3571,"3571","Carrier H","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27447","Replacement Knee Total","10","0","1",null,"45.3",null,"0","10",null,"NA","NA"],
    [3572,"3572","Carrier H","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43845","Gastric Restrictive Proc W/ Partial Gastrectomy, Pylorus-Preserving Duodenoileostomy & Ile","5","0","1",null,"33.6",null,"0","5",null,"NA","NA"],
    [3573,"3573","Carrier H","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22632","Arthrodesis, Each Additional Interspace","4","0","1",null,"54",null,"0","4",null,"NA","NA"],
    [3574,"3574","Carrier H","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","61736","Laser Interstitial Thermal Tx (Litt) Of Lesion, Intracranial, Incl Burr Hole(S), W/ Magnet","2","0","1",null,"36",null,"0","2",null,"NA","NA"],
    [3575,"3575","Carrier H","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","Echo, Transthoracic W/Doppler, Complete","32093","0.97",null,"2.4","3.8",null,"20","32073",null,"NA","NA"],
    [3576,"3576","Carrier H","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","Continuous Airway Pressure (Cpap) Device [May Be Used For Either Cpap Or Apap]","27168","0.97",null,null,"1.7",null,"0","27168",null,"NA","NA"],
    [3577,"3577","Carrier H","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","Mri, Lower Extremity Any Joint; Wo Contr","25161","0.93",null,"1.9","4.9",null,"63","25098",null,"NA","NA"],
    [3578,"3578","Carrier H","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74176","Ct Abd & Pelvis","24003","0.96",null,"2.1","4.5",null,"174","23829",null,"NA","NA"],
    [3579,"3579","Carrier H","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","MSMPT","Physical Therapy","21069","0.69",null,"4","11",null,null,null,null,"NA","NA"],
    [3580,"3580","Carrier H","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72148","Mri Of Lumbar Spine","18239","0.93",null,"6.3","5.6",null,"23","18216",null,"NA","NA"],
    [3581,"3581","Carrier H","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","Mri Of Brain And Further Sequences","15547","0.97",null,"1.7","3.6",null,"28","15519",null,"NA","NA"],
    [3582,"3582","Carrier H","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73221","Mri, Any Joint Of Upper Extremity; Wo Co","12303","0.92",null,"4","5.8",null,"18","12285",null,"NA","NA"],
    [3583,"3583","Carrier H","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72141","Mri Of Cervical Spine","10691","0.93",null,"2.4","5.9",null,"10","10681",null,"NA","NA"],
    [3584,"3584","Carrier H","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70551","Mri Of Brain","9509","0.96",null,"2.5","5",null,"19","9490",null,"NA","NA"],
    [3585,"3585","Carrier H","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","74712","Mri Fetal Sngl/1St Gestation","107","1",null,null,"0.7",null,"0","107",null,"NA","NA"],
    [3586,"3586","Carrier H","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70545","Mra, Head, W/Contrast","101","1",null,"12","3.2",null,"2","99",null,"NA","NA"],
    [3587,"3587","Carrier H","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J0585","Injection, Onabotulinumtoxin A, 1 Unit","49","1",null,null,"0",null,"0","49",null,"NA","NA"],
    [3588,"3588","Carrier H","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","74261","Ct Colonography, Diag, W/O Dye","41","1",null,null,"1.8",null,"0","41",null,"NA","NA"],
    [3589,"3589","Carrier H","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64615","Chemodenervation Of Muscle(S); Muscle(S) Innervated By Facial, Trigeminal, Cervical Spinal","34","1",null,null,"0",null,"0","34",null,"NA","NA"],
    [3590,"3590","Carrier H","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","73206","Cta Upr Extrm W/Wo Contrast","31","1",null,null,"3.9",null,"0","31",null,"NA","NA"],
    [3591,"3591","Carrier H","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72191","Cta, Pelvis W/O Cntrst Flwd Cntrst","27","1",null,null,"0",null,"0","27",null,"NA","NA"],
    [3592,"3592","Carrier H","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81340","Trb@ Gene Rearrange Amplify","24","1",null,null,"3",null,"0","24",null,"NA","NA"],
    [3593,"3593","Carrier H","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27447","Replacement Knee Total","229","0","1","4.8","34.9",null,"5","224",null,"NA","NA"],
    [3594,"3594","Carrier H","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27130","Replacement Hip Total Simple","191","0","1","0","32.5",null,"6","185",null,"NA","NA"],
    [3595,"3595","Carrier H","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","15771","Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk, Breasts, Scalp, Ar","71","0","1",null,"35",null,"0","71",null,"NA","NA"],
    [3596,"3596","Carrier H","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","58570","Tlh, Uterus 250 G Or Less","69","0","1","24","43",null,"3","66",null,"NA","NA"],
    [3597,"3597","Carrier H","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","15772","Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk, Breasts, Scalp, Ar","42","0","1",null,"31.8",null,"0","42",null,"NA","NA"],
    [3598,"3598","Carrier H","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","36465","Injection Of Non-Compounded Foam Sclerosant W/ Ultrasound Compression Maneuvers To Guide D","41","0","1",null,"38",null,"0","41",null,"NA","NA"],
    [3599,"3599","Carrier H","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22551","Arthrodesis, Anterior Interbody, Including Disc Space Preparation, Discectomy, Osteophytec","38","0","1","0","72",null,"2","36",null,"NA","NA"],
    [3600,"3600","Carrier H","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43644","Laparoscopy, Surg, Gastric Restrictive Procedure; W Gastric Bypass And Roux-En-Y Gastroent","33","0","1",null,"32",null,"0","33",null,"NA","NA"],
    [3601,"3601","Carrier H","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","37243","Vascular Embolzatn Or Occlusion Incl Of All Rad Sup & Int Intraprocedural Roadmapping & Im","32","0","1","3.4","39.3",null,"7","25",null,"NA","NA"],
    [3602,"3602","Carrier H","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","128","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation","11","0.18",null,"20.7","63.4",null,"5","6",null,"NA","NA"],
    [3603,"3603","Carrier H","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0017","Behavioral health; residential (hospital residential treatment program), without room and board, per diem","2","0.5",null,null,"24.2",null,"0","2",null,"NA","NA"],
    [3604,"3604","Carrier H","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0015","Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education","1","0",null,null,"65.4",null,"0","1",null,"NA","NA"],
    [3605,"3605","Carrier H","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric","1","0",null,"41.7",null,null,"1","0",null,"NA","NA"],
    [3606,"3606","Carrier H","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","126","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Detoxification","1","0",null,null,"65.4",null,"0","1",null,"NA","NA"],
    [3607,"3607","Carrier H","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0010","Alcohol And/Or Drug Services; Subacute Detoxification (Residential Addiction Program Inpat","1","0",null,null,"0",null,"0","1",null,"NA","NA"],
    [3608,"3608","Carrier H","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0008","Alcohol And/Or Drug Services; Subacute Detoxification (Hospital Inpatient)","1","0",null,null,"0",null,"0","1",null,"NA","NA"],
    [3609,"3609","Carrier H","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0011","Alcohol And/Or Drug Services; Acute Detoxification (Residential Addiction Program Inpatien","1","0",null,null,"0",null,"0","1",null,"NA","NA"],
    [3610,"3610","Carrier H","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0017","Behavioral health; residential (hospital residential treatment program), without room and board, per diem","2","0.5",null,null,"24.2",null,"0","2",null,"NA","NA"],
    [3611,"3611","Carrier H","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","128","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation","11","0.18",null,"20.7","63.4",null,"5","6",null,"NA","NA"],
    [3612,"3612","Carrier H","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric","1","0",null,"41.7",null,null,"1","0",null,"NA","NA"],
    [3613,"3613","Carrier H","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","126","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Detoxification","1","0",null,null,"65.4",null,"0","1",null,"NA","NA"],
    [3614,"3614","Carrier H","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0015","Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education","1","0",null,null,"65.4",null,"0","1",null,"NA","NA"],
    [3615,"3615","Carrier H","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0010","Alcohol And/Or Drug Services; Subacute Detoxification (Residential Addiction Program Inpat","1","0",null,null,"0",null,"0","1",null,"NA","NA"],
    [3616,"3616","Carrier H","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0008","Alcohol And/Or Drug Services; Subacute Detoxification (Hospital Inpatient)","1","0",null,null,"0",null,"0","1",null,"NA","NA"],
    [3617,"3617","Carrier H","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0011","Alcohol And/Or Drug Services; Acute Detoxification (Residential Addiction Program Inpatien","1","0",null,null,"0",null,"0","1",null,"NA","NA"],
    [3618,"3618","Carrier H","2022","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","H0017","Behavioral health; residential (hospital residential treatment program), without room and board, per diem","2","0","0.5",null,"24.2",null,"0","2",null,"NA","NA"],
    [3619,"3619","Carrier H","2022","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","128","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation","11","0","0.18","20.7","63.4",null,"5","6",null,"NA","NA"],
    [3620,"3620","Carrier H","2022","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","124","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric","1","0","0","41.7",null,null,"1","0",null,"NA","NA"],
    [3621,"3621","Carrier H","2022","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","126","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Detoxification","1","0","0",null,"65.4",null,"0","1",null,"NA","NA"],
    [3622,"3622","Carrier H","2022","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","H0015","Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education","1","0","0",null,"65.4",null,"0","1",null,"NA","NA"],
    [3623,"3623","Carrier H","2022","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","H0010","Alcohol And/Or Drug Services; Subacute Detoxification (Residential Addiction Program Inpat","1","0","0",null,"0",null,"0","1",null,"NA","NA"],
    [3624,"3624","Carrier H","2022","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","H0008","Alcohol And/Or Drug Services; Subacute Detoxification (Hospital Inpatient)","1","0","0",null,"0",null,"0","1",null,"NA","NA"],
    [3625,"3625","Carrier H","2022","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","H0011","Alcohol And/Or Drug Services; Acute Detoxification (Residential Addiction Program Inpatien","1","0","0",null,"0",null,"0","1",null,"NA","NA"],
    [3626,"3626","Carrier H","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Therapeutic Repetitive Transcranial Magnetic Simulation (Tms) Treatment; Initial, Includin","258","0.87",null,"6.9","54.5",null,"10","248",null,"NA","NA"],
    [3627,"3627","Carrier H","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","Therapeutic Repetitive Transcranial Magnetic Simulation (Tms) Treatment; Including Cortica","202","0.86",null,"78","52.4",null,"4","198",null,"NA","NA"],
    [3628,"3628","Carrier H","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","Mental health partial hospitalization, treatment, less than 24 hours","176","0.8",null,"33.5","43.9",null,"11","165",null,"NA","NA"],
    [3629,"3629","Carrier H","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","Therapeutic Repetitive Transcranial Magnetic Stimulation (Tms) Treatment; Subsequent Motor","174","0.83",null,"56","59.8",null,"8","166",null,"NA","NA"],
    [3630,"3630","Carrier H","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan","93","0.7",null,"32.4","58.3",null,"14","79",null,"NA","NA"],
    [3631,"3631","Carrier H","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97156","Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes","93","0.74",null,"31.6","50.8",null,"18","75",null,"NA","NA"],
    [3632,"3632","Carrier H","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","92","0.73",null,"16.5","53.8",null,"11","81",null,"NA","NA"],
    [3633,"3633","Carrier H","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97155","Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes","90","0.72",null,"32.2","53.3",null,"21","69",null,"NA","NA"],
    [3634,"3634","Carrier H","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S9480","Intensive outpatient psychiatric services, per diem","86","0.72",null,"17.1","45.3",null,"7","79",null,"NA","NA"],
    [3635,"3635","Carrier H","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97153","Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes","79","0.72",null,"32.4","51.2",null,"18","61",null,"NA","NA"],
    [3636,"3636","Carrier H","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97156","Family Adptve Bhvr Trtmnt Guidance, Admnstrd By Phys Or Other Qualified Hlth Care Profess","9","1",null,"24","9",null,"1","8",null,"NA","NA"],
    [3637,"3637","Carrier H","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97153","Adaptive Behavior Treatment By Protocol, Admnstrd By Tech Under The Direction Of A Phys Or","9","1",null,"24","9",null,"1","8",null,"NA","NA"],
    [3638,"3638","Carrier H","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97151","Behavior Identification Assessment, Administered By A Physician Or Other Qualified Health","8","1",null,null,"12",null,"0","8",null,"NA","NA"],
    [3639,"3639","Carrier H","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97155","Adptve Bhvr Trtmnt W/ Protocol Modifictn, Admnstrd By Phys Or Other Qualified Hlth Care Pr","8","1",null,"24","10.3",null,"1","7",null,"NA","NA"],
    [3640,"3640","Carrier H","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S9480","Intensive Outpatient Psychiatric Services Per Diem","7","1",null,"0","33",null,"1","6",null,"NA","NA"],
    [3641,"3641","Carrier H","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0035","Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours","6","1",null,null,"28",null,"0","6",null,"NA","NA"],
    [3642,"3642","Carrier H","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90870","Electroconvulsive Therapy;1 Seizure","2","1",null,null,"0",null,"0","2",null,"NA","NA"],
    [3643,"3643","Carrier H","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H2014","Skills Training And Development Per 15 Minutes","1","1",null,null,"24",null,"0","1",null,"NA","NA"],
    [3644,"3644","Carrier H","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90868","Therapeutic Repetitive Transcranial Magnetic Simulation (Tms) Treatment; Initial, Includin","258","0","1","6.9","54.5",null,"10","248",null,"NA","NA"],
    [3645,"3645","Carrier H","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90867","Therapeutic Repetitive Transcranial Magnetic Simulation (Tms) Treatment; Including Cortica","202","0","1","78","52.4",null,"4","198",null,"NA","NA"],
    [3646,"3646","Carrier H","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90869","Therapeutic Repetitive Transcranial Magnetic Stimulation (Tms) Treatment; Subsequent Motor","174","0","1","56","59.8",null,"8","166",null,"NA","NA"],
    [3647,"3647","Carrier H","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","G2083","Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patie","44","0","1","74.4","45",null,"11","33",null,"NA","NA"],
    [3648,"3648","Carrier H","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","G2082","Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patie","31","0","1","82.7","45.2",null,"10","21",null,"NA","NA"],
    [3649,"3649","Carrier H","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","J3490","Unclassified drugs","3","0","0.33","26.4","121.9",null,"2","1",null,"NA","NA"],
    [3650,"3650","Carrier H","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97151","Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan","93","0","0.02","32.4","58.3",null,"14","79",null,"NA","NA"],
    [3651,"3651","Carrier H","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97153","Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes","79","0","0.01","32.4","51.2",null,"18","61",null,"NA","NA"],
    [3652,"3652","Carrier H","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97155","Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes","90","0","0.01","32.2","53.3",null,"21","69",null,"NA","NA"],
    [3653,"3653","Carrier H","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97156","Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes","93","0","0.01","31.6","50.8",null,"18","75",null,"NA","NA"],
    [3654,"3654","Carrier H","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0486","Adjustable, Custom Fabricated, Includes Fitting And Adjustment","208","0.95",null,null,"7.7",null,"0","1329",null,"NA","NA"],
    [3655,"3655","Carrier H","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0108","Wheelchair Component Or Accessory, Not Otherwise Specified","99","0.8",null,null,"43",null,"0","99",null,"NA","NA"],
    [3656,"3656","Carrier H","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S1040","Cranial Remolding Orthosis, Rigid, With Soft Interface Material, Custom Fabricated, Includ","71","0.94",null,"0","56.9",null,"2","69",null,"NA","NA"],
    [3657,"3657","Carrier H","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L8680","Implantable Neurostimulator Electrode Each","48","0.92",null,"24","105.4",null,"1","47",null,"NA","NA"],
    [3658,"3658","Carrier H","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0652","Pneumatic Compressor, Segmental Home Model With Calibrated Gradient Pr","41","0.8",null,"0","62.4",null,"1","40",null,"NA","NA"],
    [3659,"3659","Carrier H","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0748","Osteogenic Stimulator, Noninvasive, Spinal Applications","36","0.36",null,"24","87.2",null,"1","35",null,"NA","NA"],
    [3660,"3660","Carrier H","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0747","Osteogenesis Stimulator (Non-Invasive)","32","0.25",null,"48","88.6",null,"3","29",null,"NA","NA"],
    [3661,"3661","Carrier H","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L2755","Addition To Lower Extremity Orthosis Carbon Graphite Lamination","27","0.89",null,"24","36",null,"1","26",null,"NA","NA"],
    [3662,"3662","Carrier H","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0606","Aed Garment With Electrocardiogram Analysis","26","0.58",null,"21.8","72",null,"24","2",null,"NA","NA"],
    [3663,"3663","Carrier H","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L8688","Implt Nrostm Pls Gen Dua Non","23","0.87",null,null,"109.4",null,"0","23",null,"NA","NA"],
    [3664,"3664","Carrier H","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8691","Auditory Osseointegrated Device, External Sound Processor, Excludes Transducer/Actuator, R","9","1",null,null,"97.7",null,"0","9",null,"NA","NA"],
    [3665,"3665","Carrier H","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8694","Auditory Osseointegrated Device, Transducer/Actuator, Replacement Only, Each","8","1",null,null,"61.7",null,"0","8",null,"NA","NA"],
    [3666,"3666","Carrier H","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0955","Wheelchair Accessory, Headrest, Cushioned, Prefabricated, Including Fixed Mounting Hardwar","6","1",null,null,"67.2",null,"0","6",null,"NA","NA"],
    [3667,"3667","Carrier H","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A6549","Gradient compression stocking/sleeve, not otherwise specified","5","1",null,null,"60.4",null,"0","5",null,"NA","NA"],
    [3668,"3668","Carrier H","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9276","Sensor; invasive (e.g., subcutaneous), disposable, for use with nondurable medical equipment interstitial continuous glucose monitoring system (CGM), one unit = 1 day supply","4","1",null,"32.8","169.5",null,"3","1",null,"NA","NA"],
    [3669,"3669","Carrier H","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0277","Alternating Pressure Mattress","4","1",null,"0","48",null,"1","3",null,"NA","NA"],
    [3670,"3670","Carrier H","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1233","Wheelchair, Pediatric Size, Tilt-In-Space, Rigid, Adj, Wo Seating","3","1",null,null,"24",null,"0","3",null,"NA","NA"],
    [3671,"3671","Carrier H","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0265","Hospital Bed, Total Electric (Head, Foot And Height Adjustments), With Any Type Side Rails","3","1",null,null,"56",null,"0","3",null,"NA","NA"],
    [3672,"3672","Carrier H","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8687","Implt Nrostm Pls Gen Dua Rec","3","1",null,null,"108",null,"0","3",null,"NA","NA"],
    [3673,"3673","Carrier H","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8681","Pt Prgrm For Implt Neurostim","3","1",null,null,"156",null,"0","3",null,"NA","NA"],
    [3674,"3674","Carrier H","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0486","Adjustable, Custom Fabricated, Includes Fitting And Adjustment","208","0","1",null,"7.7",null,"0","1329",null,"NA","NA"],
    [3675,"3675","Carrier H","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L8680","Implantable Neurostimulator Electrode Each","48","0","1","24","105.4",null,"1","47",null,"NA","NA"],
    [3676,"3676","Carrier H","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0748","Osteogenic Stimulator, Noninvasive, Spinal Applications","36","0","1","24","87.2",null,"1","35",null,"NA","NA"],
    [3677,"3677","Carrier H","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","K0005","Ultralightweight Wheelchair","22","0","1",null,"58.7",null,"0","22",null,"NA","NA"],
    [3678,"3678","Carrier H","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L8614","Cochlear Device/System","14","0","1",null,"112",null,"0","14",null,"NA","NA"],
    [3679,"3679","Carrier H","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L8691","Auditory Osseointegrated Device, External Sound Processor, Excludes Transducer/Actuator, R","9","0","1",null,"97.7",null,"0","9",null,"NA","NA"],
    [3680,"3680","Carrier H","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L8694","Auditory Osseointegrated Device, Transducer/Actuator, Replacement Only, Each","8","0","1",null,"61.7",null,"0","8",null,"NA","NA"],
    [3681,"3681","Carrier H","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0986","Manual Wheelchair Accessory, Push-Rim Activated Power Assist, Each","4","0","1",null,"72",null,"0","4",null,"NA","NA"],
    [3682,"3682","Carrier H","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0277","Alternating Pressure Mattress","4","0","1","0","48",null,"1","3",null,"NA","NA"],
    [3683,"3683","Carrier H","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L1844","Ko, Single Upright, Thigh And Calf, With Adjustable Flexion And Extens","3","0","1",null,"80",null,"0","3",null,"NA","NA"],
    [3684,"3684","Carrier H","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","Test Strips","107","0.62",null,"9","31.2",null,"29","78",null,"NA","NA"],
    [3685,"3685","Carrier H","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","Test Strips","107","0.62",null,"9","31.2",null,"29","78",null,"NA","NA"],
    [3686,"3686","Carrier N","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","47379","UNLISTED LAPS PX LIVER","2","0.5",null,"0","60","0","0","2","0","NA","NA"],
    [3687,"3687","Carrier N","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44204","LAPARO PARTIAL COLECTOMY","2","1",null,"0","0","0","0","2","0","NA","NA"],
    [3688,"3688","Carrier N","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","33405","REPLACEMENT AORTIC VALVE OPN","2","1",null,"72","24","0","1","1","0","NA","NA"],
    [3689,"3689","Carrier N","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","TOTAL HYSTERECTOMY","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [3690,"3690","Carrier N","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","21705","REVISION OF NECK MUSCLE/RIB","1","0",null,"0","120","0","0","1","0","NA","NA"],
    [3691,"3691","Carrier N","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","33464","VALVULOPLASTY TRICUSPID","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [3692,"3692","Carrier N","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","21175","RECONSTRUCT ORBIT/FOREHEAD","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [3693,"3693","Carrier N","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","32662","THORACOSCOPY W/MEDIAST EXC","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [3694,"3694","Carrier N","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44205","LAP COLECTOMY PART W/ILEUM","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [3695,"3695","Carrier N","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22633","ARTHRD CMBN 1NTRSPC LUMBAR","1","0",null,"0","312","0","0","1","0","NA","NA"],
    [3696,"3696","Carrier N","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44204","LAPARO PARTIAL COLECTOMY","2","1",null,"0","0","0","0","2","0","NA","NA"],
    [3697,"3697","Carrier N","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33405","REPLACEMENT AORTIC VALVE OPN","2","1",null,"72","24","0","1","1","0","NA","NA"],
    [3698,"3698","Carrier N","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58150","TOTAL HYSTERECTOMY","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [3699,"3699","Carrier N","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33464","VALVULOPLASTY TRICUSPID","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [3700,"3700","Carrier N","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","21175","RECONSTRUCT ORBIT/FOREHEAD","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [3701,"3701","Carrier N","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","32662","THORACOSCOPY W/MEDIAST EXC","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [3702,"3702","Carrier N","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44205","LAP COLECTOMY PART W/ILEUM","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [3703,"3703","Carrier N","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","38240","TRANSPLT ALLO HCT/DONOR","1","1",null,"0","0","0","1","0","0","NA","NA"],
    [3704,"3704","Carrier N","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","37215","TRANSCATH STENT CCA W/EPS","1","1",null,"0","24","0","0","1","0","NA","NA"],
    [3705,"3705","Carrier N","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43659","UNLISTED LAPS PX STOMACH","1","1",null,"0","24","0","0","1","0","NA","NA"],
    [3706,"3706","Carrier N","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","92507","SPEECH/HEARING THERAPY","33","1",null,"0","133.1","0","0","33","0","NA","NA"],
    [3707,"3707","Carrier N","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95810","POLYSOM 6/> YRS 4/> PARAM","31","0.839",null,"0","151","0","0","31","0","NA","NA"],
    [3708,"3708","Carrier N","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J0585","INJECTION,ONABOTULINUMTOXINA","28","0.821",null,"72","419.5","0","3","25","0","NA","NA"],
    [3709,"3709","Carrier N","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64615","CHEMODENERV MUSC MIGRAINE","16","0.938",null,"96","56.6","0","2","14","0","NA","NA"],
    [3710,"3710","Carrier N","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95811","POLYSOM 6/>YRS CPAP 4/> PARM","14","0.786",null,"0","222.9","0","0","14","0","NA","NA"],
    [3711,"3711","Carrier N","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","36471","NJX SCLRSNT MLT INCMPTNT VN","14","0.857",null,"0","330.9","0","0","14","0","NA","NA"],
    [3712,"3712","Carrier N","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE O/P EST MOD 30-39 MIN","13","0.615",null,"0","127.4","0","0","13","0","NA","NA"],
    [3713,"3713","Carrier N","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","Q5103","INJECTION, INFLECTRA","12","0.833",null,"12","57.6","0","2","10","0","NA","NA"],
    [3714,"3714","Carrier N","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","36475","ENDOVENOUS RF 1ST VEIN","12","0.917",null,"0","666","0","0","12","0","NA","NA"],
    [3715,"3715","Carrier N","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J0178","AFLIBERCEPT INJECTION","10","0.9",null,"0","31.2","0","0","10","0","NA","NA"],
    [3716,"3716","Carrier N","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","92507","SPEECH/HEARING THERAPY","33","1",null,"0","133.1","0","0","33","0","NA","NA"],
    [3717,"3717","Carrier N","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95810","POLYSOM 6/> YRS 4/> PARAM","26","0.839",null,"0","98.8","0","0","26","0","NA","NA"],
    [3718,"3718","Carrier N","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J0585","INJECTION,ONABOTULINUMTOXINA","23","0.821",null,"96","468.6","0","2","21","0","NA","NA"],
    [3719,"3719","Carrier N","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64615","CHEMODENERV MUSC MIGRAINE","15","0.938",null,"96","60.9","0","2","13","0","NA","NA"],
    [3720,"3720","Carrier N","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","36471","NJX SCLRSNT MLT INCMPTNT VN","12","0.857",null,"0","368","0","0","12","0","NA","NA"],
    [3721,"3721","Carrier N","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","36475","ENDOVENOUS RF 1ST VEIN","11","0.917",null,"0","717.8","0","0","11","0","NA","NA"],
    [3722,"3722","Carrier N","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95811","POLYSOM 6/>YRS CPAP 4/> PARM","11","0.786",null,"0","117.8","0","0","11","0","NA","NA"],
    [3723,"3723","Carrier N","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J9299","INJECTION, NIVOLUMAB","10","1",null,"0","962.7","0","1","9","0","NA","NA"],
    [3724,"3724","Carrier N","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81162","BRCA1&2 GEN FULL SEQ DUP/DEL","10","1",null,"0","60","0","0","10","0","NA","NA"],
    [3725,"3725","Carrier N","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","Q5103","INJECTION, INFLECTRA","10","0.833",null,"12","39","0","2","8","0","NA","NA"],
    [3726,"3726","Carrier N","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","89356","Reproductive Medicine","1","0","1","0","480","0","0","1","0","NA","NA"],
    [3727,"3727","Carrier N","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21139","Head, Repair, Revision, and/or Reconstruction","1","0","1","0","384","0","0","1","0","NA","NA"],
    [3728,"3728","Carrier N","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43239","Surgery Digestive System","1","0","1","0","912","0","0","1","0","NA","NA"],
    [3729,"3729","Carrier N","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22842","Posterior segmental instrumentation","1","0","1","24","0","0","1","0","0","NA","NA"],
    [3730,"3730","Carrier N","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27096","Injection procedure for sacroiliac joint","1","0","1","48","0","0","1","0","0","NA","NA"],
    [3731,"3731","Carrier N","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","Substance Use Residential","2","1",null,"12",null,null,"2",null,null,"NA","NA"],
    [3732,"3732","Carrier N","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","Detox","1","1",null,"12",null,null,"1",null,null,"NA","NA"],
    [3733,"3733","Carrier N","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","Substance Use Residential","2","1",null,"12",null,null,"2",null,null,"NA","NA"],
    [3734,"3734","Carrier N","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","Detox","1","1",null,"12",null,null,"1",null,null,"NA","NA"],
    [3735,"3735","Carrier N","2022","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NA","NA","MH IP","1","0","1","24","0","0","1","0","0","NA","NA"],
    [3736,"3736","Carrier N","2022","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NA","NA","MH RES","1","0","1","72","0","0","1","0","0","NA","NA"],
    [3737,"3737","Carrier N","2022","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NA","NA","CD RES","1","0","1","48","0","0","1","0","0","NA","NA"],
    [3738,"3738","Carrier N","2022","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NA","NA","SA RES","1","0","1","24","0","0","1","0","0","NA","NA"],
    [3739,"3739","Carrier N","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","TCRANIAL MAGN STIM TX DELI","5","0.6",null,null,"64.12",null,null,"5",null,"NA","NA"],
    [3740,"3740","Carrier N","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97155","ADAPT BEHAVIOR TX PHYS/QHP","2","0.5",null,null,"36.23",null,null,"2",null,"NA","NA"],
    [3741,"3741","Carrier N","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYTX W PT 60 MINUTES","1","1",null,null,"12",null,null,"1",null,"NA","NA"],
    [3742,"3742","Carrier N","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","H0015","ALCOHOL AND/OR DRUG SERVICES","1","1",null,null,"135.9",null,null,"1",null,"NA","NA"],
    [3743,"3743","Carrier N","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","BHV ID ASSMT BY PHYS/QHP","1","1",null,null,"126.15",null,null,"1",null,"NA","NA"],
    [3744,"3744","Carrier N","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","S0201","PARTIAL HOSPITALIZATION SERV","1","1",null,null,"12",null,null,"1",null,"NA","NA"],
    [3745,"3745","Carrier N","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","H0035","MH PARTIAL HOSP TX UNDER 24H","1","1",null,null,"98.28",null,null,"1",null,"NA","NA"],
    [3746,"3746","Carrier N","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90868","TCRANIAL MAGN STIM TX DELI","3","0.6",null,null,"36.16",null,null,"3",null,"NA","NA"],
    [3747,"3747","Carrier N","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90837","PSYTX W PT 60 MINUTES","1","1",null,null,"12",null,null,"1",null,"NA","NA"],
    [3748,"3748","Carrier N","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97155","ADAPT BEHAVIOR TX PHYS/QHP","1","0.5",null,null,"72.15",null,null,"1",null,"NA","NA"],
    [3749,"3749","Carrier N","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H0015","ALCOHOL AND/OR DRUG SERVICES","1","1",null,null,"135.9",null,null,"1",null,"NA","NA"],
    [3750,"3750","Carrier N","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97151","BHV ID ASSMT BY PHYS/QHP","1","1",null,null,"126.15",null,null,"1",null,"NA","NA"],
    [3751,"3751","Carrier N","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","S0201","PARTIAL HOSPITALIZATION SERV","1","1",null,null,"12",null,null,"1",null,"NA","NA"],
    [3752,"3752","Carrier N","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H0035","MH PARTIAL HOSP TX UNDER 24H","1","1",null,null,"98.28",null,null,"1",null,"NA","NA"],
    [3753,"3753","Carrier N","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97151","ABA","1","0","1","0","192","0","0","1","0","NA","NA"],
    [3754,"3754","Carrier N","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97155","MH OIF","1","0","1","0","144","0","0","1","0","NA","NA"],
    [3755,"3755","Carrier N","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0784","EXT AMB INFUSN PUMP INSULIN","5","1",null,"0","5","0","0","0","0","NA","NA"],
    [3756,"3756","Carrier N","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0466","HOME VENT NON-INVASIVE INTER","3","1",null,"0","3","0","0","0","0","NA","NA"],
    [3757,"3757","Carrier N","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0760","OSTEOGEN ULTRASOUND STIMLTOR","2","0.667",null,"0","2","0","0","0","0","NA","NA"],
    [3758,"3758","Carrier N","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L8688","IMPLT NROSTM PLS GEN DUA NON","1","1",null,"0","1","0","0","0","0","NA","NA"],
    [3759,"3759","Carrier N","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E2599","SGD ACCESSORY NOC","1","1",null,"0","1","0","0","0","0","NA","NA"],
    [3760,"3760","Carrier N","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E2510","SGD W MULTI METHODS MSG/ACCS","1","1",null,"0","1","0","0","0","0","NA","NA"],
    [3761,"3761","Carrier N","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0766","ELEC STIM CANCER TREATMENT","1","1",null,"0","1","0","0","0","0","NA","NA"],
    [3762,"3762","Carrier N","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L8680","IMPLT NEUROSTIM ELCTR EACH","1","1",null,"0","1","0","0","0","0","NA","NA"],
    [3763,"3763","Carrier N","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0784","EXT AMB INFUSN PUMP INSULIN","5","1",null,"0","5","0","0","0","0","NA","NA"],
    [3764,"3764","Carrier N","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0466","HOME VENT NON-INVASIVE INTER","3","1",null,"0","3","0","0","0","0","NA","NA"],
    [3765,"3765","Carrier N","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0760","OSTEOGEN ULTRASOUND STIMLTOR","2","0.667",null,"0","2","0","0","0","0","NA","NA"],
    [3766,"3766","Carrier N","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L8688","IMPLT NROSTM PLS GEN DUA NON","1","1",null,"0","1","0","0","0","0","NA","NA"],
    [3767,"3767","Carrier N","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E2599","SGD ACCESSORY NOC","1","1",null,"0","1","0","0","0","0","NA","NA"],
    [3768,"3768","Carrier N","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E2510","SGD W MULTI METHODS MSG/ACCS","1","1",null,"0","1","0","0","0","0","NA","NA"],
    [3769,"3769","Carrier N","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0766","ELEC STIM CANCER TREATMENT","1","1",null,"0","1","0","0","0","0","NA","NA"],
    [3770,"3770","Carrier N","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L8680","IMPLT NEUROSTIM ELCTR EACH","1","1",null,"0","1","0","0","0","0","NA","NA"],
    [3771,"3771","Carrier N","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","92","0.6",null,"17.31","56.4","0","16","76","0","OZEMPIC 0.25 OR .5 PEN INJCTR","NA"],
    [3772,"3772","Carrier N","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","55","0.89",null,"0.09","90.64","0","10","45","0","OZEMPIC 1/0.75 (3) PEN INJCTR","NA"],
    [3773,"3773","Carrier N","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","42","0.81",null,"31.57","59.6","0","14","28","0","NURTEC ODT 75 MG TAB RAPDIS","NA"],
    [3774,"3774","Carrier N","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","35","1",null,"0.21","0.13","0","19","16","0","ELIQUIS 5 MG TABLET","NA"],
    [3775,"3775","Carrier N","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","33","0.85",null,"3.07","155.83","0","9","24","0","DEXCOM G6  EACH/DEXCOM G6 SENSOR  EACH","NA"],
    [3776,"3776","Carrier N","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","33","0.82",null,"0.02","29.31","0","10","23","0","TRULICITY 0.75MG/0.5 PEN INJCTR","NA"],
    [3777,"3777","Carrier N","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","29","0.86",null,"3.94","138.34","0","13","16","0","STELARA 90 MG/ML SYRINGE","NA"],
    [3778,"3778","Carrier N","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","27","0.3",null,"45.99","122.41","0","8","19","0","DESCOVY 200MG-25MG TABLET","NA"],
    [3779,"3779","Carrier N","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","26","1",null,"0.54","11.37","0","5","21","0","HUMIRA(CF) PEN 40MG/0.4ML PEN IJ KIT","NA"],
    [3780,"3780","Carrier N","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","24","0.79",null,"2.8","151.7","0","4","20","0","DEXCOM G6  EACH/DEXCOM G6 TRANSMITTER  EACH","NA"],
    [3781,"3781","Carrier N","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","26","1",null,"0.54","11.37","0","5","21","0","HUMIRA(CF) PEN 40MG/0.4ML PEN IJ KIT","NA"],
    [3782,"3782","Carrier N","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","21","1",null,"0.01","1.29","0","4","17","0","TRULICITY 1.5 MG/0.5 PEN INJCTR","NA"],
    [3783,"3783","Carrier N","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","18","1",null,"16.37","19.69","0","4","14","0","DEXTROAMPHETAMINE-AMPHET ER 20 MG CAP.SR 24H","NA"],
    [3784,"3784","Carrier N","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","16","1",null,"0.02","42.93","0","3","13","0","ENBREL SURECLICK 50MG/ML(1) PEN INJCTR","NA"],
    [3785,"3785","Carrier N","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","14","1",null,"1.28","43.49","0","2","12","0","STELARA 45MG/0.5ML SYRINGE","NA"],
    [3786,"3786","Carrier N","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","14","1",null,"0.01","12.06","0","2","12","0","TRULICITY 3 MG/0.5ML PEN INJCTR","NA"],
    [3787,"3787","Carrier N","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","13","1",null,"0.01","0.01","0","4","9","0","DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET","NA"],
    [3788,"3788","Carrier N","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","12","1",null,"3.06","25.09","0","9","3","0","MENOPUR 75 UNIT VIAL","NA"],
    [3789,"3789","Carrier N","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","11","1",null,"0.1","33.04","0","1","10","0","SKYRIZI PEN 150 MG/ML PEN INJCTR","NA"],
    [3790,"3790","Carrier N","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","10","1",null,"0","47.31","0","0","10","0","OTEZLA 30 MG TABLET","NA"],
    [3791,"3791","Carrier E","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99223","1ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES","4","1",null,"23.7","18.7",null,"1","3",null,"NA","NA"],
    [3792,"3792","Carrier E","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","367","OPERATING ROOM SERVICES, KIDNEY TRANSPLANT","4","1",null,null,"46.6",null,null,"4",null,"NA","NA"],
    [3793,"3793","Carrier E","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99221","1ST HOSPITAL IP/OBS CARE SF/LOW MDM 40 MINUTES","2","1",null,null,"45.4",null,null,"2",null,"NA","NA"],
    [3794,"3794","Carrier E","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71046","RADIOLOGIC EXAM CHEST 2 VIEWS","2","1",null,null,"66",null,null,"2",null,"NA","NA"],
    [3795,"3795","Carrier E","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","23586","REFERRAL REHAB, ACUTE","2","1",null,null,"0",null,null,"2",null,"NA","NA"],
    [3796,"3796","Carrier E","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","333","RADIOLOGY, THERAPEUTIC AND/OR CHEMO ADMIN - RADIATION THERAPY","2","1",null,null,"70.2",null,null,"2",null,"NA","NA"],
    [3797,"3797","Carrier E","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","150","ROOM & BOARD, WARD - GENERAL","2","1",null,"2.9","50.6",null,"1","1",null,"NA","NA"],
    [3798,"3798","Carrier E","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S4042","MANAGEMENT OF OVULATION INDUCTION PER CYCLE","1","1",null,null,"97.8",null,null,"1",null,"NA","NA"],
    [3799,"3799","Carrier E","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","D0501","HISTOPATHOLOGIC EXAMINATIONS","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [3800,"3800","Carrier E","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","C1901","C1901GUILLIAN BARRE WITH MOTOR >35.95.,COMORBIDITY IN TIER 2","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [3801,"3801","Carrier E","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99223","1ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES","4","1",null,"23.7","18.7",null,"1","3",null,"NA","NA"],
    [3802,"3802","Carrier E","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","367","OPERATING ROOM SERVICES, KIDNEY TRANSPLANT","4","1",null,null,"46.6",null,null,"4",null,"NA","NA"],
    [3803,"3803","Carrier E","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99221","1ST HOSPITAL IP/OBS CARE SF/LOW MDM 40 MINUTES","2","1",null,null,"45.4",null,null,"2",null,"NA","NA"],
    [3804,"3804","Carrier E","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","71046","RADIOLOGIC EXAM CHEST 2 VIEWS","2","1",null,null,"66",null,null,"2",null,"NA","NA"],
    [3805,"3805","Carrier E","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","23586","REFERRAL REHAB, ACUTE","2","1",null,null,"0",null,null,"2",null,"NA","NA"],
    [3806,"3806","Carrier E","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","333","RADIOLOGY, THERAPEUTIC AND/OR CHEMO ADMIN - RADIATION THERAPY","2","1",null,null,"70.2",null,null,"2",null,"NA","NA"],
    [3807,"3807","Carrier E","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","150","ROOM & BOARD, WARD - GENERAL","2","1",null,"2.9","50.6",null,"1","1",null,"NA","NA"],
    [3808,"3808","Carrier E","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","D0501","HISTOPATHOLOGIC EXAMINATIONS","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [3809,"3809","Carrier E","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","C1901","C1901GUILLIAN BARRE WITH MOTOR >35.95.,COMORBIDITY IN TIER 2","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [3810,"3810","Carrier E","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","C0305","C0305NON-TRAUMATIC BRAIN INJURY M <42.50 AND A <78.50.COMORBIDITY IN TIER 2","1","1",null,null,"0.1",null,null,"1",null,"NA","NA"],
    [3811,"3811","Carrier E","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99203","OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES","408","0.9951",null,"4.3","35.7",null,"26","382",null,"NA","NA"],
    [3812,"3812","Carrier E","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97161","PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS","273","0.9634",null,"7.5","36.4",null,"13","260",null,"NA","NA"],
    [3813,"3813","Carrier E","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96040","MEDICAL GENETICS COUNSELING EACH 30 MINUTES","166","1",null,"0.5","21.1","115.8","3","162","1","NA","NA"],
    [3814,"3814","Carrier E","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45385","COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ","114","1",null,null,"30.7",null,null,"114",null,"NA","NA"],
    [3815,"3815","Carrier E","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72148","MRI LUMBAR SPINE NO CONTRAST","107","1",null,"10.7","30.6",null,"39","68",null,"NA","NA"],
    [3816,"3816","Carrier E","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99204","OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES","93","1",null,"8.3","45.1",null,"2","91",null,"NA","NA"],
    [3817,"3817","Carrier E","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99213","OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN","81","0.9753",null,"26.7","38.2",null,"3","78",null,"NA","NA"],
    [3818,"3818","Carrier E","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0151","SERVICE PHYS THERAP HOME HLTH/HOSPICE EA 15 MIN","76","1",null,null,"3",null,null,"76",null,"NA","NA"],
    [3819,"3819","Carrier E","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","MRI BRAIN WO/W CONTRAST","74","1",null,"7.9","24.3",null,"22","52",null,"NA","NA"],
    [3820,"3820","Carrier E","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97810","ACUPUNCTURE 1/> NDLES W/O ELEC STIMJ INIT 15 MIN","72","0.8194",null,null,"57.6",null,null,"72",null,"NA","NA"],
    [3821,"3821","Carrier E","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96040","MEDICAL GENETICS COUNSELING EACH 30 MINUTES","166","1",null,"0.5","21.1","115.8","3","162","1","NA","NA"],
    [3822,"3822","Carrier E","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","45385","COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ","114","1",null,null,"30.7",null,null,"114",null,"NA","NA"],
    [3823,"3823","Carrier E","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72148","MRI LUMBAR SPINE NO CONTRAST","107","1",null,"10.7","30.6",null,"39","68",null,"NA","NA"],
    [3824,"3824","Carrier E","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99204","OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES","93","1",null,"8.3","45.1",null,"2","91",null,"NA","NA"],
    [3825,"3825","Carrier E","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","G0151","SERVICE PHYS THERAP HOME HLTH/HOSPICE EA 15 MIN","76","1",null,null,"3",null,null,"76",null,"NA","NA"],
    [3826,"3826","Carrier E","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70553","MRI BRAIN WO/W CONTRAST","74","1",null,"7.9","24.3",null,"22","52",null,"NA","NA"],
    [3827,"3827","Carrier E","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","73721","MRI RIGHT KNEE NO CONTRAST","72","1",null,"6","22.3",null,"41","31",null,"NA","NA"],
    [3828,"3828","Carrier E","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","45378","COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD","66","1",null,"3.8","36.6",null,"1","65",null,"NA","NA"],
    [3829,"3829","Carrier E","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","73721","MRI LEFT KNEE NO CONTRAST","64","1",null,"11.1","19.7",null,"41","23",null,"NA","NA"],
    [3830,"3830","Carrier E","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97162","PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS","55","1",null,"10","42.6",null,"2","53",null,"NA","NA"],
    [3831,"3831","Carrier E","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97810","ACUPUNCTURE 1/> NDLES W/O ELEC STIMJ INIT 15 MIN","72","0","0.0139",null,"57.6",null,null,"72",null,"NA","NA"],
    [3832,"3832","Carrier E","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","93306","ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D","16","0","0.0625","25","59.5",null,"1","15",null,"NA","NA"],
    [3833,"3833","Carrier E","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","72148","MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL","9","0","0.1111","1.1","61.9",null,"1","8",null,"NA","NA"],
    [3834,"3834","Carrier E","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","Q5103","INJECTION, INFLIXIMAB-DYYB, BIOSIMILAR, (INFLECTRA), 10 MG","6","0","0.1667","45.6","49.7",null,"1","5",null,"NA","NA"],
    [3835,"3835","Carrier E","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","23683","EXT REFERRAL OBGYN","5","0","0.2",null,"69",null,null,"5",null,"NA","NA"],
    [3836,"3836","Carrier E","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC","41","1",null,null,"15.7","26",null,"39","2","NA","NA"],
    [3837,"3837","Carrier E","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1002","BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP","32","1",null,null,"42.5","12.8",null,"30","2","NA","NA"],
    [3838,"3838","Carrier E","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","126","ROOM & BOARD, SEMIPRIVATE TWO-BED - DETOXIFICATION","20","1",null,"23.6","38","3.4","1","18","1","NA","NA"],
    [3839,"3839","Carrier E","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","194","SUBACUTE CARE, LEVEL IV","12","1",null,null,"46.4",null,null,"12",null,"NA","NA"],
    [3840,"3840","Carrier E","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1001","BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC","10","1",null,null,"32.6",null,null,"10",null,"NA","NA"],
    [3841,"3841","Carrier E","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","154","ROOM & BOARD, WARD - PSYCHIATRIC","2","1",null,null,"24.2",null,null,"2",null,"NA","NA"],
    [3842,"3842","Carrier E","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99223","1ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES","1","1",null,null,"0.5",null,null,"1",null,"NA","NA"],
    [3843,"3843","Carrier E","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99220","INITIAL OBSERVATION CARE/DAY 70 MINUTES","1","1",null,null,"95.9",null,null,"1",null,"NA","NA"],
    [3844,"3844","Carrier E","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","912","BEHAVIORAL HEALTH TREATMENTS/SVCS, PARTIAL HOSPITAL - LESS INTENSIVE","1","1",null,null,null,"0.2",null,null,"1","NA","NA"],
    [3845,"3845","Carrier E","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","128","ROOM & BOARD, SEMIPRIVATE TWO-BED - REHABILITATION","1","1",null,null,"50.1",null,null,"1",null,"NA","NA"],
    [3846,"3846","Carrier E","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC","41","1",null,null,"15.7","26",null,"39","2","NA","NA"],
    [3847,"3847","Carrier E","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1002","BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP","32","1",null,null,"42.5","12.8",null,"30","2","NA","NA"],
    [3848,"3848","Carrier E","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","126","ROOM & BOARD, SEMIPRIVATE TWO-BED - DETOXIFICATION","20","1",null,"23.6","38","3.4","1","18","1","NA","NA"],
    [3849,"3849","Carrier E","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","194","SUBACUTE CARE, LEVEL IV","12","1",null,null,"46.4",null,null,"12",null,"NA","NA"],
    [3850,"3850","Carrier E","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1001","BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC","10","1",null,null,"32.6",null,null,"10",null,"NA","NA"],
    [3851,"3851","Carrier E","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","154","ROOM & BOARD, WARD - PSYCHIATRIC","2","1",null,null,"24.2",null,null,"2",null,"NA","NA"],
    [3852,"3852","Carrier E","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99223","1ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES","1","1",null,null,"0.5",null,null,"1",null,"NA","NA"],
    [3853,"3853","Carrier E","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99220","INITIAL OBSERVATION CARE/DAY 70 MINUTES","1","1",null,null,"95.9",null,null,"1",null,"NA","NA"],
    [3854,"3854","Carrier E","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","912","BEHAVIORAL HEALTH TREATMENTS/SVCS, PARTIAL HOSPITAL - LESS INTENSIVE","1","1",null,null,null,"0.2",null,null,"1","NA","NA"],
    [3855,"3855","Carrier E","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","128","ROOM & BOARD, SEMIPRIVATE TWO-BED - REHABILITATION","1","1",null,null,"50.1",null,null,"1",null,"NA","NA"],
    [3856,"3856","Carrier E","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVALUATION","522","0.9904",null,null,"41",null,null,"522",null,"NA","NA"],
    [3857,"3857","Carrier E","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY W/PATIENT 60 MINUTES","106","1",null,null,"44.9",null,null,"106",null,"NA","NA"],
    [3858,"3858","Carrier E","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97153","ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN","56","1",null,null,"50.2",null,null,"56",null,"NA","NA"],
    [3859,"3859","Carrier E","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90899","UNLISTED PSYCHIATRIC SERVICE/PROCEDURE","23","1",null,null,"15.7","83.9",null,"20","3","NA","NA"],
    [3860,"3860","Carrier E","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0020","ALCOHOL AND/OR DRUG SERVICES METHADONE ADMINISTRATION","18","1",null,null,"27.5","20.1",null,"17","1","NA","NA"],
    [3861,"3861","Carrier E","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0001","ALCOHOL AND/OR DRUG ASSESS","17","1",null,null,"48.5","38.7",null,"16","1","NA","NA"],
    [3862,"3862","Carrier E","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN","15","1",null,null,"14.2",null,null,"15",null,"NA","NA"],
    [3863,"3863","Carrier E","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90834","PSYCHOTHERAPY W/PATIENT 45 MINUTES","13","1",null,null,"51.2",null,null,"13",null,"NA","NA"],
    [3864,"3864","Carrier E","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","905","BEHAVIORAL HEALTH TREATMENTS/SVCS, INTENSIVE OP, PSYCHIATRIC","13","1",null,null,"26.4",null,null,"13",null,"NA","NA"],
    [3865,"3865","Carrier E","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97152","BEHAVIOR ID SUPPORT ASSMT BY 1 TECH EA 15 MIN","11","1",null,null,"37.5",null,null,"11",null,"NA","NA"],
    [3866,"3866","Carrier E","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY W/PATIENT 60 MINUTES","106","1",null,null,"44.9",null,null,"106",null,"NA","NA"],
    [3867,"3867","Carrier E","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97153","ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN","56","1",null,null,"50.2",null,null,"56",null,"NA","NA"],
    [3868,"3868","Carrier E","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90899","UNLISTED PSYCHIATRIC SERVICE/PROCEDURE","23","1",null,null,"15.7","83.9",null,"20","3","NA","NA"],
    [3869,"3869","Carrier E","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0020","ALCOHOL AND/OR DRUG SERVICES METHADONE ADMINISTRATION","18","1",null,null,"27.5","20.1",null,"17","1","NA","NA"],
    [3870,"3870","Carrier E","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0001","ALCOHOL AND/OR DRUG ASSESS","17","1",null,null,"48.5","38.7",null,"16","1","NA","NA"],
    [3871,"3871","Carrier E","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97151","BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN","15","1",null,null,"14.2",null,null,"15",null,"NA","NA"],
    [3872,"3872","Carrier E","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90834","PSYCHOTHERAPY W/PATIENT 45 MINUTES","13","1",null,null,"51.2",null,null,"13",null,"NA","NA"],
    [3873,"3873","Carrier E","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","905","BEHAVIORAL HEALTH TREATMENTS/SVCS, INTENSIVE OP, PSYCHIATRIC","13","1",null,null,"26.4",null,null,"13",null,"NA","NA"],
    [3874,"3874","Carrier E","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97152","BEHAVIOR ID SUPPORT ASSMT BY 1 TECH EA 15 MIN","11","1",null,null,"37.5",null,null,"11",null,"NA","NA"],
    [3875,"3875","Carrier E","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97156","FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN","10","1",null,null,"30.4",null,null,"10",null,"NA","NA"],
    [3876,"3876","Carrier E","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVALUATION","521","0","0.0019",null,"41",null,null,"521",null,"NA","NA"],
    [3877,"3877","Carrier E","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0143","WALKER FOLDING WHEELED W/O S","160","1",null,"12.3","17.5",null,"5","155",null,"NA","NA"],
    [3878,"3878","Carrier E","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0604","BREAST PUMP HEAVY DUTY HOSP GRADE PISTON OP","133","0.985",null,"4.9","17.1",null,"15","118",null,"NA","NA"],
    [3879,"3879","Carrier E","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0570","NEBULIZER WITH COMPRESSOR","121","0.9917",null,"9.5","10.7",null,"8","113",null,"NA","NA"],
    [3880,"3880","Carrier E","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1390","OXYGEN CONCENTRATOR","86","0.9884",null,"7.9","26",null,"10","76",null,"NA","NA"],
    [3881,"3881","Carrier E","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0730","TENS DEVICE 4/MORE LEADS MULTI NERVE STIMULATION","81","1",null,null,"27.9",null,null,"81",null,"NA","NA"],
    [3882,"3882","Carrier E","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A5500","DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE","71","1",null,null,"50.9",null,null,"71",null,"NA","NA"],
    [3883,"3883","Carrier E","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0001","STANDARD WHEELCHAIR","28","1",null,"0.3","15.3",null,"1","27",null,"NA","NA"],
    [3884,"3884","Carrier E","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0693","UV LT TX SYS PANL W/BULBS/LAMPS TIMER 6 FT PANEL","23","1",null,null,"23.9",null,null,"23",null,"NA","NA"],
    [3885,"3885","Carrier E","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L1846","KNEE ORTHOSIS DOUBLE UPRIGHT THIGH & CALF CUSTOM","22","1",null,null,"77.9",null,null,"22",null,"NA","NA"],
    [3886,"3886","Carrier E","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2402","NEG PRESS WOUND THERAPY PUMP","22","1",null,"5.7","13.6",null,"4","18",null,"NA","NA"],
    [3887,"3887","Carrier E","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0143","WALKER FOLDING WHEELED W/O S","160","1",null,"12.3","17.5",null,"5","155",null,"NA","NA"],
    [3888,"3888","Carrier E","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0730","TENS DEVICE 4/MORE LEADS MULTI NERVE STIMULATION","81","1",null,null,"27.9",null,null,"81",null,"NA","NA"],
    [3889,"3889","Carrier E","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A5500","DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE","71","1",null,null,"50.9",null,null,"71",null,"NA","NA"],
    [3890,"3890","Carrier E","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0001","STANDARD WHEELCHAIR","28","1",null,"0.3","15.3",null,"1","27",null,"NA","NA"],
    [3891,"3891","Carrier E","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0693","UV LT TX SYS PANL W/BULBS/LAMPS TIMER 6 FT PANEL","23","1",null,null,"23.9",null,null,"23",null,"NA","NA"],
    [3892,"3892","Carrier E","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L1846","KNEE ORTHOSIS DOUBLE UPRIGHT THIGH & CALF CUSTOM","22","1",null,null,"77.9",null,null,"22",null,"NA","NA"],
    [3893,"3893","Carrier E","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2402","NEG PRESS WOUND THERAPY PUMP","22","1",null,"5.7","13.6",null,"4","18",null,"NA","NA"],
    [3894,"3894","Carrier E","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0691","UV LIGHT TX SYS BULB/LAMP TIMER; TX 2 SQ FT/LESS","22","1",null,null,"43.2",null,null,"22",null,"NA","NA"],
    [3895,"3895","Carrier E","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A7005","NONDISPOSABLE NEBULIZER SET","20","1",null,null,"5.2",null,null,"20",null,"NA","NA"],
    [3896,"3896","Carrier E","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L1900","AFO SPRNG WIR DRSFLX CALF BD","19","1",null,null,"107.6",null,null,"19",null,"NA","NA"],
    [3897,"3897","Carrier E","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0651","PNEUM COMPRESSOR SEGMENTAL","3","0","0.3333",null,"60.2",null,null,"3",null,"NA","NA"],
    [3898,"3898","Carrier E","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95250","Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneou","67","0.3881",null,null,"29.2",null,null,"67",null,"NA","NA"],
    [3899,"3899","Carrier E","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0553","SUPPLY ALLOW FOR TX CGM1 MO SPL = 1 U OF SERVICE","43","1",null,null,"90.4",null,null,"43",null,"NA","NA"],
    [3900,"3900","Carrier E","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4230","INFUS INSULIN PUMP NON NEEDL","28","1",null,null,"94.7",null,null,"28",null,"NA","NA"],
    [3901,"3901","Carrier E","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4211","SUPP FOR SELF-ADM INJECTIONS","23","1",null,"22.8","10.3",null,"1","22",null,"NA","NA"],
    [3902,"3902","Carrier E","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4232","SYRINGE W/NEEDLE INSULIN 3CC","21","1",null,null,"35.6",null,null,"21",null,"NA","NA"],
    [3903,"3903","Carrier E","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","EXT AMB INFUSN PUMP INSULIN","15","1",null,null,"129.8",null,null,"15",null,"NA","NA"],
    [3904,"3904","Carrier E","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A6257","TRANSPARENT FILM STERL 16 SQ IN OR LESS EA DRESS","3","1",null,null,"408.4",null,null,"3",null,"NA","NA"],
    [3905,"3905","Carrier E","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4456","ADHESIVE REMOVER WIPES ANY TYPE EACH","2","1",null,null,"331",null,null,"2",null,"NA","NA"],
    [3906,"3906","Carrier E","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0554","RECEIVER DEDICATED FOR USE W/THERAPEUTIC GCM SYS","1","1",null,null,"29.8",null,null,"1",null,"NA","NA"],
    [3907,"3907","Carrier E","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9276","SNSR;INVSV DISP USE NONDME INTRSTL CGM 1U=1D SPL","1","1",null,null,"0.1",null,null,"1",null,"NA","NA"],
    [3908,"3908","Carrier E","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0553","SUPPLY ALLOW FOR TX CGM1 MO SPL = 1 U OF SERVICE","43","1",null,null,"90.4",null,null,"43",null,"NA","NA"],
    [3909,"3909","Carrier E","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4230","INFUS INSULIN PUMP NON NEEDL","28","1",null,null,"94.7",null,null,"28",null,"NA","NA"],
    [3910,"3910","Carrier E","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4211","SUPP FOR SELF-ADM INJECTIONS","23","1",null,"22.8","10.3",null,"1","22",null,"NA","NA"],
    [3911,"3911","Carrier E","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4232","SYRINGE W/NEEDLE INSULIN 3CC","21","1",null,null,"35.6",null,null,"21",null,"NA","NA"],
    [3912,"3912","Carrier E","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","EXT AMB INFUSN PUMP INSULIN","15","1",null,null,"129.8",null,null,"15",null,"NA","NA"],
    [3913,"3913","Carrier E","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A6257","TRANSPARENT FILM STERL 16 SQ IN OR LESS EA DRESS","3","1",null,null,"408.4",null,null,"3",null,"NA","NA"],
    [3914,"3914","Carrier E","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4456","ADHESIVE REMOVER WIPES ANY TYPE EACH","2","1",null,null,"331",null,null,"2",null,"NA","NA"],
    [3915,"3915","Carrier E","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0554","RECEIVER DEDICATED FOR USE W/THERAPEUTIC GCM SYS","1","1",null,null,"29.8",null,null,"1",null,"NA","NA"],
    [3916,"3916","Carrier E","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9276","SNSR;INVSV DISP USE NONDME INTRSTL CGM 1U=1D SPL","1","1",null,null,"0.1",null,null,"1",null,"NA","NA"],
    [3917,"3917","Carrier E","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95250","Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneou","67","0.3881",null,null,"29.2",null,null,"67",null,"NA","NA"],
    [3918,"3918","Carrier E","2022","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","95250","Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneou","67","0","0.0149",null,"29.2",null,null,"67",null,"NA","NA"],
    [3919,"3919","Carrier E","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","122","0.8197",null,null,"23.91155738",null,"0","122","0","EMPAGLIFLOZIN","NA"],
    [3920,"3920","Carrier E","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","66","0.4697",null,null,"30.93660354",null,"0","66","0","VARENICLINE TARTRATE","NA"],
    [3921,"3921","Carrier E","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","57","0.9649",null,null,"18.10929337",null,"0","57","0","UBROGEPANT","NA"],
    [3922,"3922","Carrier E","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","51","0.6471",null,null,"17.95818627",null,"0","51","0","INSULIN GLARGINE","NA"],
    [3923,"3923","Carrier E","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","49","1",null,null,"29.88755102",null,"0","49","0","RIVAROXABAN","NA"],
    [3924,"3924","Carrier E","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","45","0.4889",null,null,"25.21466667",null,"0","45","0","SEMAGLUTIDE","NA"],
    [3925,"3925","Carrier E","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","40","0.975",null,null,"13.00740972",null,"0","40","0","SECUKINUMAB","NA"],
    [3926,"3926","Carrier E","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","39","0.9744",null,null,"17.96470085",null,"0","39","0","FREMANEZUMAB-VFRM","NA"],
    [3927,"3927","Carrier E","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","35","0.6286",null,null,"27.68711111",null,"0","35","0","LISDEXAMFETAMINE DIMESYLATE","NA"],
    [3928,"3928","Carrier E","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","35","1",null,null,"14.15750794",null,"0","35","0","ADALIMUMAB","NA"],
    [3929,"3929","Carrier E","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","49","1",null,null,"29.88755102",null,"0","49","0","RIVAROXABAN","NA"],
    [3930,"3930","Carrier E","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","35","1",null,null,"14.15750794",null,"0","35","0","ADALIMUMAB","NA"],
    [3931,"3931","Carrier E","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","28","1",null,null,"76.1397619",null,"0","28","0","TICAGRELOR","NA"],
    [3932,"3932","Carrier E","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","11","1",null,null,"21.82257576",null,"0","11","0","GALCANEZUMAB-GNLM","NA"],
    [3933,"3933","Carrier E","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","10","1",null,null,"10.72491667",null,"0","10","0","GUSELKUMAB","NA"],
    [3934,"3934","Carrier E","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","5","1",null,null,"12.0475",null,"0","5","0","VORTIOXETINE HBR","NA"],
    [3935,"3935","Carrier E","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","5","1",null,null,"28.54044444",null,"0","5","0","BREXPIPRAZOLE","NA"],
    [3936,"3936","Carrier E","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","4","1",null,null,"17.31354167",null,"0","4","0","ABATACEPT","NA"],
    [3937,"3937","Carrier E","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","4","1",null,null,"37.44520833",null,"0","4","0","EMTRICITABINE-TENOFOVIR ALAFENAMIDE FUMARATE","NA"],
    [3938,"3938","Carrier E","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","3","1",null,null,"8.633796296",null,"0","3","0","LACOSAMIDE","NA"],
    [3939,"3939","Carrier E","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","51","0","0.0196",null,"17.95818627",null,"0","51","0","INSULIN GLARGINE","NA"],
    [3940,"3940","Carrier C","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","120","ROOM AND BOARD","11080","0.9922",null,"18","24",null,"11060","20",null,"NA","NA"],
    [3941,"3941","Carrier C","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","128","ROOM AND BOARD","77","0.9737",null,"15","3",null,"76","1",null,"NA","NA"],
    [3942,"3942","Carrier C","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","59510","FULL ROUT OBSTE CARE,CESAREAN DELIV","40","0.95",null,"2","24",null,"1","39",null,"NA","NA"],
    [3943,"3943","Carrier C","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","59400","FULL ROUT OBSTE CARE,VAGINAL DELIV","25","1",null,null,"6",null,"0","25",null,"NA","NA"],
    [3944,"3944","Carrier C","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44204","COLECTOMY LAP PARTIAL W/ ANAST","19","0.8947",null,"9","16",null,"3","16",null,"NA","NA"],
    [3945,"3945","Carrier C","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","33533","CABG USING ART GRFTS 1 ART GRFT","15","0.8",null,"2","10",null,"5","10",null,"NA","NA"],
    [3946,"3946","Carrier C","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU","15","0.8",null,"25","95",null,"4","11",null,"NA","NA"],
    [3947,"3947","Carrier C","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","TOTAL ABDOM HYSTERECTOMY","13","0.9231",null,"1.5","11",null,"2","11",null,"NA","NA"],
    [3948,"3948","Carrier C","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","35301","THROMBOENDARTECTMY NECK,NECK INCIS","11","0.8182",null,null,"14",null,"0","11",null,"NA","NA"],
    [3949,"3949","Carrier C","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","33405","REPLACE PROSTH AORTIC VALVE, OPEN, W/BYPASS NON-HOMO","9","0.7778",null,"9","31",null,"3","6",null,"NA","NA"],
    [3950,"3950","Carrier C","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","59400","FULL ROUT OBSTE CARE,VAGINAL DELIV","25","1",null,null,"6",null,"0","25",null,"NA","NA"],
    [3951,"3951","Carrier C","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22551","ARTHRODESIS ANT INTERBODY CERVICAL BELOW C2","7","1",null,"18","35",null,"1","6",null,"NA","NA"],
    [3952,"3952","Carrier C","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","32663","THORACOSCOPY SURG W/ LOBECTOMY TOTAL/SEGMEN","7","1",null,null,"39",null,"0","7",null,"NA","NA"],
    [3953,"3953","Carrier C","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","762","MISC SERVICES","6","1",null,"93",null,null,"6","0",null,"NA","NA"],
    [3954,"3954","Carrier C","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","32650","THORACOSCOPY SURG W/ PLEURODESIS (MECHANICA","6","1",null,"0","1.5",null,"2","4",null,"NA","NA"],
    [3955,"3955","Carrier C","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","59410","VAG DELIVERY ONLY W/ POSTPARTUM CARE","4","1",null,null,"0",null,"0","4",null,"NA","NA"],
    [3956,"3956","Carrier C","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","59514","CESAREAN DELIVERY ONLY","4","1",null,"0","7",null,"1","3",null,"NA","NA"],
    [3957,"3957","Carrier C","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27447","TOTAL KNEE ARTHROPLASTY","3","1",null,null,"44",null,"0","3",null,"NA","NA"],
    [3958,"3958","Carrier C","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43239","UPPER GI ENDO W/ BX SINGLE/MULT","3","1",null,null,"84",null,"0","3",null,"NA","NA"],
    [3959,"3959","Carrier C","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43280","LAP,ESOPHAGOGAST FUNDOPLASTY","3","1",null,null,"24",null,"0","3",null,"NA","NA"],
    [3960,"3960","Carrier C","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","120","ROOM AND BOARD","11080","0","0.0001","18","24",null,"11060","20",null,"NA","NA"],
    [3961,"3961","Carrier C","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS","92371","0.9677",null,"4.7","13.6",null,"9679","82692",null,"NA","NA"],
    [3962,"3962","Carrier C","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES","11294","0.9368",null,"6.3","17.6",null,"391","10903",null,"NA","NA"],
    [3963,"3963","Carrier C","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97124","THERA PROC 1+ AREAS EA 15 MIN MASSAGE","10397","0.9876",null,"1","7",null,"183","10214",null,"NA","NA"],
    [3964,"3964","Carrier C","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","COLONOSCOPY W/ BX SINGLE/MULT","7042","0.9746",null,"1","4.5",null,"342","6700",null,"NA","NA"],
    [3965,"3965","Carrier C","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","762","MISC SERVICES","4748","0.9928",null,"17","4",null,"4747","1",null,"NA","NA"],
    [3966,"3966","Carrier C","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","TTE (ECHO) WITH SPECTRAL & COLOR FLOW DOPPLER","2382","0.9736",null,"2.7","14",null,"263","2119",null,"NA","NA"],
    [3967,"3967","Carrier C","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43235","UPPER GI ENDO DX (SEP PROC)","1945","0.9635",null,"1","5.5",null,"179","1766",null,"NA","NA"],
    [3968,"3968","Carrier C","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99202","OFFICE VISIT E&M NEW PT STRAIGHTFORWARD MDM, 15-29 MINS","1942","0.9197",null,"7","29",null,"334","1608",null,"NA","NA"],
    [3969,"3969","Carrier C","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97530","THERA ACTVI DIRECT PAT CONTACT EA 15 MIN","1747","0.9525",null,"8.5","22.3",null,"88","1659",null,"NA","NA"],
    [3970,"3970","Carrier C","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97802","MED NUTRIT THRPY INIT ASSESS 15 MIN","1629","0.9638",null,"5.3","16.3",null,"77","1552",null,"NA","NA"],
    [3971,"3971","Carrier C","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58300","INSERT INTRAUTERINE DEVICE","136","1",null,"2","4.7",null,"31","105",null,"NA","NA"],
    [3972,"3972","Carrier C","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J3301","TRIAMCINOLONE ACETONIDE INJ PER 10 MG","126","1",null,"1","20",null,"5","121",null,"NA","NA"],
    [3973,"3973","Carrier C","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","92523","EVALUATION OF SPEECH SOUND PRODUCTION W/EVAL LANG COMP/EXPRESSION","114","1",null,"0","8.7",null,"1","113",null,"NA","NA"],
    [3974,"3974","Carrier C","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","17260","DESTRUCT MALIG LES TRUNK/ARM/LEG < 0.5 CM","112","1",null,"0.6","2.5",null,"8","104",null,"NA","NA"],
    [3975,"3975","Carrier C","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","51798","MEASUREMENT PVR URIN&/BLADD CAPACTY US NON-IMAG","92","1",null,"4","8",null,"2","90",null,"NA","NA"],
    [3976,"3976","Carrier C","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","92526","TX SWALLOWING DYSFUNCTION &/OR ORAL FUNCTION FEED","68","1",null,"4","35.4",null,"7","61",null,"NA","NA"],
    [3977,"3977","Carrier C","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95115","PROFES SVC IMMUNOTHER NON-PROV EXTRACT SINGLE INJ","65","1",null,"0.3","11.3",null,"3","62",null,"NA","NA"],
    [3978,"3978","Carrier C","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77001","FLUORO GUIDE FOR CENT VENOUS ACCESS DEVICE","62","1",null,"5.4","7",null,"11","51",null,"NA","NA"],
    [3979,"3979","Carrier C","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","559","OTHER THERAPY SERV","59","1",null,null,"158.5",null,"0","59",null,"NA","NA"],
    [3980,"3980","Carrier C","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","92960","CARDIOVERSION ELECTIVE EXT","57","1",null,"0.5","9",null,"10","47",null,"NA","NA"],
    [3981,"3981","Carrier C","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","50688","CHANGE URETEROSTOMY TUBE","1","0","1",null,"19",null,"0","1",null,"NA","NA"],
    [3982,"3982","Carrier C","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","62380","ENDO DECOMPRESS NEURAL ELEMNTS/EXCIS HERNIATD DISK, 1 INTERSPACE, LUMBAR","2","0","0.5",null,"168",null,"0","2",null,"NA","NA"],
    [3983,"3983","Carrier C","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","70545","MAGNETIC RESONANCE ANGIO, HEAD W/DYE","2","0","0.5",null,"125",null,"0","2",null,"NA","NA"],
    [3984,"3984","Carrier C","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","76390","MRI SPECTROSCOPY","2","0","0.5",null,"65",null,"0","2",null,"NA","NA"],
    [3985,"3985","Carrier C","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27822","TRIMALLEOLAR FX W/WO FIX W/O FIX POST LIP OP TX","4","0","0.25","2","4",null,"2","2",null,"NA","NA"],
    [3986,"3986","Carrier C","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22513","PERCUTANEOUS VERTBRAL AUGMENT, UNILATRL OR BILAT CANNULATION; THORACIC","5","0","0.2","24.3","39",null,"3","2",null,"NA","NA"],
    [3987,"3987","Carrier C","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","61885","INSRT/REDO NEUROSTIM 1 ARRAY","5","0","0.2","16","124.3",null,"2","3",null,"NA","NA"],
    [3988,"3988","Carrier C","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","66991","XCAPSL CTRC RMVL INSJ IO LENS PROSTH INSJ 1+","10","0","0.2","0.5","64.8",null,"2","8",null,"NA","NA"],
    [3989,"3989","Carrier C","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","81455","TGSAP SO/HEMATOLYMPHOID NEO/DO 51/<DNA/DNA&RNA","6","0","0.1667","3.5","48.8",null,"2","4",null,"NA","NA"],
    [3990,"3990","Carrier C","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","78830","LOCLZJ TUM SPECT W/CT 1 AREA/ACQUISJ 1DAY IMG","8","0","0.125","13.5","77.3",null,"2","6",null,"NA","NA"],
    [3991,"3991","Carrier C","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","124","ROOM AND BOARD","569","0.9842",null,"7.3","11",null,"567","2",null,"NA","NA"],
    [3992,"3992","Carrier C","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","128","ROOM AND BOARD","345","0.9826",null,"29","17",null,"343","2",null,"NA","NA"],
    [3993,"3993","Carrier C","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","900","OTHER THERAPY SERV","333","0.985",null,"22","34",null,"332","1",null,"NA","NA"],
    [3994,"3994","Carrier C","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","126","ROOM AND BOARD","153","0.9935",null,"14",null,null,"153","0",null,"NA","NA"],
    [3995,"3995","Carrier C","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","120","ROOM AND BOARD","1","1",null,"58",null,null,"1","0",null,"NA","NA"],
    [3996,"3996","Carrier C","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","120","ROOM AND BOARD","1","1",null,"58",null,null,"1","0",null,"NA","NA"],
    [3997,"3997","Carrier C","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","126","ROOM AND BOARD","153","0.9935",null,"14",null,null,"153","0",null,"NA","NA"],
    [3998,"3998","Carrier C","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","900","OTHER THERAPY SERV","333","0.985",null,"22","34",null,"332","1",null,"NA","NA"],
    [3999,"3999","Carrier C","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","124","ROOM AND BOARD","569","0.9842",null,"7.3","11",null,"567","2",null,"NA","NA"],
    [4000,"4000","Carrier C","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","128","ROOM AND BOARD","345","0.9826",null,"29","17",null,"343","2",null,"NA","NA"],
    [4001,"4001","Carrier C","2022","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","124","ROOM AND BOARD","569","0","0.0053","7.3","11",null,"567","2",null,"NA","NA"],
    [4002,"4002","Carrier C","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY 60 MIN PATIENT","10830","0.9963",null,"3","8",null,"269","10561",null,"NA","NA"],
    [4003,"4003","Carrier C","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90836","PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS","3106","0.9974",null,"5","5",null,"106","3000",null,"NA","NA"],
    [4004,"4004","Carrier C","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90853","GROUP PSYCHOTHERAPY","724","0.9959",null,"6.6","6",null,"8","716",null,"NA","NA"],
    [4005,"4005","Carrier C","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES","594","0.9916",null,"5.5","16.7",null,"25","569",null,"NA","NA"],
    [4006,"4006","Carrier C","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97153","ADAPTIVE BEHAV TX BY PROTOCOL, ADM BY TECH/SUP BY PHYS, EA 15 MINS","284","0.9261",null,"108","180",null,"7","277",null,"NA","NA"],
    [4007,"4007","Carrier C","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96130","PSYCHOLOGICAL TESTING EVAL BY PHYS OR QUAL PROF;  FIRST HOUR","244","0.9754",null,"6.7","14.3",null,"3","241",null,"NA","NA"],
    [4008,"4008","Carrier C","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","TRANSCRANIAL MAG STIMJ TX DLVR & MGMT","211","0.7725",null,null,"61.7",null,"0","211",null,"NA","NA"],
    [4009,"4009","Carrier C","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","BEHAV IDENTIFICATION ASSESSMNT, ADM BY PHYS OR QUAL PROF, EA 15 MINS","152","0.8158",null,"47.8","140",null,"6","146",null,"NA","NA"],
    [4010,"4010","Carrier C","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS","127","0.9921",null,"1.3","5",null,"2","125",null,"NA","NA"],
    [4011,"4011","Carrier C","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90833","PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS","127","1",null,"2","9.2",null,"3","124",null,"NA","NA"],
    [4012,"4012","Carrier C","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90833","PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS","127","1",null,"2","9.2",null,"3","124",null,"NA","NA"],
    [4013,"4013","Carrier C","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H0020","ALCOHOL AND/OR DRUG SERVICES","47","1",null,"43","26",null,"1","46",null,"NA","NA"],
    [4014,"4014","Carrier C","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96156","HEALTH BEHAVIOR ASSESSMENT, OR RE-ASSESSMENT","18","1",null,null,"21",null,"0","18",null,"NA","NA"],
    [4015,"4015","Carrier C","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","S9480","PSYCH SVC INTENSIVE OUTPT","6","1",null,null,"73",null,"0","6",null,"NA","NA"],
    [4016,"4016","Carrier C","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90834","PSYCHOTHERAPY 45 MIN PATIENT","4","1",null,"4","5",null,"1","3",null,"NA","NA"],
    [4017,"4017","Carrier C","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97802","MED NUTRIT THRPY INIT ASSESS 15 MIN","2","1",null,null,"3.5",null,"0","2",null,"NA","NA"],
    [4018,"4018","Carrier C","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90806","IND PSYCHOTHERAPY OFFICE 45-50 MIN","1","1",null,null,"8",null,"0","1",null,"NA","NA"],
    [4019,"4019","Carrier C","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96131","PSYCHOLOGICAL TESTING EVAL BY PHYS OR QUAL PROF; EA ADDL HOUR","1","1",null,null,"18",null,"0","1",null,"NA","NA"],
    [4020,"4020","Carrier C","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96136","PSYCHOLOGICAL OR NEUROPSYCHOLOGICAL TEST BY PHYS,2 OR MORE;FIRST 30 MINS","1","1",null,null,"38",null,"0","1",null,"NA","NA"],
    [4021,"4021","Carrier C","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96138","PSYCHOLOGICAL OR NEUROPSYCHOLOGICAL TEST BY TECH,2 OR MORE;FIRST 30 MINS","1","1",null,null,"137",null,"0","1",null,"NA","NA"],
    [4022,"4022","Carrier C","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","G2082","VISIT FOR EVAL/MGMT EST PT REQ SUPERVISOIN MD, UP TO 56 MG OF ESKETAMINE NASAL, SELF ADMIM","23","0","0.0435","88","59.3",null,"3","20",null,"NA","NA"],
    [4023,"4023","Carrier C","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90868","TRANSCRANIAL MAG STIMJ TX DLVR & MGMT","211","0","0.0379",null,"61.7",null,"0","211",null,"NA","NA"],
    [4024,"4024","Carrier C","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90837","PSYCHOTHERAPY 60 MIN PATIENT","10830","0","0.0001","3","8",null,"269","10561",null,"NA","NA"],
    [4025,"4025","Carrier C","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A7034","NASAL APPLICATION DEVICE","4552","0.9866",null,"1","7.5",null,"98","4454",null,"NA","NA"],
    [4026,"4026","Carrier C","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0601","CPAP DEVICE","4416","0.9361",null,"1.5","28.4",null,"894","3522",null,"NA","NA"],
    [4027,"4027","Carrier C","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0603","DME ELECTRIC BREAST PUMP KIT PURCHASE","2021","0.9936",null,"1.2","24",null,"1876","145",null,"NA","NA"],
    [4028,"4028","Carrier C","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0604","DME ELECTRIC BREAST PUMP KIT RENTAL","1141","0.9702",null,"1.3","23",null,"736","405",null,"NA","NA"],
    [4029,"4029","Carrier C","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0143","WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT","687","0.9767",null,"1.7","14",null,"333","354",null,"NA","NA"],
    [4030,"4030","Carrier C","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L4361","PNEUMATIC, WALKING BOOT","687","0.9942",null,"8","11.7",null,"3","684",null,"NA","NA"],
    [4031,"4031","Carrier C","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0114","CRUTCHES METAL UNDERARM PAIR","624","0.992",null,"5","16",null,"21","603",null,"NA","NA"],
    [4032,"4032","Carrier C","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0118","CRUTCH SUBSTITUTE, LOWER LEG PLATFORM, WITH OR WITHOUT WHEELS, EACH","524","0.9714",null,"2.3","28",null,"176","348",null,"NA","NA"],
    [4033,"4033","Carrier C","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0570","DME NEBULIZE HOME/PORTABLE","478","0.9791",null,"2.3","11.4",null,"148","330",null,"NA","NA"],
    [4034,"4034","Carrier C","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L3908","WRIST SPLINT W/WO COCK-UP","438","0.9909",null,"0.6","11.3",null,"9","429",null,"NA","NA"],
    [4035,"4035","Carrier C","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L3660","SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND","371","1",null,"8","7.3",null,"2","369",null,"NA","NA"],
    [4036,"4036","Carrier C","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4388","DRAINABLE PCH W EX WEAR BARR","247","1",null,"0.5","10",null,"184","63",null,"NA","NA"],
    [4037,"4037","Carrier C","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4670","AUTOMATIC BP MONITOR DIAL","129","1",null,"0.7","6",null,"13","116",null,"NA","NA"],
    [4038,"4038","Carrier C","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4338","INDWELLING CATH LATEX","118","1",null,"1","6",null,"84","34",null,"NA","NA"],
    [4039,"4039","Carrier C","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L4387","WALKING BOOT, PREFAB, NONPNEUMATIC","82","1",null,"15","9",null,"1","81",null,"NA","NA"],
    [4040,"4040","Carrier C","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L4397","PLANTAR FASCITIS NIGHT SPLINT","47","1",null,null,"8.4",null,"0","47",null,"NA","NA"],
    [4041,"4041","Carrier C","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L0650","LSO SAGITTAL-CORONAL CONTROL, SACROCOCCYG JUCT TO T-9 VERT, PREFAB","44","1",null,"1.4","13",null,"8","36",null,"NA","NA"],
    [4042,"4042","Carrier C","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0849","TRACTION EQUIP,CERVICAL,FREE STAND,TRACTION FORCE OTHER THAN MANDIBLE","43","1",null,"0.1","11",null,"1","42",null,"NA","NA"],
    [4043,"4043","Carrier C","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0484","OSCILLATORY POSITIVE EXPIRATORY PRESSURE DEV, NONELEC, ANY TYPE, EACH","41","1",null,"3.6","21.3",null,"17","24",null,"NA","NA"],
    [4044,"4044","Carrier C","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L1951","AFO, SPIRAL, PLASTIC OR OTHER, PREFAB","41","1",null,null,"17",null,"0","41",null,"NA","NA"],
    [4045,"4045","Carrier C","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A5512","FOR DIAB ONLY MX DNSITY INSRT DIR FORMD PRFAB EA","3","0","0.6667",null,"26",null,"0","3",null,"NA","NA"],
    [4046,"4046","Carrier C","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L5321","AK OPEN END SACH","4","0","0.25",null,"67",null,"0","4",null,"NA","NA"],
    [4047,"4047","Carrier C","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L5981","ALL LE PROSTHESES","6","0","0.1667",null,"100",null,"0","6",null,"NA","NA"],
    [4048,"4048","Carrier C","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0766","ELECT STIMULATION DEV USED FOR CANCER TX, INCL ALL ACCESS, ANY TYPE","10","0","0.1","3.7","145",null,"3","7",null,"NA","NA"],
    [4049,"4049","Carrier C","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","B4160","ENTERAL FORMULA, PEDS, NUTRITIONALLY COMP CALORIE DENSE, 100 CAL = 1 UNIT","17","0","0.0588",null,"108.3",null,"0","17",null,"NA","NA"],
    [4050,"4050","Carrier C","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L3000","FOOT INSERT REMOV MOLDED TO PT","154","0","0.0065","8","40.6",null,"5","149",null,"NA","NA"],
    [4051,"4051","Carrier C","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0470","RESP ASSIST DEV, BI-LEVEL PRESSRE CAPABL, W/O BACK UP RATE FEATURE, NONINVAS","190","0","0.0053","1.5","31.7",null,"46","144",null,"NA","NA"],
    [4052,"4052","Carrier C","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E2402","NEGATIVE PRESSURE WOUND THERAPY ELECT PUMP, STATIONARY OR PORTABLE","204","0","0.0049","21.7","79.6",null,"176","28",null,"NA","NA"],
    [4053,"4053","Carrier C","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","K0001","WHEELCHAIR STANDARD","277","0","0.0036","2","19",null,"104","173",null,"NA","NA"],
    [4054,"4054","Carrier C","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0604","DME ELECTRIC BREAST PUMP KIT RENTAL","1141","0","0.0009","1.3","22.8",null,"736","405",null,"NA","NA"],
    [4055,"4055","Carrier C","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS","1634","0.9694",null,"2.6","15.6",null,"111","1523",null,"NA","NA"],
    [4056,"4056","Carrier C","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","K0553","SUPPLY ALLOWANCE FOR THERAPEUTIC CONTINUOUS GLUCOSE MONITOR (CGM), INCLUDES ALL SUPPLIES AND ACCESSORIES","857","0.7503",null,"7.3","61.7",null,"312","545",null,"NA","NA"],
    [4057,"4057","Carrier C","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97802","MED NUTRIT THRPY INIT ASSESS 15 MIN","494","0.9595",null,"6","13",null,"20","474",null,"NA","NA"],
    [4058,"4058","Carrier C","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A5500","DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE","217","0.9447",null,"5","29.6",null,"4","213",null,"NA","NA"],
    [4059,"4059","Carrier C","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4230","INFUS SET INSULIN PUMP NON NEEDLE","161","0.9752",null,"1.5","35",null,"142","19",null,"NA","NA"],
    [4060,"4060","Carrier C","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J9035","INJ BEVACIZUMAB 10 MG","113","0.9646",null,"6","28.6",null,"30","83",null,"NA","NA"],
    [4061,"4061","Carrier C","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","120","ROOM AND BOARD","109","1",null,"13.4",null,null,"109","0",null,"NA","NA"],
    [4062,"4062","Carrier C","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0784","EXTERN AMBUL INSULIN INFUS PUMP","106","0.8019",null,"118","72",null,"7","99",null,"NA","NA"],
    [4063,"4063","Carrier C","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","G0108","DIAB MGMT TRN PER INDIV","95","0.9579",null,"6","31.5",null,"15","80",null,"NA","NA"],
    [4064,"4064","Carrier C","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A9276","SNSR;INVSV DISP USE NONDME INTRSTL CGM 1U=1D SPL","76","0.9079",null,"1","52.3",null,"37","39",null,"NA","NA"],
    [4065,"4065","Carrier C","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","120","ROOM AND BOARD","109","1",null,"13.4",null,null,"109","0",null,"NA","NA"],
    [4066,"4066","Carrier C","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A9274","EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA","45","1",null,"1.3","15.5",null,"24","21",null,"NA","NA"],
    [4067,"4067","Carrier C","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95249","GLUCOSE MONITORING 72 HRS, PT PROVIDED EQUIP, TRAINING AND RECORDING","20","1",null,null,"11.6",null,"0","20",null,"NA","NA"],
    [4068,"4068","Carrier C","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","0403T","PREV BEHAVIOR  CHANGE, INTENS DIAB PRGRM TO INDIVIDUAL IN A GRP SETTING, MINIMUM 60 MIN, PR DY","19","1",null,null,"54.4",null,"0","19",null,"NA","NA"],
    [4069,"4069","Carrier C","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","762","MISC SERVICES","15","1",null,"19.3",null,null,"15","0",null,"NA","NA"],
    [4070,"4070","Carrier C","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","67210","DESTRUCT LOCALIZED RET LES 1+ SESS PHOTOCOAGULA","10","1",null,"7","39",null,"2","8",null,"NA","NA"],
    [4071,"4071","Carrier C","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4221","WEEKLY SUPPLIES DRUG INFUS CATH","9","1",null,null,"23",null,"0","9",null,"NA","NA"],
    [4072,"4072","Carrier C","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J2778","LUCENTIS 0.1MG, INJECTION","9","1",null,"0.1","26",null,"1","8",null,"NA","NA"],
    [4073,"4073","Carrier C","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95251","GLUC MNTR CONT REC FROM NTRSTL TISS FLU, ANALYSIS/INTERP/REP","7","1",null,null,"45.6",null,"0","7",null,"NA","NA"],
    [4074,"4074","Carrier C","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97124","THERA PROC 1+ AREAS EA 15 MIN MASSAGE","7","1",null,null,"15.6",null,"0","7",null,"NA","NA"],
    [4075,"4075","Carrier C","2022","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","K0553","SUPPLY ALLOWANCE FOR THERAPEUTIC CONTINUOUS GLUCOSE MONITOR (CGM), INCLUDES ALL SUPPLIES AND ACCESSORIES","857","0","0.0023","7.3","61.7",null,"312","545",null,"NA","NA"],
    [4076,"4076","Carrier D","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","120","ROOM AND BOARD","4462","0.9861",null,"18.4","32",null,"4445","17",null,"NA","NA"],
    [4077,"4077","Carrier D","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","59510","FULL ROUT OBSTE CARE,CESAREAN DELIV","29","1",null,"6","23",null,"1","28",null,"NA","NA"],
    [4078,"4078","Carrier D","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","128","ROOM AND BOARD","27","1",null,"23",null,null,"27","0",null,"NA","NA"],
    [4079,"4079","Carrier D","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU","9","0.8889",null,"29","91",null,"1","8",null,"NA","NA"],
    [4080,"4080","Carrier D","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","33533","CABG USING ART GRFTS 1 ART GRFT","8","1",null,"0.7","15",null,"3","5",null,"NA","NA"],
    [4081,"4081","Carrier D","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","59400","FULL ROUT OBSTE CARE,VAGINAL DELIV","8","1",null,"0","4",null,"1","7",null,"NA","NA"],
    [4082,"4082","Carrier D","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43644","LAP GASTRIC BYPASS/ROUX-EN-Y","7","1",null,null,"60",null,"0","7",null,"NA","NA"],
    [4083,"4083","Carrier D","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27447","TOTAL KNEE ARTHROPLASTY","6","0.5",null,"4","111",null,"1","5",null,"NA","NA"],
    [4084,"4084","Carrier D","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","TOTAL ABDOM HYSTERECTOMY","6","1",null,"1","16",null,"2","4",null,"NA","NA"],
    [4085,"4085","Carrier D","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99221","1ST HOSPITAL IP/OBS CARE SF/LOW MDM 40 MINUTES","6","1",null,"0","14",null,"1","5",null,"NA","NA"],
    [4086,"4086","Carrier D","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","59510","FULL ROUT OBSTE CARE,CESAREAN DELIV","29","1",null,"6","23",null,"1","28",null,"NA","NA"],
    [4087,"4087","Carrier D","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","128","ROOM AND BOARD","27","1",null,"23",null,null,"27","0",null,"NA","NA"],
    [4088,"4088","Carrier D","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33533","CABG USING ART GRFTS 1 ART GRFT","8","1",null,"0.7","15",null,"3","5",null,"NA","NA"],
    [4089,"4089","Carrier D","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","59400","FULL ROUT OBSTE CARE,VAGINAL DELIV","8","1",null,"0","4",null,"1","7",null,"NA","NA"],
    [4090,"4090","Carrier D","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43644","LAP GASTRIC BYPASS/ROUX-EN-Y","7","1",null,null,"60",null,"0","7",null,"NA","NA"],
    [4091,"4091","Carrier D","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58150","TOTAL ABDOM HYSTERECTOMY","6","1",null,"1","16",null,"2","4",null,"NA","NA"],
    [4092,"4092","Carrier D","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99221","1ST HOSPITAL IP/OBS CARE SF/LOW MDM 40 MINUTES","6","1",null,"0","14",null,"1","5",null,"NA","NA"],
    [4093,"4093","Carrier D","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","32666","THORACOSCOPY W/THERA WEDGE RESEXN INITIAL UNILAT","5","1",null,"1.5","35",null,"2","3",null,"NA","NA"],
    [4094,"4094","Carrier D","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33405","REPLACE PROSTH AORTIC VALVE, OPEN, W/BYPASS NON-HOMO","5","1",null,"3","0.5",null,"2","3",null,"NA","NA"],
    [4095,"4095","Carrier D","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44204","COLECTOMY LAP PARTIAL W/ ANAST","5","1",null,null,"36",null,"0","5",null,"NA","NA"],
    [4096,"4096","Carrier D","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS","23991","0.9911",null,"3","20",null,"2415","21576",null,"NA","NA"],
    [4097,"4097","Carrier D","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES","2851","0.9835",null,"4.7","20.7",null,"123","2728",null,"NA","NA"],
    [4098,"4098","Carrier D","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","762","MISC SERVICES","2202","0.9909",null,"15.6","4",null,"2201","1",null,"NA","NA"],
    [4099,"4099","Carrier D","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97124","THERA PROC 1+ AREAS EA 15 MIN MASSAGE","1779","0.9899",null,"4","14.5",null,"34","1745",null,"NA","NA"],
    [4100,"4100","Carrier D","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","COLONOSCOPY W/ BX SINGLE/MULT","1420","0.9944",null,"1","7",null,"110","1310",null,"NA","NA"],
    [4101,"4101","Carrier D","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","MRI BRAIN W/ & W/O CONTRAST,","828","0.7512",null,"14.7","55",null,"117","711",null,"NA","NA"],
    [4102,"4102","Carrier D","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","TTE (ECHO) WITH SPECTRAL & COLOR FLOW DOPPLER","809","0.9926",null,"2","19",null,"68","741",null,"NA","NA"],
    [4103,"4103","Carrier D","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","MRI ANY JOINT","625","0.8596",null,"9","46",null,"58","567",null,"NA","NA"],
    [4104,"4104","Carrier D","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72158","MRI LUMBAR W/WO CONTRST SPINE","619","0.33",null,"27.7","93.3",null,"61","558",null,"NA","NA"],
    [4105,"4105","Carrier D","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71250","COMPUTED TOMOGRAPHY, THORAX, DIAGNOSTIC; W/O CONTRAST MATERIAL","595","0.802",null,"10","40.7",null,"132","463",null,"NA","NA"],
    [4106,"4106","Carrier D","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77080","DXA BONE DENSITY STUDY 1+ SITS AXIAL SKE","272","1",null,"0.2","19",null,"15","257",null,"NA","NA"],
    [4107,"4107","Carrier D","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96040","GENETICS COUNSELING, EACH 30 MIN, W/ PT/FAMILY","225","1",null,"2.4","12",null,"18","207",null,"NA","NA"],
    [4108,"4108","Carrier D","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","17311","MOHS HD, NCK, HND, FEET, GEN 1ST STGE UP TO 5 BLCK","160","1",null,"1.3","12",null,"29","131",null,"NA","NA"],
    [4109,"4109","Carrier D","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","66984","EXTRACAPSULAR CAT REM W/ INSERT LENS PROSTHESIS; W/O ECP","158","1",null,"3","20.5",null,"19","139",null,"NA","NA"],
    [4110,"4110","Carrier D","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","45378","COLONOSCOPY DX W/WO SPEC/COLON DECOMP (SEP PROC)","99","1",null,"3","24",null,"1","98",null,"NA","NA"],
    [4111,"4111","Carrier D","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","17000","DESTRUCT 1ST AK PREMALIG LESION","92","1",null,"2.7","20.4",null,"3","89",null,"NA","NA"],
    [4112,"4112","Carrier D","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29881","KNEE SCOPE,MED/LAT MENISECTOMY W/DEBRIDE/CHONDRO","88","1",null,"1","16",null,"3","85",null,"NA","NA"],
    [4113,"4113","Carrier D","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99213","OFFICE VISIT E&M EST PT, LOW MDM, 20-29 MINS","87","1",null,"2","33.5",null,"3","84",null,"NA","NA"],
    [4114,"4114","Carrier D","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","20610","ARTHROCENTESIS ASP/INJ MAJOR JNT/BURSA, WITHOUT ULTRASOUND GUIDANCE.","70","1",null,"2.4","32",null,"7","63",null,"NA","NA"],
    [4115,"4115","Carrier D","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95863","EMG NEEDLE 3 EXTREMITIES W/WO RELATED PARASPINAL","69","1",null,"1","15",null,"5","64",null,"NA","NA"],
    [4116,"4116","Carrier D","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","10060","I & D ABSCESS SIMP/SINGLE","4","0","0.25","14","60.5",null,"2","2",null,"NA","NA"],
    [4117,"4117","Carrier D","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","15830","EXCISION, EXCESS SKIN & SUBQU TISSUE, ABDOMEN","5","0","0.2",null,"122.4",null,"0","5",null,"NA","NA"],
    [4118,"4118","Carrier D","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63685","INSRT/REDO SPINE N GENERATOR","5","0","0.2",null,"65",null,"0","5",null,"NA","NA"],
    [4119,"4119","Carrier D","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","77387","GUIDANCE LOCALIZTION TARGET VOLUME  DELIVERY RADIATION TX","6","0","0.1667","10","42",null,"2","4",null,"NA","NA"],
    [4120,"4120","Carrier D","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","54161","CIRCUMCISION SURG EXC NOT CLAMP EXCEPT NEWBORN","8","0","0.125","3","58.3",null,"1","7",null,"NA","NA"],
    [4121,"4121","Carrier D","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","81229","CYTOGENOM CONST MICROARRAY COPY NUMBER&SNP VAR","9","0","0.1111","4","88.3",null,"3","6",null,"NA","NA"],
    [4122,"4122","Carrier D","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","99183","PHYSICN ATTENDNCE HYPERBARIC OXYGEN THERAPY","9","0","0.1111",null,"100",null,"0","9",null,"NA","NA"],
    [4123,"4123","Carrier D","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","78816","TUMOR IMAGE PET/CT FULL BODY","10","0","0.1","95","97.7",null,"1","9",null,"NA","NA"],
    [4124,"4124","Carrier D","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","70336","MRI TEMPOROMANDIBULAR JOINT","14","0","0.0714","11","50",null,"3","11",null,"NA","NA"],
    [4125,"4125","Carrier D","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","0402T","COLLAGEN CROSS-LINKING OF CORNEA","17","0","0.0588","17","66",null,"2","15",null,"NA","NA"],
    [4126,"4126","Carrier D","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","124","ROOM AND BOARD","268","0.9925",null,"5","1",null,"267","1",null,"NA","NA"],
    [4127,"4127","Carrier D","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","128","ROOM AND BOARD","157","0.9936",null,"29",null,null,"157","0",null,"NA","NA"],
    [4128,"4128","Carrier D","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","900","OTHER THERAPY SERV","143","1",null,"31.6",null,null,"143","0",null,"NA","NA"],
    [4129,"4129","Carrier D","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","126","ROOM AND BOARD","41","1",null,"11",null,null,"41","0",null,"NA","NA"],
    [4130,"4130","Carrier D","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","120","ROOM AND BOARD","1","1",null,"7",null,null,"1","0",null,"NA","NA"],
    [4131,"4131","Carrier D","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","900","OTHER THERAPY SERV","143","1",null,"31.6",null,null,"143","0",null,"NA","NA"],
    [4132,"4132","Carrier D","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","126","ROOM AND BOARD","41","1",null,"11",null,null,"41","0",null,"NA","NA"],
    [4133,"4133","Carrier D","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","120","ROOM AND BOARD","1","1",null,"7",null,null,"1","0",null,"NA","NA"],
    [4134,"4134","Carrier D","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","128","ROOM AND BOARD","157","0.9936",null,"29",null,null,"157","0",null,"NA","NA"],
    [4135,"4135","Carrier D","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","124","ROOM AND BOARD","268","0.9925",null,"5","1",null,"267","1",null,"NA","NA"],
    [4136,"4136","Carrier D","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY 60 MIN PATIENT","1243","0.9952",null,"1.5","13.6",null,"63","1180",null,"NA","NA"],
    [4137,"4137","Carrier D","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90836","PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS","429","0.9977",null,"4","3",null,"31","398",null,"NA","NA"],
    [4138,"4138","Carrier D","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES","169","0.9822",null,"4","8.5",null,"9","160",null,"NA","NA"],
    [4139,"4139","Carrier D","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97153","ADAPTIVE BEHAV TX BY PROTOCOL, ADM BY TECH/SUP BY PHYS, EA 15 MINS","85","0.9176",null,null,"180",null,"0","85",null,"NA","NA"],
    [4140,"4140","Carrier D","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90853","GROUP PSYCHOTHERAPY","75","1",null,null,"8.7",null,"0","75",null,"NA","NA"],
    [4141,"4141","Carrier D","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","TRANSCRANIAL MAG STIMJ TX DLVR & MGMT","72","0.7361",null,null,"76.6",null,"0","72",null,"NA","NA"],
    [4142,"4142","Carrier D","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96132","NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR","52","1",null,"61","18",null,"1","51",null,"NA","NA"],
    [4143,"4143","Carrier D","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","BEHAV IDENTIFICATION ASSESSMNT, ADM BY PHYS OR QUAL PROF, EA 15 MINS","51","0.8431",null,null,"170",null,"0","51",null,"NA","NA"],
    [4144,"4144","Carrier D","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS","38","1",null,"1","5",null,"1","37",null,"NA","NA"],
    [4145,"4145","Carrier D","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96130","PSYCHOLOGICAL TESTING EVAL BY PHYS OR QUAL PROF;  FIRST HOUR","37","0.9189",null,"1","13.7",null,"1","36",null,"NA","NA"],
    [4146,"4146","Carrier D","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90853","GROUP PSYCHOTHERAPY","75","1",null,null,"8.7",null,"0","75",null,"NA","NA"],
    [4147,"4147","Carrier D","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96132","NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR","52","1",null,"61","18",null,"1","51",null,"NA","NA"],
    [4148,"4148","Carrier D","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99214","OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS","38","1",null,"1","5",null,"1","37",null,"NA","NA"],
    [4149,"4149","Carrier D","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96136","PSYCHOLOGICAL OR NEUROPSYCHOLOGICAL TEST BY PHYS,2 OR MORE;FIRST 30 MINS","7","1",null,null,"47",null,"0","7",null,"NA","NA"],
    [4150,"4150","Carrier D","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90870","ECT (W/ MONITORING) SINGLE SEIZURE","5","1",null,null,"46",null,"0","5",null,"NA","NA"],
    [4151,"4151","Carrier D","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99492","INIT PSYCHIATRIC COLLABORATIVE CARE MGMT, FIRST 70 MINS/FIRST CAL MONTH","2","1",null,null,"108",null,"0","2",null,"NA","NA"],
    [4152,"4152","Carrier D","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J2315","NALTREXONE, DEPOT FORM, 1 MG INJECTION","2","1",null,null,"26",null,"0","2",null,"NA","NA"],
    [4153,"4153","Carrier D","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90833","PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS","1","1",null,null,"0",null,"0","1",null,"NA","NA"],
    [4154,"4154","Carrier D","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96133","NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; EA ADDL HOUR","1","1",null,null,"246",null,"0","1",null,"NA","NA"],
    [4155,"4155","Carrier D","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96138","PSYCHOLOGICAL OR NEUROPSYCHOLOGICAL TEST BY TECH,2 OR MORE;FIRST 30 MINS","1","1",null,null,"0.5",null,"0","1",null,"NA","NA"],
    [4156,"4156","Carrier D","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90868","TRANSCRANIAL MAG STIMJ TX DLVR & MGMT","72","0","0.04",null,"76.6",null,"0","72",null,"NA","NA"],
    [4157,"4157","Carrier D","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0601","CPAP DEVICE","1664","0.9592",null,"1.4","23.7",null,"186","1478",null,"NA","NA"],
    [4158,"4158","Carrier D","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A7034","NASAL APPLICATION DEVICE","1090","0.9872",null,"1","12",null,"9","1081",null,"NA","NA"],
    [4159,"4159","Carrier D","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0603","DME ELECTRIC BREAST PUMP KIT PURCHASE","706","0.9958",null,"1.5","24",null,"637","69",null,"NA","NA"],
    [4160,"4160","Carrier D","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L4361","PNEUMATIC, WALKING BOOT","353","0.9688",null,"0.2","15",null,"2","351",null,"NA","NA"],
    [4161,"4161","Carrier D","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0114","CRUTCHES METAL UNDERARM PAIR","301","0.9701",null,"2","14.4",null,"5","296",null,"NA","NA"],
    [4162,"4162","Carrier D","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0604","DME ELECTRIC BREAST PUMP KIT RENTAL","260","0.9538",null,"2","26",null,"167","93",null,"NA","NA"],
    [4163,"4163","Carrier D","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L3908","WRIST SPLINT W/WO COCK-UP","217","0.9447",null,null,"17",null,"0","217",null,"NA","NA"],
    [4164,"4164","Carrier D","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L3660","SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND","212","0.9858",null,null,"18",null,"0","212",null,"NA","NA"],
    [4165,"4165","Carrier D","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0143","WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT","202","0.9653",null,"2","24.4",null,"103","99",null,"NA","NA"],
    [4166,"4166","Carrier D","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L3809","WRIST THUMB SPICA","181","0.9779",null,"15","15",null,"1","180",null,"NA","NA"],
    [4167,"4167","Carrier D","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0570","DME NEBULIZE HOME/PORTABLE","99","1",null,"2.7","15.5",null,"31","68",null,"NA","NA"],
    [4168,"4168","Carrier D","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L4205","REPAIR ORTHOTIC DEV LABOR PER 15 MIN","89","1",null,"1","28.6",null,"6","83",null,"NA","NA"],
    [4169,"4169","Carrier D","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4388","DRAINABLE PCH W EX WEAR BARR","64","1",null,"1.6","7.6",null,"45","19",null,"NA","NA"],
    [4170,"4170","Carrier D","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0935","PASSIVE EXERCISE DEVICE","48","1",null,null,"23",null,"0","48",null,"NA","NA"],
    [4171,"4171","Carrier D","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L1820","KO ELAS W/ CONDYLE PADS & JO","42","1",null,null,"13.5",null,"0","42",null,"NA","NA"],
    [4172,"4172","Carrier D","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L4387","WALKING BOOT, PREFAB, NONPNEUMATIC","41","1",null,null,"11",null,"0","41",null,"NA","NA"],
    [4173,"4173","Carrier D","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0431","PORTABLE GASEOUS 02","39","1",null,"4","19.5",null,"26","13",null,"NA","NA"],
    [4174,"4174","Carrier D","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L1852","KNEE ORTHOSIS, DOUBLE UPRIGHT, THIGH/CALF, PREFAB, OFF-THE-SHELF","36","1",null,"3","19.7",null,"6","30",null,"NA","NA"],
    [4175,"4175","Carrier D","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L8030","DME BREAST PROTHESIS ONLY","36","1",null,"6","15",null,"3","33",null,"NA","NA"],
    [4176,"4176","Carrier D","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L0650","LSO SAGITTAL-CORONAL CONTROL, SACROCOCCYG JUCT TO T-9 VERT, PREFAB","32","1",null,"1.4","22",null,"3","29",null,"NA","NA"],
    [4177,"4177","Carrier D","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E8000","GAIT TRAINER, PEDIATRIC SIZE, POSTERIOR SUPPORT INCL ALL ACCESSORIES & COMP","2","0","0.5",null,"85",null,"0","2",null,"NA","NA"],
    [4178,"4178","Carrier D","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","K0739","REPAIR OR NONROUTN SVC DME OTHER THAN O2 EQUIP,REQ TECH SKILL,PER 15 MINS","35","0","0.0571","36","79.7",null,"5","30",null,"NA","NA"],
    [4179,"4179","Carrier D","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS","463","0.987",null,"2","21",null,"40","423",null,"NA","NA"],
    [4180,"4180","Carrier D","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","K0553","SUPPLY ALLOWANCE FOR THERAPEUTIC CONTINUOUS GLUCOSE MONITOR (CGM), INCLUDES ALL SUPPLIES AND ACCESSORIES","347","0.7291",null,"11.3","77",null,"135","212",null,"NA","NA"],
    [4181,"4181","Carrier D","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97802","MED NUTRIT THRPY INIT ASSESS 15 MIN","148","0.9932",null,"2.6","27",null,"11","137",null,"NA","NA"],
    [4182,"4182","Carrier D","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A5500","DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE","69","0.9565",null,"0.3","28.7",null,"1","68",null,"NA","NA"],
    [4183,"4183","Carrier D","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J9035","INJ BEVACIZUMAB 10 MG","63","1",null,"3","28.5",null,"8","55",null,"NA","NA"],
    [4184,"4184","Carrier D","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0784","EXTERN AMBUL INSULIN INFUS PUMP","48","0.625",null,"12.5","94",null,"6","42",null,"NA","NA"],
    [4185,"4185","Carrier D","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4230","INFUS SET INSULIN PUMP NON NEEDLE","47","1",null,"2","15",null,"39","8",null,"NA","NA"],
    [4186,"4186","Carrier D","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","120","ROOM AND BOARD","41","1",null,"12.4",null,null,"41","0",null,"NA","NA"],
    [4187,"4187","Carrier D","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J0178","INJ AFLIBERCEPT (EYLEA) 1 MG","34","0.9412",null,"7","25",null,"4","30",null,"NA","NA"],
    [4188,"4188","Carrier D","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","G0108","DIAB MGMT TRN PER INDIV","33","1",null,"2","48.6",null,"5","28",null,"NA","NA"],
    [4189,"4189","Carrier D","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J9035","INJ BEVACIZUMAB 10 MG","63","1",null,"3","28.5",null,"8","55",null,"NA","NA"],
    [4190,"4190","Carrier D","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4230","INFUS SET INSULIN PUMP NON NEEDLE","47","1",null,"2","15",null,"39","8",null,"NA","NA"],
    [4191,"4191","Carrier D","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","120","ROOM AND BOARD","41","1",null,"12.4",null,null,"41","0",null,"NA","NA"],
    [4192,"4192","Carrier D","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","G0108","DIAB MGMT TRN PER INDIV","33","1",null,"2","48.6",null,"5","28",null,"NA","NA"],
    [4193,"4193","Carrier D","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A9274","EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA","10","1",null,"3","26",null,"5","5",null,"NA","NA"],
    [4194,"4194","Carrier D","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","762","MISC SERVICES","9","1",null,"28.3",null,null,"9","0",null,"NA","NA"],
    [4195,"4195","Carrier D","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","67228","DESTRUCT EXTENSIVE/PROG RETINOPATHY PHOTOCOAGULATN","9","1",null,"0.5","35",null,"2","7",null,"NA","NA"],
    [4196,"4196","Carrier D","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95249","GLUCOSE MONITORING 72 HRS, PT PROVIDED EQUIP, TRAINING AND RECORDING","8","1",null,null,"25",null,"0","8",null,"NA","NA"],
    [4197,"4197","Carrier D","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0118","CRUTCH SUBSTITUTE, LOWER LEG PLATFORM, WITH OR WITHOUT WHEELS, EACH","8","1",null,"0.4","105",null,"2","6",null,"NA","NA"],
    [4198,"4198","Carrier D","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","11042","DEBRIDE SKIN & SUBQ TISSUE","7","1",null,null,"71.7",null,"0","7",null,"NA","NA"],
    [4199,"4199","Carrier D","2022","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0784","EXTERN AMBUL INSULIN INFUS PUMP","48","0","0.0417","12.5","94",null,"6","42",null,"NA","NA"],
    [4200,"4200","Carrier B","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20930","BONE GRAFT MATERIAL ATTACHED TO SPINE","11","0.7273",null,null,"141.46","0","0","11","0","NA","NA"],
    [4201,"4201","Carrier B","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20936","AUTOGRAFT TO BONE DURING SPINAL SURGERY","10","1",null,null,"143.29","0","0","10","0","NA","NA"],
    [4202,"4202","Carrier B","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","METALLIC  MESH BETWEEN VERTEBRAE","9","1",null,null,"72.44","0","0","9","0","NA","NA"],
    [4203,"4203","Carrier B","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44620","CLOSURE OF INTESTINAL DIVERSION","6","1",null,"15.21","74.2","0","2","4","0","NA","NA"],
    [4204,"4204","Carrier B","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44204","LAPAROSCOPIC PARTIAL REMOVAL OF COLON","6","1",null,null,"91.51","0","0","6","0","NA","NA"],
    [4205,"4205","Carrier B","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","33533","CORONARY ARTERY BYPASS WITH ARTERIAL GRAFT; 1 ARTERY","6","1",null,"12.15","59.66","0","1","5","0","NA","NA"],
    [4206,"4206","Carrier B","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","J9000","DOXORUBICIN HCL INJECTION","6","1",null,"55.95","64.6","0","2","4","0","NA","NA"],
    [4207,"4207","Carrier B","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","SPINAL FUSION TO JOIN TWO VERTEBRAE IN LOW BACK","5","1",null,null,"65.86","0","0","5","0","NA","NA"],
    [4208,"4208","Carrier B","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","TOTAL ABDOMINAL HYSTERECOMY WITH TUBES AND OVARIES","5","1",null,"26.6","111.28","0","1","4","0","NA","NA"],
    [4209,"4209","Carrier B","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22614","SPINAL FUSION TO JOIN TWO VERTEBRAE","5","1",null,null,"200.19","0","0","5","0","NA","NA"],
    [4210,"4210","Carrier B","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","61700","SURGERICAL TREATMENT OF SIMPLE ANEURYSM THRU THE INTRACRANIAL CAROTID ARTERY","1","1",null,null,"49.9","0","0","1","0","NA","NA"],
    [4211,"4211","Carrier B","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","Q5119","INJ RITUXIMAB-PVVR BIOSIMILAR RUXIENCE 10 MG","4","1",null,"95.72","61","0","1","3","0","NA","NA"],
    [4212,"4212","Carrier B","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","32663","SCOPE OF LUNGS WITH REMOVAL OF LOBE","1","1",null,null,"125.97","0","0","1","0","NA","NA"],
    [4213,"4213","Carrier B","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","13102","COMPLEX REPAIR OF WOUND TO TRUNK 5CM OR LESS","1","1",null,null,"154.88","0","0","1","0","NA","NA"],
    [4214,"4214","Carrier B","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33871","TRANSVERSE AORTIC-ARCH GRAFT WITH CARDIAC BYPASS PREFERRED HYPOTHERMIA","1","1",null,null,"100.23","0","0","1","0","NA","NA"],
    [4215,"4215","Carrier B","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15002","SURG PREP/CREAT RECIP SITE BY EXCIS OPEN WOUNDS/BURN/SCAR 1ST 100 SQ CM","1","1",null,null,"142.88","0","0","1","0","NA","NA"],
    [4216,"4216","Carrier B","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","61782","SCAN PROCEDURE CRANIAL ADDON","2","1",null,"24.7","142.35","0","1","1","0","NA","NA"],
    [4217,"4217","Carrier B","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15738","SKIN FLAP FROM LOWER EXTREMITY TO TREAT ANOTHER AREA OF BODY","1","1",null,null,"63.58","0","0","1","0","NA","NA"],
    [4218,"4218","Carrier B","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J2260","MILRINONE LACTATE PER 5 ML","1","1",null,"3.27",null,"0","1","0","0","NA","NA"],
    [4219,"4219","Carrier B","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15769","HARVESTING OF SKIN WITH AUTOLOGOUS SOFT TISSUE","2","1",null,null,"133.28","0","0","2","0","NA","NA"],
    [4220,"4220","Carrier B","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","24341","TENDON/MUSCLE WOUND REPAIR TO UPPER ARM OR ELBOW","1","0","1",null,"154.88","0","0","1","0","NA","NA"],
    [4221,"4221","Carrier B","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","19371","PERI-IMPLANT CAPSULECTOMY BREAST COMPLETE","1","0","1",null,"142.88","0","0","1","0","NA","NA"],
    [4222,"4222","Carrier B","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","S2068","REMOVAL OF CAPSULE OR SCAR TISSUE AROUND BREAST IMPLANT","1","0","1",null,"142.88","0","0","1","0","NA","NA"],
    [4223,"4223","Carrier B","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","13102","COMPLEX  WOUND REPAIR TO TRUNK EACH ADDL 5 CM","1","0","1",null,"154.88","0","0","1","0","NA","NA"],
    [4224,"4224","Carrier B","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","49568","HERNIA REPAIR WITH MESH","1","0","1",null,"142.88","0","0","1","0","NA","NA"],
    [4225,"4225","Carrier B","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","15002","SURGICAL PREPRATION TO RECEIVE SKIN GRAFT  SITE DUE TO OPEN WOUNDS/BURN/SCAR 1ST 100 SQ CM","1","0","1",null,"142.88","0","0","1","0","NA","NA"],
    [4226,"4226","Carrier B","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","13101","COMPLX WOUND REPAIR TO  TRUNK; 2.6 CM TO 7.5 CM","1","0","1",null,"142.88","0","0","1","0","NA","NA"],
    [4227,"4227","Carrier B","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","19328","REMOVAL INTACT BREAST IMPLANT","1","0","1",null,"142.88","0","0","1","0","NA","NA"],
    [4228,"4228","Carrier B","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","19350","NIPPLE/AREOLA RECONSTRUCTION","1","0","1",null,"142.88","0","0","1","0","NA","NA"],
    [4229,"4229","Carrier B","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","15003","WOUND PREP  ADDITIONAL AREA OF  100 CM","1","0","1",null,"142.88","0","0","1","0","NA","NA"],
    [4230,"4230","Carrier B","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99212","OFFICE/OUTPATIENT ESTABLISHED MEMBER LASTING 10-19 MIN","106","0.6698",null,"81.53","124.79","0.03","3","102","2","NA","NA"],
    [4231,"4231","Carrier B","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95810","SLEEP STUDY GREATER THAN 6 YRS OLD","105","0.5524",null,null,"141.62",null,"0","105","0","NA","NA"],
    [4232,"4232","Carrier B","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64483","ANESTHETIC AGEN AND/OR STERIOD INJECTION FOR TRANSFORAMINAL EPIDURAL INJECTION INTO A SINGLE LEVEL","100","0.91",null,null,"114.06","0.03","0","100","1","NA","NA"],
    [4233,"4233","Carrier B","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95811","SLEEP STUDY GREATER THAN 6 YRS OLD WITH CPAP MACHINE","81","0.4321",null,"19.11","164.61",null,"1","80","0","NA","NA"],
    [4234,"4234","Carrier B","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","J0585","INJECTION,ONABOTULINUMTOXINA","67","0.7463",null,"2.1","100.39",null,"1","66","0","NA","NA"],
    [4235,"4235","Carrier B","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","551","SKILLED NURSE VISIT IN HOME","66","1",null,"25.41","87.06",null,"2","64","0","NA","NA"],
    [4236,"4236","Carrier B","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","81162","GENETIC TESTING FOR GENE DELETIONS OR DNA REPAIR-ASSOCIATED GENE","47","0.6596",null,null,"161.42",null,"0","46","0","NA","NA"],
    [4237,"4237","Carrier B","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27447","REPAIR PROCEDURES ON THE FEMUR AND KNEE JOINT","46","0.8913",null,null,"60.92",null,"0","46","0","NA","NA"],
    [4238,"4238","Carrier B","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0481","DEFINITIVE DRUG TEST OF CLASSES 8-14","44","0.1591",null,null,"115.24",null,"0","42","0","NA","NA"],
    [4239,"4239","Carrier B","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0480","DEFINITIVE DRUG TEST OF CLASSES 1-7","44","0.1591",null,null,"116.74",null,"0","42","0","NA","NA"],
    [4240,"4240","Carrier B","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","69930","COCHLEAR DEVICE IMPLANT WITH/WITHOUT MASTOID","1","1",null,null,"192.52",null,"0","1","0","NA","NA"],
    [4241,"4241","Carrier B","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J9181","ETOPOSIDE INJECTION","5","1",null,"5.02","7.29",null,"1","4","0","NA","NA"],
    [4242,"4242","Carrier B","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J1756","INJECTION IRON SUCROSE 1 MG","1","1",null,"58.22",null,null,"1","0","0","NA","NA"],
    [4243,"4243","Carrier B","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99205","OFFICE/OUTPATIENT VISIT NEW","1","1",null,null,"1.04",null,"0","1","0","NA","NA"],
    [4244,"4244","Carrier B","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27488","REMOVAL TOTAL KNEE PROSTHETIC CEMENT WITH/WITHOUT SPACER","1","1",null,null,"19.92",null,"0","1","0","NA","NA"],
    [4245,"4245","Carrier B","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99214","OFFICE/OUTPATIENT ESTABLISHED MOD MANAGEMENT 30-39 MIN","5","1",null,null,"86.19",null,"0","5","0","NA","NA"],
    [4246,"4246","Carrier B","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","30140","SUBMUCOUS RESECTION OF THE INFERIOR TURBINATE PARTIAL ORCOMPLETE ANY METHOD","1","1",null,null,"55.4",null,"0","1","0","NA","NA"],
    [4247,"4247","Carrier B","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99215","OFFICE/OUTPATIENT VISIT ESTABLISHED","1","1",null,null,"145.12",null,"0","1","0","NA","NA"],
    [4248,"4248","Carrier B","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64714","REVISION OF  LOW BACK NERVE(S)","1","1",null,null,"22.3",null,"0","1","0","NA","NA"],
    [4249,"4249","Carrier B","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99349","HOME VISIT ESTABLISHED PATIENT","4","1",null,null,"165.38",null,"0","4","0","NA","NA"],
    [4250,"4250","Carrier B","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","77063","X-RAY EXAM MOUTH JOINTS OPEN AND CLOSED, BILATERALLY","1","0","1",null,null,null,"0","0","0","NA","NA"],
    [4251,"4251","Carrier B","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","15830","SURGICAL REMOVAL OF EXCESS SKIN AND SUBCUTANEOUS TISSUE OF THE ABDOMEN","1","0","1",null,"0.09",null,"0","1","0","NA","NA"],
    [4252,"4252","Carrier B","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","70330","X-RAY EXAM MOUTH JOINTS OPEN AND CLOSED, BILATERALLY","1","0","1",null,"167.9",null,"0","1","0","NA","NA"],
    [4253,"4253","Carrier B","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90791","PSYCHOLOGICAL DIAGNOSTIC EVALUATION","1","0","1",null,null,"0.02","0","0","1","NA","NA"],
    [4254,"4254","Carrier B","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","77067","SCREENING MAMMOGRAPHY","1","0","1",null,null,null,"0","0","0","NA","NA"],
    [4255,"4255","Carrier B","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90834","PSYCHO THERAPY INDIVIDUAL/FAMILY 45 MINUTES","1","0","1",null,null,null,"0","0","0","NA","NA"],
    [4256,"4256","Carrier B","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64566","ELECTRICAL STIMULATION TO THE POSTERIOR TIBIAL NERVE WITH NEEDLE ELECTRODE","2","0","0.5",null,"259.75",null,"0","2","0","NA","NA"],
    [4257,"4257","Carrier B","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","98941","CHIROPRACTIC MANIPULATIVE TREATMENT TO; SPINAL 3-4 REGIONS","2","0","0.5",null,"331.18",null,"0","1","0","NA","NA"],
    [4258,"4258","Carrier B","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","J1602","GOLIMUMAB FOR IV USE 1MG","3","0","0.3333",null,"170.58",null,"0","3","0","NA","NA"],
    [4259,"4259","Carrier B","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","37243","PARTIAL/COMPLETE BLOCK OF VASULARE BLOOD FLOW TO AN ORGAN","4","0","0.25",null,"243.61",null,"0","4","0","NA","NA"],
    [4260,"4260","Carrier B","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","SEMI-PRIVATE PYSCHIATRIC INPATIENT STAY","57","0.9825",null,"0","20.28","0","0","57","0","NA","NA"],
    [4261,"4261","Carrier B","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1002","BEHAVIORAL HEALTH ACCOMODATIONS-RELATED TO CHEMICAL DEPENDANCY","45","1",null,"0","12.21","0","0","45","0","NA","NA"],
    [4262,"4262","Carrier B","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","126","DETOXIFICATION BED","24","1",null,"0","38.48","0","0","20","0","NA","NA"],
    [4263,"4263","Carrier B","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1001","BEHAVIORAL HEALTH ACCOMODATIONS-RESIDENTIAL TREATMENT  PSYCHIATRIC","9","1",null,"0","18.29","0","0","9","0","NA","NA"],
    [4264,"4264","Carrier B","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","100","ROOM AND BOARD-ALL INCLUSIVE PLUS ANCILLARY","1","1",null,"0","7.63","0","0","1","0","NA","NA"],
    [4265,"4265","Carrier B","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","126","DETOXIFICATION BED","24","1",null,"0","38.48","0","0","20","0","NA","NA"],
    [4266,"4266","Carrier B","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1001","BEHAVIORAL HEALTH ACCOMODATIONS-RESIDENTIAL TREATMENT  PSYCHIATRIC","9","1",null,"0","18.29","0","0","9","0","NA","NA"],
    [4267,"4267","Carrier B","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","100","REMOVL EMBEDDED FB CONJUNCT INCI","1","1",null,"0","7.63","0","0","1","0","NA","NA"],
    [4268,"4268","Carrier B","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1002","BEHAVIORAL HEALTH ACCOMODATIONS-RELATED TO CHEMICAL DEPENDANCY","45","1",null,"0","12.21","0","0","45","0","NA","NA"],
    [4269,"4269","Carrier B","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","SEMI-PRIVATE PYSCHIATRIC INPATIENT STAY","57","0.9825",null,"0","20.28","0","0","57","0","NA","NA"],
    [4270,"4270","Carrier B","2022","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","124","SEMI-PRIVATE PYSCHIATRIC INPATIENT STAY","57","0","0.0175","0","20.28","0","0","57","0","NA","NA"],
    [4271,"4271","Carrier B","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","906","PROFESSIONAL FEE FOR PSYCHOLOGY","16","1",null,"0","114.62",null,"0","14","0","NA","NA"],
    [4272,"4272","Carrier B","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","905","INTENSIVE BEHAVIORAL HEALTH TREATMENT SERVICES","13","1",null,"0","53.94",null,"0","12","0","NA","NA"],
    [4273,"4273","Carrier B","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96101","PSYCHOLOGICAL TESTING PER HOUR FACE TO FACE TIME WITH PATIENT","10","1",null,"0","110.73","0.1","0","10","1","NA","NA"],
    [4274,"4274","Carrier B","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","912","PARTIAL HOSPITALIZATION PSYCHIATRIC  PROGRAM","9","1",null,"0","24.93",null,"0","9","0","NA","NA"],
    [4275,"4275","Carrier B","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","MENTAL HEALTH PARTIAL HOSPITALIZATION, LESS THAN 24 HOURS","6","1",null,"0","27.82",null,"0","6","0","NA","NA"],
    [4276,"4276","Carrier B","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H2012","BEHAVIORAL HEALTH DAY TREATMENT, PER HOUR","5","1",null,"0","24.02",null,"0","5","0","NA","NA"],
    [4277,"4277","Carrier B","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90870","ELECTRIC CONVULSIVE THERAPY","4","1",null,"0","53.19",null,"0","4","0","NA","NA"],
    [4278,"4278","Carrier B","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S9480","INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES PER DIEM","3","1",null,"0","72.25",null,"0","3","0","NA","NA"],
    [4279,"4279","Carrier B","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97156","ADAPTIVE BEHAVIOR TREATMENT PROCEDURES","2","1",null,"0","37.33",null,"0","2","0","NA","NA"],
    [4280,"4280","Carrier B","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99212","OFFICE/OUTPATIENT ESTABLISHED MEMBER LASTING 10-19 MIN","2","1",null,"0","72.74",null,"0","2","0","NA","NA"],
    [4281,"4281","Carrier B","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","901","BEHAVIORAL HEALTH TREATMENT SERVICES, ELECTROSHOCK","1","1",null,"0","71.97",null,"0","1","0","NA","NA"],
    [4282,"4282","Carrier B","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S9480","INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES PER DIEM","3","1",null,"0","72.25",null,"0","3","0","NA","NA"],
    [4283,"4283","Carrier B","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99212","OFFICE/OUTPATIENT ESTABLISHED MEMBER LASTING 10-19 MIN","2","1",null,"0","72.74",null,"0","2","0","NA","NA"],
    [4284,"4284","Carrier B","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","906","PROFESSIONAL FEE FOR PSYCHOLOGY","16","1",null,"0","114.62",null,"0","14","0","NA","NA"],
    [4285,"4285","Carrier B","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H2012","BEHAVIORAL HEALTH DAY TREATMENT, PER HOUR","5","1",null,"0","24.02",null,"0","5","0","NA","NA"],
    [4286,"4286","Carrier B","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90870","PSYCHOTHERAPY SESSION UNDER 60 MINUTES","4","1",null,"0","53.19",null,"0","4","0","NA","NA"],
    [4287,"4287","Carrier B","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97156","ADAPTIVE BEHAVIOR TREATMENT PROCEDURES","2","1",null,"0","37.33",null,"0","2","0","NA","NA"],
    [4288,"4288","Carrier B","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","912","PARTIAL HOSPITALIZATION PSYCHIATRIC  PROGRAM","9","1",null,"0","24.93",null,"0","9","0","NA","NA"],
    [4289,"4289","Carrier B","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0015","IOP AL &/OR DRG SRV->=3HRS DA/3DAWK","1","1",null,"0",null,null,"0","0","0","NA","NA"],
    [4290,"4290","Carrier B","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96101","PSYCHOLOGICAL TESTING PER HOUR FACE TO FACE TIME WITH PATIENT","10","1",null,"0","110.73","0.1","0","10","1","NA","NA"],
    [4291,"4291","Carrier B","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","CONTINUOUS AIRWAY PRESSURE (CPAP) DEVICE","282","0.9539",null,"19.74","90.26","0","2","277","0","NA","NA"],
    [4292,"4292","Carrier B","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1390","PORTABLE OXYGEN CONCENTRATOR","71","0.9296",null,"56.9","51.87","0","6","63","0","NA","NA"],
    [4293,"4293","Carrier B","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0781","AMBULATORY INFUSION PUMP 1 OR MULTIPLE CHANNELS PATIENT WEARS","38","0.9211",null,null,"87.78","0","0","38","0","NA","NA"],
    [4294,"4294","Carrier B","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0470","BI-PAP RESPIRATORY ASSIST DEVICE WITH OUT BACKUP","24","0.9583",null,"2.39","139.98","0","1","22","0","NA","NA"],
    [4295,"4295","Carrier B","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2402","NEGATIVE PRESSURE WOUND PUMP","18","0.9444",null,"67.25","102.29","0","1","17","0","NA","NA"],
    [4296,"4296","Carrier B","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0935","PASSIVE MOTION EXERCISE DEVICE","8","1",null,null,"97.1","0","0","7","0","NA","NA"],
    [4297,"4297","Carrier B","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0471","BI-PAP RESPIRATORY ASSIST DEVICE WITH BACKUP","7","1",null,null,"89.58","0","0","6","0","NA","NA"],
    [4298,"4298","Carrier B","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0001","STANDARD WHEELCHAIR","7","0.7143",null,"14.69","67.13","0","3","4","0","NA","NA"],
    [4299,"4299","Carrier B","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","B9002","ENTERAL NUTRITION INFUSION PUMP WITH ALARM","6","1",null,null,"99.24","0","0","6","0","NA","NA"],
    [4300,"4300","Carrier B","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0604","HOSP GRADE ELECTRIC BREAST PUMP","3","0.6667",null,null,"102.69","0","0","3","0","NA","NA"],
    [4301,"4301","Carrier B","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0005","ULTRALIGHTWEIGHT WHEELCHAIR","1","1",null,null,"71.3","0","0","1","0","NA","NA"],
    [4302,"4302","Carrier B","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2202","MANUAL WHEELCHAIR NON-STANDARD SEAT FRAME WIDTH, 24-27 INCHES","1","1",null,"223.02",null,"0","1","0","0","NA","NA"],
    [4303,"4303","Carrier B","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S9342","HOME THERAPY","1","1",null,"22.17",null,"0","1","0","0","NA","NA"],
    [4304,"4304","Carrier B","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9279","MONITOR FEATURE/DEVICE, STAND-ALONE OR INTEGRATED, ANY TYPE, NOT OTHERWISE CLASSIFIED","1","1",null,null,"286.14","0","0","1","0","NA","NA"],
    [4305,"4305","Carrier B","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2611","GENERAL  WHEELCHAIR BACK CUSSION WIDTH < 22 INCHES, ANY HEIGHT MOUNT HARDWARE","1","1",null,null,"71.29","0","0","1","0","NA","NA"],
    [4306,"4306","Carrier B","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","B9002","ENTERAL NUTRITION INFUSION PUMP WITH ALARM","6","1",null,null,"99.24","0","0","6","0","NA","NA"],
    [4307,"4307","Carrier B","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0835","POWER WHEEL CHAIR, GROUP 2 STANDARD, SINGLE POWER OPTION, SLING/SOLID SEAT/BACK,","1","1",null,null,"124.03","0","0","1","0","NA","NA"],
    [4308,"4308","Carrier B","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0260","HOSPITAL BED SEMI-ELEC WITH ANY RAILS WITH MATTRESS","2","1",null,"21.73","90.12","0","1","1","0","NA","NA"],
    [4309,"4309","Carrier B","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0637","COMBINATION SIT TO STAND SYSTEM","1","1",null,null,"285.97","0","0","1","0","NA","NA"],
    [4310,"4310","Carrier B","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0471","BI-PAP RESPIRATORY ASSIST DEVICE WITH BACKUP","7","1",null,null,"89.58","0","0","6","0","NA","NA"],
    [4311,"4311","Carrier B","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0781","AMBULATORY INFUSION PUMP 1 OR MULTIPLE CHANNELS PATIENT WEARS","38","0","0.0263",null,"87.78","0","0","38","0","NA","NA"],
    [4312,"4312","Carrier B","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9277","EXTERNAL TRANSMITTER CONTINOUS GLUCOSE MONITOR DAILY","78","0.9744",null,"40.17","93.72","0","1","77","0","NA","NA"],
    [4313,"4313","Carrier B","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9276","DISPOSABLE SENSOR  FOR CONTINOUS GLUCOSE MONITORING SYSTEM DAILY","13","0.8462",null,null,"137.58","0","0","13","0","NA","NA"],
    [4314,"4314","Carrier B","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9278","EXTERNAL RECEIVER  FOR CONTINOUS GLUCOSE MONITORING","11","0.9091",null,null,"124.62","0","0","11","0","NA","NA"],
    [4315,"4315","Carrier B","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9274","EXTERNAL AMBULATORY INSULIN DELIVERY SYSTEM","8","1",null,null,"88.3","0","0","8","0","NA","NA"],
    [4316,"4316","Carrier B","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0553","CONTINOUS GLUCOSE MONITORING SYSTEM SUPPLIES MONTH AT A TIME","4","0",null,null,"122.19","0","0","4","0","NA","NA"],
    [4317,"4317","Carrier B","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","EXTERNAL AMBULATORY INFUSION PUMP, INSULIN","4","1",null,null,"74.1","0","0","4","0","NA","NA"],
    [4318,"4318","Carrier B","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0554","THERAPEUTIC CONTINOUS GLUCOSE MONITORING RECEIVER/MONITOR MONTHLY","3","0",null,null,"124.78","0","0","3","0","NA","NA"],
    [4319,"4319","Carrier B","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","EXTERNAL AMBULATORY INFUSION PUMP, INSULIN","4","1",null,null,"74.1","0","0","4","0","NA","NA"],
    [4320,"4320","Carrier B","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9274","EXTERNAL AMBULATORY INSULIN DELIVERY SYSTEM","8","1",null,null,"88.3","0","0","8","0","NA","NA"],
    [4321,"4321","Carrier B","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9277","EXTERNAL TRANSMITTER CONTINOUS GLUCOSE MONITOR DAILY","78","0.9744",null,"40.17","93.72","0","1","77","0","NA","NA"],
    [4322,"4322","Carrier B","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9278","EXTERNAL RECEIVER  FOR CONTINOUS GLUCOSE MONITORING","11","0.9091",null,null,"124.62","0","0","11","0","NA","NA"],
    [4323,"4323","Carrier B","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9276","DISPOSABLE SENSOR  FOR CONTINOUS GLUCOSE MONITORING SYSTEM DAILY","13","0.8462",null,null,"137.58","0","0","13","0","NA","NA"],
    [4324,"4324","Carrier B","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0554","THERAPEUTIC CONTINOUS GLUCOSE MONITORING RECEIVER/MONITOR MONTHLY","3","0",null,null,"124.78","0","0","3","0","NA","NA"],
    [4325,"4325","Carrier B","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0553","CONTINOUS GLUCOSE MONITORING SYSTEM SUPPLIES MONTH AT A TIME","4","0",null,null,"122.19","0","0","4","0","NA","NA"],
    [4326,"4326","Carrier G","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22842","POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG","16","0.6875",null,"4.7","75.5",null,"1","15",null,"NA","NA"],
    [4327,"4327","Carrier G","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22614","ARTHRODESIS PST/PSTLAT TQ 1NTRSPC EA ADDL NTRSPC","13","0.6154",null,"3.8","67.7",null,"2","11",null,"NA","NA"],
    [4328,"4328","Carrier G","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96416","CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP","12","0.9167",null,"11","57.8",null,"4","8",null,"NA","NA"],
    [4329,"4329","Carrier G","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63048","LAM FACETECTOMY and FORAMOT 1 VRT SGM EA ADDL SGM","10","0.7",null,"3.8","99.8",null,"2","8",null,"NA","NA"],
    [4330,"4330","Carrier G","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","69990","MICROSURG TQS REQ USE OPERATING MICROSCOPE","9","0.7778",null,"22.1","17.2",null,"1","8",null,"NA","NA"],
    [4331,"4331","Carrier G","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22600","ARTHRD PST/PSTLAT TQ 1NTRSPC CRV BELW C2 SEGMENT","9","0.7778",null,"3.8","87.4",null,"2","7",null,"NA","NA"],
    [4332,"4332","Carrier G","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44207","LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST","9","0.7778",null,"23.9","19.9",null,"2","7",null,"NA","NA"],
    [4333,"4333","Carrier G","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","38724","CERVICAL LYMPHADEC MODIFIED RADICAL NECK DSJ","9","0.6667",null,"24.9","40",null,"2","7",null,"NA","NA"],
    [4334,"4334","Carrier G","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J9100","INJECTION CYTARABINE 100 MG","8","0.75",null,"15.2","57.4",null,"4","4",null,"NA","NA"],
    [4335,"4335","Carrier G","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY","8","0.875",null,"18.1","21.4",null,"4","4",null,"NA","NA"],
    [4336,"4336","Carrier G","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22840","POSTERIOR NON-SEGMENTAL INSTRUMENTATION","13","1",null,null,"62.5",null,null,"13",null,"NA","NA"],
    [4337,"4337","Carrier G","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22558","ARTHRD ANT INTERBODY MIN DSC LUMBAR","7","1",null,null,"75.2",null,null,"7",null,"NA","NA"],
    [4338,"4338","Carrier G","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","49000","EXPLORATORY LAPAROTOMY CELIOTOMY W/WO BIOPSY SPX","6","1",null,"11.3","14",null,"4","2",null,"NA","NA"],
    [4339,"4339","Carrier G","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95961","FUNCJAL CORT and SUBCORT MAPG PHYS/QHP ATTND INIT HR","6","1",null,"20.6","45.9",null,"3","3",null,"NA","NA"],
    [4340,"4340","Carrier G","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44620","CLOSURE ENTEROSTOMY LG/SMALL INTESTINE","4","1",null,"33.1","98.1",null,"2","2",null,"NA","NA"],
    [4341,"4341","Carrier G","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","13101","REPAIR COMPLEX TRUNK 2.6-7.5 CM","3","1",null,"26.1","58.5",null,"1","2",null,"NA","NA"],
    [4342,"4342","Carrier G","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","13102","REPAIR COMPLEX TRUNK EACH ADDITIONAL 5 CM OR LT","3","1",null,"26.1","58.5",null,"1","2",null,"NA","NA"],
    [4343,"4343","Carrier G","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15002","PREP SITE TRUNK/ARM/LEG 1ST 100 SQ CM/1PCT","3","1",null,"26.1","58.5",null,"1","2",null,"NA","NA"],
    [4344,"4344","Carrier G","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15003","PREP SITE TRUNK/ARM/LEG ADDL 100 SQ CM/1PCT","3","1",null,"26.1","58.5",null,"1","2",null,"NA","NA"],
    [4345,"4345","Carrier G","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22585","ARTHRD ANT NTRBD MIN DSC EA ADDL INTERSPACE","3","1",null,null,"72.6",null,null,"3",null,"NA","NA"],
    [4346,"4346","Carrier G","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","23440","RESECTION/TRANSPLANTATION LONG TENDON BICEPS","1","0","1",null,"96.2",null,null,"1",null,"NA","NA"],
    [4347,"4347","Carrier G","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","50949","UNLISTED LAPAROSCOPY PROCEDURE URETER","1","0","1","18.2",null,null,"1",null,null,"NA","NA"],
    [4348,"4348","Carrier G","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","58146","MYOMECTOMY 5 OR GT  MYOMAS  and  OR GT 250 GM ABDOMINA","1","0","1",null,"42.6",null,null,"1",null,"NA","NA"],
    [4349,"4349","Carrier G","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","61458","CRNEC SOPL EXPL/DCMPRN CRNL NRV","1","0","1",null,"51.1",null,null,"1",null,"NA","NA"],
    [4350,"4350","Carrier G","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","44626","CLSR NTRSTM LG/SM RESCJ  and  COLORECTAL ANASTOMOSIS","2","0","0.5","48","25.6",null,"1","1",null,"NA","NA"],
    [4351,"4351","Carrier G","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","52351","CYSTO W/URTROSCOPY and /PYELOSCOPY DX","2","0","0.5","18.2","73.6",null,"1","1",null,"NA","NA"],
    [4352,"4352","Carrier G","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","92652","AEP THRESHOLD ESTIMATION MLT FREQUENCIES I and R","3","0","0.3333","21.2","37.5",null,"1","2",null,"NA","NA"],
    [4353,"4353","Carrier G","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","47135","LVR ALTRNSPLJ ORTHOTOPIC PRTL/WHL DON ANY AGE","3","0","0.3333","19.2","150.1",null,"1","2",null,"NA","NA"],
    [4354,"4354","Carrier G","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","58140","MYOMECTOMY 1-4 MYOMAS W/250 GM OR LT  ABDOMINAL APPR","3","0","0.3333",null,"46.3",null,null,"3",null,"NA","NA"],
    [4355,"4355","Carrier G","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","44620","CLOSURE ENTEROSTOMY LG/SMALL INTESTINE","4","0","0.25","33.1","98.1",null,"2","2",null,"NA","NA"],
    [4356,"4356","Carrier G","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC and COLR D","1415","0.9004",null,"9.3","45.4",null,"28","1387",null,"NA","NA"],
    [4357,"4357","Carrier G","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","78452","MYOCARDIAL SPECT MULTIPLE STUDIES","261","0.9004",null,null,"58.8",null,"3","258",null,"NA","NA"],
    [4358,"4358","Carrier G","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93015","CV STRS TST XERS and /OR RX CONT ECG W/SI and R","232","0.8707",null,"1","48.9",null,"2","230",null,"NA","NA"],
    [4359,"4359","Carrier G","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93971","DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY","197","0.9137",null,"14.5","22.1",null,"23","174",null,"NA","NA"],
    [4360,"4360","Carrier G","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","77334","TX DEVICES DESIGN  AND  CONSTRUCTION COMPLEX","171","0.924",null,"13.2","18.7",null,"65","106",null,"NA","NA"],
    [4361,"4361","Carrier G","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93350","ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST and ST","169","0.8994",null,"29","40.3",null,"3","166",null,"NA","NA"],
    [4362,"4362","Carrier G","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74177","CT ABDOMEN  and  PELVIS W/CONTRAST MATERIAL","150","0.8909",null,"27.3","36.6",null,"45","105",null,"NA","NA"],
    [4363,"4363","Carrier G","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J0585","BOTULINUM TOXIN TYPE A PER UNIT","157","0.8025",null,"7.4","63.1",null,"10","147",null,"NA","NA"],
    [4364,"4364","Carrier G","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71271","COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-","148","0.9085",null,"0","43.7",null,"1","147",null,"NA","NA"],
    [4365,"4365","Carrier G","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93248","EXTERNAL ECG REC GT 7D LT 15D REVIEW  and  INTERPRETATION","146","0.9178",null,null,"60.5",null,null,"146",null,"NA","NA"],
    [4366,"4366","Carrier G","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93271","XTRNL PT ACTIVATED ECG REC DWNLD 30 DAYS","32","1",null,null,"0",null,null,"32",null,"NA","NA"],
    [4367,"4367","Carrier G","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93975","DUP-SCAN ARTL FLO ABDL/PEL/SCROT and /RPR ORGN COM","28","1",null,null,"48.1",null,"2","26",null,"NA","NA"],
    [4368,"4368","Carrier G","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93229","XTRNL MOBILE CV TELEMETRY W/TECHNICAL SUPPORT","24","1",null,null,null,null,null,"24",null,"NA","NA"],
    [4369,"4369","Carrier G","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93280","PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER","24","1",null,null,"0",null,null,"24",null,"NA","NA"],
    [4370,"4370","Carrier G","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93460","R  AND  L HRT CATH WINJX HRT ART AND  L VENTR IMG","19","1",null,null,"0",null,null,"19",null,"NA","NA"],
    [4371,"4371","Carrier G","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A9502","TECHNETIUM TC-99M TETROFOSMIN DX PER STUDY DOSE","18","1",null,null,"26.8",null,null,"18",null,"NA","NA"],
    [4372,"4372","Carrier G","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93295","INTERROGATION EVAL REMOTE  LT 90 D 1/2/MLT LD DFB","17","1",null,null,"0",null,null,"17",null,"NA","NA"],
    [4373,"4373","Carrier G","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77470","SPECIAL TREATMENT PROCEDURE","13","1",null,null,"22.1",null,"2","11",null,"NA","NA"],
    [4374,"4374","Carrier G","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93451","RIGHT HEART CATH O2 SATURATION  AND  CARDIAC OUTPUT","13","1",null,null,"40.9",null,"1","12",null,"NA","NA"],
    [4375,"4375","Carrier G","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93990","DUPLEX SCAN HEMODIALYSIS ACCESS","13","1",null,null,null,null,"1","12",null,"NA","NA"],
    [4376,"4376","Carrier G","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","17999","UNLISTED PX SKIN MUC MEMBRANE  AND  SUBQ TISSUE","1","0","1",null,"161",null,null,"1",null,"NA","NA"],
    [4377,"4377","Carrier G","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","20930","ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED","1","0","1",null,"225",null,null,"1",null,"NA","NA"],
    [4378,"4378","Carrier G","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","20936","AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION","1","0","1",null,"225",null,null,"1",null,"NA","NA"],
    [4379,"4379","Carrier G","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21705","DIVISION SCALENUS ANTICUS RESECTION CERVICAL RIB","1","0","1",null,"33",null,null,"1",null,"NA","NA"],
    [4380,"4380","Carrier G","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","23405","TENOTOMY SHOULDER AREA 1 TENDON","1","0","1",null,"33",null,null,"1",null,"NA","NA"],
    [4381,"4381","Carrier G","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","40819","EXC FRENUM LABIAL/BUCCAL","1","0","1",null,"98",null,null,"1",null,"NA","NA"],
    [4382,"4382","Carrier G","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","41115","EXCISION LINGUAL FRENUM FRENECTOMY","1","0","1",null,"98",null,null,"1",null,"NA","NA"],
    [4383,"4383","Carrier G","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","52601","TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE","1","0","1",null,"46",null,null,"1",null,"NA","NA"],
    [4384,"4384","Carrier G","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","61783","STEREOTACTIC COMPUTER ASSISTED PX SPINAL","1","0","1",null,"225",null,null,"1",null,"NA","NA"],
    [4385,"4385","Carrier G","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64713","NEURP MAJOR PRPH NRV OPN ARM/LEG BRACH PLEXUS","1","0","1",null,"33",null,null,"1",null,"NA","NA"],
    [4386,"4386","Carrier G","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","Room & Board - Semiprivate - 2 Beds - Psychiatric","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [4387,"4387","Carrier G","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","Room & Board - Semiprivate - 2 Beds - Psychiatric","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [4388,"4388","Carrier G","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","THERAP REPETITIVE TMS TX SUBSEQ DELIVERY  AND  MNG","34","0.5294",null,null,"99.3",null,null,"34",null,"NA","NA"],
    [4389,"4389","Carrier G","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL and M","33","0.5455",null,null,"99.8",null,null,"33",null,"NA","NA"],
    [4390,"4390","Carrier G","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV  and  MN","24","0.5417",null,null,"102.2",null,null,"24",null,"NA","NA"],
    [4391,"4391","Carrier G","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVALUATION","12","0.6667",null,"98","42.3",null,"1","11",null,"NA","NA"],
    [4392,"4392","Carrier G","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY W/PATIENT 60 MINUTES","11","0.4545",null,"72.5","43",null,"3","8",null,"NA","NA"],
    [4393,"4393","Carrier G","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","80307","DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE","8","0.375",null,"40","92.7",null,"1","7",null,"NA","NA"],
    [4394,"4394","Carrier G","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90833","PSYCHOTHERAPY W/PATIENT W/E and M SRVCS 30 MIN","6","0.8333",null,null,"122",null,null,"6",null,"NA","NA"],
    [4395,"4395","Carrier G","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96131","PSYCHOLOGICAL TST EVAL SVC PHYS/QHP EA ADDL HOUR","6","0.8333",null,null,"68",null,null,"6",null,"NA","NA"],
    [4396,"4396","Carrier G","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","S9480","INTENSIVE OP PSYCHIATRIC SERVICES PER DIEM","6","0.8333",null,"32.3","60.7",null,"3","3",null,"NA","NA"],
    [4397,"4397","Carrier G","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96130","PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR","5","0.8",null,null,"82.8",null,null,"5",null,"NA","NA"],
    [4398,"4398","Carrier G","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96116","NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR","2","1",null,null,"185.5",null,null,"2",null,"NA","NA"],
    [4399,"4399","Carrier G","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96121","NEUROBEHAVIORAL STATUS XM PHYS/QHP EA ADDL HOUR","2","1",null,null,"188.5",null,null,"2",null,"NA","NA"],
    [4400,"4400","Carrier G","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96132","NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP 1ST HOUR","2","1",null,null,"185.5",null,null,"2",null,"NA","NA"],
    [4401,"4401","Carrier G","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96133","NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR","2","1",null,null,"185.5",null,null,"2",null,"NA","NA"],
    [4402,"4402","Carrier G","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H0018","BHVAL HEALTH; SHORT-TERM RES W/O ROOM and BOARD-DIEM","2","1",null,null,"72.5",null,null,"2",null,"NA","NA"],
    [4403,"4403","Carrier G","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","80305","DRUG TEST PRSMV READ DIRECT OPTICAL OBS PR DATE","1","1",null,null,null,"40","1","1",null,"NA","NA"],
    [4404,"4404","Carrier G","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90838","PSYCHOTHERAPY W/PATIENT W/E and M SRVCS 60 MIN","1","1",null,null,"350",null,null,"1",null,"NA","NA"],
    [4405,"4405","Carrier G","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90899","UNLISTED PSYCHIATRIC SERVICE/PROCEDURE","1","1",null,null,null,null,null,"1",null,"NA","NA"],
    [4406,"4406","Carrier G","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H0015","ALCOHL and /RX SRVC;INTENSV OP;CRISIS INTRVN and ACTV TX","1","1",null,null,"49",null,null,"1",null,"NA","NA"],
    [4407,"4407","Carrier G","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H2012","BEHAVIORAL HEALTH DAY TREATMENT PER HOUR","1","1",null,null,"35",null,null,"1",null,"NA","NA"],
    [4408,"4408","Carrier G","2022","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90837","PSYCHOTHERAPY W/PATIENT 60 MINUTES","11","0","0.09","72.6","56.1",null,"3","8",null,"NA","NA"],
    [4409,"4409","Carrier G","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0784","EXTERNAL AMBULATORY INFUSION PUMP INSULIN","16","1",null,"73","45.9",null,"1","15",null,"NA","NA"],
    [4410,"4410","Carrier G","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","K0553","SUPPLY ALLOW FOR TX CGM1 MO SPL  Equal to  1 U OF SERVICE","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [4411,"4411","Carrier G","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A9277","TRANSMITTER; EXT  USE WITH NONDME INTRSTL CGM","1","0",null,null,null,null,null,"1",null,"NA","NA"],
    [4412,"4412","Carrier G","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0784","EXTERNAL AMBULATORY INFUSION PUMP INSULIN","16","1",null,"73","45.9",null,"1","15",null,"NA","NA"],
    [4413,"4413","Carrier G","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","K0553","SUPPLY ALLOW FOR TX CGM1 MO SPL  Equal to  1 U OF SERVICE","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [4414,"4414","Carrier G","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E1390","O2 CONC 1 DEL PORT 85 PCT  OR GT 02 CONC AT PRSC FLW RATE","78","0.6282",null,"25.8","114.5",null,"8","70",null,"NA","NA"],
    [4415,"4415","Carrier G","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L0650","LSO SAGITTAL-CORONAL CONTRL RIGD ANT POST PANELS","12","0.25",null,null,"68.2",null,null,"12",null,"NA","NA"],
    [4416,"4416","Carrier G","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0652","PNEUMAT COMPRS SEG HOM MDL W/CALBRTD GRADNT PRSS","10","0",null,null,"155.6",null,null,"10",null,"NA","NA"],
    [4417,"4417","Carrier G","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L1960","AFO POSTERIOR SOLID ANK PLASTIC CUSTOM FAB","9","0.6667",null,null,"43",null,null,"9",null,"NA","NA"],
    [4418,"4418","Carrier G","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0601","CONTINUOUS POSITIVE AIRWAY PRESSURE DEVICE","8","0.125",null,null,"38.3",null,null,"8",null,"NA","NA"],
    [4419,"4419","Carrier G","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0466","HOME VENTILATOR ANY TYPE USED W/NON-INVASV INTF","8","0.5",null,"19.8","80.3",null,"4","4",null,"NA","NA"],
    [4420,"4420","Carrier G","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","V2624","POLISHING/RESURFACING OF OCULAR PROSTHESIS","8","1",null,null,"57.3",null,null,"8",null,"NA","NA"],
    [4421,"4421","Carrier G","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E1399","DURABLE MEDICAL EQUIPMENT MISCELLANEOUS","8","0.25",null,null,"133.6",null,null,"8",null,"NA","NA"],
    [4422,"4422","Carrier G","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","K0108","OTHER ACCESSORIES","7","0.5714",null,null,"114",null,null,"7",null,"NA","NA"],
    [4423,"4423","Carrier G","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","V2628","FABRICATION AND FITTING OF OCULAR CONFORMER","7","0.8571",null,null,"55.9",null,null,"7",null,"NA","NA"],
    [4424,"4424","Carrier G","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58571","LAPS TOTAL HYSTERECT 250 GM OR LT  W/RMVL TUBE/OVARY","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [4425,"4425","Carrier G","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A9274","EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA","1","1",null,null,"75.6",null,null,"1",null,"NA","NA"],
    [4426,"4426","Carrier G","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","B9998","NOC FOR ENTERAL SUPPLIES","1","1",null,null,"48",null,null,"1",null,"NA","NA"],
    [4427,"4427","Carrier G","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0240","BATH/SHOWER CHAIR W/WO WHEELS ANY SIZE","1","1",null,null,"32.1",null,null,"1",null,"NA","NA"],
    [4428,"4428","Carrier G","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0656","SEG PNEUMAT APPLIANCE USE W/PNEUMAT COMPRS TRUNK","1","1",null,null,"93.5",null,null,"1",null,"NA","NA"],
    [4429,"4429","Carrier G","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0986","MNL WHEELCHAIR ACSS PUSH-RIM ACT PWR ASSIST SYS","1","1",null,null,null,null,null,"1",null,"NA","NA"],
    [4430,"4430","Carrier G","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E1020","RESIDUAL LIMB SUPPORT SYSTEM WHEELCHAIR ANY TYPE","1","1",null,null,"96",null,null,"1",null,"NA","NA"],
    [4431,"4431","Carrier G","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E1161","MANUAL ADULT SIZE WHEELCHAIR INCLUDES TILT SPACE","1","1",null,null,"150.1",null,null,"1",null,"NA","NA"],
    [4432,"4432","Carrier G","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E1815","DYN ADJ ANKLE EXT/FLEX DEVC INCL SOFT INTF MATL","1","1",null,null,"99.2",null,null,"1",null,"NA","NA"],
    [4433,"4433","Carrier G","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E2325","PWR WC ACSS SIP AND PUFF INTERFCE NONPROPRTNAL","1","1",null,null,"68",null,null,"1",null,"NA","NA"],
    [4434,"4434","Carrier G","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L2999","LOWER EXTREMITY ORTHOSES NOT OTHERWISE SPECIFIED","1","0","1",null,"81",null,null,"1",null,"NA","NA"],
    [4435,"4435","Carrier G","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","B4157","ENTRAL F NUTRITION CMPL INHERITED DZ METAB","2","0","0.5","19","48",null,"1","1",null,"NA","NA"],
    [4436,"4436","Carrier G","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A4649","SURGICAL SUPPLY; MISCELLANEOUS","4","0","0.25","32","95",null,"3","1",null,"NA","NA"],
    [4437,"4437","Carrier G","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0486","ORL DEVC/APPL RDUC UP AIRWAY COLLAPSIBILITY CSTM","5","0","0.2",null,"53.5",null,null,"5",null,"NA","NA"],
    [4438,"4438","Carrier G","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0760","OSTOGNS STIM LOW INTENS ULTRASOUND NON-INVASV","5","0","0.2",null,"133.8",null,null,"5",null,"NA","NA"],
    [4439,"4439","Carrier G","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0766","ELEC STIM DVC U CANCER TX INCL ALL ACC ANY TYPE","5","0","0.2","159","92",null,"1","4",null,"NA","NA"],
    [4440,"4440","Carrier G","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","V2623","PROSTHETIC EYE PLASTIC CUSTOM","5","0","0.2",null,"73.2",null,null,"5",null,"NA","NA"],
    [4441,"4441","Carrier G","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","V2628","FABRICATION AND FITTING OF OCULAR CONFORMER","7","0","0.1429",null,"55.9",null,null,"7",null,"NA","NA"],
    [4442,"4442","Carrier G","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0466","HOME VENTILATOR ANY TYPE USED W/NON-INVASV INTF","8","0","0.125","19.8","80.3",null,"4","4",null,"NA","NA"],
    [4443,"4443","Carrier G","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","V2624","POLISHING/RESURFACING OF OCULAR PROSTHESIS","8","0","0.125",null,"57.3",null,null,"8",null,"NA","NA"],
    [4444,"4444","Carrier J","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","49","0.88",null,"1.783655699","73.67917831",null,"5","44",null,"NA","NA"],
    [4445,"4445","Carrier J","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","46","0.85",null,"2.826288659","70.91364191",null,"4","42",null,"NA","NA"],
    [4446,"4446","Carrier J","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96416","Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours), requiring use of a portable or implantable pump","36","0",null,"0.129527067","6.065881022",null,"13","23",null,"NA","NA"],
    [4447,"4447","Carrier J","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63048","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure)","29","0.83",null,"1.147280722","56.84775353",null,"7","22",null,"NA","NA"],
    [4448,"4448","Carrier J","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22633","Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar","28","0.96",null,"1.950920278","77.24536074",null,"1","27",null,"NA","NA"],
    [4449,"4449","Carrier J","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44207","Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)","27","0",null,"0.551256722","1.804173671",null,"4","23",null,"NA","NA"],
    [4450,"4450","Carrier J","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22612","Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)","23","0.91",null,"2.107086606","62.80834108",null,"2","21",null,"NA","NA"],
    [4451,"4451","Carrier J","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22842","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)","23","0.83",null,"0.347804643","86.78757963",null,"3","20",null,"NA","NA"],
    [4452,"4452","Carrier J","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","J9100","Cytarabine Hcl 100 Mg Inj","22","0",null,"0.037033333","1.014778507",null,"10","12",null,"NA","NA"],
    [4453,"4453","Carrier J","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63047","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","22","0.91",null,"1.38484525","58.50804957",null,"4","18",null,"NA","NA"],
    [4454,"4454","Carrier J","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44204","Laparoscopy, surgical; colectomy, partial, with anastomosis","22","0",null,null,"6.045091435",null,null,"22",null,"NA","NA"],
    [4455,"4455","Carrier J","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27130","Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft","14","1",null,null,"86.04741874",null,null,"14",null,"NA","NA"],
    [4456,"4456","Carrier J","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22843","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in addition to code for primary procedure)","8","1",null,"12.30354551","19.85377603",null,"2","6",null,"NA","NA"],
    [4457,"4457","Carrier J","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22610","Arthrodesis, posterior or posterolateral technique, single level; thoracic (with lateral transverse technique, when performed)","5","1",null,"1.656845608","28.28057457",null,"3","2",null,"NA","NA"],
    [4458,"4458","Carrier J","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63012","Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (Gill type procedure)","4","1",null,null,"66.06901226",null,null,"4",null,"NA","NA"],
    [4459,"4459","Carrier J","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63052","Laminectomy, facetectomy, or foraminotomy with lumbar decompression of spinal cord, cauda equina and/or nerve root during posterior interbody arthrodesis, single segment","4","1",null,null,"102.6514883",null,null,"4",null,"NA","NA"],
    [4460,"4460","Carrier J","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22325","Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; lumbar","4","1",null,null,"10.54731758",null,null,"4",null,"NA","NA"],
    [4461,"4461","Carrier J","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","47135","Liver allotransplantation, orthotopic, partial or whole, from cadaver or living donor, any age","4","1",null,"27.25222222","30.38243639",null,"1","3",null,"NA","NA"],
    [4462,"4462","Carrier J","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63046","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; thoracic","3","1",null,"0.353683765","19.45549528",null,"2","1",null,"NA","NA"],
    [4463,"4463","Carrier J","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63053","Laminectomy, facetectomy, or foraminotomy with lumbar decompression of spinal cord, cauda equina and/or nerve root, during posterior interbody arthrodesis, each additional segment","3","1",null,null,"103.1150832",null,null,"3",null,"NA","NA"],
    [4464,"4464","Carrier J","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","61867","Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative microelectrode recording; first array","3","1",null,null,"37.56240741",null,null,"3",null,"NA","NA"],
    [4465,"4465","Carrier J","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63056","Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; lumbar (including transfacet, or lateral extraforaminal approach) (eg, far lateral herniated intervertebral disc)","3","1",null,null,"51.61418883",null,null,"3",null,"NA","NA"],
    [4466,"4466","Carrier J","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22856","Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); single interspace, cervical","3","1",null,null,"152.0604888",null,null,"3",null,"NA","NA"],
    [4467,"4467","Carrier J","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33361","Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; percutaneous femoral artery approach","3","1",null,null,"17.23751732",null,null,"3",null,"NA","NA"],
    [4468,"4468","Carrier J","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22856","Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); single interspace, cervical","3",null,"0.33",null,"152.0604888",null,null,"3",null,"NA","NA"],
    [4469,"4469","Carrier J","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22633","Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar","28",null,"0.07","1.950920278","77.24536074",null,"1","27",null,"NA","NA"],
    [4470,"4470","Carrier J","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","20931","Allograft, structural, for spine surgery only (List separately in addition to code for primary procedure)","15",null,"0.07","0.132777778","47.76105976",null,"1","14",null,"NA","NA"],
    [4471,"4471","Carrier J","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","46",null,"0.07","2.826288659","70.91364191",null,"4","42",null,"NA","NA"],
    [4472,"4472","Carrier J","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22558","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","21",null,"0.05","2.107086606","75.47881978",null,"2","19",null,"NA","NA"],
    [4473,"4473","Carrier J","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63047","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","22",null,"0.05","1.38484525","58.50804957",null,"4","18",null,"NA","NA"],
    [4474,"4474","Carrier J","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22612","Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)","23",null,"0.04","2.107086606","62.80834108",null,"2","21",null,"NA","NA"],
    [4475,"4475","Carrier J","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","49",null,"0.04","1.783655699","73.67917831",null,"5","44",null,"NA","NA"],
    [4476,"4476","Carrier J","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","5448","0.7",null,"1.967357631","23.23881386","2826.610024","15","5433","18","NA","NA"],
    [4477,"4477","Carrier J","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97530","Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","5158","0.7",null,"5.32882609","24.46614153","1535.854537","11","5147","11","NA","NA"],
    [4478,"4478","Carrier J","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97140","Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes","4653","0.7",null,"1.709303195","24.2642726","3871.851042","14","4639","11","NA","NA"],
    [4479,"4479","Carrier J","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97112","Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities","4186","0.69",null,"0.706925945","23.99069922","2004.755235","4","4182","9","NA","NA"],
    [4480,"4480","Carrier J","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","ECHO, transthoracic w/doppler, complete","2961","0.94",null,null,"4.254639698","2764.8",null,"2961","5","NA","NA"],
    [4481,"4481","Carrier J","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74176","CT abd & pelvis","2851","0.94",null,"0.434583333","4.213635609",null,"12","2839",null,"NA","NA"],
    [4482,"4482","Carrier J","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","MRI, lower extremity any joint; wo contr","2597","0.88",null,"0.217361111","5.416698508","1622.934375","4","2593","3","NA","NA"],
    [4483,"4483","Carrier J","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72148","MRI of lumbar spine","1835","0.88",null,"33.27722222","5.806029607","3096","2","1833","3","NA","NA"],
    [4484,"4484","Carrier J","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0399","Home sleep test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation","1743","0.96",null,"6.877222222","2.820735736","1608","4","1739","2","NA","NA"],
    [4485,"4485","Carrier J","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","MRI of brain and further sequences","1573","0.96",null,"0.129722222","3.445440212","1473.848889","2","1571","4","NA","NA"],
    [4486,"4486","Carrier J","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43249","Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter)","33","1",null,"5.877483102","4.548783045",null,"6","27",null,"NA","NA"],
    [4487,"4487","Carrier J","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29898","Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive","27","1",null,"0.037777778","2.33629316","5304","3","24","1","NA","NA"],
    [4488,"4488","Carrier J","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","75557","Cardiac MRI for morph","25","1",null,null,"6.348544444",null,null,"25",null,"NA","NA"],
    [4489,"4489","Carrier J","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77435","Stereotactic body radiation therapy, treatment management, per treatment course, to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions","20","1",null,"11.42528333","43.97194503",null,"3","17",null,"NA","NA"],
    [4490,"4490","Carrier J","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72142","Contrast MRI of cervical spine","20","1",null,null,"0.018458333",null,null,"20",null,"NA","NA"],
    [4491,"4491","Carrier J","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","37243","Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, organ ischemia, or infarction","20","1",null,"10.20065083","17.92338387",null,"2","18",null,"NA","NA"],
    [4492,"4492","Carrier J","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77373","Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions","19","1",null,"12.41307722","46.59385613",null,"3","16",null,"NA","NA"],
    [4493,"4493","Carrier J","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72149","Contrast MRI of lumbar spine","18","1",null,null,"3.794228395",null,null,"18",null,"NA","NA"],
    [4494,"4494","Carrier J","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","75635","CTA abdm arta/lg artry w/o & w/cntrs","16","1",null,null,"0.013003472",null,null,"16",null,"NA","NA"],
    [4495,"4495","Carrier J","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72147","Contrast MRI of thoracic spine","16","1",null,null,"0.012777778",null,null,"16",null,"NA","NA"],
    [4496,"4496","Carrier J","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","15832","Excision, excessive skin and subcutaneous tissue (includes lipectomy); thigh","1",null,"1",null,"6351.911167",null,null,"1",null,"NA","NA"],
    [4497,"4497","Carrier J","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","15879","Suction assisted lipectomy; lower extremity","1",null,"1",null,"6351.911167",null,null,"1",null,"NA","NA"],
    [4498,"4498","Carrier J","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","15839","Excision, excessive skin and subcutaneous tissue (includes lipectomy); other area","1",null,"1",null,"6351.911167",null,null,"1",null,"NA","NA"],
    [4499,"4499","Carrier J","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","15877","Suction assisted lipectomy; trunk","1",null,"1",null,"6351.911167",null,null,"1",null,"NA","NA"],
    [4500,"4500","Carrier J","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22849","Reinsertion of spinal fixation device","2",null,"0.5",null,"84.8055725",null,null,"2",null,"NA","NA"],
    [4501,"4501","Carrier J","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63655","Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural","2",null,"0.5",null,"72.49758195",null,null,"2",null,"NA","NA"],
    [4502,"4502","Carrier J","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22852","Removal of posterior segmental instrumentation","3",null,"0.33",null,"77.09756591",null,null,"3",null,"NA","NA"],
    [4503,"4503","Carrier J","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","29805","Arthroscopy, shoulder, diagnostic, with or without synovial biopsy (separate procedure)","5",null,"0.2","5.458238057","163.6368785",null,"1","4",null,"NA","NA"],
    [4504,"4504","Carrier J","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63045","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; cervical","11",null,"0.18",null,"57.25166212",null,null,"11",null,"NA","NA"],
    [4505,"4505","Carrier J","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","29862","Arthroscopy, hip, surgical; with debridement/shaving of articular cartilage (chondroplasty), abrasion arthroplasty, and/or resection of labrum","7",null,"0.14",null,"51.25368665",null,null,"7",null,"NA","NA"],
    [4506,"4506","Carrier J","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1002","Residential treatment, Substance Use Disorder","256","0.98",null,"13.43465713","29.23745095","4944","3","253","1","NA","NA"],
    [4507,"4507","Carrier J","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1001","Residential treatment, Psychiatric","55","0.8",null,"32.15222222","42.34860677","5365.35762","3","52","2","NA","NA"],
    [4508,"4508","Carrier J","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","Room and board, Semi-Private, Psychiatric","19","1",null,"536.301546","25.84960406",null,"2","17",null,"NA","NA"],
    [4509,"4509","Carrier J","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","126","Room and board, Semi Private Detoxification","2","1",null,null,"12.06753056","4872",null,"2","1","NA","NA"],
    [4510,"4510","Carrier J","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99221","Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","2","0",null,null,"0.08730875",null,null,"2",null,"NA","NA"],
    [4511,"4511","Carrier J","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","14302","Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof (List separately in addition to code for primary procedure)","1","0",null,null,"238.9218658",null,null,"1",null,"NA","NA"],
    [4512,"4512","Carrier J","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95714","Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; unmonitored","1","0",null,null,"0.087204723",null,null,"1",null,"NA","NA"],
    [4513,"4513","Carrier J","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","54125","Amputation of penis; complete","1","0",null,null,"238.9218658",null,null,"1",null,"NA","NA"],
    [4514,"4514","Carrier J","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95720","Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of EEG recording, interpret","1","0",null,null,"0.087161112",null,null,"1",null,"NA","NA"],
    [4515,"4515","Carrier J","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","J9217","Leuprolide Acetate Suspnsion","1","0",null,null,"0.085735277",null,null,"1",null,"NA","NA"],
    [4516,"4516","Carrier J","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0017","Alcohol And/Or Drug Services","1","0",null,null,"0.005833334",null,null,"1",null,"NA","NA"],
    [4517,"4517","Carrier J","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","53430","Urethroplasty, reconstruction of female urethra","1","0",null,null,"238.9218658",null,null,"1",null,"NA","NA"],
    [4518,"4518","Carrier J","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","14301","Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm","1","0",null,null,"238.9218658",null,null,"1",null,"NA","NA"],
    [4519,"4519","Carrier J","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","54520","Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach","1","0",null,null,"238.9218658",null,null,"1",null,"NA","NA"],
    [4520,"4520","Carrier J","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99223","Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.","1","0",null,null,"0.087500002",null,null,"1",null,"NA","NA"],
    [4521,"4521","Carrier J","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0018","Alcohol And/Or Drug Services","1","0",null,null,"0.08719639","851.2",null,"1","3","NA","NA"],
    [4522,"4522","Carrier J","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99222","Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded.","1","0",null,null,"0.087500002",null,null,"1",null,"NA","NA"],
    [4523,"4523","Carrier J","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","Room and board, Semi-Private, Psychiatric","19","1",null,"536.301546","25.84960406",null,"2","17",null,"NA","NA"],
    [4524,"4524","Carrier J","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","126","Room and board, Semi Private Detoxification","2","1",null,null,"12.06753056","4872",null,"2","1","NA","NA"],
    [4525,"4525","Carrier J","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1002","Residential treatment, Substance Use Disorder","256","0.98",null,"13.43465713","29.23745095","4944","3","253","1","NA","NA"],
    [4526,"4526","Carrier J","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1001","Residential treatment, Psychiatric","55","0.8",null,"32.15222222","42.34860677","5365.35762","3","52","2","NA","NA"],
    [4527,"4527","Carrier J","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99221","Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","2","0",null,null,"0.08730875",null,null,"2",null,"NA","NA"],
    [4528,"4528","Carrier J","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","14302","Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof (List separately in addition to code for primary procedure)","1","0",null,null,"238.9218658",null,null,"1",null,"NA","NA"],
    [4529,"4529","Carrier J","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95714","Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; unmonitored","1","0",null,null,"0.087204723",null,null,"1",null,"NA","NA"],
    [4530,"4530","Carrier J","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","54125","Amputation of penis; complete","1","0",null,null,"238.9218658",null,null,"1",null,"NA","NA"],
    [4531,"4531","Carrier J","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95720","Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of EEG recording, interpret","1","0",null,null,"0.087161112",null,null,"1",null,"NA","NA"],
    [4532,"4532","Carrier J","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J9217","Leuprolide Acetate Suspnsion","1","0",null,null,"0.085735277",null,null,"1",null,"NA","NA"],
    [4533,"4533","Carrier J","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0017","Alcohol And/Or Drug Services","1","0",null,null,"0.005833334",null,null,"1",null,"NA","NA"],
    [4534,"4534","Carrier J","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","53430","Urethroplasty, reconstruction of female urethra","1","0",null,null,"238.9218658",null,null,"1",null,"NA","NA"],
    [4535,"4535","Carrier J","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","14301","Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm","1","0",null,null,"238.9218658",null,null,"1",null,"NA","NA"],
    [4536,"4536","Carrier J","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","54520","Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach","1","0",null,null,"238.9218658",null,null,"1",null,"NA","NA"],
    [4537,"4537","Carrier J","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99223","Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.","1","0",null,null,"0.087500002",null,null,"1",null,"NA","NA"],
    [4538,"4538","Carrier J","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0018","Alcohol And/Or Drug Services","1","0",null,null,"0.08719639","851.2",null,"1","3","NA","NA"],
    [4539,"4539","Carrier J","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99222","Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded.","1","0",null,null,"0.087500002",null,null,"1",null,"NA","NA"],
    [4540,"4540","Carrier J","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","92507","Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual","238","0.61",null,"1.166890833","49.71417048","2088","1","237","1","NA","NA"],
    [4541,"4541","Carrier J","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71271","Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)","232","0.93",null,null,"2.809104673",null,null,"232",null,"NA","NA"],
    [4542,"4542","Carrier J","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","204","1",null,"13.41949509","14.00535917",null,"3","201",null,"NA","NA"],
    [4543,"4543","Carrier J","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours","115","0.91",null,null,"40.940329",null,null,"115",null,"NA","NA"],
    [4544,"4544","Carrier J","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","104","0.93",null,"28.84766406","36.95580354","3480","5","99","1","NA","NA"],
    [4545,"4545","Carrier J","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","104","0.93",null,"35.43247868","37.27901375",null,"4","100",null,"NA","NA"],
    [4546,"4546","Carrier J","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H2036","Alcohol and/or other drug treatment program, per diem","91","0.97",null,"18.28416667","26.99379394",null,"1","90",null,"NA","NA"],
    [4547,"4547","Carrier J","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","78","0.95",null,"38.79774935","35.17500741",null,"3","75",null,"NA","NA"],
    [4548,"4548","Carrier J","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97530","Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","53","0.6",null,null,"37.99685158",null,null,"53",null,"NA","NA"],
    [4549,"4549","Carrier J","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70551","MRI of brain","44","0.98",null,null,"2.598333333",null,null,"44",null,"NA","NA"],
    [4550,"4550","Carrier J","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","92522","Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria);","8","1",null,null,"18.12766878",null,null,"8",null,"NA","NA"],
    [4551,"4551","Carrier J","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81229","Cytogenomic constitutional (genome-wide) microarray analysis; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants for chromosomal abnormalities","7","1",null,null,"9.82712869","720",null,"7","1","NA","NA"],
    [4552,"4552","Carrier J","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70450","CT, head or brain wo contrast","4","1",null,null,"0.031527778",null,null,"4",null,"NA","NA"],
    [4553,"4553","Carrier J","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19318","Breast reduction","4","1",null,null,"42.5827616",null,null,"4",null,"NA","NA"],
    [4554,"4554","Carrier J","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","41899","Unlisted procedure, dentoalveolar structures","3","1",null,null,"43.04668055",null,null,"3",null,"NA","NA"],
    [4555,"4555","Carrier J","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81416","Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure)","3","1",null,null,"32.24690926",null,null,"3",null,"NA","NA"],
    [4556,"4556","Carrier J","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","92609","Therapeutic services for the use of speech-generating device, including programming and modification","3","1",null,null,"28.34968239",null,null,"3",null,"NA","NA"],
    [4557,"4557","Carrier J","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81415","Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis","3","1",null,null,"32.24690926",null,null,"3",null,"NA","NA"],
    [4558,"4558","Carrier J","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","21122","Genioplasty; sliding osteotomies, 2 or more osteotomies (eg, wedge excision or bone wedge reversal for asymmetrical chin)","2","1",null,null,"150.1566292",null,null,"2",null,"NA","NA"],
    [4559,"4559","Carrier J","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","17380","Electrolysis epilation, each 30 minutes","2","1",null,null,"54.46004028",null,null,"2",null,"NA","NA"],
    [4560,"4560","Carrier J","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15769","Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia)","2","1",null,null,"2949.905131",null,null,"2",null,"NA","NA"],
    [4561,"4561","Carrier J","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","21296","Reduction of masseter muscle and bone (eg, for treatment of benign masseteric hypertrophy); intraoral approach","2","1",null,null,"173.1659833",null,null,"2",null,"NA","NA"],
    [4562,"4562","Carrier J","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81243","FMR1 (fragile X mental retardation 1) (eg, fragile X mental retardation) gene analysis; evaluation to detect abnormal (eg, expanded) alleles","2","1",null,null,"12.36625","720",null,"2","1","NA","NA"],
    [4563,"4563","Carrier J","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]","3645","0.96",null,null,"1.854224334","1440",null,"3645","2","NA","NA"],
    [4564,"4564","Carrier J","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","187","1",null,null,"0.342040998",null,null,"187",null,"NA","NA"],
    [4565,"4565","Carrier J","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate","102","0.99",null,"20.49277778","0.210775","4872","2","100","1","NA","NA"],
    [4566,"4566","Carrier J","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0108","W/C Component-Accessory Nos","26","0.27",null,"19.50730556","44.5256387",null,"1","25",null,"NA","NA"],
    [4567,"4567","Carrier J","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1399","Durable Medical Equipment Mi","26","0.27",null,null,"82.60064437",null,null,"26",null,"NA","NA"],
    [4568,"4568","Carrier J","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0747","Elec Osteogen Stim Not Spine","15","0.2",null,null,"142.5876372",null,null,"15",null,"NA","NA"],
    [4569,"4569","Carrier J","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2402","Negative pressure wound therapy electrical pump, stationary or portable","15","0.33",null,"3.796158334","117.8163427",null,"1","14",null,"NA","NA"],
    [4570,"4570","Carrier J","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0739","Repair/svc DME non-oxygen eq","13","0",null,null,"0.21648993",null,null,"13",null,"NA","NA"],
    [4571,"4571","Carrier J","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0760","Osteogen Ultrasound Stimltor","11","0.09",null,null,"96.55618687",null,null,"11",null,"NA","NA"],
    [4572,"4572","Carrier J","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0040","Adjustable Angle Footplate","10","0",null,null,"0.622384784",null,null,"10",null,"NA","NA"],
    [4573,"4573","Carrier J","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","187","1",null,null,"0.342040998",null,null,"187",null,"NA","NA"],
    [4574,"4574","Carrier J","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0861","PWC gp 3 std mult pow opt s/b","3","1",null,null,"23.04890343",null,null,"3",null,"NA","NA"],
    [4575,"4575","Carrier J","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0856","PWC gp 3 std sing pow opt s/b","1","1",null,null,null,null,null,"1",null,"NA","NA"],
    [4576,"4576","Carrier J","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate","102","0.99",null,"20.49277778","0.210775","4872","2","100","1","NA","NA"],
    [4577,"4577","Carrier J","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0601","Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]","3645","0.96",null,null,"1.854224334","1440",null,"3645","2","NA","NA"],
    [4578,"4578","Carrier J","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0748","Elec Osteogen Stim Spinal","5","0.6",null,null,"86.14078667",null,null,"5",null,"NA","NA"],
    [4579,"4579","Carrier J","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2599","Accessory for speech generating device, not otherwise classified","2","0.5",null,null,"10.0750157",null,null,"2",null,"NA","NA"],
    [4580,"4580","Carrier J","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2402","Negative pressure wound therapy electrical pump, stationary or portable","15","0.33",null,"3.796158334","117.8163427",null,"1","14",null,"NA","NA"],
    [4581,"4581","Carrier J","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0108","W/C Component-Accessory Nos","26","0.27",null,"19.50730556","44.5256387",null,"1","25",null,"NA","NA"],
    [4582,"4582","Carrier J","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1399","Durable Medical Equipment Mi","26","0.27",null,null,"82.60064437",null,null,"26",null,"NA","NA"],
    [4583,"4583","Carrier J","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0748","Elec Osteogen Stim Spinal","5",null,"0.2",null,"86.14078667",null,null,"5",null,"NA","NA"],
    [4584,"4584","Carrier J","2022","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0601","Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]","3645",null,"0",null,"1.854224334","1440",null,"3645","2","NA","NA"],
    [4585,"4585","Carrier J","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","84","0.96",null,null,"27.22983188","624",null,"84","1","NA","NA"],
    [4586,"4586","Carrier J","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9277","Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system","7","0",null,null,"0.800513849",null,null,"7",null,"NA","NA"],
    [4587,"4587","Carrier J","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4232","Syringe W/Needle Insulin 3cc","7","0",null,null,"11.98567639",null,null,"7",null,"NA","NA"],
    [4588,"4588","Carrier J","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9276","Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply","6","0",null,null,"0.919602732",null,null,"6",null,"NA","NA"],
    [4589,"4589","Carrier J","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4230","Infus Insulin Pump Non Needl","6","0",null,null,"13.35062761",null,null,"6",null,"NA","NA"],
    [4590,"4590","Carrier J","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4216","Sterile water/saline, 10 ml","5","0",null,null,"0.069804833",null,null,"5",null,"NA","NA"],
    [4591,"4591","Carrier J","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4253","Blood Glucose/Reagent Strips","1","0",null,null,"5.160955555",null,null,"1",null,"NA","NA"],
    [4592,"4592","Carrier J","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4231","Infusion Insulin Pump Needle","1","0",null,null,"0.005900002",null,null,"1",null,"NA","NA"],
    [4593,"4593","Carrier J","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","84","0.96",null,null,"27.22983188","624",null,"84","1","NA","NA"],
    [4594,"4594","Carrier J","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9277","Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system","7","0",null,null,"0.800513849",null,null,"7",null,"NA","NA"],
    [4595,"4595","Carrier J","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4232","Syringe W/Needle Insulin 3cc","7","0",null,null,"11.98567639",null,null,"7",null,"NA","NA"],
    [4596,"4596","Carrier J","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9276","Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply","6","0",null,null,"0.919602732",null,null,"6",null,"NA","NA"],
    [4597,"4597","Carrier J","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4230","Infus Insulin Pump Non Needl","6","0",null,null,"13.35062761",null,null,"6",null,"NA","NA"],
    [4598,"4598","Carrier J","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4216","Sterile water/saline, 10 ml","5","0",null,null,"0.069804833",null,null,"5",null,"NA","NA"],
    [4599,"4599","Carrier J","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4253","Blood Glucose/Reagent Strips","1","0",null,null,"5.160955555",null,null,"1",null,"NA","NA"],
    [4600,"4600","Carrier J","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4231","Infusion Insulin Pump Needle","1","0",null,null,"0.005900002",null,null,"1",null,"NA","NA"],
    [4601,"4601","Carrier J","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","673","0.777",null,"8.8","54",null,"170","503",null,"ADALIMUMAB","NA"],
    [4602,"4602","Carrier J","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","410","0.695",null,"10.8","46.3",null,"34","376",null,"CYCLOSPORINE (OPHTH)","NA"],
    [4603,"4603","Carrier J","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","353","0.011",null,"10.7","47.5",null,"154","199",null,"INSULIN GLARGINE","NA"],
    [4604,"4604","Carrier J","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","298","0.074",null,"14","51.6",null,"65","233",null,"TIRZEPATIDE","NA"],
    [4605,"4605","Carrier J","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","295","0.519",null,"9.8","134.8",null,"129","166",null,"OXYCODONE HCL","NA"],
    [4606,"4606","Carrier J","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","280","0.689",null,"22.4","92.8",null,"84","196",null,"GALCANEZUMAB-GNLM","NA"],
    [4607,"4607","Carrier J","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","277","0.534",null,"15.4","127.6",null,"90","187",null,"HYDROCODONE-ACETAMINOPHEN","NA"],
    [4608,"4608","Carrier J","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","266","0.331",null,"28.3","63.8",null,"51","215",null,"DUPILUMAB","NA"],
    [4609,"4609","Carrier J","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","245","0.004",null,"8.1","48.4",null,"44","201",null,"SEMAGLUTIDE","NA"],
    [4610,"4610","Carrier J","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","239","0.77",null,"8.4","34.1",null,"48","191",null,"ETANERCEPT","NA"],
    [4611,"4611","Carrier J","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,"1.7","34.7",null,"2","5",null,"TAFLUPROST","NA"],
    [4612,"4612","Carrier J","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","6","1",null,"8.2",null,null,"6","0",null,"OSIMERTINIB MESYLATE","NA"],
    [4613,"4613","Carrier J","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","5","1",null,"12.3","27.4",null,"4","1",null,"DABRAFENIB MESYLATE","NA"],
    [4614,"4614","Carrier J","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","5","1",null,"14.6","28.9",null,"1","4",null,"TERIPARATIDE (RECOMBINANT)","NA"],
    [4615,"4615","Carrier J","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","5","1",null,"1.8","69.4",null,"4","1",null,"IBRUTINIB","NA"],
    [4616,"4616","Carrier J","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","3","1",null,"10.8","2.9",null,"2","1",null,"ANAKINRA","NA"],
    [4617,"4617","Carrier J","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","2","1",null,"20.6",null,null,"2","0",null,"NINTEDANIB ESYLATE","NA"],
    [4618,"4618","Carrier J","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","2","1",null,"27.7",null,null,"2","0",null,"REGORAFENIB","NA"],
    [4619,"4619","Carrier J","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","2","1",null,null,"48.4",null,"0","2",null,"ABALOPARATIDE","NA"],
    [4620,"4620","Carrier J","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","1","1",null,null,"50.9",null,"0","1",null,"DEUCRAVACITINIB","NA"],
    [4621,"4621","Carrier J","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3",null,"1","22.5","24.5",null,"1","1",null,"ALPELISIB","NA"],
    [4622,"4622","Carrier J","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","7",null,"1","12.7",null,null,"2","0",null,"TRAMETINIB DIMETHYL SULFOXIDE","NA"],
    [4623,"4623","Carrier J","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3",null,"1",null,"154.1",null,"0","2",null,"INSULIN GLULISINE","NA"],
    [4624,"4624","Carrier J","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","31",null,"0.667","3.2","187.8",null,"1","1",null,"ABEMACICLIB","NA"],
    [4625,"4625","Carrier J","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","8",null,"0.667",null,"157.1",null,"0","2",null,"SARILUMAB","NA"],
    [4626,"4626","Carrier J","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","182",null,"0.5","2.9",null,null,"1","0",null,"RISANKIZUMAB-RZAA","NA"],
    [4627,"4627","Carrier J","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","134",null,"0.5","1.6","238.6",null,"1","1",null,"APREMILAST","NA"],
    [4628,"4628","Carrier J","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","32",null,"0.5","2.4",null,null,"1","0",null,"PALBOCICLIB","NA"],
    [4629,"4629","Carrier J","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","16",null,"0.5","15.9",null,null,"1","0",null,"INSULIN REGULAR (HUMAN)","NA"],
    [4630,"4630","Carrier J","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","12",null,"0.5",null,"150.1",null,"0","1",null,"SOFOSBUVIR-VELPATASVIR","NA"],
    [4631,"4631","Carrier I","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","69990","Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure)","5","0",null,null,"0.084813842",null,null,"5",null,"NA","NA"],
    [4632,"4632","Carrier I","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","5","1",null,null,"20.46583562",null,null,"5",null,"NA","NA"],
    [4633,"4633","Carrier I","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","J9100","Cytarabine Hcl 100 Mg Inj","4","0",null,null,"0.060605",null,null,"4",null,"NA","NA"],
    [4634,"4634","Carrier I","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","47135","Liver allotransplantation, orthotopic, partial or whole, from cadaver or living donor, any age","4","1",null,"2.43375","9.766398194",null,"2","2",null,"NA","NA"],
    [4635,"4635","Carrier I","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","61781","Stereotactic computer-assisted (navigational) procedure; cranial, intradural (List separately in addition to code for primary procedure)","4","0",null,null,"0.084285722",null,null,"4",null,"NA","NA"],
    [4636,"4636","Carrier I","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99223","Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.","3","0",null,"2.110233334","0.047420417",null,"1","2",null,"NA","NA"],
    [4637,"4637","Carrier I","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96415","Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary procedure)","3","0",null,"2.110233334","0.047501806",null,"1","2",null,"NA","NA"],
    [4638,"4638","Carrier I","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96413","Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug","3","0",null,"2.110233334","0.047449584",null,"1","2",null,"NA","NA"],
    [4639,"4639","Carrier I","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22633","Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar","3","1",null,null,"24.86217376",null,null,"3",null,"NA","NA"],
    [4640,"4640","Carrier I","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","3","1",null,null,"21.49393272",null,null,"3",null,"NA","NA"],
    [4641,"4641","Carrier I","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","61519","Craniectomy for excision of brain tumor, infratentorial or posterior fossa; meningioma","3","0",null,null,"0.082916389",null,null,"3",null,"NA","NA"],
    [4642,"4642","Carrier I","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","5","1",null,null,"20.46583562",null,null,"5",null,"NA","NA"],
    [4643,"4643","Carrier I","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","47135","Liver allotransplantation, orthotopic, partial or whole, from cadaver or living donor, any age","4","1",null,"2.43375","9.766398194",null,"2","2",null,"NA","NA"],
    [4644,"4644","Carrier I","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22633","Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar","3","1",null,null,"24.86217376",null,null,"3",null,"NA","NA"],
    [4645,"4645","Carrier I","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","3","1",null,null,"21.49393272",null,null,"3",null,"NA","NA"],
    [4646,"4646","Carrier I","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","49560","Repair initial incisional or ventral hernia; reducible","2","1",null,null,"121.2763403",null,null,"2",null,"NA","NA"],
    [4647,"4647","Carrier I","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22845","Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure)","2","1",null,null,"1.415037038",null,null,"2",null,"NA","NA"],
    [4648,"4648","Carrier I","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","38240","Hematopoietic progenitor cell (HPC); allogeneic transplantation per donor","1","1",null,"6.402222223",null,null,"1",null,null,"NA","NA"],
    [4649,"4649","Carrier I","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27132","Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft","1","1",null,null,"19.00441667",null,null,"1",null,"NA","NA"],
    [4650,"4650","Carrier I","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22558","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","1","1",null,null,"2.101027778",null,null,"1",null,"NA","NA"],
    [4651,"4651","Carrier I","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","38205","Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic","1","1",null,"6.402222223",null,null,"1",null,null,"NA","NA"],
    [4652,"4652","Carrier I","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44238","Unlisted laparoscopy procedure, intestine (except rectum)","1","1",null,null,"145.4329417",null,null,"1",null,"NA","NA"],
    [4653,"4653","Carrier I","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15769","Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia)","1","1",null,null,"1.174722223",null,null,"1",null,"NA","NA"],
    [4654,"4654","Carrier I","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22612","Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)","1","1",null,null,"2.101027778",null,null,"1",null,"NA","NA"],
    [4655,"4655","Carrier I","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","49654","Laparoscopy, surgical, repair, incisional hernia (includes mesh insertion, when performed); reducible","1","1",null,null,"14.82840278",null,null,"1",null,"NA","NA"],
    [4656,"4656","Carrier I","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22842","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)","1","1",null,null,"26.49525639",null,null,"1",null,"NA","NA"],
    [4657,"4657","Carrier I","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22614","Arthrodesis, posterior or posterolateral technique, single level; each additional vertebral segment (List separately in addition to code for primary procedure)","1","1",null,null,"26.49525639",null,null,"1",null,"NA","NA"],
    [4658,"4658","Carrier I","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63051","Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and non-segmental fixation devices [eg, wire, suture, mini-plates], when performed)","1","1",null,null,"0.043055556",null,null,"1",null,"NA","NA"],
    [4659,"4659","Carrier I","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63052","Laminectomy, facetectomy, or foraminotomy with lumbar decompression of spinal cord, cauda equina and/or nerve root during posterior interbody arthrodesis, single segment","1","1",null,null,"23.81538417",null,null,"1",null,"NA","NA"],
    [4660,"4660","Carrier I","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63030","Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar","1","1",null,null,"26.49525639",null,null,"1",null,"NA","NA"],
    [4661,"4661","Carrier I","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63045","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; cervical","1","1",null,null,"0.043055556",null,null,"1",null,"NA","NA"],
    [4662,"4662","Carrier I","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63047","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","1","1",null,null,"2.101027778",null,null,"1",null,"NA","NA"],
    [4663,"4663","Carrier I","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63048","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure)","1","1",null,null,"2.101027778",null,null,"1",null,"NA","NA"],
    [4664,"4664","Carrier I","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63200","Laminectomy, with release of tethered spinal cord, lumbar","1","1",null,"23.00301861",null,null,"1",null,null,"NA","NA"],
    [4665,"4665","Carrier I","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22551","Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2","1","1",null,null,"0.043055556",null,null,"1",null,"NA","NA"],
    [4666,"4666","Carrier I","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74176","CT abd & pelvis","186","0.91",null,null,"3.457180484","72",null,"186","1","NA","NA"],
    [4667,"4667","Carrier I","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","ECHO, transthoracic w/doppler, complete","185","0.93",null,null,"5.466368528",null,null,"185",null,"NA","NA"],
    [4668,"4668","Carrier I","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","MRI, lower extremity any joint; wo contr","168","0.74",null,null,"11.37845238",null,null,"168",null,"NA","NA"],
    [4669,"4669","Carrier I","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","MRI of brain and further sequences","135","0.93",null,null,"6.374585346","2016",null,"135","1","NA","NA"],
    [4670,"4670","Carrier I","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0399","Home sleep test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation","122","0.9",null,null,"4.890858175",null,null,"122",null,"NA","NA"],
    [4671,"4671","Carrier I","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72148","MRI of lumbar spine","115","0.79",null,null,"8.113943495","2400",null,"115","1","NA","NA"],
    [4672,"4672","Carrier I","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71250","DIAGNOSTIC CT THORAX W/O CNTRST","85","0.91",null,null,"3.865003087",null,null,"85",null,"NA","NA"],
    [4673,"4673","Carrier I","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73221","MRI, any joint of upper extremity; wo co","78","0.76",null,null,"11.34610776",null,null,"78",null,"NA","NA"],
    [4674,"4674","Carrier I","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70551","MRI of brain","66","0.85",null,null,"7.230772947",null,null,"66",null,"NA","NA"],
    [4675,"4675","Carrier I","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93307","ECHO, transthoracic, heart, complete","64","0.97",null,null,"10.20146032",null,null,"64",null,"NA","NA"],
    [4676,"4676","Carrier I","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71260","DIAGNOSTIC CT THORAX W/CONTRAST","64","0.95",null,null,"1.650824916",null,null,"64",null,"NA","NA"],
    [4677,"4677","Carrier I","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70491","Contrast CAT scan of neck tissue","19","1",null,null,"7.883347953",null,null,"19",null,"NA","NA"],
    [4678,"4678","Carrier I","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","74177","CT abd & pelv w contrast","17","1",null,null,"0.028070988",null,null,"17",null,"NA","NA"],
    [4679,"4679","Carrier I","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70544","MRA, head, w/o contrast","12","1",null,null,"5.519935897",null,null,"12",null,"NA","NA"],
    [4680,"4680","Carrier I","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72157","MRI of thoracic spine","11","1",null,null,"2.283383838","2016",null,"11","1","NA","NA"],
    [4681,"4681","Carrier I","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70543","MRI orb/fc/nck w/o cntrst flwd cntr","8","1",null,null,"15.97277778",null,null,"8",null,"NA","NA"],
    [4682,"4682","Carrier I","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","73223","MRI upr ext jnt w/o cntrst flwd cnt","7","1",null,null,"14.35349206",null,null,"7",null,"NA","NA"],
    [4683,"4683","Carrier I","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77301","Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications","7","1",null,"7.47025993","32.80474069",null,"5","2",null,"NA","NA"],
    [4684,"4684","Carrier I","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29827","Arthroscopy, shoulder, surgical; with rotator cuff repair","7","1",null,null,"8.094536684","2520",null,"7","1","NA","NA"],
    [4685,"4685","Carrier I","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","74181","MRI, abdomen; wo contrast material(s)","7","1",null,null,"11.34635417",null,null,"7",null,"NA","NA"],
    [4686,"4686","Carrier I","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64491","Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; second level (List separately in addition to code for primary procedure)","7","1",null,null,"4.021460039",null,null,"7",null,"NA","NA"],
    [4687,"4687","Carrier I","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29823","Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular si","7","1",null,null,"14.4030581",null,null,"7",null,"NA","NA"],
    [4688,"4688","Carrier I","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77338","Multi-leaf collimator (MLC) device(s) for intensity modulated radiation therapy (IMRT), design and construction per IMRT plan","7","1",null,"7.47025993","32.80474069",null,"5","2",null,"NA","NA"],
    [4689,"4689","Carrier I","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","93350","Stress ECHO exam of heart","25",null,"0.04",null,"17.4485",null,null,"25",null,"NA","NA"],
    [4690,"4690","Carrier I","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","77049","MRI breast bilateral C-/+ w/CAD","39",null,"0.03",null,"10.82368056",null,null,"39",null,"NA","NA"],
    [4691,"4691","Carrier I","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","73221","MRI, any joint of upper extremity; wo co","78",null,"0.01",null,"11.34610776",null,null,"78",null,"NA","NA"],
    [4692,"4692","Carrier I","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","70553","MRI of brain and further sequences","135",null,"0.01",null,"6.374585346","2016",null,"135","1","NA","NA"],
    [4693,"4693","Carrier I","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","73721","MRI, lower extremity any joint; wo contr","168",null,"0.01",null,"11.37845238",null,null,"168",null,"NA","NA"],
    [4694,"4694","Carrier I","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1002","Residential treatment, Substance Use Disorder","18","1",null,null,"31.55648576",null,null,"18",null,"NA","NA"],
    [4695,"4695","Carrier I","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1001","Residential treatment, Psychiatric","5","1",null,null,"63.93583333",null,null,"5",null,"NA","NA"],
    [4696,"4696","Carrier I","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","Room and board, Semi-Private, Psychiatric","3","1",null,"1.971944445","12.63392264",null,"1","2",null,"NA","NA"],
    [4697,"4697","Carrier I","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1002","Residential treatment, Substance Use Disorder","18","1",null,null,"31.55648576",null,null,"18",null,"NA","NA"],
    [4698,"4698","Carrier I","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1001","Residential treatment, Psychiatric","5","1",null,null,"63.93583333",null,null,"5",null,"NA","NA"],
    [4699,"4699","Carrier I","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","Room and board, Semi-Private, Psychiatric","3","1",null,"1.971944445","12.63392264",null,"1","2",null,"NA","NA"],
    [4700,"4700","Carrier I","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","12","1",null,null,"83.13438671",null,null,"12",null,"NA","NA"],
    [4701,"4701","Carrier I","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H2036","Alcohol and/or other drug treatment program, per diem","11","1",null,null,"26.97784694",null,null,"11",null,"NA","NA"],
    [4702,"4702","Carrier I","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19350","Nipple/areola reconstruction","6","1",null,null,"18.36854273",null,null,"6",null,"NA","NA"],
    [4703,"4703","Carrier I","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19303","Mastectomy, simple, complete","6","1",null,null,"18.36854213",null,null,"6",null,"NA","NA"],
    [4704,"4704","Carrier I","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","5","1",null,"25.58472222","12.44678222",null,"1","4",null,"NA","NA"],
    [4705,"4705","Carrier I","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","5","1",null,"25.58472222","12.44678222",null,"1","4",null,"NA","NA"],
    [4706,"4706","Carrier I","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","5","1",null,"25.58472222","12.44678104",null,"1","4",null,"NA","NA"],
    [4707,"4707","Carrier I","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours","5","0.8",null,null,"36.59735794",null,null,"5",null,"NA","NA"],
    [4708,"4708","Carrier I","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","MRI of brain and further sequences","4","1",null,null,"0.000208333",null,null,"4",null,"NA","NA"],
    [4709,"4709","Carrier I","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71271","Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)","2","1",null,null,"0.000277776",null,null,"2",null,"NA","NA"],
    [4710,"4710","Carrier I","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","17999","Unlisted procedure, skin, mucous membrane and subcutaneous tissue","2","0.5",null,null,"45.86353792",null,null,"2",null,"NA","NA"],
    [4711,"4711","Carrier I","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19318","Breast reduction","2","1",null,null,"123.1842619",null,null,"2",null,"NA","NA"],
    [4712,"4712","Carrier I","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","12","1",null,null,"83.13438671",null,null,"12",null,"NA","NA"],
    [4713,"4713","Carrier I","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H2036","Alcohol and/or other drug treatment program, per diem","11","1",null,null,"26.97784694",null,null,"11",null,"NA","NA"],
    [4714,"4714","Carrier I","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19350","Nipple/areola reconstruction","6","1",null,null,"18.36854273",null,null,"6",null,"NA","NA"],
    [4715,"4715","Carrier I","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19303","Mastectomy, simple, complete","6","1",null,null,"18.36854213",null,null,"6",null,"NA","NA"],
    [4716,"4716","Carrier I","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","5","1",null,"25.58472222","12.44678222",null,"1","4",null,"NA","NA"],
    [4717,"4717","Carrier I","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","5","1",null,"25.58472222","12.44678222",null,"1","4",null,"NA","NA"],
    [4718,"4718","Carrier I","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","5","1",null,"25.58472222","12.44678104",null,"1","4",null,"NA","NA"],
    [4719,"4719","Carrier I","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70553","MRI of brain and further sequences","4","1",null,null,"0.000208333",null,null,"4",null,"NA","NA"],
    [4720,"4720","Carrier I","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","71271","Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)","2","1",null,null,"0.000277776",null,null,"2",null,"NA","NA"],
    [4721,"4721","Carrier I","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19318","Breast reduction","2","1",null,null,"123.1842619",null,null,"2",null,"NA","NA"],
    [4722,"4722","Carrier I","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]","281","0.95",null,null,"1.995146947",null,null,"281",null,"NA","NA"],
    [4723,"4723","Carrier I","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","19","0.89",null,null,"6.461608187",null,null,"19",null,"NA","NA"],
    [4724,"4724","Carrier I","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0108","W/C Component-Accessory Nos","5","0.4",null,null,"81.35809017",null,null,"5",null,"NA","NA"],
    [4725,"4725","Carrier I","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate","4","1",null,null,"0.000138889",null,null,"4",null,"NA","NA"],
    [4726,"4726","Carrier I","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0960","Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","3","0",null,null,"23.18757065",null,null,"3",null,"NA","NA"],
    [4727,"4727","Carrier I","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0739","Repair/svc DME non-oxygen eq","3","0",null,null,"21.67603333",null,null,"3",null,"NA","NA"],
    [4728,"4728","Carrier I","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0955","Wheelchair accessory, headrest, cushioned, prefabricated, including fixed mounting hardware, each","3","0",null,null,"23.18753028",null,null,"3",null,"NA","NA"],
    [4729,"4729","Carrier I","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1399","Durable Medical Equipment Mi","3","0",null,"40.84433056","61.47392361",null,"1","2",null,"NA","NA"],
    [4730,"4730","Carrier I","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2607","Skin pro/pos wc cus wd <22in","2","0",null,null,"32.47239861",null,null,"2",null,"NA","NA"],
    [4731,"4731","Carrier I","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2620","WC planar back cush wd <22in","2","0",null,null,"0.044263472",null,null,"2",null,"NA","NA"],
    [4732,"4732","Carrier I","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0978","Wheelchair Belt W/Airplane B","2","0",null,null,"34.77837083",null,null,"2",null,"NA","NA"],
    [4733,"4733","Carrier I","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1028","Wheelchair accessory, manual swingaway, retractable or removable mounting hardware","2","0",null,null,"32.47245278",null,null,"2",null,"NA","NA"],
    [4734,"4734","Carrier I","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate","4","1",null,null,"0.000138889",null,null,"4",null,"NA","NA"],
    [4735,"4735","Carrier I","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0760","Osteogen Ultrasound Stimltor","1","1",null,null,"133.9513889",null,null,"1",null,"NA","NA"],
    [4736,"4736","Carrier I","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0601","Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]","281","0.95",null,null,"1.995146947",null,null,"281",null,"NA","NA"],
    [4737,"4737","Carrier I","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","19","0.89",null,null,"6.461608187",null,null,"19",null,"NA","NA"],
    [4738,"4738","Carrier I","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0108","W/C Component-Accessory Nos","5","0.4",null,null,"81.35809017",null,null,"5",null,"NA","NA"],
    [4739,"4739","Carrier I","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0960","Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","3","0",null,null,"23.18757065",null,null,"3",null,"NA","NA"],
    [4740,"4740","Carrier I","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0739","Repair/svc DME non-oxygen eq","3","0",null,null,"21.67603333",null,null,"3",null,"NA","NA"],
    [4741,"4741","Carrier I","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0955","Wheelchair accessory, headrest, cushioned, prefabricated, including fixed mounting hardware, each","3","0",null,null,"23.18753028",null,null,"3",null,"NA","NA"],
    [4742,"4742","Carrier I","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1399","Durable Medical Equipment Mi","3","0",null,"40.84433056","61.47392361",null,"1","2",null,"NA","NA"],
    [4743,"4743","Carrier I","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2607","Skin pro/pos wc cus wd <22in","2","0",null,null,"32.47239861",null,null,"2",null,"NA","NA"],
    [4744,"4744","Carrier I","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2620","WC planar back cush wd <22in","2","0",null,null,"0.044263472",null,null,"2",null,"NA","NA"],
    [4745,"4745","Carrier I","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0978","Wheelchair Belt W/Airplane B","2","0",null,null,"34.77837083",null,null,"2",null,"NA","NA"],
    [4746,"4746","Carrier I","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1028","Wheelchair accessory, manual swingaway, retractable or removable mounting hardware","2","0",null,null,"32.47245278",null,null,"2",null,"NA","NA"],
    [4747,"4747","Carrier I","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","12","0.58",null,"0.614080555","26.50367164",null,"1","11",null,"NA","NA"],
    [4748,"4748","Carrier I","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","12","0.58",null,"0.614080555","26.50367164",null,"1","11",null,"NA","NA"],
    [4749,"4749","Carrier I","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","39","0.846",null,"2.1","60.7",null,"9","30",null,"ADALIMUMAB","NA"],
    [4750,"4750","Carrier I","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","26","0",null,"3.8","13.6",null,"5","21",null,"RIMEGEPANT SULFATE","NA"],
    [4751,"4751","Carrier I","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","25","0.8",null,"2","128",null,"1","24",null,"CYCLOSPORINE (OPHTH)","NA"],
    [4752,"4752","Carrier I","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","21","0.857",null,"5.8","36.1",null,"5","16",null,"ETANERCEPT","NA"],
    [4753,"4753","Carrier I","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","20","0.25",null,"21.2","45.2",null,"9","11",null,"RIFAXIMIN","NA"],
    [4754,"4754","Carrier I","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","20","0.6",null,"6.2","554.9",null,"3","17",null,"RISANKIZUMAB-RZAA","NA"],
    [4755,"4755","Carrier I","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","18","0.278",null,"21.6","36.2",null,"4","14",null,"DUPILUMAB","NA"],
    [4756,"4756","Carrier I","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","18","0.5",null,"23.9","142",null,"7","11",null,"HYDROCODONE-ACETAMINOPHEN","NA"],
    [4757,"4757","Carrier I","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","17","0.706",null,"45.2","52.5",null,"1","16",null,"GALCANEZUMAB-GNLM","NA"],
    [4758,"4758","Carrier I","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","16","0",null,"1.1","12.3",null,"1","15",null,"UBROGEPANT","NA"],
    [4759,"4759","Carrier I","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,null,"40.1",null,"0","8",null,"LIFITEGRAST","NA"],
    [4760,"4760","Carrier I","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","6","1",null,null,"13.5",null,"0","6",null,"GUSELKUMAB","NA"],
    [4761,"4761","Carrier I","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","3","1",null,"9.7","25.8",null,"2","1",null,"MORPHINE SULFATE","NA"],
    [4762,"4762","Carrier I","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","3","1",null,null,"56",null,"0","3",null,"LEVALBUTEROL TARTRATE","NA"],
    [4763,"4763","Carrier I","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","3","1",null,null,"41.1",null,"0","3",null,"ELEXACAFTOR-TEZACAFTOR-IVACAFTOR","NA"],
    [4764,"4764","Carrier I","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","2","1",null,"2.2","66.6",null,"1","1",null,"HYDROCODONE BITARTRATE","NA"],
    [4765,"4765","Carrier I","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","2","1",null,null,"613.9",null,"0","2",null,"TERIPARATIDE (RECOMBINANT)","NA"],
    [4766,"4766","Carrier I","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","2","1",null,null,"23.3",null,"0","2",null,"ALIROCUMAB","NA"],
    [4767,"4767","Carrier I","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","1","1",null,null,"64.6",null,"0","1",null,"TUCATINIB","NA"],
    [4768,"4768","Carrier I","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","1","1",null,null,"45.2",null,"0","1",null,"FENTANYL","NA"],
    [4769,"4769","Carrier I","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3",null,"1","19.5",null,null,"1","0",null,"TOCILIZUMAB","NA"],
    [4770,"4770","Carrier I","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1","44.2",null,null,"1","0",null,"IVABRADINE HCL","NA"],
    [4771,"4771","Carrier I","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"0.5","2.2",null,null,"1","0",null,"ABEMACICLIB","NA"],
    [4772,"4772","Carrier I","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","17",null,"0.25","2.2",null,null,"1","0",null,"GALCANEZUMAB-GNLM","NA"],
    [4773,"4773","Carrier I","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","18",null,"0.2",null,"24.3",null,"0","1",null,"HYDROCODONE-ACETAMINOPHEN","NA"],
    [4774,"4774","Carrier I","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","20",null,"0.1",null,"329.7",null,"0","1",null,"RIFAXIMIN","NA"],
    [4775,"4775","Carrier A","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","7","0.71",null,"2.791348054","70.39001822",null,"1","6",null,"NA","NA"],
    [4776,"4776","Carrier A","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","7","0.86",null,"2.791348054","111.0486359",null,"1","6",null,"NA","NA"],
    [4777,"4777","Carrier A","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","6","0.83",null,"2.791348054","77.45881962",null,"1","5",null,"NA","NA"],
    [4778,"4778","Carrier A","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63047","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","5","1",null,"2.791348054","117.0430522",null,"1","4",null,"NA","NA"],
    [4779,"4779","Carrier A","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22612","Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)","5","1",null,"2.791348054","78.1373829",null,"1","4",null,"NA","NA"],
    [4780,"4780","Carrier A","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","55866","Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed","4","0",null,null,"18.41237042",null,null,"4",null,"NA","NA"],
    [4781,"4781","Carrier A","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44620","Closure of enterostomy, large or small intestine;","4","0",null,"0.0869125","0.7616",null,"2","2",null,"NA","NA"],
    [4782,"4782","Carrier A","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22802","Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 vertebral segments","3","0.67",null,null,"69.37639917",null,null,"3",null,"NA","NA"],
    [4783,"4783","Carrier A","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S2068","Breast DIEP flag reconstruct","3","0",null,"0.086522222","0.785751388",null,"1","2",null,"NA","NA"],
    [4784,"4784","Carrier A","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","11971","Removal of tissue expander without insertion of implant","3","0",null,"0.0866175","0.788512082",null,"1","2",null,"NA","NA"],
    [4785,"4785","Carrier A","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43280","Laparoscopy, surgical, esophagogastric fundoplasty (eg, Nissen, Toupet procedures)","3","0.67",null,null,"139.3575947",null,null,"3",null,"NA","NA"],
    [4786,"4786","Carrier A","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","49000","Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure)","3","0",null,"0.080127778","0.764777778",null,"1","2",null,"NA","NA"],
    [4787,"4787","Carrier A","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22842","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)","3","0.67",null,null,"49.1706165",null,null,"3",null,"NA","NA"],
    [4788,"4788","Carrier A","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","49568","Implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection (List separately in addition to code for the incisional or ventral hernia repair)","3","0",null,"0.086561112","0.78579861",null,"1","2",null,"NA","NA"],
    [4789,"4789","Carrier A","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63047","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","5","1",null,"2.791348054","117.0430522",null,"1","4",null,"NA","NA"],
    [4790,"4790","Carrier A","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22612","Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)","5","1",null,"2.791348054","78.1373829",null,"1","4",null,"NA","NA"],
    [4791,"4791","Carrier A","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","20931","Allograft, structural, for spine surgery only (List separately in addition to code for primary procedure)","2","1",null,"2.791348054","289.3120186",null,"1","1",null,"NA","NA"],
    [4792,"4792","Carrier A","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27486","Revision of total knee arthroplasty, with or without allograft; 1 component","1","1",null,null,"115.2717814",null,null,"1",null,"NA","NA"],
    [4793,"4793","Carrier A","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27487","Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component","1","1",null,null,"115.2717814",null,null,"1",null,"NA","NA"],
    [4794,"4794","Carrier A","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","37215","Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; with distal embolic protection","1","1",null,null,"0.694999999",null,null,"1",null,"NA","NA"],
    [4795,"4795","Carrier A","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63030","Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar","1","1",null,null,"93.06694444",null,null,"1",null,"NA","NA"],
    [4796,"4796","Carrier A","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22610","Arthrodesis, posterior or posterolateral technique, single level; thoracic (with lateral transverse technique, when performed)","1","1",null,null,"97.46275917",null,null,"1",null,"NA","NA"],
    [4797,"4797","Carrier A","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22633","Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar","1","1",null,null,"289.3120186",null,null,"1",null,"NA","NA"],
    [4798,"4798","Carrier A","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63001","Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; cervical","1","1",null,null,"103.8729481",null,null,"1",null,"NA","NA"],
    [4799,"4799","Carrier A","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63045","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; cervical","1","1",null,null,"0.138055555",null,null,"1",null,"NA","NA"],
    [4800,"4800","Carrier A","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63048","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure)","1","1",null,null,"289.3120186",null,null,"1",null,"NA","NA"],
    [4801,"4801","Carrier A","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22830","Exploration of spinal fusion","1","1",null,null,"97.46275917",null,null,"1",null,"NA","NA"],
    [4802,"4802","Carrier A","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","47370","Laparoscopy, surgical, ablation of 1 or more liver tumor(s); radiofrequency","1","1",null,null,"0.015",null,null,"1",null,"NA","NA"],
    [4803,"4803","Carrier A","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22843","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in addition to code for primary procedure)","1","1",null,null,"101.6552175",null,null,"1",null,"NA","NA"],
    [4804,"4804","Carrier A","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","49565","Repair recurrent incisional or ventral hernia; reducible","1","1",null,null,"18.58944444",null,null,"1",null,"NA","NA"],
    [4805,"4805","Carrier A","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63051","Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and non-segmental fixation devices [eg, wire, suture, mini-plates], when performed)","1","1",null,null,"0.138055555",null,null,"1",null,"NA","NA"],
    [4806,"4806","Carrier A","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","376","0.7",null,null,"16.8683212","840",null,"376","2","NA","NA"],
    [4807,"4807","Carrier A","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97140","Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes","371","0.71",null,null,"16.56013626","960",null,"371","1","NA","NA"],
    [4808,"4808","Carrier A","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97530","Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","275","0.67",null,null,"19.31818752","720",null,"275","1","NA","NA"],
    [4809,"4809","Carrier A","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","ECHO, transthoracic w/doppler, complete","263","0.9",null,null,"7.545336257","4536",null,"263","1","NA","NA"],
    [4810,"4810","Carrier A","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97112","Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities","236","0.63",null,null,"19.74551118","720",null,"236","1","NA","NA"],
    [4811,"4811","Carrier A","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","MRI, lower extremity any joint; wo contr","235","0.89",null,"20.66222222","5.891002268","960","1","234","1","NA","NA"],
    [4812,"4812","Carrier A","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74176","CT abd & pelvis","217","0.92",null,"0.072777778","6.737107843","1632","1","216","1","NA","NA"],
    [4813,"4813","Carrier A","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72148","MRI of lumbar spine","151","0.84",null,null,"8.820283224",null,null,"151",null,"NA","NA"],
    [4814,"4814","Carrier A","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","MRI of brain and further sequences","136","0.95",null,null,"4.436449716",null,null,"136",null,"NA","NA"],
    [4815,"4815","Carrier A","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0399","Home sleep test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation","135","0.97",null,null,"4.253513072",null,null,"135",null,"NA","NA"],
    [4816,"4816","Carrier A","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72156","MRI of cervical spine","28","1",null,null,"1.575935185",null,null,"28",null,"NA","NA"],
    [4817,"4817","Carrier A","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72157","MRI of thoracic spine","17","1",null,null,"0.037679739",null,null,"17",null,"NA","NA"],
    [4818,"4818","Carrier A","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93303","ECHO, transthoracic, complete cng","16","1",null,null,"2.667864584",null,null,"16",null,"NA","NA"],
    [4819,"4819","Carrier A","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29823","Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular si","15","1",null,null,"57.91622694",null,null,"15",null,"NA","NA"],
    [4820,"4820","Carrier A","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81162","BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, detection of large gene rearrangements)","11","1",null,null,"18.944518",null,null,"11",null,"NA","NA"],
    [4821,"4821","Carrier A","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77338","Multi-leaf collimator (MLC) device(s) for intensity modulated radiation therapy (IMRT), design and construction per IMRT plan","11","1",null,"0.985416666","7.284476667",null,"2","9",null,"NA","NA"],
    [4822,"4822","Carrier A","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77301","Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications","10","1",null,"0.985277778","7.874306945",null,"2","8",null,"NA","NA"],
    [4823,"4823","Carrier A","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70480","CT, orbit, sella or pos fos wo contrast","10","1",null,null,"1.978555555",null,null,"10",null,"NA","NA"],
    [4824,"4824","Carrier A","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70498","CTA, neck, w/o cntrst flwd by cntrst","10","1",null,null,"3.707416667",null,null,"10",null,"NA","NA"],
    [4825,"4825","Carrier A","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70543","MRI orb/fc/nck w/o cntrst flwd cntr","10","1",null,null,"6.893388889",null,null,"10",null,"NA","NA"],
    [4826,"4826","Carrier A","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L8614","Cochlear implant system","1",null,"1",null,"674.5363889",null,null,"1",null,"NA","NA"],
    [4827,"4827","Carrier A","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","69930","Cochlear device implantation, with or without mastoidectomy","1",null,"1",null,"674.5363889",null,null,"1",null,"NA","NA"],
    [4828,"4828","Carrier A","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","73721","MRI, lower extremity any joint; wo contr","235",null,"0.01","20.66222222","5.891002268","960","1","234","1","NA","NA"],
    [4829,"4829","Carrier A","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","72148","MRI of lumbar spine","151",null,"0.01",null,"8.820283224",null,null,"151",null,"NA","NA"],
    [4830,"4830","Carrier A","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1002","Residential treatment, Substance Use Disorder","3","1",null,null,"31.80842593",null,null,"3",null,"NA","NA"],
    [4831,"4831","Carrier A","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0011","Alcohol And/Or Drug Services","1","0",null,null,"11.98046111",null,null,"1",null,"NA","NA"],
    [4832,"4832","Carrier A","2022","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1001","Residential treatment, Psychiatric","1","0",null,null,"138.8416667",null,null,"1",null,"NA","NA"],
    [4833,"4833","Carrier A","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1002","Residential treatment, Substance Use Disorder","3","1",null,null,"31.80842593",null,null,"3",null,"NA","NA"],
    [4834,"4834","Carrier A","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0011","Alcohol And/Or Drug Services","1","0",null,null,"11.98046111",null,null,"1",null,"NA","NA"],
    [4835,"4835","Carrier A","2022","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1001","Residential treatment, Psychiatric","1","0",null,null,"138.8416667",null,null,"1",null,"NA","NA"],
    [4836,"4836","Carrier A","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71271","Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)","32","0.88",null,null,"4.858012153",null,null,"32",null,"NA","NA"],
    [4837,"4837","Carrier A","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","92507","Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual","15","0.6",null,null,"30.65467244",null,null,"15",null,"NA","NA"],
    [4838,"4838","Carrier A","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","8","0.88",null,"20.65861028","9.896249603",null,"1","7",null,"NA","NA"],
    [4839,"4839","Carrier A","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70551","MRI of brain","4","0.75",null,null,"12.01145833",null,null,"4",null,"NA","NA"],
    [4840,"4840","Carrier A","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","4","0.5",null,"42.90027778","56.57980991",null,"1","3",null,"NA","NA"],
    [4841,"4841","Carrier A","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","4","0.5",null,"42.90027778","56.5799025",null,"1","3",null,"NA","NA"],
    [4842,"4842","Carrier A","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","3","0.67",null,"42.90027778","23.61735375",null,"1","2",null,"NA","NA"],
    [4843,"4843","Carrier A","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours","3","1",null,null,"44.39453704",null,null,"3",null,"NA","NA"],
    [4844,"4844","Carrier A","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90834","Psychotherapy, 45 minutes with patient","2","0",null,null,"25.08706903",null,null,"2",null,"NA","NA"],
    [4845,"4845","Carrier A","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97530","Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","2","1",null,null,"44.20490278",null,null,"2",null,"NA","NA"],
    [4846,"4846","Carrier A","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H2036","Alcohol and/or other drug treatment program, per diem","2","1",null,"14.23416667","14.68944444",null,"1","1",null,"NA","NA"],
    [4847,"4847","Carrier A","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90853","Group psychotherapy (other than of a multiple-family group)","2","0",null,null,"25.08706903",null,null,"2",null,"NA","NA"],
    [4848,"4848","Carrier A","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90847","Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes","2","0",null,null,"25.08706903",null,null,"2",null,"NA","NA"],
    [4849,"4849","Carrier A","2022","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97113","Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises","2","1",null,null,"44.20490278",null,null,"2",null,"NA","NA"],
    [4850,"4850","Carrier A","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0035","Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours","3","1",null,null,"44.39453704",null,null,"3",null,"NA","NA"],
    [4851,"4851","Carrier A","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97530","Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","2","1",null,null,"44.20490278",null,null,"2",null,"NA","NA"],
    [4852,"4852","Carrier A","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H2036","Alcohol and/or other drug treatment program, per diem","2","1",null,"14.23416667","14.68944444",null,"1","1",null,"NA","NA"],
    [4853,"4853","Carrier A","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97113","Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises","2","1",null,null,"44.20490278",null,null,"2",null,"NA","NA"],
    [4854,"4854","Carrier A","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S9131","Physical therapy, in the home, per diem","1","1",null,null,"0.442930555",null,null,"1",null,"NA","NA"],
    [4855,"4855","Carrier A","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70450","CT, head or brain wo contrast","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [4856,"4856","Carrier A","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","71271","Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)","32","0.88",null,null,"4.858012153",null,null,"32",null,"NA","NA"],
    [4857,"4857","Carrier A","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","8","0.88",null,"20.65861028","9.896249603",null,"1","7",null,"NA","NA"],
    [4858,"4858","Carrier A","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70551","MRI of brain","4","0.75",null,null,"12.01145833",null,null,"4",null,"NA","NA"],
    [4859,"4859","Carrier A","2022","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","3","0.67",null,"42.90027778","23.61735375",null,"1","2",null,"NA","NA"],
    [4860,"4860","Carrier A","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]","245","0.94",null,null,"2.69965873",null,null,"245",null,"NA","NA"],
    [4861,"4861","Carrier A","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","14","1",null,null,"0.041626984",null,null,"14",null,"NA","NA"],
    [4862,"4862","Carrier A","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate","8","0.88",null,null,"3.344930555",null,null,"8",null,"NA","NA"],
    [4863,"4863","Carrier A","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2402","Negative pressure wound therapy electrical pump, stationary or portable","5","0.4",null,null,"68.2403285",null,null,"5",null,"NA","NA"],
    [4864,"4864","Carrier A","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0748","Elec Osteogen Stim Spinal","4","0.5",null,null,"40.2791625",null,null,"4",null,"NA","NA"],
    [4865,"4865","Carrier A","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1399","Durable Medical Equipment Mi","3","0",null,null,"130.2526389",null,null,"3",null,"NA","NA"],
    [4866,"4866","Carrier A","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0108","W/C Component-Accessory Nos","3","0",null,null,"52.96021167",null,null,"3",null,"NA","NA"],
    [4867,"4867","Carrier A","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0747","Elec Osteogen Stim Not Spine","3","0",null,null,"48.99296296",null,null,"3",null,"NA","NA"],
    [4868,"4868","Carrier A","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0760","Osteogen Ultrasound Stimltor","3","0",null,null,"129.1766667",null,null,"3",null,"NA","NA"],
    [4869,"4869","Carrier A","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0040","Adjustable Angle Footplate","2","0",null,null,"2.362090834",null,null,"2",null,"NA","NA"],
    [4870,"4870","Carrier A","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0971","Wheelchair Anti-Tipping Devi","2","0",null,null,"2.362090834",null,null,"2",null,"NA","NA"],
    [4871,"4871","Carrier A","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0961","Wheelchair Brake Extension","2","0",null,null,"2.362090834",null,null,"2",null,"NA","NA"],
    [4872,"4872","Carrier A","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0978","Wheelchair Belt W/Airplane B","2","0",null,null,"2.362368611",null,null,"2",null,"NA","NA"],
    [4873,"4873","Carrier A","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0637","Combination sit to stand system, any size, with seat lift feature, with or without wheels","2","0",null,null,"3.269207362",null,null,"2",null,"NA","NA"],
    [4874,"4874","Carrier A","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0955","Wheelchair accessory, headrest, cushioned, prefabricated, including fixed mounting hardware, each","2","0",null,null,"2.362368611",null,null,"2",null,"NA","NA"],
    [4875,"4875","Carrier A","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1028","Wheelchair accessory, manual swingaway, retractable or removable mounting hardware","2","0",null,null,"2.362229723",null,null,"2",null,"NA","NA"],
    [4876,"4876","Carrier A","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","14","1",null,null,"0.041626984",null,null,"14",null,"NA","NA"],
    [4877,"4877","Carrier A","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0601","Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]","245","0.94",null,null,"2.69965873",null,null,"245",null,"NA","NA"],
    [4878,"4878","Carrier A","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate","8","0.88",null,null,"3.344930555",null,null,"8",null,"NA","NA"],
    [4879,"4879","Carrier A","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0748","Elec Osteogen Stim Spinal","4","0.5",null,null,"40.2791625",null,null,"4",null,"NA","NA"],
    [4880,"4880","Carrier A","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2402","Negative pressure wound therapy electrical pump, stationary or portable","5","0.4",null,null,"68.2403285",null,null,"5",null,"NA","NA"],
    [4881,"4881","Carrier A","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1399","Durable Medical Equipment Mi","3","0",null,null,"130.2526389",null,null,"3",null,"NA","NA"],
    [4882,"4882","Carrier A","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0108","W/C Component-Accessory Nos","3","0",null,null,"52.96021167",null,null,"3",null,"NA","NA"],
    [4883,"4883","Carrier A","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0747","Elec Osteogen Stim Not Spine","3","0",null,null,"48.99296296",null,null,"3",null,"NA","NA"],
    [4884,"4884","Carrier A","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0760","Osteogen Ultrasound Stimltor","3","0",null,null,"129.1766667",null,null,"3",null,"NA","NA"],
    [4885,"4885","Carrier A","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0040","Adjustable Angle Footplate","2","0",null,null,"2.362090834",null,null,"2",null,"NA","NA"],
    [4886,"4886","Carrier A","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0971","Wheelchair Anti-Tipping Devi","2","0",null,null,"2.362090834",null,null,"2",null,"NA","NA"],
    [4887,"4887","Carrier A","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0961","Wheelchair Brake Extension","2","0",null,null,"2.362090834",null,null,"2",null,"NA","NA"],
    [4888,"4888","Carrier A","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0978","Wheelchair Belt W/Airplane B","2","0",null,null,"2.362368611",null,null,"2",null,"NA","NA"],
    [4889,"4889","Carrier A","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0637","Combination sit to stand system, any size, with seat lift feature, with or without wheels","2","0",null,null,"3.269207362",null,null,"2",null,"NA","NA"],
    [4890,"4890","Carrier A","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0955","Wheelchair accessory, headrest, cushioned, prefabricated, including fixed mounting hardware, each","2","0",null,null,"2.362368611",null,null,"2",null,"NA","NA"],
    [4891,"4891","Carrier A","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1028","Wheelchair accessory, manual swingaway, retractable or removable mounting hardware","2","0",null,null,"2.362229723",null,null,"2",null,"NA","NA"],
    [4892,"4892","Carrier A","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","10","1",null,null,"14.01482231",null,null,"10",null,"NA","NA"],
    [4893,"4893","Carrier A","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4230","Infus Insulin Pump Non Needl","3","0",null,null,"1.194520648",null,null,"3",null,"NA","NA"],
    [4894,"4894","Carrier A","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4232","Syringe W/Needle Insulin 3cc","3","0",null,null,"1.194530834",null,null,"3",null,"NA","NA"],
    [4895,"4895","Carrier A","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9277","Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system","2","0",null,null,"0.086330557",null,null,"2",null,"NA","NA"],
    [4896,"4896","Carrier A","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9276","Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply","2","0",null,null,"0.086365278",null,null,"2",null,"NA","NA"],
    [4897,"4897","Carrier A","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","10","1",null,null,"14.01482231",null,null,"10",null,"NA","NA"],
    [4898,"4898","Carrier A","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4230","Infus Insulin Pump Non Needl","3","0",null,null,"1.194520648",null,null,"3",null,"NA","NA"],
    [4899,"4899","Carrier A","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4232","Syringe W/Needle Insulin 3cc","3","0",null,null,"1.194530834",null,null,"3",null,"NA","NA"],
    [4900,"4900","Carrier A","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9277","Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system","2","0",null,null,"0.086330557",null,null,"2",null,"NA","NA"],
    [4901,"4901","Carrier A","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9276","Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply","2","0",null,null,"0.086365278",null,null,"2",null,"NA","NA"],
    [4902,"4902","Carrier A","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","68","0.853",null,"12.6","39.2",null,"8","60",null,"ADALIMUMAB","NA"],
    [4903,"4903","Carrier A","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","50","0.68",null,"25","33.6",null,"3","47",null,"CYCLOSPORINE (OPHTH)","NA"],
    [4904,"4904","Carrier A","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","47","0.851",null,"9.2","26.6",null,"20","27",null,"INSULIN GLARGINE","NA"],
    [4905,"4905","Carrier A","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","31","0.581",null,"9.9","54.2",null,"5","26",null,"HYDROCODONE-ACETAMINOPHEN","NA"],
    [4906,"4906","Carrier A","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","27","0.704",null,"5.7","136.1",null,"15","12",null,"OXYCODONE W/ ACETAMINOPHEN","NA"],
    [4907,"4907","Carrier A","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","25","0.32",null,"10.5","98.4",null,"3","22",null,"EVOLOCUMAB","NA"],
    [4908,"4908","Carrier A","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","25","0",null,"22.7","48.4",null,"1","24",null,"TIRZEPATIDE","NA"],
    [4909,"4909","Carrier A","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","24","0.75",null,"13.2","63.2",null,"4","20",null,"GALCANEZUMAB-GNLM","NA"],
    [4910,"4910","Carrier A","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","24","0.708",null,"1.4","34.4",null,"4","20",null,"ETANERCEPT","NA"],
    [4911,"4911","Carrier A","2022","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","22","0.273",null,"38.8","22.9",null,"6","16",null,"DUPILUMAB","NA"],
    [4912,"4912","Carrier A","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","4","1",null,"2.9","23.6",null,"1","3",null,"FENTANYL","NA"],
    [4913,"4913","Carrier A","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","3","1",null,"15.9","57.7",null,"1","2",null,"LIFITEGRAST","NA"],
    [4914,"4914","Carrier A","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","3","1",null,"2.4",null,null,"3","0",null,"ACALABRUTINIB MALEATE","NA"],
    [4915,"4915","Carrier A","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","2","1",null,null,"86.6",null,"0","2",null,"MAVACAMTEN","NA"],
    [4916,"4916","Carrier A","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","2","1",null,"1.9",null,null,"2","0",null,"CANNABIDIOL","NA"],
    [4917,"4917","Carrier A","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","2","1",null,"17.3","19.7",null,"1","1",null,"CANAGLIFLOZIN-METFORMIN HCL","NA"],
    [4918,"4918","Carrier A","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","2","1",null,null,"31.8",null,"0","2",null,"INSULIN ASPART (WITH NIACINAMIDE)","NA"],
    [4919,"4919","Carrier A","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","2","1",null,"16.1","45",null,"1","1",null,"ABALOPARATIDE","NA"],
    [4920,"4920","Carrier A","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","2","1",null,null,"309.4",null,"0","2",null,"ELAGOLIX SODIUM","NA"],
    [4921,"4921","Carrier A","2022","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","2","1",null,null,"56.7",null,"0","2",null,"TERIPARATIDE (RECOMBINANT)","NA"],
    [4922,"4922","Carrier A","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1","1",null,"222.9",null,null,"1","0",null,"SELEXIPAG","NA"],
    [4923,"4923","Carrier A","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1","1",null,"5.3",null,null,"1","0",null,"GLYCOPYRRONIUM TOSYLATE","NA"],
    [4924,"4924","Carrier A","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1","1",null,"23.9",null,null,"1","0",null,"ANAKINRA","NA"],
    [4925,"4925","Carrier A","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","24","0.667",null,null,"83.8",null,"0","2",null,"GALCANEZUMAB-GNLM","NA"],
    [4926,"4926","Carrier A","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","13","0.5",null,null,"234.6",null,"0","1",null,"ERENUMAB-AOOE","NA"],
    [4927,"4927","Carrier A","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","50","0.167",null,null,"141.8",null,"0","1",null,"CYCLOSPORINE (OPHTH)","NA"],
    [4928,"4928","Carrier A","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","25","0.154",null,"25.1","312.6",null,"1","1",null,"EVOLOCUMAB","NA"],
    [4929,"4929","Carrier L","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95716","Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; with continuous, real-time monitoring and maintenance","5","0.2",null,null,"151.7",null,"0","5",null,"NA","NA"],
    [4930,"4930","Carrier L","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19364","Breast reconstruction; with free flap�","4","1",null,null,"49.2",null,"0","4",null,"NA","NA"],
    [4931,"4931","Carrier L","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","55866","Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed","4","1",null,null,"69.6",null,"0","4",null,"NA","NA"],
    [4932,"4932","Carrier L","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s)","4","1",null,null,"76.6",null,"0","4",null,"NA","NA"],
    [4933,"4933","Carrier L","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95720","Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of EEG recording, interpretation and report after each 24-hour period; with video (VEEG)","4","0",null,null,"189.5",null,"0","4",null,"NA","NA"],
    [4934,"4934","Carrier L","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","38571","Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy","3","1",null,null,"92.6",null,"0","3",null,"NA","NA"],
    [4935,"4935","Carrier L","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58571","Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)","3","1",null,null,"379.8",null,"0","3",null,"NA","NA"],
    [4936,"4936","Carrier L","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15860","Intravenous injection of agent (eg, fluorescein) to test vascular flow in flap or graft�","2","1",null,null,"14.2",null,"0","2",null,"NA","NA"],
    [4937,"4937","Carrier L","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","21743","Reconstructive repair of pectus excavatum or carinatum; minimally invasive approach (Nuss procedure), with thoracoscopy","2","0",null,null,"131.2",null,"0","2",null,"NA","NA"],
    [4938,"4938","Carrier L","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","32666","Thoracoscopy, surgical; with therapeutic wedge resection (eg, mass, nodule), initial unilateral","2","1",null,"22.7","143.5",null,"1","1",null,"NA","NA"],
    [4939,"4939","Carrier L","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","33361","Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; percutaneous femoral artery approach","2","0.5",null,"67.3","134.2",null,"1","1",null,"NA","NA"],
    [4940,"4940","Carrier L","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","33362","Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open femoral artery approach","2","0.5",null,null,"83.1",null,"1","1",null,"NA","NA"],
    [4941,"4941","Carrier L","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","38570","Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple","2","1",null,null,"490.3",null,"0","2",null,"NA","NA"],
    [4942,"4942","Carrier L","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","38900","Intraoperative identification (eg, mapping) of sentinel lymph node(s), includes injection of non-radioactive dye, when performed (List separately in addition to code for primary procedure)","2","1",null,null,"490.3",null,"0","2",null,"NA","NA"],
    [4943,"4943","Carrier L","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44207","Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)�","2","1",null,null,"102.1",null,"0","2",null,"NA","NA"],
    [4944,"4944","Carrier L","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","49568","mplantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection (List separately in addition to code for the incisional or ventral hernia repair)","2","1",null,null,"95.6",null,"0","2",null,"NA","NA"],
    [4945,"4945","Carrier L","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19364","Breast reconstruction; with free flap�","4","1",null,null,"49.2",null,"0","4",null,"NA","NA"],
    [4946,"4946","Carrier L","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","55866","Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed","4","1",null,null,"69.6",null,"0","4",null,"NA","NA"],
    [4947,"4947","Carrier L","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58150","Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s)","4","1",null,null,"76.6",null,"0","4",null,"NA","NA"],
    [4948,"4948","Carrier L","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","38571","Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy","3","1",null,null,"92.6",null,"0","3",null,"NA","NA"],
    [4949,"4949","Carrier L","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58571","Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)","3","1",null,null,"379.8",null,"0","3",null,"NA","NA"],
    [4950,"4950","Carrier L","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15860","Intravenous injection of agent (eg, fluorescein) to test vascular flow in flap or graft�","2","1",null,null,"14.2",null,"0","2",null,"NA","NA"],
    [4951,"4951","Carrier L","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","32666","Thoracoscopy, surgical; with therapeutic wedge resection (eg, mass, nodule), initial unilateral","2","1",null,"22.7","143.5",null,"1","1",null,"NA","NA"],
    [4952,"4952","Carrier L","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","38570","Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple","2","1",null,null,"490.3",null,"0","2",null,"NA","NA"],
    [4953,"4953","Carrier L","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","38900","Intraoperative identification (eg, mapping) of sentinel lymph node(s), includes injection of non-radioactive dye, when performed (List separately in addition to code for primary procedure)","2","1",null,null,"490.3",null,"0","2",null,"NA","NA"],
    [4954,"4954","Carrier L","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44207","Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)�","2","1",null,null,"102.1",null,"0","2",null,"NA","NA"],
    [4955,"4955","Carrier L","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","49568","mplantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection (List separately in addition to code for the incisional or ventral hernia repair)","2","1",null,null,"95.6",null,"0","2",null,"NA","NA"],
    [4956,"4956","Carrier L","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","Colonoscopy, flexible; with biopsy, single or multiple","265","0.84",null,"26.4","35.8",null,"2","263",null,"NA","NA"],
    [4957,"4957","Carrier L","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45378","Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","264","0.82",null,"32.4","37.2",null,"3","261",null,"NA","NA"],
    [4958,"4958","Carrier L","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45385","Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique�","219","0.84",null,"52.5","39.8",null,"1","218",null,"NA","NA"],
    [4959,"4959","Carrier L","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45384","Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","129","0.82",null,null,"19.3",null,"2","129",null,"NA","NA"],
    [4960,"4960","Carrier L","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43235","Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","91","1",null,"0.1","2.8",null,"1","90",null,"NA","NA"],
    [4961,"4961","Carrier L","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43239","Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple","90","1",null,"0.1","2.2",null,"3","87",null,"NA","NA"],
    [4962,"4962","Carrier L","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","81479","Unlisted molecular pathology procedure","87","0.91",null,null,"20.2",null,null,"87",null,"NA","NA"],
    [4963,"4963","Carrier L","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95810","Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","58","0.55",null,null,"62",null,null,"58",null,"NA","NA"],
    [4964,"4964","Carrier L","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","G0121","Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk","53","0.7",null,"52.5","26.6",null,"1","52",null,"NA","NA"],
    [4965,"4965","Carrier L","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95811","Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist","43","0.51",null,null,"55",null,null,"43",null,"NA","NA"],
    [4966,"4966","Carrier L","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43235","Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","91","1",null,"0.1","2.8",null,"1","90",null,"NA","NA"],
    [4967,"4967","Carrier L","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43239","Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple","90","1",null,"0.1","2.2",null,"3","87",null,"NA","NA"],
    [4968,"4968","Carrier L","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43249","Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter)","26","1",null,"0.1","1.9",null,"1","25",null,"NA","NA"],
    [4969,"4969","Carrier L","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43248","Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire","25","1",null,null,"1.8",null,null,"25",null,"NA","NA"],
    [4970,"4970","Carrier L","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","52356","Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, Gibbons or double-J type)�","23","1",null,"0.2","0.1",null,"10","13",null,"NA","NA"],
    [4971,"4971","Carrier L","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","87799","Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism","22","1",null,null,"0.2",null,null,"22",null,"NA","NA"],
    [4972,"4972","Carrier L","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58558","Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D and C","21","1",null,"9.3","2.9",null,"2","19",null,"NA","NA"],
    [4973,"4973","Carrier L","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","52442","Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; each additional permanent adjustable transprostatic implant (List separately in addition to code for primary procedure)","18","1",null,null,"12.8",null,null,"18",null,"NA","NA"],
    [4974,"4974","Carrier L","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81256","HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D)","16","1",null,null,"9.1",null,null,"16",null,"NA","NA"],
    [4975,"4975","Carrier L","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43251","Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","14","1",null,null,"0.2",null,null,"14",null,"NA","NA"],
    [4976,"4976","Carrier L","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","52332","Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type)","14","1",null,"0.2","0.2",null,"3","11",null,"NA","NA"],
    [4977,"4977","Carrier L","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","87798","Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism","14","1",null,null,"0.2",null,null,"14",null,"NA","NA"],
    [4978,"4978","Carrier L","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","Z12.11","Encounter for screening for malignant neoplasm of colon","2",null,"1",null,"228",null,"0","2","0","NA","NA"],
    [4979,"4979","Carrier L","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","F64.9","Gender identity disorder, unspecified","1",null,"1",null,"240",null,"0","1","0","NA","NA"],
    [4980,"4980","Carrier L","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","M26.6","Temporomandibular joint disorders","1",null,"1",null,"456",null,"0","1","0","NA","NA"],
    [4981,"4981","Carrier L","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","M47.816","Spondylosis without myelopathy or radiculopathy, lumbar region","1",null,"1",null,"312",null,"0","1","0","NA","NA"],
    [4982,"4982","Carrier L","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","N80.01","Superficial endometriosis of the uterus","1",null,"1",null,"336",null,"0","1","0","NA","NA"],
    [4983,"4983","Carrier L","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","n80.13","Superficial endometriosis of bilateral ovaries","1",null,"1",null,"336",null,"0","1","0","NA","NA"],
    [4984,"4984","Carrier L","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","N93.9","Abnormal uterine and vaginal bleeding, unspecified","1",null,"1",null,"336",null,"0","1","0","NA","NA"],
    [4985,"4985","Carrier L","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","R41.83","Borderline intellectual functioning","1",null,"1",null,"696",null,"0","1","0","NA","NA"],
    [4986,"4986","Carrier L","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","Z91.89","Other specified personal risk factors, not elsewhere classified","1",null,"1",null,"648",null,"0","1","0","NA","NA"],
    [4987,"4987","Carrier L","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0760","Osteogenesis stimulator, low intensity ultrasound, non-invasive","4","0.5",null,null,"40.2",null,"0","4",null,"NA","NA"],
    [4988,"4988","Carrier L","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1028","Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory","3","0",null,null,"97.3",null,"0","3",null,"NA","NA"],
    [4989,"4989","Carrier L","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2402","Negative pressure wound therapy electrical pump, stationary or portable","3","1",null,null,"92.8",null,"0","3",null,"NA","NA"],
    [4990,"4990","Carrier L","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0486","Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","2","1",null,null,"81.8",null,"0","2",null,"NA","NA"],
    [4991,"4991","Carrier L","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0747","Osteogenesis stimulator, electrical, noninvasive, other than spinal applications","2","0",null,null,"103",null,"0","2",null,"NA","NA"],
    [4992,"4992","Carrier L","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0748","Osteogenesis stimulator, electrical, noninvasive, spinal applications","2","1",null,null,"13.4",null,"0","2",null,"NA","NA"],
    [4993,"4993","Carrier L","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0956","Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","2","1",null,null,"97.3",null,"0","2",null,"NA","NA"],
    [4994,"4994","Carrier L","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1002","Wheelchair accessory, power seating system, tilt only","2","1",null,null,"85.7",null,"0","2",null,"NA","NA"],
    [4995,"4995","Carrier L","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L0482","TLSO, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated�","2","1",null,null,"57.8",null,"0","2",null,"NA","NA"],
    [4996,"4996","Carrier L","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L8691","Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","2","1",null,null,"95",null,"0","2",null,"NA","NA"],
    [4997,"4997","Carrier L","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2402","Negative pressure wound therapy electrical pump, stationary or portable","3","1",null,null,"92.8",null,"0","3",null,"NA","NA"],
    [4998,"4998","Carrier L","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0486","Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","2","1",null,null,"81.8",null,"0","2",null,"NA","NA"],
    [4999,"4999","Carrier L","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0748","Osteogenesis stimulator, electrical, noninvasive, spinal applications","2","1",null,null,"13.4",null,"0","2",null,"NA","NA"],
    [5000,"5000","Carrier L","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L0482","TLSO, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated�","2","1",null,null,"57.8",null,"0","2",null,"NA","NA"],
    [5001,"5001","Carrier L","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8691","Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","2","1",null,null,"95",null,"0","2",null,"NA","NA"],
    [5002,"5002","Carrier L","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0978","Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","1","1",null,null,"49",null,"0","1",null,"NA","NA"],
    [5003,"5003","Carrier L","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1802","Dynamic adjustable forearm pronation/supination device, includes soft interface material�","1","1",null,null,"0.1",null,"0","1",null,"NA","NA"],
    [5004,"5004","Carrier L","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1805","Dynamic adjustable wrist extension / flexion device, includes soft interface material�","1","1",null,null,"0.1",null,"0","1",null,"NA","NA"],
    [5005,"5005","Carrier L","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2510","Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","1","1",null,null,"7.4",null,"0","1",null,"NA","NA"],
    [5006,"5006","Carrier L","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0005","Ultralightweight wheelchair�","1","1",null,null,"49",null,"0","1",null,"NA","NA"],
    [5007,"5007","Carrier L","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","7",null,"1","4.06","11.04",null,"4","3","0","STELARA INJ 90MG/ML","NA"],
    [5008,"5008","Carrier L","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","5",null,"1","1.42","11.04",null,"3","2","0","ENBREL SRCLK INJ 50MG/ML","NA"],
    [5009,"5009","Carrier L","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","5",null,"0.8",null,"10.91",null,"0","4","0","TALTZ INJ 80MG/ML","NA"],
    [5010,"5010","Carrier L","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","9",null,"0.44","3.47","10.32",null,"1","3","0","DUPIXENT INJ 300/2ML","NA"],
    [5011,"5011","Carrier L","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","5",null,"0.8","1.31","9.51",null,"1","3","0","NURTEC TAB 75MG ODT","NA"],
    [5012,"5012","Carrier L","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3",null,"1",null,"7.25",null,"0","3","0","AIMOVIG INJ 140MG/ML","NA"],
    [5013,"5013","Carrier L","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"1","2.61","11.15",null,"1","1","0","AJOVY INJ 225/1.5","NA"],
    [5014,"5014","Carrier L","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"1",null,"9.9",null,"0","2","0","OZEMPIC INJ 4MG/3ML","NA"],
    [5015,"5015","Carrier L","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"1",null,"9.4",null,"0","2","0","ENTRESTO TAB 24-26MG","NA"],
    [5016,"5016","Carrier L","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"1",null,"6.87",null,"0","2","0","DUPIXENT INJ 200MG","NA"],
    [5017,"5017","Carrier L","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","External ambulatory infusion pump, insulin","8","1",null,null,"59.8",null,"0","8",null,"NA","NA"],
    [5018,"5018","Carrier L","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0553","Supply allowance for therapeutic continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service","4","0.5",null,"25.9","37.1",null,"1","3",null,"NA","NA"],
    [5019,"5019","Carrier L","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0554","Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system�","3","0.33",null,"25.9","43.8",null,"1","2",null,"NA","NA"],
    [5020,"5020","Carrier L","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9274","External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories","2","1",null,"23","71.7",null,"1","1",null,"NA","NA"],
    [5021,"5021","Carrier L","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9276","Sensor; invasive (e.g., subcutaneous), disposable, for use with nondurable medical equipment interstitial continuous glucose monitoring system (CGM), one unit = 1 day supply","2","0.5",null,null,"109.9",null,"0","2",null,"NA","NA"],
    [5022,"5022","Carrier L","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0607","Home blood glucose monitor","2","1",null,"23","71.7",null,"1","1",null,"NA","NA"],
    [5023,"5023","Carrier L","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9277","Transmitter; external, for use with nondurable medical equipment interstitial continuous glucose monitoring system (CGM)","1","1",null,null,"95.8",null,"0","1",null,"NA","NA"],
    [5024,"5024","Carrier L","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9278","Receiver (monitor); external, for use with nondurable medical equipment interstitial continuous glucose monitoring system (CGM)","1","1",null,null,"95.8",null,"0","1",null,"NA","NA"],
    [5025,"5025","Carrier L","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","External ambulatory infusion pump, insulin","8","1",null,null,"59.8",null,"0","8",null,"NA","NA"],
    [5026,"5026","Carrier L","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9274","External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories","2","1",null,"23","71.7",null,"1","1",null,"NA","NA"],
    [5027,"5027","Carrier L","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0607","Home blood glucose monitor","2","1",null,"23","71.7",null,"1","1",null,"NA","NA"],
    [5028,"5028","Carrier L","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9277","Transmitter; external, for use with nondurable medical equipment interstitial continuous glucose monitoring system (CGM)","1","1",null,null,"95.8",null,"0","1",null,"NA","NA"],
    [5029,"5029","Carrier L","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9278","Receiver (monitor); external, for use with nondurable medical equipment interstitial continuous glucose monitoring system (CGM)","1","1",null,null,"95.8",null,"0","1",null,"NA","NA"],
    [5030,"5030","Carrier L","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0553","Supply allowance for therapeutic continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service","4","0.5",null,"25.9","37.1",null,"1","3",null,"NA","NA"],
    [5031,"5031","Carrier L","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9276","Sensor; invasive (e.g., subcutaneous), disposable, for use with nondurable medical equipment interstitial continuous glucose monitoring system (CGM), one unit = 1 day supply","2","0.5",null,null,"109.9",null,"0","2",null,"NA","NA"],
    [5032,"5032","Carrier L","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0554","Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system�","3","0.33",null,"25.9","43.8",null,"1","2",null,"NA","NA"],
    [5033,"5033","Carrier L","2022","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E10.65","Dexcom - - TYPE 1 DIABETES MELLITUS WITHOUT COMPLICATIONS","4",null,"0.5","1.51","8.61",null,"1","1",null,"NA","NA"],
    [5034,"5034","Carrier L","2022","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E10.65","FreeStyle- TYPE 1 DIABETES MELLITUS WITHOUT COMPLICATIONS","4",null,"0.25","1.59",null,null,"1","0",null,"NA","NA"],
    [5035,"5035","Carrier K","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);","5","0.8",null,"0.3","58.4",null,"1","4",null,"NA","NA"],
    [5036,"5036","Carrier K","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19364","Breast reconstruction; with free flap","3","1",null,null,"43.95",null,null,"3",null,"NA","NA"],
    [5037,"5037","Carrier K","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15860","Intravenous injection of agent (eg, fluorescein) to test vascular flow in flap or graft�","2","1",null,null,"42",null,null,"2",null,"NA","NA"],
    [5038,"5038","Carrier K","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","38562","Limited lymphadenectomy for staging (separate procedure); pelvic and para-aortic","2","0.5",null,null,"90.1",null,null,"2",null,"NA","NA"],
    [5039,"5039","Carrier K","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","38900","Intraoperative identification (eg, mapping) of sentinel lymph node(s), includes injection of non-radioactive dye, when performed (List separately in addition to code for primary procedure)�","2","0.5",null,null,"90.1",null,null,"2",null,"NA","NA"],
    [5040,"5040","Carrier K","2022","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","49255","Omentectomy, epiploectomy, resection of omentum (separate procedure)","2","0.5",null,null,"90.1",null,null,"2",null,"NA","NA"],
    [5041,"5041","Carrier K","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19364","Breast reconstruction; with free flap","3","1",null,null,"43.95",null,null,"3",null,"NA","NA"],
    [5042,"5042","Carrier K","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15860","Intravenous injection of agent (eg, fluorescein) to test vascular flow in flap or graft�","2","1",null,null,"42",null,null,"2",null,"NA","NA"],
    [5043,"5043","Carrier K","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15770","Graft; derma-fat-fascia","1","1",null,null,"45.9",null,null,"1",null,"NA","NA"],
    [5044,"5044","Carrier K","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","21615","Excision first and/or cervical rib","1","1",null,null,"124.2",null,null,"1",null,"NA","NA"],
    [5045,"5045","Carrier K","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","21705","Division of scalenus anticus; with resection of cervical rib","1","1",null,null,"124.2",null,null,"1",null,"NA","NA"],
    [5046,"5046","Carrier K","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","31622","Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)","1","1",null,null,"8.4",null,null,"1",null,"NA","NA"],
    [5047,"5047","Carrier K","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","32100","Thoracotomy; with exploration","1","1",null,null,"8.4",null,null,"1",null,"NA","NA"],
    [5048,"5048","Carrier K","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","32607","Thoracoscopy; with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional), unilateral","1","1",null,null,"8.4",null,null,"1",null,"NA","NA"],
    [5049,"5049","Carrier K","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","38530","Biopsy or excision of lymph node(s); open, internal mammary node(s)","1","1",null,null,"45.9",null,null,"1",null,"NA","NA"],
    [5050,"5050","Carrier K","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","39200","Resection of mediastinal cyst","1","1",null,null,"8.4",null,null,"1",null,"NA","NA"],
    [5051,"5051","Carrier K","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","45400","Laparoscopy, surgical; proctopexy (for prolapse)","1","1",null,null,"98",null,null,"1",null,"NA","NA"],
    [5052,"5052","Carrier K","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","57250","Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy","1","1",null,null,"98",null,null,"1",null,"NA","NA"],
    [5053,"5053","Carrier K","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","57288","Sling operation for stress incontinence (eg, fascia or synthetic)�","1","1",null,null,"98",null,null,"1",null,"NA","NA"],
    [5054,"5054","Carrier K","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","57425","Laparoscopy, surgical, colpopexy (suspension of vaginal apex)�","1","1",null,null,"98",null,null,"1",null,"NA","NA"],
    [5055,"5055","Carrier K","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58571","Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)","1","1",null,null,"98",null,null,"1",null,"NA","NA"],
    [5056,"5056","Carrier K","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58700","Salpingectomy, complete or partial, unilateral or bilateral (separate procedure)�","1","1",null,null,"98.4",null,null,"1",null,"NA","NA"],
    [5057,"5057","Carrier K","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95714","Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; unmonitored�","1","1",null,null,"90.7",null,null,"1",null,"NA","NA"],
    [5058,"5058","Carrier K","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95720","Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of EEG recording, interpretation and report after each 24-hour period; with video (VEEG)","1","1",null,null,"90.7",null,null,"1",null,"NA","NA"],
    [5059,"5059","Carrier K","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96365","Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour�","1","1",null,null,"48.1",null,null,"1",null,"NA","NA"],
    [5060,"5060","Carrier K","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96366","Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)�","1","1",null,null,"48.1",null,null,"1",null,"NA","NA"],
    [5061,"5061","Carrier K","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99221","Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","1","1",null,null,"90.7",null,null,"1",null,"NA","NA"],
    [5062,"5062","Carrier K","2022","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","C1771","Repair device, urinary, incontinence, with sling graft","1","1",null,null,"98",null,null,"1",null,"NA","NA"],
    [5063,"5063","Carrier K","2022","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","Q67.6","Pectus excavatum","1",null,"1",null,"1248",null,"0","1","0","NA","NA"],
    [5064,"5064","Carrier K","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45378","Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","130","0.81",null,"49.4","22.7",null,"5","125",null,"NA","NA"],
    [5065,"5065","Carrier K","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","Colonoscopy, flexible; with biopsy, single or multiple","120","0.82",null,"49.4","19.9",null,"5","115",null,"NA","NA"],
    [5066,"5066","Carrier K","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45385","Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","111","0.81",null,"49.4","20.7",null,"4","107",null,"NA","NA"],
    [5067,"5067","Carrier K","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45384","Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","58","0.76",null,null,"24.9",null,null,"58",null,"NA","NA"],
    [5068,"5068","Carrier K","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","81479","Unlisted molecular pathology procedure","53","0.92",null,null,"12.9",null,null,"53",null,"NA","NA"],
    [5069,"5069","Carrier K","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43235","Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","35","0.91",null,"0.2","10.4",null,"1","34",null,"NA","NA"],
    [5070,"5070","Carrier K","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43239","Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple","35","0.91",null,"0.2","8.4",null,"1","34",null,"NA","NA"],
    [5071,"5071","Carrier K","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95810","Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","35","0.71",null,"42.5","114.6",null,"1","34",null,"NA","NA"],
    [5072,"5072","Carrier K","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","G0121","Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk","27","0.7",null,"24.5","32.3",null,"3","34",null,"NA","NA"],
    [5073,"5073","Carrier K","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95811","Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist","24","0.67",null,null,"145.9",null,null,"24",null,"NA","NA"],
    [5074,"5074","Carrier K","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99499","Chiropractic Care","237","0.996",null,null,null,null,null,"237",null,"NA","NA"],
    [5075,"5075","Carrier K","2022","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99499","Therapy Care","389","0.982",null,null,null,null,null,"389",null,"NA","NA"],
    [5076,"5076","Carrier K","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81162","BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, detection of large gene rearrangements)","15","1",null,null,"13.4",null,"0","15",null,"NA","NA"],
    [5077,"5077","Carrier K","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43248","�Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire","13","1",null,"0.2","11.3",null,"1","12",null,"NA","NA"],
    [5078,"5078","Carrier K","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81420","Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21","12","1",null,null,"10.3",null,"0","12",null,"NA","NA"],
    [5079,"5079","Carrier K","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","52332","Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type)","10","1",null,"0.15","8.9",null,"2","8",null,"NA","NA"],
    [5080,"5080","Carrier K","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81256","HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D)�","10","1",null,null,"0.35",null,"0","10",null,"NA","NA"],
    [5081,"5081","Carrier K","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43249","Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter)","9","1",null,null,"2.3",null,"0","9",null,"NA","NA"],
    [5082,"5082","Carrier K","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64490","Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level�","9","1",null,null,"0.14",null,"0","9",null,"NA","NA"],
    [5083,"5083","Carrier K","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43251","Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","8","1",null,"0.2","0.14",null,"1","7",null,"NA","NA"],
    [5084,"5084","Carrier K","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58571","Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)�","8","1",null,"27.9","62.1",null,"1","7",null,"NA","NA"],
    [5085,"5085","Carrier K","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","52353","Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)","7","1",null,"0.2","0.13",null,"1","6",null,"NA","NA"],
    [5086,"5086","Carrier K","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81401","MOLECULAR PATHOLOGY PROCEDURE LEVEL 2","7","1",null,null,"0.11",null,"0","7",null,"NA","NA"],
    [5087,"5087","Carrier K","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81519","Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin embedded tissue, algorithm reported as recurrence score","7","1",null,null,"2.87",null,"0","7",null,"NA","NA"],
    [5088,"5088","Carrier K","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99499","Chiropractic Care","237","0.996",null,null,null,null,null,"237",null,"NA","NA"],
    [5089,"5089","Carrier K","2022","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99499","Therapy Care","389","0.982",null,null,null,null,null,"389",null,"NA","NA"],
    [5090,"5090","Carrier K","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","F64.9","Gender identity disorder, unspecified","1",null,"0.5",null,"264",null,"0","2","0","NA","NA"],
    [5091,"5091","Carrier K","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","G47.30","Sleep apnea, unspecified","1",null,"1",null,"336",null,"0","1","0","NA","NA"],
    [5092,"5092","Carrier K","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","I47.1","Supraventricular tachycardia","1",null,"1",null,"360",null,"0","1","0","NA","NA"],
    [5093,"5093","Carrier K","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","M26.02","Maxillary hypoplasia","1",null,"1",null,"336",null,"0","1","0","NA","NA"],
    [5094,"5094","Carrier K","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","M47.812","Spondylosis without myelopathy or radiculopathy, cervical region","1",null,"1",null,"240",null,"0","1","0","NA","NA"],
    [5095,"5095","Carrier K","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","R07.9","Chest pain, unspecified","1",null,"1",null,"2448",null,"0","1","0","NA","NA"],
    [5096,"5096","Carrier K","2022","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","Z12.11","Encounter for screening for malignant neoplasm of colon","1",null,"1",null,"336",null,"0","1","0","NA","NA"],
    [5097,"5097","Carrier K","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0766","Electrical stimulation device used for cancer treatment, includes all accessories, any type","4","1",null,"0.6","81.9",null,"1","3",null,"NA","NA"],
    [5098,"5098","Carrier K","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1399","Durable medical equipment, miscellaneous","3","0",null,null,"70.9",null,null,"3",null,"NA","NA"],
    [5099,"5099","Carrier K","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L8614","Cochlear device, includes all internal and external components","2","0",null,null,"165.1",null,null,"2",null,"NA","NA"],
    [5100,"5100","Carrier K","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","B4087","Gastrostomy/jejunostomy tube, standard, any material, any type, each","1","1",null,null,"167.5",null,null,"1",null,"NA","NA"],
    [5101,"5101","Carrier K","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","B4088","Gastrostomy/jejunostomy tube, low-profile, any material, any type, each","1","1",null,null,"167.5",null,null,"1",null,"NA","NA"],
    [5102,"5102","Carrier K","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","B4149","Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","1","1",null,null,"167.5",null,null,"1",null,"NA","NA"],
    [5103,"5103","Carrier K","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","B4153","Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, May include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","1","1",null,null,"167.5",null,null,"1",null,"NA","NA"],
    [5104,"5104","Carrier K","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0642","Standing frame/table system, mobile (dynamic stander), any size including pediatric","1","1",null,null,"70.9",null,null,"1",null,"NA","NA"],
    [5105,"5105","Carrier K","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1805","Dynamic adjustable wrist extension / flexion device, includes soft interface material","1","1",null,null,"0.2",null,null,"1",null,"NA","NA"],
    [5106,"5106","Carrier K","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L2330","Addition to lower extremity, lacer molded to Patient model, for custom fabricated orthosis only","1","1",null,null,"4.1",null,null,"1",null,"NA","NA"],
    [5107,"5107","Carrier K","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L8615","Headset/headpiece for Use with cochlear implant device, replacement","1","1",null,null,"25.1",null,null,"1",null,"NA","NA"],
    [5108,"5108","Carrier K","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L8616","Microphone for Use with cochlear implant device, replacement","1","1",null,null,"25.1",null,null,"1",null,"NA","NA"],
    [5109,"5109","Carrier K","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L8619","Cochlear implant, external speech processor and controller, integrated system, replacement","1","1",null,null,"25.1",null,null,"1",null,"NA","NA"],
    [5110,"5110","Carrier K","2022","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L8624","Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","1","1",null,null,"25.1",null,null,"1",null,"NA","NA"],
    [5111,"5111","Carrier K","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","B4087","Gastrostomy/jejunostomy tube, standard, any material, any type, each","1","1",null,null,"167.5",null,null,"1",null,"NA","NA"],
    [5112,"5112","Carrier K","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","B4088","Gastrostomy/jejunostomy tube, low-profile, any material, any type, each","1","1",null,null,"167.5",null,null,"1",null,"NA","NA"],
    [5113,"5113","Carrier K","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","B4149","Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","1","1",null,null,"167.5",null,null,"1",null,"NA","NA"],
    [5114,"5114","Carrier K","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","B4153","Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, May include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","1","1",null,null,"167.5",null,null,"1",null,"NA","NA"],
    [5115,"5115","Carrier K","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0642","Standing frame/table system, mobile (dynamic stander), any size including pediatric","1","1",null,null,"70.9",null,null,"1",null,"NA","NA"],
    [5116,"5116","Carrier K","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0766","Electrical stimulation device used for cancer treatment, includes all accessories, any type","4","1",null,"0.6","81.9",null,"1","3",null,"NA","NA"],
    [5117,"5117","Carrier K","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1805","Dynamic adjustable wrist extension / flexion device, includes soft interface material","1","1",null,null,"0.2",null,null,"1",null,"NA","NA"],
    [5118,"5118","Carrier K","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L2330","Addition to lower extremity, lacer molded to Patient model, for custom fabricated orthosis only","1","1",null,null,"4.1",null,null,"1",null,"NA","NA"],
    [5119,"5119","Carrier K","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8615","Headset/headpiece for Use with cochlear implant device, replacement","1","1",null,null,"25.1",null,null,"1",null,"NA","NA"],
    [5120,"5120","Carrier K","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8616","Microphone for Use with cochlear implant device, replacement","1","1",null,null,"25.1",null,null,"1",null,"NA","NA"],
    [5121,"5121","Carrier K","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8619","Cochlear implant, external speech processor and controller, integrated system, replacement","1","1",null,null,"25.1",null,null,"1",null,"NA","NA"],
    [5122,"5122","Carrier K","2022","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8624","Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","1","1",null,null,"25.1",null,null,"1",null,"NA","NA"],
    [5123,"5123","Carrier K","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","External ambulatory infusion pump, insulin","4","0.5",null,null,"52.4",null,null,"4",null,"NA","NA"],
    [5124,"5124","Carrier K","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9274","External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories","1","1",null,null,"39.9",null,null,"1",null,"NA","NA"],
    [5125,"5125","Carrier K","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0607","Home blood glucose monitor","1","1",null,null,"39.9",null,null,"1",null,"NA","NA"],
    [5126,"5126","Carrier K","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0553","Supply allowance for therapeutic continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service","1","0",null,null,"45.2",null,null,"1",null,"NA","NA"],
    [5127,"5127","Carrier K","2022","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0554","Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system","1","0",null,null,"45.2",null,null,"1",null,"NA","NA"],
    [5128,"5128","Carrier K","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9274","External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories","1","1",null,null,"39.9",null,null,"1",null,"NA","NA"],
    [5129,"5129","Carrier K","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0607","Home blood glucose monitor","1","1",null,null,"39.9",null,null,"1",null,"NA","NA"],
    [5130,"5130","Carrier K","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","External ambulatory infusion pump, insulin","4","0.5",null,null,"52.4",null,null,"4",null,"NA","NA"],
    [5131,"5131","Carrier K","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0553","Supply allowance for therapeutic continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service","1","0",null,null,"45.2",null,null,"1",null,"NA","NA"],
    [5132,"5132","Carrier K","2022","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0554","Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system","1","0",null,null,"45.2",null,null,"1",null,"NA","NA"],
    [5133,"5133","Carrier K","2022","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E10.65","Dexcom - - TYPE 1 DIABETES MELLITUS WITHOUT COMPLICATIONS","6",null,"0.83",null,"10.22",null,"0","5",null,"NA","NA"],
    [5134,"5134","Carrier K","2022","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E10.66","FreeStyle - - TYPE 1 DIABETES MELLITUS WITHOUT COMPLICATIONS","2",null,"1",null,"13.57",null,"0","2",null,"NA","NA"],
    [5135,"5135","Carrier K","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","13",null,"0.92","2.44","9.48",null,"1","11","0","DUPIXENT INJ 300/2ML","NA"],
    [5136,"5136","Carrier K","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","11",null,"0.91","2.1","11.49",null,"7","3","0","STELARA INJ 90MG/ML","NA"],
    [5137,"5137","Carrier K","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","9",null,"1","1.9","10.5",null,"3","6","0","EMGALITY INJ 120MG/ML","NA"],
    [5138,"5138","Carrier K","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","8",null,"1",null,"9.1",null,"0","8","0","XIFAXAN TAB 550MG","NA"],
    [5139,"5139","Carrier K","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","10",null,"0.6","2.43","9.9",null,"2","4","0","SKYRIZI PEN INJ 150MG/ML","NA"],
    [5140,"5140","Carrier K","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","5",null,"1","1.64","12.5",null,"2","3","0","ENBREL SRCLK INJ 50MG/ML","NA"],
    [5141,"5141","Carrier K","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","7",null,"0.57",null,"8.54",null,"0","4","0","TALTZ INJ 80MG/ML","NA"],
    [5142,"5142","Carrier K","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","4",null,"1","3.18","10.75",null,"3","1","0","AIMOVIG INJ 140MG/ML","NA"],
    [5143,"5143","Carrier K","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","5",null,"0.8","2.57","11.52",null,"1","3","0","HUMIRA INJ 40/0.4ML","NA"],
    [5144,"5144","Carrier K","2022","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","6",null,"0.5",null,"11.76",null,"0","3","0","UBRELVY TAB 100MG","NA"],
    [5145,"5145","Carrier M","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44207","LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST","10","1",null,null,"17.84466667",null,"0","10",null,"NA","NA"],
    [5146,"5146","Carrier M","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20930","ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED","8","0.25",null,null,"143.2235069",null,"0","8",null,"NA","NA"],
    [5147,"5147","Carrier M","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44213","LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLECTOMY","7","1",null,null,"18.97309524",null,"0","7",null,"NA","NA"],
    [5148,"5148","Carrier M","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY","7","1",null,"92.39472222","11.49472222",null,"1","6",null,"NA","NA"],
    [5149,"5149","Carrier M","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45330","SIGMOIDOSCOPY FLX DX W/WO COLLJ SPECIMENS","5","1",null,null,"24.09572222",null,"0","5",null,"NA","NA"],
    [5150,"5150","Carrier M","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22842","POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG","5","0.8",null,"63.41777778","123.3530556",null,"1","4",null,"NA","NA"],
    [5151,"5151","Carrier M","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95720","ELECTROENCEPHALOGRAM (EEG), CONTINUOUS RECORDING, PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL REVIEW OF RECORDED EVENTS, ANALYSIS OF SPIKE AND SEIZURE DETECTION, EACH INCREMENT OF GREATER TH","5","0.6",null,null,"25.88944444",null,"0","5",null,"NA","NA"],
    [5152,"5152","Carrier M","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44204","LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS","4","1",null,null,"7.779166667",null,"0","4",null,"NA","NA"],
    [5153,"5153","Carrier M","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27130","ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT","4","0.25",null,null,"55.84805556",null,"0","4",null,"NA","NA"],
    [5154,"5154","Carrier M","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20936","AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION","4","0.5",null,null,"88.14319444",null,"0","4",null,"NA","NA"],
    [5155,"5155","Carrier M","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44207","LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST","10","1",null,null,"17.84466667",null,"0","10",null,"NA","NA"],
    [5156,"5156","Carrier M","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58150","TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY","7","1",null,"92.39472222","11.49472222",null,"1","6",null,"NA","NA"],
    [5157,"5157","Carrier M","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44213","LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLECTOMY","7","1",null,null,"18.97309524",null,"0","7",null,"NA","NA"],
    [5158,"5158","Carrier M","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","45330","SIGMOIDOSCOPY FLX DX W/WO COLLJ SPECIMENS","5","1",null,null,"24.09572222",null,"0","5",null,"NA","NA"],
    [5159,"5159","Carrier M","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58140","MYOMECTOMY 1-4 MYOMAS W/250 GM/< ABDOMINAL APPR","4","1",null,null,"21.99340278",null,"0","4",null,"NA","NA"],
    [5160,"5160","Carrier M","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22614","ARTHRD PST TQ 1NTRSPC EA ADD","4","1",null,null,"122.2299306",null,"0","4",null,"NA","NA"],
    [5161,"5161","Carrier M","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44204","LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS","4","1",null,null,"7.779166667",null,"0","4",null,"NA","NA"],
    [5162,"5162","Carrier M","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J0185","INJ., APREPITANT, 1 MG","3","1",null,null,"150.8003704",null,"0","3",null,"NA","NA"],
    [5163,"5163","Carrier M","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33405","RPLCMT PROST AORTIC VALVE XCP HOMOGRF/STENT","3","1",null,"1.111944444","13.40486111",null,"1","2",null,"NA","NA"],
    [5164,"5164","Carrier M","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","55866","LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT","3","1",null,"6.489722222","2.689305556",null,"1","2",null,"NA","NA"],
    [5165,"5165","Carrier M","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","20930","ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED","8",null,"0.25",null,"143.2235069",null,"0","8",null,"NA","NA"],
    [5166,"5166","Carrier M","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22842","POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG","5",null,"0.8","63.41777778","123.3530556",null,"1","4",null,"NA","NA"],
    [5167,"5167","Carrier M","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","20936","AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION","4",null,"0.5",null,"88.14319444",null,"0","4",null,"NA","NA"],
    [5168,"5168","Carrier M","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27130","ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT","4",null,"0.25",null,"55.84805556",null,"0","4",null,"NA","NA"],
    [5169,"5169","Carrier M","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22633","ARTHRD CMBN 1NTRSPC LUMBAR","4",null,"0.25","63.39555556","77.29768519",null,"1","3",null,"NA","NA"],
    [5170,"5170","Carrier M","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22840","POSTERIOR NON-SEGMENTAL INSTRUMENTATION","3",null,"0.3333",null,"114.5568519",null,"0","3",null,"NA","NA"],
    [5171,"5171","Carrier M","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43644","LAPS GSTR RSTCV PX W/BYP ROUX-EN-Y LIMB <150 CM","2",null,"0.5","70.25777778","52.61138889",null,"1","1",null,"NA","NA"],
    [5172,"5172","Carrier M","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","20931","ALLOGRAFT FOR SPINE SURGERY ONLY STRUCTURAL","1",null,"0",null,"25.34638889",null,"0","1",null,"NA","NA"],
    [5173,"5173","Carrier M","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22802","ARTHRODESIS POSTERIOR SPINAL DFRM 7-12 VRT SEG","1",null,"0",null,"161.6419444",null,"0","1",null,"NA","NA"],
    [5174,"5174","Carrier M","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22843","POSTERIOR SEGMENTAL INSTRUMENTATION 7-12 VRT SEG","1",null,"0",null,"161.6752778",null,"0","1",null,"NA","NA"],
    [5175,"5175","Carrier M","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","J0585","Botox","212","0.89",null,"6","33",null,"16","196",null,"NA","NA"],
    [5176,"5176","Carrier M","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","Q5103","Inflectra","111","0.95",null,"29","47",null,"32","79",null,"NA","NA"],
    [5177,"5177","Carrier M","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","66984","EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1 STAGE PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGATION AND ASPIRATION OR PHACOEMULSIFICATION); WITHOUT ENDOSCO","62","1",null,"4","31.38857013",null,"1","61",null,"NA","NA"],
    [5178,"5178","Carrier M","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","J3380","Entyvio","57","0.98",null,"16","59",null,"11","46",null,"NA","NA"],
    [5179,"5179","Carrier M","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","J7323","Euflexxa","52","0.85",null,"0.3","60",null,"1","51",null,"NA","NA"],
    [5180,"5180","Carrier M","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","J0178","Eylea","50","0.92",null,"27","54",null,"8","42",null,"NA","NA"],
    [5181,"5181","Carrier M","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","J9217","Lupron Depot/eligard","47","0.83",null,"16","45",null,"11","36",null,"NA","NA"],
    [5182,"5182","Carrier M","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","30520","SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF","40","0.8",null,null,"52.8568125",null,"0","40",null,"NA","NA"],
    [5183,"5183","Carrier M","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","89253","ASSTD EMBRYO HATCHING MICROTQS ANY METH","40","0.55",null,null,"140.8267361",null,"0","40",null,"NA","NA"],
    [5184,"5184","Carrier M","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27447","ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS","39","0.6667",null,null,"31.19041311",null,"0","39",null,"NA","NA"],
    [5185,"5185","Carrier M","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","66984","EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1 STAGE PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGATION AND ASPIRATION OR PHACOEMULSIFICATION); WITHOUT ENDOSCO","62","1",null,"4","31.38857013",null,"1","61",null,"NA","NA"],
    [5186,"5186","Carrier M","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J2350","Ocrevus","29","1",null,"16","42",null,"7","22",null,"NA","NA"],
    [5187,"5187","Carrier M","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58558","HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C","19","1",null,"19.11361111","135.8474074",null,"1","18",null,"NA","NA"],
    [5188,"5188","Carrier M","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","36475","ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN","19","1",null,null,"37.16324561",null,"0","19",null,"NA","NA"],
    [5189,"5189","Carrier M","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J2777","Vabysmo","16","1",null,"6","29",null,"2","14",null,"NA","NA"],
    [5190,"5190","Carrier M","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","52000","CYSTOURETHROSCOPY (SEPARATE PROCEDURE)","12","1",null,null,"72.62516204",null,"0","12",null,"NA","NA"],
    [5191,"5191","Carrier M","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","21196","RECONSTRUCTION OF MANDIBULAR RAMUS, SAGITTAL SPLIT; IN INTERNAL RIGID FIXATION","11","1",null,null,"57.66227273",null,"0","11",null,"NA","NA"],
    [5192,"5192","Carrier M","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99354","PROLNG SVC O/P 1ST HOUR","10","1",null,"33.89736111","53.6059375",null,"2","8",null,"NA","NA"],
    [5193,"5193","Carrier M","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","66982","EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1-STAGE PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGATION AND ASPIRATION OR PHACOEMULSIFICATION), COMPLEX, REQUIR","10","1",null,null,"14.24536111",null,"0","10",null,"NA","NA"],
    [5194,"5194","Carrier M","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J9299","Opdivo","10","1",null,"24","22",null,"4","6",null,"NA","NA"],
    [5195,"5195","Carrier M","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","89253","ASSTD EMBRYO HATCHING MICROTQS ANY METH","40",null,"0.55",null,"140.8267361",null,"0","40",null,"NA","NA"],
    [5196,"5196","Carrier M","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27447","ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS","39",null,"0.6667",null,"31.19041311",null,"0","39",null,"NA","NA"],
    [5197,"5197","Carrier M","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27130","ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT","38",null,"0.7895",null,"58.55517544",null,"0","38",null,"NA","NA"],
    [5198,"5198","Carrier M","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","89258","CRYOPRSRV EMBRYO","27",null,"0.6296",null,"131.0831276",null,"0","27",null,"NA","NA"],
    [5199,"5199","Carrier M","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","89342","STORAGE, (PER YEAR); EMBRYO(S)","23",null,"0.6522",null,"106.5142633",null,"0","23",null,"NA","NA"],
    [5200,"5200","Carrier M","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","S4011","IVF PACKAGE","22",null,"0.5",null,"105.7116667",null,"0","22",null,"NA","NA"],
    [5201,"5201","Carrier M","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","31267","NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS","21",null,"0.4762","1.895277778","64.18061111",null,"1","20",null,"NA","NA"],
    [5202,"5202","Carrier M","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","31276","NASAL/SINUS NDSC W/FRONTAL SINUS EXPLORATION","20",null,"0.55","9.720138889","92.69424383",null,"2","18",null,"NA","NA"],
    [5203,"5203","Carrier M","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","31255","NASAL/SINUS ENDOSCOPY W/ETHMOIDECTOMY TOTAL","9",null,"0.4444",null,"97.52666667",null,"0","9",null,"NA","NA"],
    [5204,"5204","Carrier M","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","23472","ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER","7",null,"0.5714",null,"53.75230159",null,"0","7",null,"NA","NA"],
    [5205,"5205","Carrier M","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","MENTAL HEALTH RESIDENTIAL TREATMENT FACILITY","25","0.92",null,"26.83916667","12.8031746",null,"4","21",null,"NA","NA"],
    [5206,"5206","Carrier M","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","CHEMICAL DEPENDENCY RESIDENTIAL TREATMENT FACILITY","9","1",null,"11.36972222","14.952",null,"4","5",null,"NA","NA"],
    [5207,"5207","Carrier M","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","DETOXIFICATION","1","1",null,null,"0.093611111",null,"0","1",null,"NA","NA"],
    [5208,"5208","Carrier M","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","CHEMICAL DEPENDENCY RESIDENTIAL TREATMENT FACILITY","9","1",null,"11.36972222","14.952",null,"4","5",null,"NA","NA"],
    [5209,"5209","Carrier M","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","DETOXIFICATION","1","1",null,null,"0.093611111",null,"0","1",null,"NA","NA"],
    [5210,"5210","Carrier M","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","MENTAL HEALTH RESIDENTIAL TREATMENT FACILITY","25","0.92",null,"26.83916667","12.8031746",null,"4","21",null,"NA","NA"],
    [5211,"5211","Carrier M","2023","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NA","NA","MENTAL HEALTH RESIDENTIAL TREATMENT FACILITY","25",null,"0.92","26.83916667","12.8031746",null,"4","21",null,"NA","NA"],
    [5212,"5212","Carrier M","2023","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NA","NA","CHEMICAL DEPENDENCY RESIDENTIAL TREATMENT FACILITY","9",null,"1","11.36972222","14.952",null,"4","5",null,"NA","NA"],
    [5213,"5213","Carrier M","2023","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NA","NA","DETOXIFICATION","1",null,"1",null,"0.093611111",null,"0","1",null,"NA","NA"],
    [5214,"5214","Carrier M","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY, 60 MINUTES WITH PATIENT","50","1",null,null,"839.5197833",null,"0","50",null,"NA","NA"],
    [5215,"5215","Carrier M","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN","45","0.9556",null,null,"130.0407222",null,"0","45",null,"NA","NA"],
    [5216,"5216","Carrier M","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97155","ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN","42","0.9286",null,null,"158.0830952",null,"0","42",null,"NA","NA"],
    [5217,"5217","Carrier M","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97156","FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN","42","0.9524",null,null,"155.3306085",null,"0","42",null,"NA","NA"],
    [5218,"5218","Carrier M","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97153","ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN","39","0.9744",null,null,"163.1087892",null,"0","39",null,"NA","NA"],
    [5219,"5219","Carrier M","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","H0035","MH PARTIAL HOSP TX UNDER 24H","33","1",null,"9.801805556","65.04741936",null,"2","31",null,"NA","NA"],
    [5220,"5220","Carrier M","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","H2036","A/D TX PROGRAM, PER DIEM","21","0.9524",null,"81.18569444","28.45656433",null,"2","19",null,"NA","NA"],
    [5221,"5221","Carrier M","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG","13","0.6923",null,null,"312.391047",null,"0","13",null,"NA","NA"],
    [5222,"5222","Carrier M","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90834","PSYCHOTHERAPY, 45 MINUTES WITH PATIENT","12","1",null,"1.035833333","22.5030303",null,"1","11",null,"NA","NA"],
    [5223,"5223","Carrier M","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M","12","0.6667",null,null,"331.9065972",null,"0","12",null,"NA","NA"],
    [5224,"5224","Carrier M","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY, 60 MINUTES WITH PATIENT","50","1",null,null,"839.5197833",null,"0","50",null,"NA","NA"],
    [5225,"5225","Carrier M","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H0035","MH PARTIAL HOSP TX UNDER 24H","33","1",null,"9.801805556","65.04741936",null,"2","31",null,"NA","NA"],
    [5226,"5226","Carrier M","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90834","PSYCHOTHERAPY, 45 MINUTES WITH PATIENT","12","1",null,"1.035833333","22.5030303",null,"1","11",null,"NA","NA"],
    [5227,"5227","Carrier M","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVALUATION","9","1",null,null,"103.9694753",null,"0","9",null,"NA","NA"],
    [5228,"5228","Carrier M","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90832","PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES","5","1",null,null,"10.91311111",null,"0","5",null,"NA","NA"],
    [5229,"5229","Carrier M","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90847","FAMILY PSYCHOTHERAPY W/PATIENT PRESENT","3","1",null,null,"1645.739074",null,"0","3",null,"NA","NA"],
    [5230,"5230","Carrier M","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99215","OFFICE O/P EST HI 40-54 MIN","3","1",null,null,"84.96925926",null,"0","3",null,"NA","NA"],
    [5231,"5231","Carrier M","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99214","OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH REQUIRES A MEDICALLY APPROPRIATE HISTORY AND/OR EXAMINATION AND MODERATE LEVEL OF MEDICAL DECISION MAKING. WHEN USING TIME FOR CODE SELECTION, 30-39 MINUT","3","1",null,null,"431.1512963",null,"0","3",null,"NA","NA"],
    [5232,"5232","Carrier M","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90846","FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT","2","1",null,null,"2292.1175",null,"0","2",null,"NA","NA"],
    [5233,"5233","Carrier M","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90833","PSYCHOTHERAPY, 30 MINUTES WITH PATIENT WHEN PERFORMED WITH AN EVALUATION AND MANAGEMENT SERVICE (LIST SEPARATELY IN ADDITION TO THE CODE FOR PRIMARY PROCEDURE)","2","1",null,null,"46.73347222",null,"0","2",null,"NA","NA"],
    [5234,"5234","Carrier M","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97151","BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN","45",null,"0.9556",null,"130.0407222",null,"0","45",null,"NA","NA"],
    [5235,"5235","Carrier M","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97156","FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN","42",null,"0.9524",null,"155.3306085",null,"0","42",null,"NA","NA"],
    [5236,"5236","Carrier M","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97155","ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN","42",null,"0.9286",null,"158.0830952",null,"0","42",null,"NA","NA"],
    [5237,"5237","Carrier M","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90868","THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG","13",null,"0.6923",null,"312.391047",null,"0","13",null,"NA","NA"],
    [5238,"5238","Carrier M","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90867","REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M","12",null,"0.6667",null,"331.9065972",null,"0","12",null,"NA","NA"],
    [5239,"5239","Carrier M","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90832","PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES","5",null,"1",null,"10.91311111",null,"0","5",null,"NA","NA"],
    [5240,"5240","Carrier M","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90836","PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 45 MIN","4",null,"0.75",null,"29.37972222",null,"0","4",null,"NA","NA"],
    [5241,"5241","Carrier M","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","96130","PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR","1",null,"0",null,"21.6475",null,"0","1",null,"NA","NA"],
    [5242,"5242","Carrier M","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","99205","OFFICE O/P NEW HI 60-74 MIN","1",null,"0",null,"115.6119444",null,"0","1",null,"NA","NA"],
    [5243,"5243","Carrier M","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97158","GRP ADAPT BHV PRTCL MODIFCAJ PHYS/QHP EA 15 MIN","1",null,"0",null,"119.2194444",null,"0","1",null,"NA","NA"],
    [5244,"5244","Carrier M","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0486","ORAL DEVICE/APPLIANCE CUSFAB","2","0",null,null,"59.67041667",null,"0","2",null,"NA","NA"],
    [5245,"5245","Carrier M","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L5845","KNEE-SHIN SYS STANCE FLEXION","1","1",null,null,"28.26305556",null,"0","1",null,"NA","NA"],
    [5246,"5246","Carrier M","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L5920","ENDO AK/HIP ALIGNABLE SYSTEM","1","1",null,null,"28.19777778",null,"0","1",null,"NA","NA"],
    [5247,"5247","Carrier M","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L5968","MULTIAXIAL ANKLE W DORSIFLEX","1","1",null,null,"21.89944444",null,"0","1",null,"NA","NA"],
    [5248,"5248","Carrier M","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L5652","SUCTION SUSP AK/KNEE DISART","1","1",null,null,"28.25111111",null,"0","1",null,"NA","NA"],
    [5249,"5249","Carrier M","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L5649","ISCH CONTAINMT/NARROW M-L SO","1","1",null,null,"28.21222222",null,"0","1",null,"NA","NA"],
    [5250,"5250","Carrier M","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L5650","TOT CONTACT AK/KNEE DISART S","1","1",null,null,"28.18277778",null,"0","1",null,"NA","NA"],
    [5251,"5251","Carrier M","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L5631","AK/KNEE DISARTIC ACRYLIC SOC","1","1",null,null,"28.27666667",null,"0","1",null,"NA","NA"],
    [5252,"5252","Carrier M","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L5999","LOWR EXTREMITY PROSTHES NOS","1","1",null,null,"28.08805556",null,"0","1",null,"NA","NA"],
    [5253,"5253","Carrier M","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L5828","ENDO KNEE-SHIN FLUID SWG/STA","1","1",null,null,"28.2575",null,"0","1",null,"NA","NA"],
    [5254,"5254","Carrier M","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L5845","KNEE-SHIN SYS STANCE FLEXION","1","1",null,null,"28.26305556",null,"0","1",null,"NA","NA"],
    [5255,"5255","Carrier M","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L5652","SUCTION SUSP AK/KNEE DISART","1","1",null,null,"28.25111111",null,"0","1",null,"NA","NA"],
    [5256,"5256","Carrier M","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L5920","ENDO AK/HIP ALIGNABLE SYSTEM","1","1",null,null,"28.19777778",null,"0","1",null,"NA","NA"],
    [5257,"5257","Carrier M","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L5968","MULTIAXIAL ANKLE W DORSIFLEX","1","1",null,null,"21.89944444",null,"0","1",null,"NA","NA"],
    [5258,"5258","Carrier M","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L8460","SHRINKER ABOVE KNEE","1","1",null,null,"28.23888889",null,"0","1",null,"NA","NA"],
    [5259,"5259","Carrier M","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L5649","ISCH CONTAINMT/NARROW M-L SO","1","1",null,null,"28.21222222",null,"0","1",null,"NA","NA"],
    [5260,"5260","Carrier M","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L5650","TOT CONTACT AK/KNEE DISART S","1","1",null,null,"28.18277778",null,"0","1",null,"NA","NA"],
    [5261,"5261","Carrier M","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L5651","AK FLEX INNER SOCKET EXT FRA","1","1",null,null,"28.20472222",null,"0","1",null,"NA","NA"],
    [5262,"5262","Carrier M","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L5999","LOWR EXTREMITY PROSTHES NOS","1","1",null,null,"28.08805556",null,"0","1",null,"NA","NA"],
    [5263,"5263","Carrier M","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L5631","AK/KNEE DISARTIC ACRYLIC SOC","1","1",null,null,"28.27666667",null,"0","1",null,"NA","NA"],
    [5264,"5264","Carrier M","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0486","ORAL DEVICE/APPLIANCE CUSFAB","2",null,"1",null,"59.67041667",null,"0","2",null,"NA","NA"],
    [5265,"5265","Carrier M","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L5845","KNEE-SHIN SYS STANCE FLEXION","1",null,"1",null,"28.26305556",null,"0","1",null,"NA","NA"],
    [5266,"5266","Carrier M","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L5920","ENDO AK/HIP ALIGNABLE SYSTEM","1",null,"1",null,"28.19777778",null,"0","1",null,"NA","NA"],
    [5267,"5267","Carrier M","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L5968","MULTIAXIAL ANKLE W DORSIFLEX","1",null,"1",null,"21.89944444",null,"0","1",null,"NA","NA"],
    [5268,"5268","Carrier M","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L5652","SUCTION SUSP AK/KNEE DISART","1",null,"1",null,"28.25111111",null,"0","1",null,"NA","NA"],
    [5269,"5269","Carrier M","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L5649","ISCH CONTAINMT/NARROW M-L SO","1",null,"1",null,"28.21222222",null,"0","1",null,"NA","NA"],
    [5270,"5270","Carrier M","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L5650","TOT CONTACT AK/KNEE DISART S","1",null,"1",null,"28.18277778",null,"0","1",null,"NA","NA"],
    [5271,"5271","Carrier M","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L5631","AK/KNEE DISARTIC ACRYLIC SOC","1",null,"1",null,"28.27666667",null,"0","1",null,"NA","NA"],
    [5272,"5272","Carrier M","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L5999","LOWR EXTREMITY PROSTHES NOS","1",null,"1",null,"28.08805556",null,"0","1",null,"NA","NA"],
    [5273,"5273","Carrier M","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L5828","ENDO KNEE-SHIN FLUID SWG/STA","1",null,"1",null,"28.2575",null,"0","1",null,"NA","NA"],
    [5274,"5274","Carrier M","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","797","0.522",null,"6.477589012","14.70088325","0","179","618","0","SEMAGLUTIDE","RYBELSUS,OZEMPIC"],
    [5275,"5275","Carrier M","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","351","0.7265",null,"1.472544038","7.279893469","0","80","271","0","TESTOSTERONE","ANDROGEL"],
    [5276,"5276","Carrier M","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","303","0.8218",null,"6.566422056","10.36717708","0","67","236","0","SEMAGLUTIDE","WEGOVY"],
    [5277,"5277","Carrier M","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","294","0.3912",null,"13.86616466","13.64884643","0","74","220","0","TIRZEPATIDE","MOUNJARO"],
    [5278,"5278","Carrier M","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","238","0.8992",null,"1.48001773","11.4857375","0","47","191","0","OMEPRAZOLE","OMEPRAZOLE"],
    [5279,"5279","Carrier M","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","227","0.5815",null,"14.35487558","19.51986299","0","90","137","0","AMPHET/DEXTR","ADDERALL,MYDAYIS"],
    [5280,"5280","Carrier M","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","189","0.7354",null,"2.533647343","12.01464661","0","23","166","0","TACROLIMUS","PROTOPIC"],
    [5281,"5281","Carrier M","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","178","0.6742",null,"8.015108025","36.25770651","0","34","144","0","DUPILUMAB","DUPIXENT"],
    [5282,"5282","Carrier M","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","156","0.7628",null,"5.242064394","9.855296771","0","43","113","0","DULAGLUTIDE","TRULICITY"],
    [5283,"5283","Carrier M","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","143","0.8881",null,"0.764269547","9.454905093","0","27","116","0","PANTOPRAZOLE","PANTOPRAZOLE"],
    [5284,"5284","Carrier M","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","36","1",null,"0.1","6.75","0","4","32","0","CLASCOTERONE","WINLEVI"],
    [5285,"5285","Carrier M","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","17","1",null,"0.1","14.66666667","0","1","16","0","LANSOPRAZOLE","LANSOPRAZOLE"],
    [5286,"5286","Carrier M","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","14","1",null,"0.1","18","0","2","12","0","RABEPRAZOLE","RABEPRAZOLE,PANTOPRAZOLE,OMEPRAZOLE"],
    [5287,"5287","Carrier M","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","13","1",null,"36","15.27272727","0","2","11","0","IMMUNE GLOBULIN","HIZENTRA"],
    [5288,"5288","Carrier M","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","12","1",null,"0.1","0.1","0","1","11","0","PLECANATIDE","TRULANCE"],
    [5289,"5289","Carrier M","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","11","1",null,"14.4","12","0","5","6","0","DIROXIMEL FUMARATE","VUMERITY"],
    [5290,"5290","Carrier M","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","11","1",null,"0.1","14.4","0","1","10","0","TAZAROTENE TOPICAL","ARAZLO"],
    [5291,"5291","Carrier M","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","10","1",null,"0.1","378","0","6","4","0","MORPHINE SUL","MORPHINE"],
    [5292,"5292","Carrier M","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","9","1",null,"6","28","0","4","5","0","BUPROPION/DEXTROMETHORPHAN","AUVELITY"],
    [5293,"5293","Carrier M","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,"3","6","0","8","0","0","VALGANCICLOVIR","VALGANCICLOVIR"],
    [5294,"5294","Carrier M","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","9",null,"1","48","0.1","0","2","7","0","SEMIGLUTIDE","WEGOVY"],
    [5295,"5295","Carrier M","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","4",null,"1","24","0.1","0","1","3","0","SEMIGLUTIDE","RYBELSUS,OZEMPIC"],
    [5296,"5296","Carrier M","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","4",null,"1","120","16","0","1","3","0","LIRAGLUTIDE","SAXENDA"],
    [5297,"5297","Carrier M","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","4",null,"1","0.1","40","0","1","3","0","USTEKINUMAB","STELARA"],
    [5298,"5298","Carrier M","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3",null,"1","0.1","24","0","1","2","0","TESTOSTERONE","TESTOSTERONE,DEPO-TESTOSTERONE"],
    [5299,"5299","Carrier M","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3",null,"1","0.1","36","0","1","2","0","METHYLPHENIDATE","CONCERTA,JORNAY,QUILLIVANT,RELEXXII"],
    [5300,"5300","Carrier M","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3",null,"1","0.1","0.1","0","2","1","0","MODAFINIL","MODAFINIL"],
    [5301,"5301","Carrier M","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3",null,"1",null,"16","0",null,"3","0","FREMANEZUMAB-VFRM","AJOVY"],
    [5302,"5302","Carrier M","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3",null,"1",null,"32","0",null,"3","0","DUPILUMAB","DUPIXENT"],
    [5303,"5303","Carrier M","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"1",null,"24","0",null,"2","0","TIRZEPATIDE","MOUNJARO,TIRZEPATIDE"],
    [5304,"5304","Carrier A","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","8","0.625",null,"14.49","40.71",null,"1","7","1","NA","NA"],
    [5305,"5305","Carrier A","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","6","0.8333",null,"14.49","30.4",null,"1","5",null,"NA","NA"],
    [5306,"5306","Carrier A","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22612","Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)","5","0.8",null,null,"37.13",null,null,"5","1","NA","NA"],
    [5307,"5307","Carrier A","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63047","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","5","0.8",null,null,"49.32",null,null,"5","1","NA","NA"],
    [5308,"5308","Carrier A","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22633","Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar","4","0.75",null,"14.49","37.68",null,"1","3",null,"NA","NA"],
    [5309,"5309","Carrier A","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","33533","Coronary artery bypass, using arterial graft(s); single arterial graft","4","0",null,"0.01","2.16",null,"1","3",null,"NA","NA"],
    [5310,"5310","Carrier A","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","4","0.75",null,null,"40.88",null,null,"4","1","NA","NA"],
    [5311,"5311","Carrier A","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22614","Arthrodesis, posterior or posterolateral technique, single level; each additional vertebral segment (List separately in addition to code for primary procedure)","3","0.6667",null,null,"57.79","972",null,"3","2","NA","NA"],
    [5312,"5312","Carrier A","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22842","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)","3","1",null,null,"81.65","972",null,"3","2","NA","NA"],
    [5313,"5313","Carrier A","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22585","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace (List separately in addition to code for primary procedure)","2","0.5",null,null,"59.87",null,null,"2","1","NA","NA"],
    [5314,"5314","Carrier A","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","47563","Laparoscopy, surgical; cholecystectomy with cholangiography","2","0",null,null,"1.26",null,null,"2",null,"NA","NA"],
    [5315,"5315","Carrier A","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44205","Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomy","2","0",null,"5.02","0.01",null,"1","1",null,"NA","NA"],
    [5316,"5316","Carrier A","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","33508","Endoscopy, surgical, including video-assisted harvest of vein(s) for coronary artery bypass procedure (List separately in addition to code for primary procedure)","2","0",null,null,"0.09",null,null,"2",null,"NA","NA"],
    [5317,"5317","Carrier A","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22845","Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure)","2","0.5",null,null,"58.67",null,null,"2",null,"NA","NA"],
    [5318,"5318","Carrier A","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","33518","Coronary artery bypass, using venous graft(s) and arterial graft(s); 2 venous grafts (List separately in addition to code for primary procedure)","2","0",null,null,"0.09",null,null,"2",null,"NA","NA"],
    [5319,"5319","Carrier A","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63048","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure)","2","0.5",null,null,"56.33",null,null,"2",null,"NA","NA"],
    [5320,"5320","Carrier A","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44213","Laparoscopy, surgical, mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (List separately in addition to primary procedure)","2","0",null,"1.24","0.09",null,"1","1",null,"NA","NA"],
    [5321,"5321","Carrier A","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22842","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)","3","1",null,null,"81.65","972",null,"3","2","NA","NA"],
    [5322,"5322","Carrier A","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22610","Arthrodesis, posterior or posterolateral technique, single level; thoracic (with lateral transverse technique, when performed)","1","1",null,null,"107.89","768",null,"1","1","NA","NA"],
    [5323,"5323","Carrier A","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27134","Revision of total hip arthroplasty; both components, with or without autograft or allograft","1","1",null,null,"20.75",null,null,"1",null,"NA","NA"],
    [5324,"5324","Carrier A","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33340","Percutaneous transcatheter closure of the left atrial appendage with endocardial implant, including fluoroscopy, transseptal puncture, catheter placement(s), left atrial angiography, left atrial appendage angiography, when performed, and radiological supervision and interpretation","1","1",null,null,"1.63",null,null,"1",null,"NA","NA"],
    [5325,"5325","Carrier A","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33361","Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; percutaneous femoral artery approach","1","1",null,"63.6",null,null,"1",null,null,"NA","NA"],
    [5326,"5326","Carrier A","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22830","Exploration of spinal fusion","1","1",null,null,"107.89",null,null,"1",null,"NA","NA"],
    [5327,"5327","Carrier A","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63042","Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumbar","1","1",null,null,"2.54","768",null,"1","1","NA","NA"],
    [5328,"5328","Carrier A","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15769","Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia)","1","1",null,null,"6.94",null,null,"1",null,"NA","NA"],
    [5329,"5329","Carrier A","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64999","Unlisted procedure, nervous system","1","1",null,null,"6.94",null,null,"1",null,"NA","NA"],
    [5330,"5330","Carrier A","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22600","Arthrodesis, posterior or posterolateral technique, single level; cervical below C2 segment","1","1",null,null,"53.63",null,null,"1",null,"NA","NA"],
    [5331,"5331","Carrier A","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","49593","Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","1","1",null,null,"91.06",null,null,"1",null,"NA","NA"],
    [5332,"5332","Carrier A","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","425","0.68",null,null,"20.69",null,null,"425",null,"NA","NA"],
    [5333,"5333","Carrier A","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97140","Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes","380","0.6789",null,null,"21.57",null,null,"380",null,"NA","NA"],
    [5334,"5334","Carrier A","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","Colonoscopy, flexible; with biopsy, single or multiple","359","0.9666",null,"4.66","14.27",null,"10","349","1","NA","NA"],
    [5335,"5335","Carrier A","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45378","Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","336","0.9554",null,"4.66","19.3","240","10","326","1","NA","NA"],
    [5336,"5336","Carrier A","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97530","Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","327","0.6483",null,null,"22.03",null,null,"327",null,"NA","NA"],
    [5337,"5337","Carrier A","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","ECHO, transthoracic w/doppler, complete","308","0.9123",null,null,"5.65",null,null,"308",null,"NA","NA"],
    [5338,"5338","Carrier A","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97112","Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities","256","0.6523",null,null,"19.94",null,null,"256",null,"NA","NA"],
    [5339,"5339","Carrier A","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","MRI, lower extremity any joint; wo contr","231","0.8831",null,null,"6.61",null,null,"231",null,"NA","NA"],
    [5340,"5340","Carrier A","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45385","Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","220","0.9773",null,"7.49","14.89","276","6","214","2","NA","NA"],
    [5341,"5341","Carrier A","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74177","CT abd & pelv w contrast","167","0.9521",null,"0.28","4.83",null,"1","166",null,"NA","NA"],
    [5342,"5342","Carrier A","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27447","Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)","33","1",null,null,"34.36",null,null,"33",null,"NA","NA"],
    [5343,"5343","Carrier A","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93303","ECHO, transthoracic, complete cng","26","1",null,null,"0.69","120",null,"26","1","NA","NA"],
    [5344,"5344","Carrier A","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70552","Contrast MRI of brain","20","1",null,null,"0",null,null,"20",null,"NA","NA"],
    [5345,"5345","Carrier A","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","45384","Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","19","1",null,null,"11.23",null,null,"19",null,"NA","NA"],
    [5346,"5346","Carrier A","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93312","ECHO, transesophageal, heart, compl","18","1",null,null,"0.01",null,null,"18",null,"NA","NA"],
    [5347,"5347","Carrier A","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72157","MRI of thoracic spine","16","1",null,null,"1.47",null,null,"16",null,"NA","NA"],
    [5348,"5348","Carrier A","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29823","Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular si","16","1",null,null,"42.16",null,null,"16","1","NA","NA"],
    [5349,"5349","Carrier A","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","45381","Colonoscopy, flexible; with directed submucosal injection(s), any substance","14","1",null,"0.02","18.05",null,"1","13",null,"NA","NA"],
    [5350,"5350","Carrier A","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","78816","Imaging PET/CT full body","13","1",null,null,"7.69",null,null,"13",null,"NA","NA"],
    [5351,"5351","Carrier A","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70543","MRI orb/fc/nck w/o cntrst flwd cntr","11","1",null,null,"8.95",null,null,"11",null,"NA","NA"],
    [5352,"5352","Carrier A","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","72196","MRI, pelvis; with contrast material(s)","6",null,"0.1667","0.66","14.73",null,"1","5",null,"NA","NA"],
    [5353,"5353","Carrier A","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","72148","MRI of lumbar spine","163",null,"0.0123",null,"16.27",null,null,"163",null,"NA","NA"],
    [5354,"5354","Carrier A","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","71250","DIAGNOSTIC CT THORAX W/O CNTRST","95",null,"0.0105","0.27","8.18","168","1","94","1","NA","NA"],
    [5355,"5355","Carrier A","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","73721","MRI, lower extremity any joint; wo contr","231",null,"0.0043",null,"6.61",null,null,"231",null,"NA","NA"],
    [5356,"5356","Carrier A","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1002","Residential treatment, Substance Use Disorder","7","1",null,null,"36.66",null,null,"7",null,"NA","NA"],
    [5357,"5357","Carrier A","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1002","Residential treatment, Substance Use Disorder","7","1",null,null,"36.66",null,null,"7",null,"NA","NA"],
    [5358,"5358","Carrier A","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71271","CT THORAX LW DOSE LNG CA SCR C-","36","0.8889",null,null,"3.38",null,null,"36",null,"NA","NA"],
    [5359,"5359","Carrier A","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","92507","Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual","20","0.45",null,null,"42.26",null,null,"20",null,"NA","NA"],
    [5360,"5360","Carrier A","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","20","1",null,null,"17.36",null,null,"20",null,"NA","NA"],
    [5361,"5361","Carrier A","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","8","0.75",null,"34.72","136.73",null,"2","6",null,"NA","NA"],
    [5362,"5362","Carrier A","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","8","0.75",null,"34.72","136.73",null,"2","6",null,"NA","NA"],
    [5363,"5363","Carrier A","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","8","0.75",null,"34.72","136.73",null,"2","6",null,"NA","NA"],
    [5364,"5364","Carrier A","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H2036","Alcohol and/or other drug treatment program, per diem","6","0.8333",null,null,"54.38",null,null,"6",null,"NA","NA"],
    [5365,"5365","Carrier A","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours","5","1",null,null,"38.04",null,null,"5",null,"NA","NA"],
    [5366,"5366","Carrier A","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","92523","Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language)","2","1",null,null,"19.39",null,null,"2",null,"NA","NA"],
    [5367,"5367","Carrier A","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70551","MRI of brain","2","1",null,null,"0.07",null,null,"2",null,"NA","NA"],
    [5368,"5368","Carrier A","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90834","Psychotherapy, 45 minutes with patient","2","0",null,null,"4.15",null,null,"2",null,"NA","NA"],
    [5369,"5369","Carrier A","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","20","1",null,null,"17.36",null,null,"20",null,"NA","NA"],
    [5370,"5370","Carrier A","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0035","Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours","5","1",null,null,"38.04",null,null,"5",null,"NA","NA"],
    [5371,"5371","Carrier A","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","92523","Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language)","2","1",null,null,"19.39",null,null,"2",null,"NA","NA"],
    [5372,"5372","Carrier A","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70551","MRI of brain","2","1",null,null,"0.07",null,null,"2",null,"NA","NA"],
    [5373,"5373","Carrier A","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","67900","Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)","1","1",null,null,"114.66",null,null,"1",null,"NA","NA"],
    [5374,"5374","Carrier A","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70553","MRI of brain and further sequences","1","1",null,null,"0",null,null,"1",null,"NA","NA"],
    [5375,"5375","Carrier A","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","21209","Osteoplasty, facial bones; reduction","1","1",null,null,"114.66",null,null,"1",null,"NA","NA"],
    [5376,"5376","Carrier A","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","21137","Reduction forehead; contouring only","1","1",null,null,"114.66",null,null,"1",null,"NA","NA"],
    [5377,"5377","Carrier A","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","21270","Malar augmentation, prosthetic material","1","1",null,null,"114.66",null,null,"1",null,"NA","NA"],
    [5378,"5378","Carrier A","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97110","Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","1","1",null,null,"19.14",null,null,"1",null,"NA","NA"],
    [5379,"5379","Carrier A","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19303","Mastectomy, simple, complete","1","1",null,null,"22.64",null,null,"1",null,"NA","NA"],
    [5380,"5380","Carrier A","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97140","Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes","1","1",null,null,"19.14",null,null,"1",null,"NA","NA"],
    [5381,"5381","Carrier A","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H2035","Alcohol and/or other drug treatment program, per hour","1","1",null,null,"72.13",null,null,"1",null,"NA","NA"],
    [5382,"5382","Carrier A","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","30400","Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tip","1","1",null,null,"114.66",null,null,"1",null,"NA","NA"],
    [5383,"5383","Carrier A","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19350","Nipple/areola reconstruction","1","1",null,null,"22.64",null,null,"1",null,"NA","NA"],
    [5384,"5384","Carrier A","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]","300","0.95",null,null,"2.13",null,null,"300",null,"NA","NA"],
    [5385,"5385","Carrier A","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","14","0.9286",null,null,"4.05",null,null,"14",null,"NA","NA"],
    [5386,"5386","Carrier A","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","7","0.8571",null,null,"6.57",null,null,"7",null,"NA","NA"],
    [5387,"5387","Carrier A","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0748","Elec Osteogen Stim Spinal","2","0.5",null,null,"12.99",null,null,"2",null,"NA","NA"],
    [5388,"5388","Carrier A","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2402","Negative pressure wound therapy electrical pump, stationary or portable","1","1",null,null,"46.44",null,null,"1",null,"NA","NA"],
    [5389,"5389","Carrier A","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2402","Negative pressure wound therapy electrical pump, stationary or portable","1","1",null,null,"46.44",null,null,"1",null,"NA","NA"],
    [5390,"5390","Carrier A","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0601","Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]","300","0.95",null,null,"2.13",null,null,"300",null,"NA","NA"],
    [5391,"5391","Carrier A","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","14","0.9286",null,null,"4.05",null,null,"14",null,"NA","NA"],
    [5392,"5392","Carrier A","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","7","0.8571",null,null,"6.57",null,null,"7",null,"NA","NA"],
    [5393,"5393","Carrier A","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0748","Elec Osteogen Stim Spinal","2","0.5",null,null,"12.99",null,null,"2",null,"NA","NA"],
    [5394,"5394","Carrier A","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0601","Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]","300",null,"0.0033",null,"2.13",null,null,"300",null,"NA","NA"],
    [5395,"5395","Carrier A","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","5","0.6",null,null,"12.01",null,null,"5",null,"NA","NA"],
    [5396,"5396","Carrier A","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4216","Sterile water/saline, 10 ml","4","0",null,"4.54","0.01",null,"3","1",null,"NA","NA"],
    [5397,"5397","Carrier A","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4232","Syringe W/Needle Insulin 3cc","1","0",null,null,"20.26",null,null,"1",null,"NA","NA"],
    [5398,"5398","Carrier A","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4217","Sterile water/saline, 500 ml","1","0",null,"0.01",null,null,"1",null,null,"NA","NA"],
    [5399,"5399","Carrier A","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4230","Infus Insulin Pump Non Needl","1","0",null,null,"20.26",null,null,"1",null,"NA","NA"],
    [5400,"5400","Carrier A","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","5","0.6",null,null,"12.01",null,null,"5",null,"NA","NA"],
    [5401,"5401","Carrier A","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4216","Sterile water/saline, 10 ml","4","0",null,"4.54","0.01",null,"3","1",null,"NA","NA"],
    [5402,"5402","Carrier A","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4232","Syringe W/Needle Insulin 3cc","1","0",null,null,"20.26",null,null,"1",null,"NA","NA"],
    [5403,"5403","Carrier A","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4217","Sterile water/saline, 500 ml","1","0",null,"0.01",null,null,"1",null,null,"NA","NA"],
    [5404,"5404","Carrier A","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4230","Infus Insulin Pump Non Needl","1","0",null,null,"20.26",null,null,"1",null,"NA","NA"],
    [5405,"5405","Carrier A","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","52","0.6346",null,"28.19","46.09",null,"27","25",null,"HYDROCODONE-ACETAMINOPHEN","HYDROCODONE-ACETAMINOPHEN"],
    [5406,"5406","Carrier A","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","52","0.3077",null,"7.4","32",null,"8","44",null,"SEMAGLUTIDE","OZEMPIC, RYBELSUS"],
    [5407,"5407","Carrier A","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","50","0.82",null,"34.58","52.45",null,"11","39",null,"ADALIMUMAB","HUMIRA"],
    [5408,"5408","Carrier A","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","46","0.1957",null,"18.69","41.79",null,"4","42",null,"TIRZEPATIDE","MOUNJARO"],
    [5409,"5409","Carrier A","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","32","0.875",null,"1.68","28.39",null,"1","31",null,"CYCLOSPORINE (OPHTH)","CEQUA, CYCLOSPORINE, RESTASIS"],
    [5410,"5410","Carrier A","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","24","0.8333",null,"10.67","79.91",null,"6","18",null,"DUPILUMAB","DUPIXENT, DUPIXENT DUPILUMAB"],
    [5411,"5411","Carrier A","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","24","0",null,"6.3","10.21",null,"3","21",null,"SEMAGLUTIDE (WEIGHT MANAGEMENT)","WEGOVY"],
    [5412,"5412","Carrier A","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","22","0.6364",null,"6.73","42.8",null,"9","13",null,"OXYCODONE HCL","OXYCODONE HCL, OXYCONTIN"],
    [5413,"5413","Carrier A","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","16","0.75",null,"6.09","192.26",null,"5","11",null,"GALCANEZUMAB-GNLM","EMGALITY"],
    [5414,"5414","Carrier A","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","16","0.8125",null,"2.49","40.85",null,"2","14",null,"ETANERCEPT","ENBREL"],
    [5415,"5415","Carrier A","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","12","1",null,"18.01","62.83",null,"4","8",null,"FREMANEZUMAB-VFRM","AJOVY"],
    [5416,"5416","Carrier A","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","12","1",null,"8.31","27.14",null,"3","9",null,"PLECANATIDE","TRULANCE"],
    [5417,"5417","Carrier A","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","9","1",null,"37.57","41.59",null,"1","8",null,"RISANKIZUMAB-RZAA","SKYRIZI"],
    [5418,"5418","Carrier A","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,"5.18","1.7",null,"6","1",null,"OXYCODONE W/ ACETAMINOPHEN","OXYCODONE-ACETAMINOPHEN"],
    [5419,"5419","Carrier A","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","6","1",null,null,"33.93",null,"0","6",null,"TOCILIZUMAB","ACTEMRA"],
    [5420,"5420","Carrier A","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","5","1",null,"13.04","24.66",null,"4","1",null,"BUPRENORPHINE","BUPRENORPHINE"],
    [5421,"5421","Carrier A","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","5","1",null,"1.43","6.52",null,"1","4",null,"DULAGLUTIDE","TRULICITY"],
    [5422,"5422","Carrier A","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","4","1",null,"14.73","40.74",null,"1","3",null,"UPADACITINIB","RINVOQ/ER"],
    [5423,"5423","Carrier A","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","4","1",null,"10.1",null,null,"4","0",null,"BUPRENORPHINE HCL","BELBUCA"],
    [5424,"5424","Carrier A","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","3","1",null,"1.98","37.83",null,"1","2",null,"LIFITEGRAST","XIIDRA"],
    [5425,"5425","Carrier A","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"1","7.73",null,null,"2","0",null,"HYDROCODONE BITARTRATE","HYDROCODONE BITARTRATE"],
    [5426,"5426","Carrier A","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1",null,"309.76",null,"0","1",null,"SIPONIMOD FUMARATE","MAYZENT"],
    [5427,"5427","Carrier A","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1",null,"265.86",null,"0","1",null,"NICOTINE","NICOTROL"],
    [5428,"5428","Carrier A","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1",null,"234.62",null,"0","1",null,"ERENUMAB-AOOE","AIMOVIG"],
    [5429,"5429","Carrier A","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"0.4","25.05","97.18",null,"1","1",null,"EVOLOCUMAB","REPATHA SURECLICK"],
    [5430,"5430","Carrier A","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3",null,"0.3333","267.93","101.67",null,"2","1",null,"ADALIMUMAB","HUMIRA"],
    [5431,"5431","Carrier A","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"0.3333",null,"76.77",null,"0","1",null,"ETANERCEPT","ENBREL"],
    [5432,"5432","Carrier A","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"0.25","2.77",null,null,"1","0",null,"DUPILUMAB","DUPIXENT DUPILUMAB"],
    [5433,"5433","Carrier A","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"0.125","306.26",null,null,"1","0",null,"OXYCODONE HCL","OXYCODONE HCL"],
    [5434,"5434","Carrier A","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"0.0769","5.89",null,null,"1","0",null,"FLUTICASONE PROPIONATE  HFA","FLOVENT HFA"],
    [5435,"5435","Carrier N","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44205","LAP COLECTOMY PART W/ILEUM","2","1",null,"0","0","0","0","2","0","NA","NA"],
    [5436,"5436","Carrier N","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44207","L COLECTOMY/COLOPROCTOSTOMY","2","1",null,"0","0","0","0","2","0","NA","NA"],
    [5437,"5437","Carrier N","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43644","LAP GASTRIC BYPASS/ROUX-EN-Y","1","1",null,"0","24","0","0","1","0","NA","NA"],
    [5438,"5438","Carrier N","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27299","UNLISTED PX PELVIS/HIP JOINT","1","1",null,"0","24","0","0","1","0","NA","NA"],
    [5439,"5439","Carrier N","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","51590","REMOVE BLADDER/REVISE TRACT","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [5440,"5440","Carrier N","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","62165","REMOVE PITUIT TUMOR W/SCOPE","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [5441,"5441","Carrier N","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93654","COMPRE EP EVAL TX VT","1","1",null,"0","24","0","0","1","0","NA","NA"],
    [5442,"5442","Carrier N","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44204","LAPARO PARTIAL COLECTOMY","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [5443,"5443","Carrier N","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19361","BRST RCNSTJ LATSMS DRSI FLAP","1","1",null,"0","24","0","0","1","0","NA","NA"],
    [5444,"5444","Carrier N","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96416","CHEMO PROLONG INFUSE W/PUMP","1","1",null,"0","48","0","0","1","0","NA","NA"],
    [5445,"5445","Carrier N","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44205","LAP COLECTOMY PART W/ILEUM","2","1",null,"0","0","0","0","2","0","NA","NA"],
    [5446,"5446","Carrier N","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44207","L COLECTOMY/COLOPROCTOSTOMY","2","1",null,"0","0","0","0","2","0","NA","NA"],
    [5447,"5447","Carrier N","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43644","LAP GASTRIC BYPASS/ROUX-EN-Y","1","1",null,"0","24","0","0","1","0","NA","NA"],
    [5448,"5448","Carrier N","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27299","UNLISTED PX PELVIS/HIP JOINT","1","1",null,"0","24","0","0","1","0","NA","NA"],
    [5449,"5449","Carrier N","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","51590","REMOVE BLADDER/REVISE TRACT","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [5450,"5450","Carrier N","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","62165","REMOVE PITUIT TUMOR W/SCOPE","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [5451,"5451","Carrier N","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93654","COMPRE EP EVAL TX VT","1","1",null,"0","24","0","0","1","0","NA","NA"],
    [5452,"5452","Carrier N","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44204","LAPARO PARTIAL COLECTOMY","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [5453,"5453","Carrier N","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19361","BRST RCNSTJ LATSMS DRSI FLAP","1","1",null,"0","24","0","0","1","0","NA","NA"],
    [5454,"5454","Carrier N","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96416","CHEMO PROLONG INFUSE W/PUMP","1","1",null,"0","48","0","0","1","0","NA","NA"],
    [5455,"5455","Carrier N","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","92507","SPEECH/HEARING THERAPY","39","0.974",null,"0","12.9","0","0","39","0","NA","NA"],
    [5456,"5456","Carrier N","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J0585","INJECTION,ONABOTULINUMTOXINA","30","0.767",null,"342","108.9","0","4","26","0","NA","NA"],
    [5457,"5457","Carrier N","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95810","POLYSOM 6/> YRS 4/> PARAM","21","0.905",null,"24","85.2","0","1","20","0","NA","NA"],
    [5458,"5458","Carrier N","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64615","CHEMODENERV MUSC MIGRAINE","17","0.824",null,"240","114","0","1","16","0","NA","NA"],
    [5459,"5459","Carrier N","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J7323","EUFLEXXA INJ PER DOSE","15","0.867",null,"24","54.9","0","1","14","0","NA","NA"],
    [5460,"5460","Carrier N","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","Q5103","INJECTION, INFLECTRA","14","0.929",null,"102","1032","0","8","6","0","NA","NA"],
    [5461,"5461","Carrier N","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE O/P EST MOD 30 MIN","13","0.769",null,"0","79.4","0","0","13","0","NA","NA"],
    [5462,"5462","Carrier N","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","81479","UNLISTED MOLECULAR PATHOLOGY","12","0.833",null,"0","46","0","0","12","0","NA","NA"],
    [5463,"5463","Carrier N","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J9035","BEVACIZUMAB INJECTION","8","1",null,"0","33","0","0","8","0","NA","NA"],
    [5464,"5464","Carrier N","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J0178","AFLIBERCEPT INJECTION","7","0.857",null,"0","24","0","0","7","0","NA","NA"],
    [5465,"5465","Carrier N","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","92507","SPEECH/HEARING THERAPY","38","0.974",null,"0","10.1","0","0","38","0","NA","NA"],
    [5466,"5466","Carrier N","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J0585","INJECTION,ONABOTULINUMTOXINA","23","0.767",null,"552","117.8","0","1","22","0","NA","NA"],
    [5467,"5467","Carrier N","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95810","POLYSOM 6/> YRS 4/> PARAM","19","0.905",null,"24","62.7","0","1","18","0","NA","NA"],
    [5468,"5468","Carrier N","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64615","CHEMODENERV MUSC MIGRAINE","14","0.824",null,"0","113.1","0","0","14","0","NA","NA"],
    [5469,"5469","Carrier N","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J7323","EUFLEXXA INJ PER DOSE","13","0.867",null,"24","38","0","1","12","0","NA","NA"],
    [5470,"5470","Carrier N","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","Q5103","INJECTION, INFLECTRA","13","0.929",null,"113.1","1032","0","7","6","0","NA","NA"],
    [5471,"5471","Carrier N","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81479","UNLISTED MOLECULAR PATHOLOGY","10","0.833",null,"0","36","0","0","10","0","NA","NA"],
    [5472,"5472","Carrier N","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99214","OFFICE O/P EST MOD 30 MIN","10","0.769",null,"0","74.4","0","0","10","0","NA","NA"],
    [5473,"5473","Carrier N","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J9035","BEVACIZUMAB INJECTION","8","1",null,"0","33","0","0","8","0","NA","NA"],
    [5474,"5474","Carrier N","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A9276","DISPOSABLE SENSOR, CGM SYS","7","1",null,"48","44","0","1","6","0","NA","NA"],
    [5475,"5475","Carrier N","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22633","Arthrodesis","2",null,"1","48","0","0","2","0","0","NA","NA"],
    [5476,"5476","Carrier N","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","J0585","INJECTION, ONABOTULINUMTOXINA, 1 UNIT;  Other complications of pregnancy","2",null,"1","24","0","0","2","0","0","NA","NA"],
    [5477,"5477","Carrier N","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","30465","Under Repair Procedures on the Nose","1",null,"1","24","0","0","1","0","0","NA","NA"],
    [5478,"5478","Carrier N","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","36476","�Endovascular Ablation Therapy of Incompetent Extremity Veins�","1",null,"1","0","432","0","0","1","0","NA","NA"],
    [5479,"5479","Carrier N","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27279","ARTHRODESIS, SACROILIAC JOINT, PERCUTANEOUS OR MINIMALLY INVASIVE (INDIRECT VISUALIZATION), WITH IMAGE GUIDANCE, INCLUDES OBTAINING BONE GRAFT WHEN PERFORMED, AND PLACEMENT OF TRANSFIXING DEVICE","1",null,"1","0","840","0","0","1","0","NA","NA"],
    [5480,"5480","Carrier N","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","31599","Endoscopic laryngoplasty, Percutaneous laryngeal injections, and Removal of a keel or stent.","1",null,"1","0","144","0","0","1","0","NA","NA"],
    [5481,"5481","Carrier N","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","73221","Magnetic resonance imaging (MRI) of the upper extremity without contrast material","1",null,"1","0","984","0","0","1","0","NA","NA"],
    [5482,"5482","Carrier N","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L2055","Hip-knee-ankle-foot Orthotics","1",null,"1","0","2448","0","0","1","0","NA","NA"],
    [5483,"5483","Carrier N","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","42975","drug-induced sleep endoscopy (DISE) that includes a dynamic evaluation of the tongue base, velum, pharynx, and larynx to assess sleep-disordered breathing.","1",null,"1","0","3096","0","0","1","0","NA","NA"],
    [5484,"5484","Carrier N","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","Q5103","INFLECTRA","1",null,"1","0","264","0","0","1","0","NA","NA"],
    [5485,"5485","Carrier N","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","MENTAL HEALTH INPATIENT","3","1",null,null,"0","0","3","0","0","NA","NA"],
    [5486,"5486","Carrier N","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1002","SUBSTANCE ABUSE RESIDENTIAL","2","1",null,null,"0","0","2","0","0","NA","NA"],
    [5487,"5487","Carrier N","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1001","MENTAL HEALTH RESIDENTIAL","1","0",null,null,"0","0","1","0","0","NA","NA"],
    [5488,"5488","Carrier N","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","MENTAL HEALTH INPATIENT","3","1",null,null,"0","0","3","0","0","NA","NA"],
    [5489,"5489","Carrier N","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1002","SUBSTANCE ABUSE RESIDENTIAL","2","1",null,null,"0","0","2","0","0","NA","NA"],
    [5490,"5490","Carrier N","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","TRANSCRANIAL MAGNETIC STIMULATION (TMS)","4","1",null,"0",null,"0","0","4","0","NA","NA"],
    [5491,"5491","Carrier N","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","SUBSTANCE ABUSE PARTIAL HOSPITALIZATION PROGRAM","2","1",null,"0",null,"0","0","2","0","NA","NA"],
    [5492,"5492","Carrier N","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","PSYCHIATRIC TREATMENT PARTIAL HOSPITALIZATION","2","1",null,"0",null,"0","0","2","0","NA","NA"],
    [5493,"5493","Carrier N","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90853","MENTAL HEALTH GROUP THERAPY","1","1",null,"0",null,"0","0","1","0","NA","NA"],
    [5494,"5494","Carrier N","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","EATING DISORDER PARTIAL HOSPITALIZATION PROGRAM","1","1",null,"0",null,"0","0","1","0","NA","NA"],
    [5495,"5495","Carrier N","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","036T","APPLIED BEHAVIORAL ANALYSIS","1","1",null,"0",null,"0","0","1","0","NA","NA"],
    [5496,"5496","Carrier N","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90867","TRANSCRANIAL MAGNETIC STIMULATION (TMS)","4","1",null,"0",null,"0","0","4","0","NA","NA"],
    [5497,"5497","Carrier N","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0035","SUBSTANCE ABUSE PARTIAL HOSPITALIZATION PROGRAM","2","1",null,"0",null,"0","0","2","0","NA","NA"],
    [5498,"5498","Carrier N","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0035","PSYCHIATRIC TREATMENT PARTIAL HOSPITALIZATION","2","1",null,"0",null,"0","0","2","0","NA","NA"],
    [5499,"5499","Carrier N","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90853","MENTAL HEALTH GROUP THERAPY","1","1",null,"0",null,"0","0","1","0","NA","NA"],
    [5500,"5500","Carrier N","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0035","EATING DISORDER PARTIAL HOSPITALIZATION PROGRAM","1","1",null,"0",null,"0","0","1","0","NA","NA"],
    [5501,"5501","Carrier N","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","036T","APPLIED BEHAVIORAL ANALYSIS","1","1",null,"0",null,"0","0","1","0","NA","NA"],
    [5502,"5502","Carrier N","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97151","ABA Therapy","1",null,"1","0","264","0","0","1","0","NA","NA"],
    [5503,"5503","Carrier N","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L5645","BK FLEX INNER SOCKET EXT FRA","1","1",null,"0","144","0","0","1","0","NA","NA"],
    [5504,"5504","Carrier N","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L5301","BK MOLD SOCKET SACH FT ENDO","1","1",null,"0","144","0","0","1","0","NA","NA"],
    [5505,"5505","Carrier N","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L5679","SOCKET INSERT W/O LOCK MECH","1","1",null,"0","144","0","0","1","0","NA","NA"],
    [5506,"5506","Carrier N","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L5629","BELOW KNEE ACRYLIC SOCKET","1","1",null,"0","144","0","0","1","0","NA","NA"],
    [5507,"5507","Carrier N","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L8699","PROSTHETIC IMPLANT NOS","1","0",null,"0","0","0","0","1","0","NA","NA"],
    [5508,"5508","Carrier N","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L5637","BELOW KNEE TOTAL CONTACT","1","1",null,"0","144","0","0","1","0","NA","NA"],
    [5509,"5509","Carrier N","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L5940","ENDO BK ULTRA-LIGHT MATERIAL","1","1",null,"0","144","0","0","1","0","NA","NA"],
    [5510,"5510","Carrier N","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L8680","IMPLT NEUROSTIM ELCTR EACH","1","1",null,"0","96","0","0","1","0","NA","NA"],
    [5511,"5511","Carrier N","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L5685","BELOW KNEE SUS/SEAL SLEEVE","1","1",null,"0","144","0","0","1","0","NA","NA"],
    [5512,"5512","Carrier N","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L5620","TEST SOCKET BELOW KNEE","1","1",null,"0","144","0","0","1","0","NA","NA"],
    [5513,"5513","Carrier N","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L5645","BK FLEX INNER SOCKET EXT FRA","1","1",null,"0","144","0","0","1","0","NA","NA"],
    [5514,"5514","Carrier N","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L5301","BK MOLD SOCKET SACH FT ENDO","1","1",null,"0","144","0","0","1","0","NA","NA"],
    [5515,"5515","Carrier N","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L5679","SOCKET INSERT W/O LOCK MECH","1","1",null,"0","144","0","0","1","0","NA","NA"],
    [5516,"5516","Carrier N","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L5629","BELOW KNEE ACRYLIC SOCKET","1","1",null,"0","144","0","0","1","0","NA","NA"],
    [5517,"5517","Carrier N","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L5637","BELOW KNEE TOTAL CONTACT","1","1",null,"0","144","0","0","1","0","NA","NA"],
    [5518,"5518","Carrier N","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L5940","ENDO BK ULTRA-LIGHT MATERIAL","1","1",null,"0","144","0","0","1","0","NA","NA"],
    [5519,"5519","Carrier N","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L8680","IMPLT NEUROSTIM ELCTR EACH","1","1",null,"0","96","0","0","1","0","NA","NA"],
    [5520,"5520","Carrier N","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L5685","BELOW KNEE SUS/SEAL SLEEVE","1","1",null,"0","144","0","0","1","0","NA","NA"],
    [5521,"5521","Carrier N","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L5620","TEST SOCKET BELOW KNEE","1","1",null,"0","144","0","0","1","0","NA","NA"],
    [5522,"5522","Carrier N","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","K0861","PWC GP3 STD MULT POW OPT S/B","1","1",null,"0","96","0","0","1","0","NA","NA"],
    [5523,"5523","Carrier N","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","79","0.37",null,"1.38","28.53","0","9","70","0","Semaglutide","OZEMPIC"],
    [5524,"5524","Carrier N","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","63","0.8413",null,"1.03","38.58","0","16","47","0","Rimegepant","NURTEC"],
    [5525,"5525","Carrier N","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","45","0.8",null,"2.34","40.825","0","8","37","0","Ssemaglutide","WEGOVY"],
    [5526,"5526","Carrier N","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","43","0.47",null,"0.2625","2.875","0","7","36","0","Ssemaglutide","OZEMPIC"],
    [5527,"5527","Carrier N","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","38","0.92",null,"8.07","29.725","0","10","28","0","Ssemaglutide","OZEMPIC"],
    [5528,"5528","Carrier N","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","36","0.56",null,"10.985","52.64","0","15","21","0","Lisdexamfetamine","VYVANSE"],
    [5529,"5529","Carrier N","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","36","0.89",null,"1.34","20.695","0","15","21","0","Deucravacitinib","STELARA"],
    [5530,"5530","Carrier N","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","34","0.56",null,"0.96","33.92","0","6","28","0","Ruxolitinib","OPZELURA"],
    [5531,"5531","Carrier N","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","33","0.39",null,"1.44","19.25","0","2","31","0","Tirzepatide","MOUNJARO"],
    [5532,"5532","Carrier N","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","31","0.29",null,"57.625","60.77","0","16","15","0","EmtricitabineTenofovir Alafenamide)","DESCOVY"],
    [5533,"5533","Carrier N","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","27","1",null,"1","16.64","0","6","21","0","Adalimumab","HUMIRA"],
    [5534,"5534","Carrier N","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","24","1",null,"0.01","23.5","0","16","8","0","Apixaban","ELIQUIS"],
    [5535,"5535","Carrier N","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","16","1",null,"0.01","0.02","0","2","14","0","Dupilumab","DUPIXENT"],
    [5536,"5536","Carrier N","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","15","1",null,"1.05","13.72","0","6","9","0","Amphetamine and Dextroamphetamine","DEXTROAMPHETAMINE"],
    [5537,"5537","Carrier N","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","13","1",null,"11.51","17.07","0","2","11","0","Evolocumab","REPATHA SURECLICK"],
    [5538,"5538","Carrier N","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","13","1",null,"0.01","34.53","0","4","9","0","Risankizumab-rzaa","SKYRIZI PEN"],
    [5539,"5539","Carrier N","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","10","1",null,"0.01","0.01","0","5","5","0","Concerta","METHYLPHENIDATE ER"],
    [5540,"5540","Carrier N","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","10","1",null,null,"6.7","0","0","10","0","Ssemaglutide","WEGOVY"],
    [5541,"5541","Carrier N","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","9","1",null,"8.86","0.04","0","7","2","0","Menotropins","MENOPUR"],
    [5542,"5542","Carrier N","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","9","1",null,"1.62","47","0","3","6","0","Erenumab-aooe","AIMOVIG"],
    [5543,"5543","Carrier N","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3",null,"1","32","0","0","3","0","0","Ustekinumab","STELARA"],
    [5544,"5544","Carrier B","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","METALLIC  MESH BETWEEN VERTEBRAE","13","0.9231",null,"0","189.88","0","0","13","0","NA","NA"],
    [5545,"5545","Carrier B","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20930","BONE GRAFT MATERIAL ATTACHED TO SPINE","10","0.7",null,"0","54.02","0","0","10","0","NA","NA"],
    [5546,"5546","Carrier B","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","SPINAL FUSION TO JOIN TWO VERTEBRAE IN LOW BACK","10","1",null,"0","61.22","0","0","10","0","NA","NA"],
    [5547,"5547","Carrier B","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22842","SPINAL INSTRUMENTATION PLACE AT BACK OF SPINE TO CORRECT DEFORMITY","9","1",null,"0","40.12","0","0","9","0","NA","NA"],
    [5548,"5548","Carrier B","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22614","SPINAL FUSION TO JOIN TWO VERTEBRAE","9","1",null,"0","49.39","0","0","9","0","NA","NA"],
    [5549,"5549","Carrier B","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63048","ADDITIONAL VERTEBRAE SEGMENT DURING ANOTHER PROCEDURE","9","0.8889",null,"0","56.06","0","0","9","0","NA","NA"],
    [5550,"5550","Carrier B","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22612","LUMBAR SPINE FUSION","9","1",null,"0","245.01","0","0","9","0","NA","NA"],
    [5551,"5551","Carrier B","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22845","SPINAL INSTRUMENTATION PLACE AT FRONT OF SPINE TO CORRECT DEFORMITY","9","0.4444",null,"0","244.27","0","0","9","0","NA","NA"],
    [5552,"5552","Carrier B","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63047","INCISION AT A SINGLE VERTEBREA TO CORRECT SPINAL STENOSIS","8","0.875",null,"0","270.73","0","0","8","0","NA","NA"],
    [5553,"5553","Carrier B","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20936","AUTOGRAFT TO BONE DURING SPINAL SURGERY","7","1",null,"0","55.36","0","0","7","0","NA","NA"],
    [5554,"5554","Carrier B","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22848","SPINAL DEVICE FIXATION TO PELVIC BONES","1","1",null,"0","11.93","0","0","1","0","NA","NA"],
    [5555,"5555","Carrier B","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63046","SINGLE THORACIC VERTEBRAL TO CORRECT STENOSIS","2","1",null,"0","94.06","0","0","2","0","NA","NA"],
    [5556,"5556","Carrier B","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27487","REVISION OF KNEE JOINT WITH FEMORAL AND TIBIAL COMPONENTS","1","1",null,"0","77.87","0","0","1","0","NA","NA"],
    [5557,"5557","Carrier B","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15769","HARVESTING OF SKIN WITH AUTOLOGOUS SOFT TISSUE","1","1",null,"164.83","0","0","1","0","0","NA","NA"],
    [5558,"5558","Carrier B","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22840","PLACEMENT OF SPINAL INSTRUMENTATION IN THE NECK ACROSS C1-C2.","7","1",null,"0","317.79","0","0","7","0","NA","NA"],
    [5559,"5559","Carrier B","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","20939","AUTOGRAFT TO BONE DURING SPINAL SURGERY","2","1",null,"0","22.28","0","0","2","0","NA","NA"],
    [5560,"5560","Carrier B","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15734","MUSCLE FLAP FROM AN AREA OF THE TRUNK","1","1",null,"0.89","0","0","1","0","0","NA","NA"],
    [5561,"5561","Carrier B","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","20939","BONE MARROW HARVEST TO USE AS A BONE GRAFT","2","1",null,"0","22.28","0","0","2","0","NA","NA"],
    [5562,"5562","Carrier B","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63045","SINGLE CERVICAL VERTEBRAL PROCEDURE","2","1",null,"0","33.39","0","0","2","0","NA","NA"],
    [5563,"5563","Carrier B","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22551","CERVICAL DISC REMOVAL FROM FRONT OF NECK TO RELIEVE PAIN","1","1",null,"0","50.88","0","0","1","0","NA","NA"],
    [5564,"5564","Carrier B","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","44204","LAPAROSCOPIC PARTIAL REMOVAL OF COLON","1",null,"1","0","0.12","0","0","1","0","NA","NA"],
    [5565,"5565","Carrier B","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95810","SLEEP STUDY GREATER THAN 6 YRS OLD","141","0.7305",null,"0","83.31","0","0","141","0","NA","NA"],
    [5566,"5566","Carrier B","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95811","SLEEP STUDY GREATER THAN 6 YRS OLD WITH CPAP MACHINE","111","0.7027",null,"0","72.27","0","0","111","0","NA","NA"],
    [5567,"5567","Carrier B","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99212","OFFICE/OUTPATIENT ESTABLISHED MEMBER LASTING 10-19 MIN","97","0.5321",null,"47.77","131.12","0.07","10","86","1","NA","NA"],
    [5568,"5568","Carrier B","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0481","DEFINITIVE DRUG TEST OF CLASSES 8-14","58","0.5347",null,"0","78.58","0","0","58","0","NA","NA"],
    [5569,"5569","Carrier B","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0480","DEFINITIVE DRUG TEST OF CLASSES 1-7","56","0.5053",null,"0","77.23","0","0","56","0","NA","NA"],
    [5570,"5570","Carrier B","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0483","DEFINITIVE DRUG TEST OF CLASSES 22+","56","0.0215",null,"0","78.51","0","0","56","0","NA","NA"],
    [5571,"5571","Carrier B","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","J0585","INJECTION,ONABOTULINUMTOXINA","93","0.8172",null,"11.6","34.17","0","7","86","0","NA","NA"],
    [5572,"5572","Carrier B","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0482","DEFINITIVE DRUG TEST OF CLASSES 15-22","55","0.022",null,"0","78.92","0","0","55","0","NA","NA"],
    [5573,"5573","Carrier B","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0299","DIRECT SKILLED NURSING SERVICES OF A REGISTERED NURSE IN HOME OR HOSPICE SETTING","65","1",null,"0","116.5","0","0","65","0","NA","NA"],
    [5574,"5574","Carrier B","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","J3489","ZOLEDRONIC ACID 1MG (ZOMETA)","83","0.9157",null,"28.67","19.47","0","3","80","0","NA","NA"],
    [5575,"5575","Carrier B","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72110","X-RAY OF AT LEAST 4 VIEWS OF THE LUMBOSACRAL SPINE","0","1",null,"0","0","0","0","0","0","NA","NA"],
    [5576,"5576","Carrier B","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9607","LUTETIUM LU 177 VIPIVOTIDE TETRAXETAN THER 1 MCI (PLUVICTO)","1","1",null,"4.19","0","0","1","0","0","NA","NA"],
    [5577,"5577","Carrier B","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","G6002","STEREOSCOPIC X-RAY GUIDANCE TO ASSIST WITH RADIATION THERAPY TARGETING","1","1",null,"24.58","0","0","1","0","0","NA","NA"],
    [5578,"5578","Carrier B","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J9145","INJECTION DARATUMUMAB 10 MG (DARZALEX)-CHEMOTHERAPY","1","1",null,"0","44.58","0","0","1","0","NA","NA"],
    [5579,"5579","Carrier B","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","31575","LARYNGOSCOPY FLEXIBLE FIBEROPTIC TO LOOK INSIDE THE LARYNX","0","1",null,"0","0","0","0","0","0","NA","NA"],
    [5580,"5580","Carrier B","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81379","GENETIC TEST TO FOR HIGH RESOLUTION OF HUMAN LEUKOCYTE ANTIGEN GENES","3","1",null,"0","209.25","0","0","3","0","NA","NA"],
    [5581,"5581","Carrier B","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J9304","INJECTION PEMETREXED PEMFEXY 10 MG FOR CHEMOTHERAPY","1","1",null,"0","0.03","0","0","1","0","NA","NA"],
    [5582,"5582","Carrier B","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81380","GENETIC TEST TO FOR HIGH RESOLUTION OF HUMAN LEUKOCYTE ANTIGEN GENES, FOR CLASS 1, USING MOLECULAR TECHNIQUES","2","1",null,"0","228.85","0","0","2","0","NA","NA"],
    [5583,"5583","Carrier B","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","650","ROUTINE HOME HOSPICE CARE DELIVERED IN A NURSING FACILITY","0","1",null,"0","0","0","0","0","0","NA","NA"],
    [5584,"5584","Carrier B","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81383","GENETIC TEST TO FOR HIGH RESOLUTION OF HUMAN LEUKOCYTE ANTIGEN GENES, FOR CLASS 2 ALLELE GROUP","2","1",null,"0","228.85","0","0","2","0","NA","NA"],
    [5585,"5585","Carrier B","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","1480","ANESTHESIA SERVICES FOR OPEN PROCEDURE OF THE LOWER LEG, ANKLE, AND FOOT","0",null,"1","0","0","0","0","0","0","NA","NA"],
    [5586,"5586","Carrier B","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","95024","ALLERGY SKIN TESTING","0",null,"1","0","0","0","0","0","0","NA","NA"],
    [5587,"5587","Carrier B","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","99385","WELL-PATIENT VISIT FOR PATIENT 18-39 YEARS OLD.","0",null,"1","0","0","0","0","0","0","NA","NA"],
    [5588,"5588","Carrier B","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","H0031","MENTAL HEALTH ASSESSMENT BY A NON-PHYSICIAN","0",null,"1","0","0","0","0","0","0","NA","NA"],
    [5589,"5589","Carrier B","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","30435","SURGURY TO REPAIR OR CHANGE SHAPE OF THE NOSE ON A PATIENT WHO HAS HAD THE SURGERY BEFORE","1",null,"1","0","75.47","0","0","1","0","NA","NA"],
    [5590,"5590","Carrier B","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","H2015","COMPREHENSIVE COMMUNITY SUPPORT SERVICES, PER 15 MINUTES","0",null,"1","0","0","0","0","0","0","NA","NA"],
    [5591,"5591","Carrier B","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27829","SURGIICAL REPAIR INJURY TO THE TIBIOFIBULAR JOINT AND SECURES THE TIBIA AND FIBULA WITH PLATES AND SCREWS, WIRES OR PINS","0",null,"1","0","0","0","0","0","0","NA","NA"],
    [5592,"5592","Carrier B","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90677","PNEUMONIA VACCINE FOR INTRAMUSCULAR USE","0",null,"1","0","0","0","0","0","0","NA","NA"],
    [5593,"5593","Carrier B","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","99125","RISK OR PHYISICAL STATUS FOR ANESTHESIA","0",null,"1","0","0","0","0","0","0","NA","NA"],
    [5594,"5594","Carrier B","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","80050","LAB TEST FOR A GENERAL HEALTH PANEL","0",null,"1","0","0","0","0","0","0","NA","NA"],
    [5595,"5595","Carrier B","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","SEMI-PRIVATE PYSCHIATRIC INPATIENT STAY","113","0.9187",null,"0","22.18","0","0","113","0","NA","NA"],
    [5596,"5596","Carrier B","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1002","BEHAVIORAL HEALTH ACCOMODATIONS-RELATED TO CHEMICAL DEPENDANCY","67","0.9851",null,"0","14.17","0","0","67","0","NA","NA"],
    [5597,"5597","Carrier B","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","126","DETOXIFICATION BED","34","1",null,"0","7.83","0","0","34","0","NA","NA"],
    [5598,"5598","Carrier B","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","100","ROOM AND BOARD-ALL INCLUSIVE PLUS ANCILLARY","3","1",null,"0","11.21","0","0","3","0","NA","NA"],
    [5599,"5599","Carrier B","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1001","BEHAVIORAL HEALTH ACCOMODATIONS-RESIDENTIAL TREATMENT  PSYCHIATRIC","1","1",null,"0","30.67","0","0","1","0","NA","NA"],
    [5600,"5600","Carrier B","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","126","DETOXIFICATION BED","34","1",null,"0","7.83","0","0","34","0","NA","NA"],
    [5601,"5601","Carrier B","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1001","BEHAVIORAL HEALTH ACCOMODATIONS-RESIDENTIAL TREATMENT  PSYCHIATRIC","1","1",null,"0","30.67","0","0","1","0","NA","NA"],
    [5602,"5602","Carrier B","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","100","ROOM AND BOARD-ALL INCLUSIVE PLUS ANCILLARY","3","1",null,"0","11.21","0","0","3","0","NA","NA"],
    [5603,"5603","Carrier B","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1002","BEHAVIORAL HEALTH ACCOMODATIONS-RELATED TO CHEMICAL DEPENDANCY","67","0.9851",null,"0","14.17","0","0","67","0","NA","NA"],
    [5604,"5604","Carrier B","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","SEMI-PRIVATE PYSCHIATRIC INPATIENT STAY","113","0.9187",null,"0","22.18","0","0","113","0","NA","NA"],
    [5605,"5605","Carrier B","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","912","PARTIAL HOSPITALIZATION PSYCHIATRIC  PROGRAM","48","1",null,"0","45.72","0","0","48","0","NA","NA"],
    [5606,"5606","Carrier B","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","905","INTENSIVE BEHAVIORAL HEALTH TREATMENT SERVICES","29","1",null,"0","40.65","0","0","29","0","NA","NA"],
    [5607,"5607","Carrier B","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","906","PROFESSIONAL FEE FOR PSYCHOLOGY","13","1",null,"0","38.28","0","0","13","0","NA","NA"],
    [5608,"5608","Carrier B","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96101","PSYCHOLOGICAL TESTING PER HOUR FACE TO FACE TIME WITH PATIENT","10","1",null,"0","48.96","0","0","10","0","NA","NA"],
    [5609,"5609","Carrier B","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","MENTAL HEALTH PARTIAL HOSPITALIZATION, LESS THAN 24 HOURS","9","1",null,"0","106.91","0","0","9","0","NA","NA"],
    [5610,"5610","Carrier B","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90791","PSYCHOLOGICAL DIAGNOSTIC EVALUATION","1","1",null,"0","189.8","0","0","1","0","NA","NA"],
    [5611,"5611","Carrier B","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S9480","INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES PER DIEM","2","1",null,"0","0","0","0","2","0","NA","NA"],
    [5612,"5612","Carrier B","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96132","NEUROPSYCHOLOGICAL TEST EVALUATION BY A PHYSICIAN/QUALIFIED HEALTH PROFESSIONAL UP TO 1 HOUR.","2","1",null,"0","61.37","0","0","2","0","NA","NA"],
    [5613,"5613","Carrier B","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97156","ADAPTIVE BEHAVIOR TREATMENT PROCEDURES","2","1",null,"0","0.12","0","0","2","0","NA","NA"],
    [5614,"5614","Carrier B","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H2012","BEHAVIORAL HEALTH DAY TREATMENT, PER HOUR","2","1",null,"0","23.19","0","0","2","0","NA","NA"],
    [5615,"5615","Carrier B","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0035","MENTAL HEALTH PARTIAL HOSPITALIZATION, LESS THAN 24 HOURS","9","1",null,"0","106.91","0","0","9","0","NA","NA"],
    [5616,"5616","Carrier B","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97156","ADAPTIVE BEHAVIOR TREATMENT PROCEDURES","2","1",null,"0","0.12","0","0","2","0","NA","NA"],
    [5617,"5617","Carrier B","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90792","PSYCHIATRIC EVALUATION IN ADDITION TO RENDERING ADDITIONAL MEDICAL SERVICES","0","1",null,"0","0","0","0","0","0","NA","NA"],
    [5618,"5618","Carrier B","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","906","PROFESSIONAL FEE FOR PSYCHOLOGY","13","1",null,"0","38.28","0","0","13","0","NA","NA"],
    [5619,"5619","Carrier B","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99213","OFFICE/OUTPATIENT VISIT TO AN ESTABLISHED PATIENT","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [5620,"5620","Carrier B","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90791","PSYCHOLOGICAL DIAGNOSTIC EVALUATION","1","1",null,"0","189.8","0","0","1","0","NA","NA"],
    [5621,"5621","Carrier B","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96132","NEUROPSYCHOLOGICAL TEST EVALUATION BY A PHYSICIAN/QUALIFIED HEALTH PROFESSIONAL UP TO 1 HOUR.","2","1",null,"0","61.37","0","0","2","0","NA","NA"],
    [5622,"5622","Carrier B","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90867","TRANSCRANIAL MAGNETIC STIMULATION USED TO IMPROVE DEPRESSION","1","1",null,"0","23.62","0","0","1","0","NA","NA"],
    [5623,"5623","Carrier B","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97155","ADAPTIVE BEHAVIOR TREATMENT FACE TO FACE TO MODIFY TARGETS AND TREATMENT TECHNIQUES, 15 MINUTES","2","1",null,"0","0.12","0","0","2","0","NA","NA"],
    [5624,"5624","Carrier B","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90869","TRANSCRANIAL MAGNETIC STIMULATION SUBSQUENT REDETERMINATION","1","1",null,"0","24.62","0","0","1","0","NA","NA"],
    [5625,"5625","Carrier B","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","906","PROFESSIONAL FEE FOR PSYCHOLOGY","13",null,"0.0714","0","38.28","0","0","13","0","NA","NA"],
    [5626,"5626","Carrier B","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","CONTINUOUS AIRWAY PRESSURE (CPAP) DEVICE","549","0.927",null,"54.61","75.54","0","5","544","0","NA","NA"],
    [5627,"5627","Carrier B","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1390","PORTABLE OXYGEN CONCENTRATOR","100","0.8304",null,"28.02","81.77","0","8","92","0","NA","NA"],
    [5628,"5628","Carrier B","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4239","CONTINUOUS GLUCOSE MONITORING SUPPLIES BY MONTH","59","0.9153",null,"39.92","76.82","0","1","58","0","NA","NA"],
    [5629,"5629","Carrier B","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0781","AMBULATORY INFUSION PUMP 1 OR MULTIPLE CHANNELS PATIENT WEARS","41","0.8913",null,"12.1","56.88","0","2","39","0","NA","NA"],
    [5630,"5630","Carrier B","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0470","BI-PAP RESPIRATORY ASSIST DEVICE WITH OUT BACKUP","32","0.8788",null,"17.85","70.76","0","1","31","0","NA","NA"],
    [5631,"5631","Carrier B","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0935","PASSIVE MOTION EXERCISE DEVICE","16","0.5",null,"23.65","97.52","0","2","14","0","NA","NA"],
    [5632,"5632","Carrier B","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2402","NEGATIVE PRESSURE WOUND PUMP","10","1",null,"0","70.3","0","0","10","0","NA","NA"],
    [5633,"5633","Carrier B","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1399","DURABLE MEDICAL EQUIPMENT NOT CLASSIFIED ELSEWHERE","11","0.8182",null,"32.11","71.45","0","1","10","0","NA","NA"],
    [5634,"5634","Carrier B","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0471","BI-PAP RESPIRATORY ASSIST DEVICE WITH BACKUP","9","1",null,"0","61.05","0","0","9","0","NA","NA"],
    [5635,"5635","Carrier B","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0466","HOME VENTILATOR, USED WITH NON-INVASIVE INTERFACE (MASK, CHEST SHELL)","8","0.75",null,"0","116.74","0","0","8","0","NA","NA"],
    [5636,"5636","Carrier B","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2313","POWER WHEELCHAIR HARNESS","1","1",null,"0","44.76","0","0","1","0","NA","NA"],
    [5637,"5637","Carrier B","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8690","AUDITORY OSSEOINTEGRATED DEVICE INCLUDES ALL  INTERNAL & EXTERNAL COMPONENTS","3","1",null,"0","73.94","0","0","3","0","NA","NA"],
    [5638,"5638","Carrier B","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0005","ULTRALIGHTWEIGHT WHEELCHAIR","2","1",null,"0","113.67","0","0","2","0","NA","NA"],
    [5639,"5639","Carrier B","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","B9002","ENTERAL NUTRITION INFUSION PUMP WITH ALARM","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [5640,"5640","Carrier B","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0188","SYNTHETIC SHEEPSKIN PAD","1","1",null,"0","140.54","0","0","1","0","NA","NA"],
    [5641,"5641","Carrier B","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0261","HOSPITAL  BED SEMI-ELECTRIC WITH  ANY RAILS AND WITHOUT MATTRESS","2","1",null,"0","193.26","0","0","2","0","NA","NA"],
    [5642,"5642","Carrier B","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2402","NEGATIVE PRESSURE WOUND PUMP","10","1",null,"0","70.3","0","0","10","0","NA","NA"],
    [5643,"5643","Carrier B","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0277","POWERED PRESS-REDUCING AIR MATRESS","1","1",null,"32.11","0","0","1","0","0","NA","NA"],
    [5644,"5644","Carrier B","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0861","POWER WH EELCHAIR, GROUP 3 , STANDARD, MULTIPLE POWER OPTION, SLING/SOLID SEAT/BACK, UP TO 300LBS IN WEIGHT","1","1",null,"0","44.76","0","0","1","0","NA","NA"],
    [5645,"5645","Carrier B","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0303","HEAVY DUTY HOSPITAL BED, EXTRA WIDE, WITH WEIGHT CAPACITY GREATER THAN 350 POUNDS BUT LESS THAN OR EQUAL TO 600 POINS, WITH ANY TYPE SIDE RAILS AND MATTRESS","4","1",null,"7.75","67.66","0","1","3","0","NA","NA"],
    [5646,"5646","Carrier B","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E1161","MANUAL ADLUT SIZE WHEELCHAIR INCLUIDING  TILT SPACE","2",null,"0.5","0","70.06","0","0","2","0","NA","NA"],
    [5647,"5647","Carrier B","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","K0108","OTHER ACCESSORY NOT LISTED","4",null,"0.25","0","81.18","0","0","4","0","NA","NA"],
    [5648,"5648","Carrier B","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","K0001","STANDARD WHEELCHAIR","5",null,"0.2","0","57.77","0","0","5","0","NA","NA"],
    [5649,"5649","Carrier B","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0630","PATIENT LIFT HYDRAULIC","5",null,"0.2","50.39","70.57","0","1","4","0","NA","NA"],
    [5650,"5650","Carrier B","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0562","HUMIDIFIER, HEATED, USED WITH POSITIVE AIRWAY PRESSURE DEVICE","7",null,"0.125","0","82.96","0","0","7","0","NA","NA"],
    [5651,"5651","Carrier B","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0935","PASSIVE MOTION EXERCISE DEVICE","16",null,"0.125","23.65","97.52","0","2","14","0","NA","NA"],
    [5652,"5652","Carrier B","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E1399","DURABLE MEDICAL EQUIPMENT NOT CLASSIFIED ELSEWHERE","11",null,"0.0909","32.11","71.45","0","1","10","0","NA","NA"],
    [5653,"5653","Carrier B","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E1390","PORTABLE OXYGEN CONCENTRATOR","100",null,"0.0446","28.02","81.77","0","8","92","0","NA","NA"],
    [5654,"5654","Carrier B","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0601","CONTINUOUS AIRWAY PRESSURE (CPAP) DEVICE","549",null,"0.0196","54.61","75.54","0","5","544","0","NA","NA"],
    [5655,"5655","Carrier B","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","A4239","CONTINUOUS GLUCOSE MONITORING SUPPLIES BY MONTH","59",null,"0.0169","39.92","76.82","0","1","58","0","NA","NA"],
    [5656,"5656","Carrier B","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9277","EXTERNAL TRANSMITTER CONTINOUS GLUCOSE MONITOR DAILY","39","0.975",null,"13.79","71.49","0","2","37","0","NA","NA"],
    [5657,"5657","Carrier B","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","EXTERNAL AMBULATORY INFUSION PUMP, INSULIN","14","1",null,"0","63.38","0","0","14","0","NA","NA"],
    [5658,"5658","Carrier B","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9278","EXTERNAL RECEIVER  FOR CONTINOUS GLUCOSE MONITORING","7","1",null,"0","64.28","0","0","7","0","NA","NA"],
    [5659,"5659","Carrier B","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9274","EXTERNAL AMBULATORY INSULIN DELIVERY SYSTEM","2","1",null,"0","100.74","0","0","2","0","NA","NA"],
    [5660,"5660","Carrier B","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","EXTERNAL AMBULATORY INFUSION PUMP, INSULIN","14","1",null,"0","63.38","0","0","14","0","NA","NA"],
    [5661,"5661","Carrier B","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9278","EXTERNAL RECEIVER  FOR CONTINOUS GLUCOSE MONITORING","7","1",null,"0","64.28","0","0","7","0","NA","NA"],
    [5662,"5662","Carrier B","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9274","EXTERNAL AMBULATORY INSULIN DELIVERY SYSTEM","2","1",null,"0","100.74","0","0","2","0","NA","NA"],
    [5663,"5663","Carrier B","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9277","EXTERNAL TRANSMITTER CONTINOUS GLUCOSE MONITOR DAILY","39","0.975",null,"13.79","71.49","0","2","37","0","NA","NA"],
    [5664,"5664","Carrier B","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","1160","0.6276",null,"13","606",null,"221","939",null,"Semaglutide","Ozempic"],
    [5665,"5665","Carrier B","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","531","0.307",null,"19","943",null,"69","462",null,"Clobetasol Propionate","Clobetasol"],
    [5666,"5666","Carrier B","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","358","0.6872",null,"9","417",null,"87","271",null,"Liraglutide","Victoza"],
    [5667,"5667","Carrier B","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","355","0.8901",null,"11","281",null,"70","285",null,"Dulaglutide","Trulicity"],
    [5668,"5668","Carrier B","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","345","0.313",null,"42","963",null,"100","245",null,"Pregabalin","Pregabalin"],
    [5669,"5669","Carrier B","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","255","0.9176",null,"39","653",null,"113","142",null,"Hydrocodone-Acetaminophen","Hydroco/apap"],
    [5670,"5670","Carrier B","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","233","0.8155",null,"17","233",null,"70","163",null,"Lisdexamfetamine Dimesylate","Vyvanse"],
    [5671,"5671","Carrier B","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","202","0.7921",null,"27","1074",null,"36","166",null,"Adalimumab","Humira Pen"],
    [5672,"5672","Carrier B","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","183","0.8907",null,"75","537",null,"97","86",null,"Oxycodone HCl","Oxycodone"],
    [5673,"5673","Carrier B","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","182","0.5549",null,"19","1143",null,"24","158",null,"Continuous Glucose System Sensor","Freesty Libr"],
    [5674,"5674","Carrier B","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","16","1",null,"55","155",null,"7","9",null,"Sodium Zirconium Cyclosilicate","Lokelma"],
    [5675,"5675","Carrier B","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","11","1",null,null,"283",null,"0","11",null,"Oxybutynin Chloride","Oxybutynin"],
    [5676,"5676","Carrier B","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","11","1",null,"427","56",null,"3","8",null,"Segesterone Acetate-Ethinyl Estradiol","Annovera"],
    [5677,"5677","Carrier B","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","10","1",null,null,"783",null,"0","10",null,"Fluticasone Propionate HFA","Flovent Hfa"],
    [5678,"5678","Carrier B","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","9","1",null,"49","356",null,"5","4",null,"Insulin Aspart","Novolog"],
    [5679,"5679","Carrier B","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,"1","0",null,"2","6",null,"Etonogestrel","Nexplanon"],
    [5680,"5680","Carrier B","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,"77","0",null,"7","1",null,"Dasatinib","Sprycel"],
    [5681,"5681","Carrier B","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,"1","0",null,"3","5",null,"Levonorgestrel (IUD)","Mirena"],
    [5682,"5682","Carrier B","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,null,"749",null,"0","7",null,"Ketoconazole (Topical)","Ketoconazole"],
    [5683,"5683","Carrier B","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,"178","769",null,"5","2",null,"Trifluridine-Tipiracil","Lonsurf"],
    [5684,"5684","Carrier E","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","150","ROOM & BOARD, WARD - GENERAL","12","1",null,"21.2","17.8",null,"2","10",null,"NA","NA"],
    [5685,"5685","Carrier E","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99223","1ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES","10","1",null,"1.06","17.3",null,"1","9",null,"NA","NA"],
    [5686,"5686","Carrier E","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99291","CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN","5","1",null,null,"11.6",null,null,"5",null,"NA","NA"],
    [5687,"5687","Carrier E","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99222","1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES","5","1",null,null,"10.6",null,null,"5",null,"NA","NA"],
    [5688,"5688","Carrier E","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27447","ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS","3","1",null,null,"14.6",null,null,"3",null,"NA","NA"],
    [5689,"5689","Carrier E","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27130","ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT","3","1",null,null,"18.2",null,null,"3",null,"NA","NA"],
    [5690,"5690","Carrier E","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","762","SPECIALTY SERVICES, OBSERVATION HOURS","3","1",null,null,"20.6",null,null,"3",null,"NA","NA"],
    [5691,"5691","Carrier E","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","158","ROOM & BOARD, WARD - REHABILITATION","3","1",null,null,"16.7",null,null,"3",null,"NA","NA"],
    [5692,"5692","Carrier E","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99232","SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES","2","1",null,null,"0",null,null,"2",null,"NA","NA"],
    [5693,"5693","Carrier E","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71045","RADIOLOGIC EXAM CHEST SINGLE VIEW","2","1",null,null,"8.1",null,null,"2",null,"NA","NA"],
    [5694,"5694","Carrier E","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","150","ROOM & BOARD, WARD - GENERAL","12","1",null,"21.2","17.8",null,"2","10",null,"NA","NA"],
    [5695,"5695","Carrier E","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99223","1ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES","10","1",null,"1.06","17.3",null,"1","9",null,"NA","NA"],
    [5696,"5696","Carrier E","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99291","CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN","5","1",null,null,"11.6",null,null,"5",null,"NA","NA"],
    [5697,"5697","Carrier E","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99222","1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES","5","1",null,null,"10.6",null,null,"5",null,"NA","NA"],
    [5698,"5698","Carrier E","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27447","ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS","3","1",null,null,"14.6",null,null,"3",null,"NA","NA"],
    [5699,"5699","Carrier E","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27130","ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT","3","1",null,null,"18.2",null,null,"3",null,"NA","NA"],
    [5700,"5700","Carrier E","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","762","SPECIALTY SERVICES, OBSERVATION HOURS","3","1",null,null,"20.6",null,null,"3",null,"NA","NA"],
    [5701,"5701","Carrier E","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","158","ROOM & BOARD, WARD - REHABILITATION","3","1",null,null,"16.7",null,null,"3",null,"NA","NA"],
    [5702,"5702","Carrier E","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99232","SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES","2","1",null,null,"0",null,null,"2",null,"NA","NA"],
    [5703,"5703","Carrier E","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","71045","RADIOLOGIC EXAM CHEST SINGLE VIEW","2","1",null,null,"8.1",null,null,"2",null,"NA","NA"],
    [5704,"5704","Carrier E","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99203","OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES","300","0.9933",null,"7.8","60.7",null,"20","280",null,"NA","NA"],
    [5705,"5705","Carrier E","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97161","PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS","187","0.9679",null,"0.8","77.4",null,"5","182",null,"NA","NA"],
    [5706,"5706","Carrier E","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99204","OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES","140","0.9929",null,"9.4","52.2",null,"5","135",null,"NA","NA"],
    [5707,"5707","Carrier E","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97530","THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN","118","0.8983",null,"17.4","219.6",null,"4","114",null,"NA","NA"],
    [5708,"5708","Carrier E","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72148","MRI LUMBAR SPINE NO CONTRAST","118","1",null,"17","42.8",null,"40","78",null,"NA","NA"],
    [5709,"5709","Carrier E","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","MRI BRAIN WO/W CONTRAST","82","1",null,"7.2","17.9",null,"16","66",null,"NA","NA"],
    [5710,"5710","Carrier E","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45378","COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD","77","0.987",null,null,"106.6",null,null,"77",null,"NA","NA"],
    [5711,"5711","Carrier E","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","MRI RIGHT KNEE NO CONTRAST","72","1",null,"13","30.6",null,"35","37",null,"NA","NA"],
    [5712,"5712","Carrier E","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","MRI LEFT KNEE NO CONTRAST","69","1",null,"7.5","22.2",null,"36","33",null,"NA","NA"],
    [5713,"5713","Carrier E","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72141","MRI CERVICAL SPINE NO CONTRAST","66","1",null,"14.4","16.4",null,"14","52",null,"NA","NA"],
    [5714,"5714","Carrier E","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72148","MRI LUMBAR SPINE NO CONTRAST","118","1",null,"17","42.8",null,"40","78",null,"NA","NA"],
    [5715,"5715","Carrier E","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70553","MRI BRAIN WO/W CONTRAST","82","1",null,"7.2","17.9",null,"16","66",null,"NA","NA"],
    [5716,"5716","Carrier E","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","73721","MRI RIGHT KNEE NO CONTRAST","72","1",null,"13","30.6",null,"35","37",null,"NA","NA"],
    [5717,"5717","Carrier E","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","73721","MRI LEFT KNEE NO CONTRAST","69","1",null,"7.5","22.2",null,"36","33",null,"NA","NA"],
    [5718,"5718","Carrier E","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72141","MRI CERVICAL SPINE NO CONTRAST","66","1",null,"14.4","16.4",null,"14","52",null,"NA","NA"],
    [5719,"5719","Carrier E","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97162","PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS","63","1",null,"1.4","29.2",null,"5","58",null,"NA","NA"],
    [5720,"5720","Carrier E","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","73221","MRI RIGHT SHOULDER NO CONTRAST","55","1",null,"8.4","20.6",null,"29","26",null,"NA","NA"],
    [5721,"5721","Carrier E","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","45385","COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ","52","1",null,null,"19.8",null,null,"52",null,"NA","NA"],
    [5722,"5722","Carrier E","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","G0151","SERVICE PHYS THERAP HOME HLTH/HOSPICE EA 15 MIN","43","1",null,null,"5.6",null,null,"43",null,"NA","NA"],
    [5723,"5723","Carrier E","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70551","MRI BRAIN NO CONTRAST","43","1",null,"12.3","24.4",null,"16","27",null,"NA","NA"],
    [5724,"5724","Carrier E","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","A56589","BARIUM SWALLOW STUDIES, MODIFIED","1",null,"1",null,"1466.5",null,null,"1",null,"NA","NA"],
    [5725,"5725","Carrier E","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64615","CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE","1",null,"1",null,"315",null,null,"1",null,"NA","NA"],
    [5726,"5726","Carrier E","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","J3490","UNCLASSIFIED DRUGS","2",null,"0.5","15.3",null,null,"2",null,null,"NA","NA"],
    [5727,"5727","Carrier E","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","99201","OFFICE OUTPATIENT NEW 10 MINUTES","2",null,"0.5",null,"505.2",null,null,"2",null,"NA","NA"],
    [5728,"5728","Carrier E","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","25043","REFERRAL PHYSICAL THERAPY CANCER REHAB","5",null,"0.2",null,"303.6",null,null,"5",null,"NA","NA"],
    [5729,"5729","Carrier E","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43239","EGD TRANSORAL BIOPSY SINGLE/MULTIPLE","10",null,"0.1","52.6","64.2",null,"1","9",null,"NA","NA"],
    [5730,"5730","Carrier E","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","23660","EXT REFERRAL PEDS","13",null,"0.08","20.2","231.3",null,"4","9",null,"NA","NA"],
    [5731,"5731","Carrier E","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","20041","REFERRAL THERAPY, SPEECH AND LANGUAGE","29",null,"0.07","1","259.4",null,"5","24",null,"NA","NA"],
    [5732,"5732","Carrier E","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","99205","OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES","31",null,"0.06","25.7","405.8",null,"4","27",null,"NA","NA"],
    [5733,"5733","Carrier E","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97110","THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES","25",null,"0.04",null,"324.6",null,null,"25",null,"NA","NA"],
    [5734,"5734","Carrier E","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC","53","1",null,null,"17.1","21.6",null,"44","9","NA","NA"],
    [5735,"5735","Carrier E","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","126","ROOM & BOARD, SEMIPRIVATE TWO-BED - DETOXIFICATION","26","1",null,null,"37.6","35.5",null,"17","9","NA","NA"],
    [5736,"5736","Carrier E","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1002","BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP","21","1",null,null,"43.9","88.4",null,"19","2","NA","NA"],
    [5737,"5737","Carrier E","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1001","BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC","13","1",null,null,"36.6","81",null,"12","1","NA","NA"],
    [5738,"5738","Carrier E","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","194","SUBACUTE CARE, LEVEL IV","5","1",null,null,"72",null,null,"5",null,"NA","NA"],
    [5739,"5739","Carrier E","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90792","PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES","1","1",null,null,null,"74.5",null,null,"1","NA","NA"],
    [5740,"5740","Carrier E","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","200","INTENSIVE CARE, GENERAL","1","1",null,null,"2.6",null,null,"1",null,"NA","NA"],
    [5741,"5741","Carrier E","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC","53","1",null,null,"17.1","21.6",null,"44","9","NA","NA"],
    [5742,"5742","Carrier E","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","126","ROOM & BOARD, SEMIPRIVATE TWO-BED - DETOXIFICATION","26","1",null,null,"37.6","35.5",null,"17","9","NA","NA"],
    [5743,"5743","Carrier E","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1002","BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP","21","1",null,null,"43.9","88.4",null,"19","2","NA","NA"],
    [5744,"5744","Carrier E","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1001","BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC","13","1",null,null,"36.6","81",null,"12","1","NA","NA"],
    [5745,"5745","Carrier E","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","194","SUBACUTE CARE, LEVEL IV","5","1",null,null,"72",null,null,"5",null,"NA","NA"],
    [5746,"5746","Carrier E","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90792","PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES","1","1",null,null,null,"74.5",null,null,"1","NA","NA"],
    [5747,"5747","Carrier E","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","200","INTENSIVE CARE, GENERAL","1","1",null,null,"2.6",null,null,"1",null,"NA","NA"],
    [5748,"5748","Carrier E","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVALUATION","69","0.9565",null,null,"106.2",null,null,"69",null,"NA","NA"],
    [5749,"5749","Carrier E","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97153","ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN","52","1",null,null,"53.6",null,null,"52",null,"NA","NA"],
    [5750,"5750","Carrier E","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY W/PATIENT 60 MINUTES","37","1",null,null,"69.2",null,null,"37",null,"NA","NA"],
    [5751,"5751","Carrier E","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99205","OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES","25","1",null,null,"75.7",null,null,"25",null,"NA","NA"],
    [5752,"5752","Carrier E","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN","23","1",null,null,"27.8",null,null,"23",null,"NA","NA"],
    [5753,"5753","Carrier E","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0001","ALCOHOL AND/OR DRUG ASSESS","19","1",null,null,"50.8","430.2",null,"18","1","NA","NA"],
    [5754,"5754","Carrier E","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96116","NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR","18","1",null,null,"42.9",null,null,"18",null,"NA","NA"],
    [5755,"5755","Carrier E","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97155","ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN","17","1",null,null,"56.5",null,null,"17",null,"NA","NA"],
    [5756,"5756","Carrier E","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97156","FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN","16","1",null,null,"59.3",null,null,"16",null,"NA","NA"],
    [5757,"5757","Carrier E","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S9480","INTENSIVE OUTPATIENT PSYCHIA","13","1",null,null,"34.5","109.1",null,"12","1","NA","NA"],
    [5758,"5758","Carrier E","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97153","ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN","52","1",null,null,"53.6",null,null,"52",null,"NA","NA"],
    [5759,"5759","Carrier E","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY W/PATIENT 60 MINUTES","37","1",null,null,"69.2",null,null,"37",null,"NA","NA"],
    [5760,"5760","Carrier E","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99205","OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES","25","1",null,null,"75.7",null,null,"25",null,"NA","NA"],
    [5761,"5761","Carrier E","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97151","BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN","23","1",null,null,"27.8",null,null,"23",null,"NA","NA"],
    [5762,"5762","Carrier E","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0001","ALCOHOL AND/OR DRUG ASSESS","19","1",null,null,"50.8","430.2",null,"18","1","NA","NA"],
    [5763,"5763","Carrier E","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96116","NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR","18","1",null,null,"42.9",null,null,"18",null,"NA","NA"],
    [5764,"5764","Carrier E","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97155","ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN","17","1",null,null,"56.5",null,null,"17",null,"NA","NA"],
    [5765,"5765","Carrier E","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97156","FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN","16","1",null,null,"59.3",null,null,"16",null,"NA","NA"],
    [5766,"5766","Carrier E","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S9480","INTENSIVE OUTPATIENT PSYCHIA","13","1",null,null,"34.5","109.1",null,"12","1","NA","NA"],
    [5767,"5767","Carrier E","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90899","UNLISTED PSYCHIATRIC SERVICE/PROCEDURE","11","1",null,"0.6","33.7",null,"1","10",null,"NA","NA"],
    [5768,"5768","Carrier E","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVALUATION","69",null,"0.01","270.9","107.7",null,"1","68",null,"NA","NA"],
    [5769,"5769","Carrier E","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0143","WALKER FOLDING WHEELED W/O S","161","1",null,"4.7","7.6",null,"5","156",null,"NA","NA"],
    [5770,"5770","Carrier E","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4239","SPLY ALW NONADJUNC NONIMPL CGM 1 MO SPLY= 1 UOS","118","1",null,null,"23.4",null,null,"118",null,"NA","NA"],
    [5771,"5771","Carrier E","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0604","BREAST PUMP HEAVY DUTY HOSP GRADE PISTON OP","116","0.9914",null,"8.6","63.3",null,"21","95",null,"NA","NA"],
    [5772,"5772","Carrier E","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0570","NEBULIZER WITH COMPRESSOR","89","1",null,"11.2","2.9",null,"5","84",null,"NA","NA"],
    [5773,"5773","Carrier E","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0730","TENS DEVICE 4/MORE LEADS MULTI NERVE STIMULATION","79","1",null,null,"20.3",null,null,"79",null,"NA","NA"],
    [5774,"5774","Carrier E","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A5500","DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE","60","1",null,null,"24.4",null,null,"60",null,"NA","NA"],
    [5775,"5775","Carrier E","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1390","OXYGEN CONCENTRATOR","55","1",null,"7.6","11.2",null,"2","53",null,"NA","NA"],
    [5776,"5776","Carrier E","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L1852","KNEE ORTHOSIS DOUBLE UPRIGHT THIGH AND CALF","53","1",null,"0.7","24.3",null,"1","52",null,"NA","NA"],
    [5777,"5777","Carrier E","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0202","PHOTOTHERAPY LIGHT W/ PHOTOM","29","1",null,"11.2","15.3",null,"7","22",null,"NA","NA"],
    [5778,"5778","Carrier E","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","B4161","ENTERAL F PED HYDROLYZED/AA&PEPTIDE CHAIN PROTS","29","1",null,null,"5.6",null,null,"29",null,"NA","NA"],
    [5779,"5779","Carrier E","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0143","WALKER FOLDING WHEELED W/O S","161","1",null,"4.7","7.6",null,"5","156",null,"NA","NA"],
    [5780,"5780","Carrier E","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4239","SPLY ALW NONADJUNC NONIMPL CGM 1 MO SPLY= 1 UOS","118","1",null,null,"23.4",null,null,"118",null,"NA","NA"],
    [5781,"5781","Carrier E","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0570","NEBULIZER WITH COMPRESSOR","89","1",null,"11.2","2.9",null,"5","84",null,"NA","NA"],
    [5782,"5782","Carrier E","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0730","TENS DEVICE 4/MORE LEADS MULTI NERVE STIMULATION","79","1",null,null,"20.3",null,null,"79",null,"NA","NA"],
    [5783,"5783","Carrier E","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A5500","DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE","60","1",null,null,"24.4",null,null,"60",null,"NA","NA"],
    [5784,"5784","Carrier E","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1390","OXYGEN CONCENTRATOR","55","1",null,"7.6","11.2",null,"2","53",null,"NA","NA"],
    [5785,"5785","Carrier E","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L1852","KNEE ORTHOSIS DOUBLE UPRIGHT THIGH AND CALF","53","1",null,"0.7","24.3",null,"1","52",null,"NA","NA"],
    [5786,"5786","Carrier E","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0202","PHOTOTHERAPY LIGHT W/ PHOTOM","29","1",null,"11.2","15.3",null,"7","22",null,"NA","NA"],
    [5787,"5787","Carrier E","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","B4161","ENTERAL F PED HYDROLYZED/AA&PEPTIDE CHAIN PROTS","29","1",null,null,"5.6",null,null,"29",null,"NA","NA"],
    [5788,"5788","Carrier E","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0691","UV LIGHT TX SYS BULB/LAMP TIMER; TX 2 SQ FT/LESS","28","1",null,null,"21.5",null,null,"28",null,"NA","NA"],
    [5789,"5789","Carrier E","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0604","BREAST PUMP HEAVY DUTY HOSP GRADE PISTON OP","116",null,"0.01","8.6","63.3",null,"21","95",null,"NA","NA"],
    [5790,"5790","Carrier E","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95250","Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneou","97","0.3814",null,null,"38.2",null,null,"97",null,"NA","NA"],
    [5791,"5791","Carrier E","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0553","SUPPLY ALLOW FOR TX CGM1 MO SPL = 1 U OF SERVICE","18","1",null,null,"18.1",null,null,"18",null,"NA","NA"],
    [5792,"5792","Carrier E","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4230","INFUS INSULIN PUMP NON NEEDL","11","1",null,null,"33.6",null,null,"11",null,"NA","NA"],
    [5793,"5793","Carrier E","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","EXT AMB INFUSN PUMP INSULIN","9","1",null,null,"38.8",null,null,"9",null,"NA","NA"],
    [5794,"5794","Carrier E","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4232","SYRINGE W/NEEDLE INSULIN 3CC","5","1",null,null,"11.1",null,null,"5",null,"NA","NA"],
    [5795,"5795","Carrier E","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A6257","TRANSPARENT FILM STERL 16 SQ IN OR LESS EA DRESS","1","1",null,null,"44.3",null,null,"1",null,"NA","NA"],
    [5796,"5796","Carrier E","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A5120","SKIN BARRIER WIPES OR SWABS EACH","1","1",null,null,"69",null,null,"1",null,"NA","NA"],
    [5797,"5797","Carrier E","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0553","SUPPLY ALLOW FOR TX CGM1 MO SPL = 1 U OF SERVICE","18","1",null,null,"18.1",null,null,"18",null,"NA","NA"],
    [5798,"5798","Carrier E","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4230","INFUS INSULIN PUMP NON NEEDL","11","1",null,null,"33.6",null,null,"11",null,"NA","NA"],
    [5799,"5799","Carrier E","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","EXT AMB INFUSN PUMP INSULIN","9","1",null,null,"38.8",null,null,"9",null,"NA","NA"],
    [5800,"5800","Carrier E","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4232","SYRINGE W/NEEDLE INSULIN 3CC","5","1",null,null,"11.1",null,null,"5",null,"NA","NA"],
    [5801,"5801","Carrier E","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A6257","TRANSPARENT FILM STERL 16 SQ IN OR LESS EA DRESS","1","1",null,null,"44.3",null,null,"1",null,"NA","NA"],
    [5802,"5802","Carrier E","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A5120","SKIN BARRIER WIPES OR SWABS EACH","1","1",null,null,"69",null,null,"1",null,"NA","NA"],
    [5803,"5803","Carrier E","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95250","Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneou","97","0.3814",null,null,"38.2",null,null,"97",null,"NA","NA"],
    [5804,"5804","Carrier E","2023","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","95250","Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneou","97",null,"0.03",null,"38.2",null,null,"97",null,"NA","NA"],
    [5805,"5805","Carrier E","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","197","0.8071",null,null,"79.32117315",null,"0","197","0","EMPAGLIFLOZIN","JARDIANCE"],
    [5806,"5806","Carrier E","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","87","0.3218",null,null,"67.43068966",null,"0","87","0","SEMAGLUTIDE","OZEMPIC, RYBELSUS"],
    [5807,"5807","Carrier E","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","69","0.913",null,null,"24.14852657",null,"0","69","0","UBROGEPANT","UBRELVY"],
    [5808,"5808","Carrier E","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","66","0.7121",null,null,"33.74263047",null,"0","66","0","LISDEXAMFETAMINE DIMESYLATE","VYVANSE"],
    [5809,"5809","Carrier E","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","52","0.4615",null,null,"40.6425",null,"0","52","0","VARENICLINE TARTRATE","APO-VARENICLINE"],
    [5810,"5810","Carrier E","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","46","0.9783",null,null,"31.74908213",null,"0","46","0","RIVAROXABAN","XARELTO"],
    [5811,"5811","Carrier E","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","46","1",null,null,"27.57171498",null,"0","46","0","FREMANEZUMAB-VFRM","AJOVY"],
    [5812,"5812","Carrier E","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","36","0.4722",null,null,"31.19655093",null,"0","36","0","LIRAGLUTIDE","VICTOZA"],
    [5813,"5813","Carrier E","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","33","1",null,null,"22.99237374",null,"0","33","0","SECUKINUMAB","COSENTYX"],
    [5814,"5814","Carrier E","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","32","0.7813",null,null,"46.11569444",null,"0","32","0","TESTOSTERONE CYPIONATE","DEPO-TESTOST"],
    [5815,"5815","Carrier E","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","46","1",null,null,"27.6",null,"0","46","0","FREMANEZUMAB-VFRM","AJOVY"],
    [5816,"5816","Carrier E","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","33","1",null,null,"23",null,"0","33","0","SECUKINUMAB","COSENTYX"],
    [5817,"5817","Carrier E","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","22","1",null,null,"13.6",null,"0","22","0","TESTOSTERONE","ANDRODERM, TESTOSTERONE"],
    [5818,"5818","Carrier E","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","22","1",null,null,"77.3",null,"0","22","0","TICAGRELOR","BRILINTA"],
    [5819,"5819","Carrier E","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","20","1",null,null,"59",null,"0","20","0","SACUBITRIL-VALSARTAN","ENTRESTO"],
    [5820,"5820","Carrier E","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","12","1",null,null,"23.5",null,"0","12","0","TOFACITINIB CITRATE","XELJANZ"],
    [5821,"5821","Carrier E","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","12","1",null,null,"23.8",null,"0","12","0","CARIPRAZINE HCL","VRAYLAR"],
    [5822,"5822","Carrier E","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","12","1",null,null,"27.1",null,"0","12","0","GUSELKUMAB","TREMFYA"],
    [5823,"5823","Carrier E","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,null,"33.6",null,"0","8","0","ERENUMAB-AOOE","AIMOVIG"],
    [5824,"5824","Carrier E","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,null,"21.6",null,"0","7","0","APREMILAST","OTEZLA"],
    [5825,"5825","Carrier E","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"0.5",null,"68.78",null,"0","2","0","ZOLMITRIPTAN","ZOMIG"],
    [5826,"5826","Carrier E","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","7",null,"0.2857",null,"33.75",null,"0","7","0","RIFAXIMIN","XIFAXAN"],
    [5827,"5827","Carrier E","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","52",null,"0.0385",null,"40.64",null,"0","52","0","VARENICLINE TARTRATE","APO-VARENICLINE"],
    [5828,"5828","Carrier E","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","36",null,"0.0278",null,"31.2",null,"0","36","0","LIRAGLUTIDE","VICTOZA"],
    [5829,"5829","Carrier E","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","197",null,"0.0152",null,"79.32",null,"0","197","0","EMPAGLIFLOZIN","JARDIANCE"],
    [5830,"5830","Carrier E","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","69",null,"0.0145",null,"24.15",null,"0","69","0","UBROGEPANT","UBRELVY"],
    [5831,"5831","Carrier C","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","59400","FULL ROUT OBSTE CARE,VAGINAL DELIV","45","1",null,"13","7.5",null,"1","44","0","NA","NA"],
    [5832,"5832","Carrier C","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","59510","FULL ROUT OBSTE CARE,CESAREAN DELIV","29","1",null,"22.5","33.4",null,"2","27","0","NA","NA"],
    [5833,"5833","Carrier C","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44204","COLECTOMY LAP PARTIAL W/ ANAST","16","1",null,"11","14.5",null,"1","15","0","NA","NA"],
    [5834,"5834","Carrier C","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU","12","0.75",null,null,"93.5",null,"0","12","0","NA","NA"],
    [5835,"5835","Carrier C","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43644","LAP GASTRIC BYPASS/ROUX-EN-Y","12","1",null,null,"75.2",null,"0","12","0","NA","NA"],
    [5836,"5836","Carrier C","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99404","PREV MED COUNSELING IND 53-67 MIN","8","1",null,null,"61",null,"0","8","0","NA","NA"],
    [5837,"5837","Carrier C","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","32650","THORACOSCOPY SURG W/ PLEURODESIS (MECHANICA","7","1",null,"13","17.4",null,"2","5","0","NA","NA"],
    [5838,"5838","Carrier C","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","TOTAL ABDOM HYSTERECTOMY","7","1",null,"1","39.3",null,"1","6","0","NA","NA"],
    [5839,"5839","Carrier C","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44207","LAP SURG; COLECT PART W/ANASTOM W/COLOPROCTOST","6","1",null,"13","32.8",null,"2","4","0","NA","NA"],
    [5840,"5840","Carrier C","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","33405","REPLACE PROSTH AORTIC VALVE, OPEN, W/BYPASS NON-HOMO","6","1",null,null,"38.2",null,"0","6","0","NA","NA"],
    [5841,"5841","Carrier C","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","59400","FULL ROUT OBSTE CARE,VAGINAL DELIV","45","1",null,"13","7.5",null,"1","44","0","NA","NA"],
    [5842,"5842","Carrier C","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","59510","FULL ROUT OBSTE CARE,CESAREAN DELIV","29","1",null,"22.5","33.4",null,"2","27","0","NA","NA"],
    [5843,"5843","Carrier C","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44204","COLECTOMY LAP PARTIAL W/ ANAST","16","1",null,"11","14.5",null,"1","15","0","NA","NA"],
    [5844,"5844","Carrier C","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43644","LAP GASTRIC BYPASS/ROUX-EN-Y","12","1",null,null,"75.2",null,"0","12","0","NA","NA"],
    [5845,"5845","Carrier C","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99404","PREV MED COUNSELING IND 53-67 MIN","8","1",null,null,"61",null,"0","8","0","NA","NA"],
    [5846,"5846","Carrier C","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","32650","THORACOSCOPY SURG W/ PLEURODESIS (MECHANICA","7","1",null,"13","17.4",null,"2","5","0","NA","NA"],
    [5847,"5847","Carrier C","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58150","TOTAL ABDOM HYSTERECTOMY","7","1",null,"1","39.3",null,"1","6","0","NA","NA"],
    [5848,"5848","Carrier C","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44207","LAP SURG; COLECT PART W/ANASTOM W/COLOPROCTOST","6","1",null,"13","32.8",null,"2","4","0","NA","NA"],
    [5849,"5849","Carrier C","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33405","REPLACE PROSTH AORTIC VALVE, OPEN, W/BYPASS NON-HOMO","6","1",null,null,"38.2",null,"0","6","0","NA","NA"],
    [5850,"5850","Carrier C","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","50360","TRANSPLANTATION OF KIDNEY","6","1",null,null,"46.8",null,"0","6","0","NA","NA"],
    [5851,"5851","Carrier C","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS","79701","0.971",null,"19.7","29.4",null,"7679","72022","0","NA","NA"],
    [5852,"5852","Carrier C","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES","11199","0.9711",null,"14.6","26.8",null,"372","10827","0","NA","NA"],
    [5853,"5853","Carrier C","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97124","THERA PROC 1+ AREAS EA 15 MIN MASSAGE","7564","0.9901",null,"12.9","19.3",null,"126","7438","0","NA","NA"],
    [5854,"5854","Carrier C","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","COLONOSCOPY W/ BX SINGLE/MULT","3994","0.996",null,"12.8","16.8",null,"81","3913","0","NA","NA"],
    [5855,"5855","Carrier C","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","TTE (ECHO) WITH SPECTRAL & COLOR FLOW DOPPLER","1896","0.9895",null,"26.6","57",null,"248","1648","0","NA","NA"],
    [5856,"5856","Carrier C","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97530","THERA ACTVI DIRECT PAT CONTACT EA 15 MIN","1736","0.9804",null,"15.5","32.2",null,"82","1654","0","NA","NA"],
    [5857,"5857","Carrier C","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96040","GENETICS COUNSELING, EACH 30 MIN, W/ PT/FAMILY","1635","0.9976",null,"13.9","21.2",null,"203","1432","0","NA","NA"],
    [5858,"5858","Carrier C","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97802","MED NUTRIT THRPY INIT ASSESS 15 MIN","1435","0.9686",null,"16.4","25.3",null,"78","1357","0","NA","NA"],
    [5859,"5859","Carrier C","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99202","OFFICE VISIT E&M NEW PT STRAIGHTFORWARD MDM, 15-29 MINS","1414","0.9187",null,"19.5","38.7",null,"208","1206","0","NA","NA"],
    [5860,"5860","Carrier C","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","MRI BRAIN W/ & W/O CONTRAST,","1413","0.8273",null,"16.8","72.4",null,"242","1171","0","NA","NA"],
    [5861,"5861","Carrier C","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","52000","CYSTOURETHROSCOPY (SEP PROC)","322","1",null,"12.2","24",null,"56","266","0","NA","NA"],
    [5862,"5862","Carrier C","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","17000","DESTRUCT 1ST AK PREMALIG LESION","281","1",null,"14","14.8",null,"5","276","0","NA","NA"],
    [5863,"5863","Carrier C","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29881","KNEE SCOPE,MED/LAT MENISECTOMY W/DEBRIDE/CHONDRO","169","1",null,"14","26.5",null,"8","161","0","NA","NA"],
    [5864,"5864","Carrier C","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","20550","INJECT TENDON SHEATH / TRIGGER FINGER","150","1",null,"12.5","33.3",null,"4","146","0","NA","NA"],
    [5865,"5865","Carrier C","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J3301","TRIAMCINOLONE ACETONIDE INJ PER 10 MG","146","1",null,"14.5","26.4",null,"6","140","0","NA","NA"],
    [5866,"5866","Carrier C","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","14000","ADJ TIS TRANS/REARRANGE TRUNK DEFECT <10 SQCM","143","1",null,null,"19.8",null,"0","143","0","NA","NA"],
    [5867,"5867","Carrier C","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93303","ECHO CONGEN CARDIAC ANOMALIES","133","1",null,null,"46.8",null,"0","133","0","NA","NA"],
    [5868,"5868","Carrier C","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93270","EVENT MONITOR - HOOKUP RECORD & DISCON ONLY","124","1",null,"11.9","20.7",null,"23","101","0","NA","NA"],
    [5869,"5869","Carrier C","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","76885","ECHOGRAPHY OF INFANT HIPS, DYNAMIC","112","1",null,"12.5","10.7",null,"4","108","0","NA","NA"],
    [5870,"5870","Carrier C","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93922","NON-INVASIVE STUDY EXTREMITY ARTERY BILAT SINGLE","109","1",null,"8","31.6",null,"3","106","0","NA","NA"],
    [5871,"5871","Carrier C","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","93321","ECHOCARDIOGRAPHY DOPPLER F/UP/LTD","2",null,"0.5",null,"81",null,"0","2","0","NA","NA"],
    [5872,"5872","Carrier C","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","61885","INSRT/REDO NEUROSTIM 1 ARRAY","2",null,"0.5",null,"85.5",null,"0","2","0","NA","NA"],
    [5873,"5873","Carrier C","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","85999","UNLISTED HEMATOLOGY AND COAGULATION PRO","3",null,"0.333",null,"83.7",null,"0","3","0","NA","NA"],
    [5874,"5874","Carrier C","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","58559","HYSTEROSCOPY W/ LYSIS INTRAUTERINE ADHES","5",null,"0.2","12","48.7",null,"2","3","0","NA","NA"],
    [5875,"5875","Carrier C","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","19316","MASTOPEXY","5",null,"0.2","37","75",null,"1","4","0","NA","NA"],
    [5876,"5876","Carrier C","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90868","TRANSCRANIAL MAG STIMJ TX DLVR & MGMT","6",null,"0.167","119","112.2",null,"1","5","0","NA","NA"],
    [5877,"5877","Carrier C","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","78608","BRAIN IMAGING PET METABOLIC","7",null,"0.143","26.3","138.3",null,"3","4","0","NA","NA"],
    [5878,"5878","Carrier C","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22551","ARTHRODESIS ANT INTERBODY CERVICAL BELOW C2","16",null,"0.125","13","110.5",null,"1","15","0","NA","NA"],
    [5879,"5879","Carrier C","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","81415","EXOME ; SEQUENCE ANALYSIS","10",null,"0.1","25","89.1",null,"2","8","0","NA","NA"],
    [5880,"5880","Carrier C","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","77373","STEREOTACTIC BODY RADIATION DELIVERY","21",null,"0.095","19.33","83",null,"9","12","0","NA","NA"],
    [5881,"5881","Carrier C","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","128.102","REF IP CD RESIDENTIAL TREATMENT CENTER","3","1",null,"10.3",null,null,"3","0","0","NA","NA"],
    [5882,"5882","Carrier C","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90853","GROUP PSYCHOTHERAPY","1","1",null,"70",null,null,"1","0","0","NA","NA"],
    [5883,"5883","Carrier C","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","128.102","REF IP CD RESIDENTIAL TREATMENT CENTER","3","1",null,"10.3",null,null,"3","0","0","NA","NA"],
    [5884,"5884","Carrier C","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90853","GROUP PSYCHOTHERAPY","1","1",null,"70",null,null,"1","0","0","NA","NA"],
    [5885,"5885","Carrier C","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY 60 MIN PATIENT","10091","0.9944",null,"2.9","2.9",null,"322","9769","0","NA","NA"],
    [5886,"5886","Carrier C","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90836","PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS","3482","0.9951",null,"3","2.9",null,"138","3344","0","NA","NA"],
    [5887,"5887","Carrier C","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES","696","0.9641",null,"18.5","22",null,"34","662","0","NA","NA"],
    [5888,"5888","Carrier C","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90853","GROUP PSYCHOTHERAPY","597","0.9983",null,"17.3","5.3",null,"3","594","0","NA","NA"],
    [5889,"5889","Carrier C","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96130","PSYCHOLOGICAL TESTING EVAL BY PHYS OR QUAL PROF;  FIRST HOUR","253","0.9684",null,"9.4","17.7",null,"5","248","0","NA","NA"],
    [5890,"5890","Carrier C","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","BEHAV IDENTIFICATION ASSESSMNT, ADM BY PHYS OR QUAL PROF, EA 15 MINS","242","0.8802",null,"55","152.4",null,"3","239","0","NA","NA"],
    [5891,"5891","Carrier C","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","TRANSCRANIAL MAG STIMJ TX DLVR & MGMT","228","0.807",null,null,"63.7",null,"0","228","0","NA","NA"],
    [5892,"5892","Carrier C","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96132","NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR","114","0.8684",null,"9","44.2",null,"2","112","0","NA","NA"],
    [5893,"5893","Carrier C","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90792","PSYCHIATRIC DIAGNOSTIC EVALUATION W/MEDICAL SERVICES","114","0.9211",null,"35.4","59.9",null,"7","107","0","NA","NA"],
    [5894,"5894","Carrier C","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97153","ADAPTIVE BEHAV TX BY PROTOCOL, ADM BY TECH/SUP BY PHYS, EA 15 MINS","88","0.9659",null,"75","119.5",null,"1","87","0","NA","NA"],
    [5895,"5895","Carrier C","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96156","HEALTH BEHAVIOR ASSESSMENT, OR RE-ASSESSMENT","19","1",null,null,"29",null,"0","19","0","NA","NA"],
    [5896,"5896","Carrier C","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90806.102","REF MENTAL HEALTH EXTERNAL","7","1",null,null,"25.6",null,"0","7","0","NA","NA"],
    [5897,"5897","Carrier C","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90849","MULT-FAMILY GROUP PSYCHOTHERAPY","5","1",null,null,"41.8",null,"0","5","0","NA","NA"],
    [5898,"5898","Carrier C","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96164","HEALTH BEHAVIOR INTERVENTION, GROUP (2 OR MORE PTS), FTF; INIT 30 MINS","3","1",null,null,"13.3",null,"0","3","0","NA","NA"],
    [5899,"5899","Carrier C","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90867","TRANSCRANIAL MAG STIMJ TX PLANNING","2","1",null,"32","33",null,"1","1","0","NA","NA"],
    [5900,"5900","Carrier C","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97152","BEHAV IDENT-SUPPORT ASSESSMNT, ADM BY TECH/SUPV OF PHYS, EA 15 MINS","1","1",null,null,"15",null,"0","1","0","NA","NA"],
    [5901,"5901","Carrier C","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96167","HEALTH BEHAVIOR INTERVENTION, FAMILY (WITH THE PATIENT PRESENT),FTF; INIT 30 MINS","1","1",null,null,"15",null,"0","1","0","NA","NA"],
    [5902,"5902","Carrier C","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96158","HEALTH BEHAVIOR INTERVENTION, INDIVIDUAL, FACE-TO-FACE; INITIAL 30 MINS","1","1",null,null,"11",null,"0","1","0","NA","NA"],
    [5903,"5903","Carrier C","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64568","INC IMPLTJ CRNL NRV NSTIM ELTRDS & PULSE GENER","1","1",null,null,"2",null,"0","1","0","NA","NA"],
    [5904,"5904","Carrier C","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90806","IND PSYCHOTHERAPY OFFICE 45-50 MIN","1","1",null,null,"33",null,"0","1","0","NA","NA"],
    [5905,"5905","Carrier C","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90834","PSYCHOTHERAPY 45 MIN PATIENT","3",null,"0.333","14","67",null,"1","2","0","NA","NA"],
    [5906,"5906","Carrier C","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90868","TRANSCRANIAL MAG STIMJ TX DLVR & MGMT","228",null,"0.009",null,"63.7",null,"0","228","0","NA","NA"],
    [5907,"5907","Carrier C","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0601","CPAP DEVICE","3097","0.9655",null,"13.5","31",null,"603","2494","0","NA","NA"],
    [5908,"5908","Carrier C","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0603","DME ELECTRIC BREAST PUMP KIT PURCHASE","1721","0.9971",null,"11.6","27.7",null,"1301","420","0","NA","NA"],
    [5909,"5909","Carrier C","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A7027","COMB ORAL/NASAL MASK USED W/CPAP DEVICE EA","1323","0.997",null,"14.4","21.2",null,"311","1012","0","NA","NA"],
    [5910,"5910","Carrier C","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A7034","NASAL APPLICATION DEVICE","1317","0.9924",null,null,"13.7",null,"0","1317","0","NA","NA"],
    [5911,"5911","Carrier C","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0604","DME ELECTRIC BREAST PUMP KIT RENTAL","887","0.982",null,"12.7","27.8",null,"571","316","0","NA","NA"],
    [5912,"5912","Carrier C","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0143","WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT","576","0.9878",null,"6","24.4",null,"276","300","0","NA","NA"],
    [5913,"5913","Carrier C","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L4361","PNEUMATIC, WALKING BOOT","555","0.9982",null,"5.5","18.6",null,"2","553","0","NA","NA"],
    [5914,"5914","Carrier C","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0114","CRUTCHES METAL UNDERARM PAIR","552","0.9964",null,"12.9","14",null,"20","532","0","NA","NA"],
    [5915,"5915","Carrier C","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E1390","OXYGEN CONCENTRATOR","401","0.9701",null,"4.9","26.1",null,"93","308","0","NA","NA"],
    [5916,"5916","Carrier C","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L3908","WRIST SPLINT W/WO COCK-UP","386","1",null,"12","16.1",null,"4","382","0","NA","NA"],
    [5917,"5917","Carrier C","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L3908","WRIST SPLINT W/WO COCK-UP","386","1",null,"12","16.1",null,"4","382","0","NA","NA"],
    [5918,"5918","Carrier C","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L3660","SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND","352","1",null,null,"15",null,"0","352","0","NA","NA"],
    [5919,"5919","Carrier C","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L4205","REPAIR ORTHOTIC DEV LABOR PER 15 MIN","300","1",null,"15.1","32.5",null,"28","272","0","NA","NA"],
    [5920,"5920","Carrier C","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L3809","WRIST THUMB SPICA","283","1",null,"9.8","14.6",null,"4","279","0","NA","NA"],
    [5921,"5921","Carrier C","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L3670","SHLDER IMMOB W/ABDUCTION PILLOW","216","1",null,"21","15.6",null,"3","213","0","NA","NA"],
    [5922,"5922","Carrier C","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4388","DRAINABLE PCH W EX WEAR BARR","196","1",null,"13.8","16.2",null,"123","73","0","NA","NA"],
    [5923,"5923","Carrier C","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L1833","WARRIOR WRAP WITH HINGES/FLEX STOP","162","1",null,"16","0.7",null,"1","161","0","NA","NA"],
    [5924,"5924","Carrier C","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4670","AUTOMATIC BP MONITOR DIAL","149","1",null,"13","0.8",null,"25","124","0","NA","NA"],
    [5925,"5925","Carrier C","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L8000","BREAST PROSTHESIS MASTECTOMY BRA","149","1",null,"14","32",null,"3","146","0","NA","NA"],
    [5926,"5926","Carrier C","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L1830","KO IMMOBILIZER CANVAS LONGIT","141","1",null,null,"14.9",null,"0","141","0","NA","NA"],
    [5927,"5927","Carrier C","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E8000","GAIT TRAINER, PEDIATRIC SIZE, POSTERIOR SUPPORT INCL ALL ACCESSORIES & COMP","2",null,"0.5",null,"98",null,"0","2","0","NA","NA"],
    [5928,"5928","Carrier C","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L5331","HIP DISART CANADIAN SACH FT","2",null,"0.5",null,"78.5",null,"0","2","0","NA","NA"],
    [5929,"5929","Carrier C","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L5920","ADDN KNEE-SHIN ALIGNABLE","2",null,"0.5",null,"66.5",null,"0","2","0","NA","NA"],
    [5930,"5930","Carrier C","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L5321","AK OPEN END SACH","2",null,"0.5",null,"144.5",null,"0","2","0","NA","NA"],
    [5931,"5931","Carrier C","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0483","HIGH FREQ CHEST WALL OCSILLATION SYSTEM, INCL ALL ACCESSORIES/SUPPLIES, EA","6",null,"0.167",null,"87.3",null,"0","6","0","NA","NA"],
    [5932,"5932","Carrier C","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","K0005","ULTRALIGHTWEIGHT WHEELCHAIR","11",null,"0.091",null,"123.9",null,"0","11","0","NA","NA"],
    [5933,"5933","Carrier C","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","B4153","ENTERAL FORMULAE CATEGORYIII","13",null,"0.077","16","108",null,"1","12","0","NA","NA"],
    [5934,"5934","Carrier C","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A5500","DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE","25",null,"0.04","30","21",null,"1","24","0","NA","NA"],
    [5935,"5935","Carrier C","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E2103","NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER","25",null,"0.04","30","81.4",null,"4","21","0","NA","NA"],
    [5936,"5936","Carrier C","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","B4160","ENTERAL FORMULA, PEDS, NUTRITIONALLY COMP CALORIE DENSE, 100 CAL = 1 UNIT","49",null,"0.02",null,"105.4",null,"0","49","0","NA","NA"],
    [5937,"5937","Carrier C","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS","1406","0.9651",null,"14.8","24.9",null,"77","1329","0","NA","NA"],
    [5938,"5938","Carrier C","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E2103","NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER","692","0.7254",null,"15.1","66.1",null,"68","624","0","NA","NA"],
    [5939,"5939","Carrier C","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4239","SPLY ALW NONADJUNC NONIMPL CGM 1 MO SPLY= 1 UOS","586","0.9369",null,"13.9","34.7",null,"340","246","0","NA","NA"],
    [5940,"5940","Carrier C","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97802","MED NUTRIT THRPY INIT ASSESS 15 MIN","390","0.9897",null,"11.9","20.1",null,"23","367","0","NA","NA"],
    [5941,"5941","Carrier C","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4224","SUPPLIES FOR MAINTENANCE OF INSULIN INFUSION CATH, PER WEEK","291","1",null,"11.3","37.9",null,"214","77","0","NA","NA"],
    [5942,"5942","Carrier C","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A5500","DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE","162","0.9753",null,"7.4","30.5",null,"5","157","0","NA","NA"],
    [5943,"5943","Carrier C","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A9276","SNSR;INVSV DISP USE NONDME INTRSTL CGM 1U=1D SPL","94","0.8511",null,"11.4","60.7",null,"31","63","0","NA","NA"],
    [5944,"5944","Carrier C","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","G0108","DIAB MGMT TRN PER INDIV","85","0.9765",null,"11.5","45.6",null,"2","83","0","NA","NA"],
    [5945,"5945","Carrier C","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","K0553","SUPPLY ALLOWANCE FOR THERAPEUTIC CONTINUOUS GLUCOSE MONITOR (CGM), INCLUDES ALL SUPPLIES AND ACCESSORIES","77","0.7792",null,"12.3","59.7",null,"20","57","0","NA","NA"],
    [5946,"5946","Carrier C","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4221","WEEKLY SUPPLIES DRUG INFUS CATH","77","0.987",null,"11","36.6",null,"43","34","0","NA","NA"],
    [5947,"5947","Carrier C","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4224","SUPPLIES FOR MAINTENANCE OF INSULIN INFUSION CATH, PER WEEK","291","1",null,"11.3","37.9",null,"214","77","0","NA","NA"],
    [5948,"5948","Carrier C","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J9035","INJ BEVACIZUMAB 10 MG","58","1",null,"17.5","31.4",null,"16","42","0","NA","NA"],
    [5949,"5949","Carrier C","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","67228","DESTRUCT EXTENSIVE/PROG RETINOPATHY PHOTOCOAGULATN","23","1",null,"10.3","47.8",null,"8","15","0","NA","NA"],
    [5950,"5950","Carrier C","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97597","DEBRIDEMENT, OPEN WOUND, ASSESSMENT, ONGOING CARE, PER SESSION,  FIRST 20 SQ CM OR LESS","21","1",null,"14.4","25.8",null,"5","16","0","NA","NA"],
    [5951,"5951","Carrier C","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A5513","FOR DIAB ONLY MX DNSITY INSRT CSTM MOLD CSTM EA","21","1",null,"7","41.3",null,"2","19","0","NA","NA"],
    [5952,"5952","Carrier C","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95250","GLUCOSE MONITORING 72 HRS MD OR OTH QUAL, EQUIP PROV, REC/STORAGE GL","20","1",null,"13","28.8",null,"2","18","0","NA","NA"],
    [5953,"5953","Carrier C","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4230","INFUS SET INSULIN PUMP NON NEEDLE","17","1",null,"9.4","21.6",null,"8","9","0","NA","NA"],
    [5954,"5954","Carrier C","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","92012","INTERMEDIATE EYE EXAM ESTABLISHED PATIENT","14","1",null,null,"22.9",null,"0","14","0","NA","NA"],
    [5955,"5955","Carrier C","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99204","OFFICE VISIT E&M NEW PT MODERATE MDM, 45-59 MINS","14","1",null,"13.3","26.1",null,"3","11","0","NA","NA"],
    [5956,"5956","Carrier C","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E2402","NEGATIVE PRESSURE WOUND THERAPY ELECT PUMP, STATIONARY OR PORTABLE","16","1",null,"19.2","75.5",null,"10","6","0","NA","NA"],
    [5957,"5957","Carrier C","2023","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E2103","NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER","692",null,"0.0029","15.1","66.1",null,"68","624","0","NA","NA"],
    [5958,"5958","Carrier C","2023","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A4239","SPLY ALW NONADJUNC NONIMPL CGM 1 MO SPLY= 1 UOS","586",null,"0.0017","13.9","34.7",null,"340","246","0","NA","NA"],
    [5959,"5959","Carrier C","2023","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","99214","OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS","1406",null,"0.0014","14.8","24.9",null,"77","1329","0","NA","NA"],
    [5960,"5960","Carrier C","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","2485","0.3172",null,"11","78",null,"43","2442","0","semaglutide","Ozempic, Rybelsus"],
    [5961,"5961","Carrier C","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","1247","0.4258",null,"22","79",null,"36","1211","0","lisdexamphetamine","Vyvanse"],
    [5962,"5962","Carrier C","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","736","0.7745",null,"13","47",null,"5","731","0","cyclosporine","Restasis, Cequa"],
    [5963,"5963","Carrier C","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","701","0.5991",null,"23","54",null,"15","686","0","BUDESONIDE-FORMOTEROL","Symbicort"],
    [5964,"5964","Carrier C","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","691","0.8292",null,"8","36",null,"70","621","0","rivaroxaba","XARELTO"],
    [5965,"5965","Carrier C","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","642","0.553",null,"7","72",null,"14","628","0","liraglutide","VICTOZA"],
    [5966,"5966","Carrier C","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","603","0.9436",null,"20","81",null,"8","595","0","empagliflozin","Jardiance"],
    [5967,"5967","Carrier C","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","580","0.4759",null,"16","68",null,"84","496","0","apixiban","ELIQUIS"],
    [5968,"5968","Carrier C","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","479","0.0313",null,"0","92",null,"3","476","0","tirzepatide","MOUNJARO"],
    [5969,"5969","Carrier C","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","348","0.8851",null,"10","46",null,"3","345","0","adalimumab-atto","AMJEVITA"],
    [5970,"5970","Carrier C","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","32","1",null,"3","36",null,"6","26","0","LENALIDOMIDE","Revlamid"],
    [5971,"5971","Carrier C","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","22","1",null,"40","39",null,"2","20","0","enzalutamide","Xtandi"],
    [5972,"5972","Carrier C","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","19","1",null,"0","31",null,"1","18","0","midazolam","Nayzilam"],
    [5973,"5973","Carrier C","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","18","1",null,"2","24",null,"3","15","0","dofetilide","Tikosyn"],
    [5974,"5974","Carrier C","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","18","1",null,"33","34",null,"2","16","0","ribociclib","Kisqali"],
    [5975,"5975","Carrier C","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","12","1",null,"28","43",null,"1","11","0","acalabrutinib","Calquence"],
    [5976,"5976","Carrier C","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","11","1",null,null,"82",null,"0","11","0","Epoetin Alfa","Epogen, Procrit"],
    [5977,"5977","Carrier C","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","11","1",null,"23","52",null,"2","9","0","pomalidomide","Pomalyst"],
    [5978,"5978","Carrier C","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","10","1",null,"35","34",null,"2","8","0","Posaconazole","Noxafil"],
    [5979,"5979","Carrier C","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","9","1",null,null,"43",null,"0","9","0","Pirfenidone","Esbriet"],
    [5980,"5980","Carrier C","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1","21",null,null,"1","0","0","pegfilgrastim-jmdb","Fulphila"],
    [5981,"5981","Carrier C","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1",null,"123",null,"0","1","0","lonapegsomatropin-tcgd","Skytrofa"],
    [5982,"5982","Carrier C","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1",null,"76",null,"0","1","0","darbepoetin","Aranesp"],
    [5983,"5983","Carrier C","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","4",null,"0.5",null,"94",null,"0","4","0","sodium oxybate","Xyrem"],
    [5984,"5984","Carrier C","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","4",null,"0.5",null,"98",null,"0","4","0","teriflunomide","Aubagio"],
    [5985,"5985","Carrier C","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"0.5","0","121",null,"1","1","0","selinexor","Xpovio"],
    [5986,"5986","Carrier C","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","17",null,"0.353",null,"119",null,"0","17","0","calcium/magnesium/potassium/sodium oxybates","Xywav"],
    [5987,"5987","Carrier C","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3",null,"0.333",null,"93",null,"0","3","0","peg-filgrastim","Neulasta"],
    [5988,"5988","Carrier C","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3",null,"0.333","49","42",null,"1","2","0","ponatinib","Iclusig"],
    [5989,"5989","Carrier C","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3",null,"0.333",null,"108",null,"0","3","0","droxidopa","Northera"],
    [5990,"5990","Carrier D","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","59400","FULL ROUT OBSTE CARE,VAGINAL DELIV","17","1",null,null,"7.2",null,"0","17","0","NA","NA"],
    [5991,"5991","Carrier D","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","59510","FULL ROUT OBSTE CARE,CESAREAN DELIV","16","1",null,null,"26.4",null,"0","16","0","NA","NA"],
    [5992,"5992","Carrier D","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27447","TOTAL KNEE ARTHROPLASTY","12","0.3333",null,"43","99.7",null,"2","10","0","NA","NA"],
    [5993,"5993","Carrier D","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU","8","0.875",null,null,"92.1",null,"0","8","0","NA","NA"],
    [5994,"5994","Carrier D","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44204","COLECTOMY LAP PARTIAL W/ ANAST","5","1",null,null,"11.2",null,"0","5","0","NA","NA"],
    [5995,"5995","Carrier D","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44205","COLECTOMY LAP PART W/ REM TERM ILEUM","5","1",null,"13.5","41",null,"2","3","0","NA","NA"],
    [5996,"5996","Carrier D","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","50360","TRANSPLANTATION OF KIDNEY","5","0.8",null,null,"65.2",null,"0","5","0","NA","NA"],
    [5997,"5997","Carrier D","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19364","BREAST RECONSTRUCTION; WITH FREE FLAP","4","1",null,null,"66.3",null,"0","4","0","NA","NA"],
    [5998,"5998","Carrier D","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96413","CHEMO ADMIN IV INFUS SING/INITIAL SUB/DRUG UP TO *","4","1",null,"21.7","41",null,"3","1","0","NA","NA"],
    [5999,"5999","Carrier D","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43644","LAP GASTRIC BYPASS/ROUX-EN-Y","4","0.75",null,null,"80.3",null,"0","4","0","NA","NA"],
    [6000,"6000","Carrier D","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","59400","FULL ROUT OBSTE CARE,VAGINAL DELIV","17","1",null,null,"7.2",null,"0","17","0","NA","NA"],
    [6001,"6001","Carrier D","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","59510","FULL ROUT OBSTE CARE,CESAREAN DELIV","16","1",null,null,"26.4",null,"0","16","0","NA","NA"],
    [6002,"6002","Carrier D","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44204","COLECTOMY LAP PARTIAL W/ ANAST","5","1",null,null,"11.2",null,"0","5","0","NA","NA"],
    [6003,"6003","Carrier D","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44205","COLECTOMY LAP PART W/ REM TERM ILEUM","5","1",null,"13.5","41",null,"2","3","0","NA","NA"],
    [6004,"6004","Carrier D","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19364","BREAST RECONSTRUCTION; WITH FREE FLAP","4","1",null,null,"66.3",null,"0","4","0","NA","NA"],
    [6005,"6005","Carrier D","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96413","CHEMO ADMIN IV INFUS SING/INITIAL SUB/DRUG UP TO *","4","1",null,"21.7","41",null,"3","1","0","NA","NA"],
    [6006,"6006","Carrier D","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99404","PREV MED COUNSELING IND 53-67 MIN","4","1",null,null,"37",null,"0","4","0","NA","NA"],
    [6007,"6007","Carrier D","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93306","TTE (ECHO) WITH SPECTRAL & COLOR FLOW DOPPLER","4","1",null,null,"57.5",null,"0","4","0","NA","NA"],
    [6008,"6008","Carrier D","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22551","ARTHRODESIS ANT INTERBODY CERVICAL BELOW C2","3","1",null,"35","86.5",null,"1","2","0","NA","NA"],
    [6009,"6009","Carrier D","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96416","CHEMO ADMIN IV INFUS >8 HRS W/PORT/IMPLANTED PUMP","3","1",null,"12","31",null,"2","1","0","NA","NA"],
    [6010,"6010","Carrier D","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS","22813","0.989",null,"18","28.4",null,"1894","20919","0","NA","NA"],
    [6011,"6011","Carrier D","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES","3145","0.9933",null,"17.6","25.8",null,"109","3036","0","NA","NA"],
    [6012,"6012","Carrier D","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97124","THERA PROC 1+ AREAS EA 15 MIN MASSAGE","1509","0.9934",null,"15.3","22.3",null,"23","1486","0","NA","NA"],
    [6013,"6013","Carrier D","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","COLONOSCOPY W/ BX SINGLE/MULT","1060","0.9962",null,"13","20",null,"62","998","0","NA","NA"],
    [6014,"6014","Carrier D","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","MRI BRAIN W/ & W/O CONTRAST,","988","0.7834",null,"19.2","74.7",null,"127","861","0","NA","NA"],
    [6015,"6015","Carrier D","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","TTE (ECHO) WITH SPECTRAL & COLOR FLOW DOPPLER","825","0.9963",null,"12.8","34.9",null,"94","731","0","NA","NA"],
    [6016,"6016","Carrier D","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","MRI ANY JOINT","787","0.7649",null,"32.5","63.8",null,"113","674","0","NA","NA"],
    [6017,"6017","Carrier D","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74178","CT ABD & PELVIS W/O CONTRST 1+ BODY REGNS","688","0.9157",null,"14.7","28.4",null,"202","486","0","NA","NA"],
    [6018,"6018","Carrier D","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73718","MRI LOWER EXTREMITY W/O CONTRAST","651","0.871",null,"16.4","47.8",null,"97","554","0","NA","NA"],
    [6019,"6019","Carrier D","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71250","COMPUTED TOMOGRAPHY, THORAX, DIAGNOSTIC; W/O CONTRAST MATERIAL","599","0.8447",null,"20.2","37.2",null,"123","476","0","NA","NA"],
    [6020,"6020","Carrier D","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96040","GENETICS COUNSELING, EACH 30 MIN, W/ PT/FAMILY","390","1",null,"14.1","23.2",null,"56","334","0","NA","NA"],
    [6021,"6021","Carrier D","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99204","OFFICE VISIT E&M NEW PT MODERATE MDM, 45-59 MINS","207","1",null,"15.3","33",null,"24","183","0","NA","NA"],
    [6022,"6022","Carrier D","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","11102","TANGENTIAL BIOPSY OF SKIN; FIRST LESION","168","1",null,"12.7","43.2",null,"3","165","0","NA","NA"],
    [6023,"6023","Carrier D","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","52000","CYSTOURETHROSCOPY (SEP PROC)","155","1",null,"11.9","29.1",null,"22","133","0","NA","NA"],
    [6024,"6024","Carrier D","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95863","EMG NEEDLE 3 EXTREMITIES W/WO RELATED PARASPINAL","153","1",null,"11.8","54.9",null,"6","147","0","NA","NA"],
    [6025,"6025","Carrier D","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","17311","MOHS HD, NCK, HND, FEET, GEN 1ST STGE UP TO 5 BLCK","144","1",null,"12.5","19",null,"27","117","0","NA","NA"],
    [6026,"6026","Carrier D","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","17000","DESTRUCT 1ST AK PREMALIG LESION","141","1",null,"12.3","21.4",null,"34","107","0","NA","NA"],
    [6027,"6027","Carrier D","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","66984","EXTRACAPSULAR CAT REM W/ INSERT LENS PROSTHESIS; W/O ECP","115","1",null,"15.2","31.2",null,"11","104","0","NA","NA"],
    [6028,"6028","Carrier D","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","94010","SPIROMETRY W/GRAPHIC RECORD/VITAL CAPACITY/FLOW","112","1",null,"12","35.8",null,"5","107","0","NA","NA"],
    [6029,"6029","Carrier D","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64400","INJ(S), ANESTHETIC AGENT(S) AND/OR STEROID; TRIGEMINAL NRV, EA BRANCH","106","1",null,"10.7","25.1",null,"21","85","0","NA","NA"],
    [6030,"6030","Carrier D","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43284","LAPAROSCOPY SURG, ESOPHAGEAL SPHINCTER AUGMNTATION W/DEV (IE MAGNETIC BAND)","1",null,"1",null,"129",null,"0","1","0","NA","NA"],
    [6031,"6031","Carrier D","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","77385","INTENSITY MODULATED RADIATION TREATMENT DELIVERY (IMRT),  SIMPLE","1",null,"1",null,"71",null,"0","1","0","NA","NA"],
    [6032,"6032","Carrier D","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","B4154","ENTERAL FORMULAE CATEGORY IV","1",null,"1",null,"132",null,"0","1","0","NA","NA"],
    [6033,"6033","Carrier D","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","J1559","INJECTION, IMMUNE GLOBULIN (HIZENTRA), 100 MG","1",null,"1",null,"38",null,"0","1","0","NA","NA"],
    [6034,"6034","Carrier D","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","81204","AR GENE ANALYSIS; CHARACTERIZATION OF ALLELES","2",null,"0.5",null,"57",null,"0","2","0","NA","NA"],
    [6035,"6035","Carrier D","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90868","TRANSCRANIAL MAG STIMJ TX DLVR & MGMT","3",null,"0.333",null,"113.7",null,"0","3","0","NA","NA"],
    [6036,"6036","Carrier D","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64582","OPEN IMPLTJ HPGLSL NRV NSTIM RA PG&RESPIR SENSOR","4",null,"0.25",null,"111",null,"0","4","0","NA","NA"],
    [6037,"6037","Carrier D","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","29916","ARTHROSCOPY HIP W/LABRAL REPAIR","9",null,"0.222","5","65.1",null,"1","8","0","NA","NA"],
    [6038,"6038","Carrier D","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","77522","PROTON TRMT, SIMPLE W/COMP","5",null,"0.2","18","78.3",null,"2","3","0","NA","NA"],
    [6039,"6039","Carrier D","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","81439","HEREDIT CARDIOMYOPTHY, GENOMIC ANALY PANEL MUST INCL 5 GENES","5",null,"0.2",null,"83.6",null,"0","5","0","NA","NA"],
    [6040,"6040","Carrier D","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY 60 MIN PATIENT","860","0.9553",null,"1.8","3.8",null,"95","765","0","NA","NA"],
    [6041,"6041","Carrier D","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90836","PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS","304","1",null,"3.1","3.1",null,"36","268","0","NA","NA"],
    [6042,"6042","Carrier D","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES","150","0.9933",null,"19.3","24.2",null,"4","146","0","NA","NA"],
    [6043,"6043","Carrier D","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","TRANSCRANIAL MAG STIMJ TX DLVR & MGMT","113","0.8053",null,null,"65.9",null,"0","113","0","NA","NA"],
    [6044,"6044","Carrier D","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","BEHAV IDENTIFICATION ASSESSMNT, ADM BY PHYS OR QUAL PROF, EA 15 MINS","70","0.9",null,"39","157",null,"1","69","0","NA","NA"],
    [6045,"6045","Carrier D","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96132","NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR","51","0.8824",null,"15","42",null,"2","49","0","NA","NA"],
    [6046,"6046","Carrier D","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90853","GROUP PSYCHOTHERAPY","45","1",null,null,"25.8",null,"0","45","0","NA","NA"],
    [6047,"6047","Carrier D","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96130","PSYCHOLOGICAL TESTING EVAL BY PHYS OR QUAL PROF;  FIRST HOUR","43","0.9767",null,null,"17.3",null,"0","43","0","NA","NA"],
    [6048,"6048","Carrier D","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97153","ADAPTIVE BEHAV TX BY PROTOCOL, ADM BY TECH/SUP BY PHYS, EA 15 MINS","25","0.88",null,null,"105.6",null,"0","25","0","NA","NA"],
    [6049,"6049","Carrier D","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90792","PSYCHIATRIC DIAGNOSTIC EVALUATION W/MEDICAL SERVICES","22","0.9091",null,"37","52.4",null,"4","18","0","NA","NA"],
    [6050,"6050","Carrier D","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90836","PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS","304","1",null,"3.1","3.1",null,"36","268","0","NA","NA"],
    [6051,"6051","Carrier D","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90853","GROUP PSYCHOTHERAPY","45","1",null,null,"25.8",null,"0","45","0","NA","NA"],
    [6052,"6052","Carrier D","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99214","OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS","12","1",null,"36","17.1",null,"1","11","0","NA","NA"],
    [6053,"6053","Carrier D","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96136","PSYCHOLOGICAL OR NEUROPSYCHOLOGICAL TEST BY PHYS,2 OR MORE;FIRST 30 MINS","8","1",null,null,"21",null,"0","8","0","NA","NA"],
    [6054,"6054","Carrier D","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","G2082","VISIT FOR EVAL/MGMT EST PT REQ SUPERVISOIN MD, UP TO 56 MG OF ESKETAMINE NASAL, SELF ADMIM","6","1",null,null,"33.5",null,"0","6","0","NA","NA"],
    [6055,"6055","Carrier D","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96116","NEUROBEHAVIORAL STATUS EXAM, PHYS OR QUAL PROF, FIRST HOUR","3","1",null,null,"31",null,"0","3","0","NA","NA"],
    [6056,"6056","Carrier D","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96138","PSYCHOLOGICAL OR NEUROPSYCHOLOGICAL TEST BY TECH,2 OR MORE;FIRST 30 MINS","3","1",null,null,"745",null,"0","3","0","NA","NA"],
    [6057,"6057","Carrier D","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90833","PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS","2","1",null,null,"0",null,"0","2","0","NA","NA"],
    [6058,"6058","Carrier D","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97155","ADAPTIVE BEHAV TX W/PROTOCOL MOD, ADM BY PHYS OR QUAL PROF, EA 15 MINS","1","1",null,null,"141",null,"0","1","0","NA","NA"],
    [6059,"6059","Carrier D","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H0020","ALCOHOL AND/OR DRUG SERVICES","1","1",null,null,"11",null,"0","1","0","NA","NA"],
    [6060,"6060","Carrier D","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90792","PSYCHIATRIC DIAGNOSTIC EVALUATION W/MEDICAL SERVICES","22",null,"0.045","37","52.4",null,"4","18","0","NA","NA"],
    [6061,"6061","Carrier D","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90868","TRANSCRANIAL MAG STIMJ TX DLVR & MGMT","113",null,"0.035",null,"65.9",null,"0","113","0","NA","NA"],
    [6062,"6062","Carrier D","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0601","CPAP DEVICE","1504","0.9561",null,"12.6","26.4",null,"149","1355","0","NA","NA"],
    [6063,"6063","Carrier D","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0603","DME ELECTRIC BREAST PUMP KIT PURCHASE","537","0.9981",null,"11.5","21",null,"475","62","0","NA","NA"],
    [6064,"6064","Carrier D","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A7027","COMB ORAL/NASAL MASK USED W/CPAP DEVICE EA","470","1",null,"12.3","16.2",null,"92","378","0","NA","NA"],
    [6065,"6065","Carrier D","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A7034","NASAL APPLICATION DEVICE","333","0.988",null,"13.5","19.5",null,"2","331","0","NA","NA"],
    [6066,"6066","Carrier D","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L4361","PNEUMATIC, WALKING BOOT","321","0.9969",null,"16","18.4",null,"2","319","0","NA","NA"],
    [6067,"6067","Carrier D","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0114","CRUTCHES METAL UNDERARM PAIR","286","1",null,"15","17.5",null,"1","285","0","NA","NA"],
    [6068,"6068","Carrier D","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0604","DME ELECTRIC BREAST PUMP KIT RENTAL","195","0.9846",null,"12.6","24",null,"115","80","0","NA","NA"],
    [6069,"6069","Carrier D","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L3908","WRIST SPLINT W/WO COCK-UP","191","1",null,null,"17.6",null,"0","191","0","NA","NA"],
    [6070,"6070","Carrier D","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L3809","WRIST THUMB SPICA","156","1",null,"8","15.9",null,"1","155","0","NA","NA"],
    [6071,"6071","Carrier D","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0143","WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT","151","0.9934",null,"5.3","30.1",null,"56","95","0","NA","NA"],
    [6072,"6072","Carrier D","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A7027","COMB ORAL/NASAL MASK USED W/CPAP DEVICE EA","470","1",null,"12.3","16.2",null,"92","378","0","NA","NA"],
    [6073,"6073","Carrier D","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0114","CRUTCHES METAL UNDERARM PAIR","286","1",null,"15","17.5",null,"1","285","0","NA","NA"],
    [6074,"6074","Carrier D","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L3908","WRIST SPLINT W/WO COCK-UP","191","1",null,null,"17.6",null,"0","191","0","NA","NA"],
    [6075,"6075","Carrier D","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L3809","WRIST THUMB SPICA","156","1",null,"8","15.9",null,"1","155","0","NA","NA"],
    [6076,"6076","Carrier D","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L3660","SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND","149","1",null,null,"19.2",null,"0","149","0","NA","NA"],
    [6077,"6077","Carrier D","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L3670","SHLDER IMMOB W/ABDUCTION PILLOW","101","1",null,"27","14.7",null,"2","99","0","NA","NA"],
    [6078,"6078","Carrier D","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0118","CRUTCH SUBSTITUTE, LOWER LEG PLATFORM, WITH OR WITHOUT WHEELS, EACH","95","1",null,"12.2","69",null,"31","64","0","NA","NA"],
    [6079,"6079","Carrier D","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L1902","ANKLE LACE UP BRACE","89","1",null,null,"17",null,"0","89","0","NA","NA"],
    [6080,"6080","Carrier D","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0570","DME NEBULIZE HOME/PORTABLE","83","1",null,"14.1","28.7",null,"15","68","0","NA","NA"],
    [6081,"6081","Carrier D","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L4205","REPAIR ORTHOTIC DEV LABOR PER 15 MIN","75","1",null,"34.7","33.2",null,"3","72","0","NA","NA"],
    [6082,"6082","Carrier D","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L5321","AK OPEN END SACH","2",null,"0.5",null,"72.5",null,"0","2","0","NA","NA"],
    [6083,"6083","Carrier D","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E1161","MANUAL ADULT SIZE WHEELCHAIR, INCLUDES TILT IN SPACE","5",null,"0.2",null,"95.2",null,"0","5","0","NA","NA"],
    [6084,"6084","Carrier D","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","K0861","POWER WHEELCHAIR, GROUP 3 STD, MULT POWER OPTION, CAP UP TO 300 LBS","5",null,"0.2",null,"51.2",null,"0","5","0","NA","NA"],
    [6085,"6085","Carrier D","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","K0005","ULTRALIGHTWEIGHT WHEELCHAIR","9",null,"0.111",null,"96.2",null,"0","9","0","NA","NA"],
    [6086,"6086","Carrier D","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","B4149","ENTERAL FORMULA, MANUFACT, ADM VIA ENTERAL FEED TUBE, 100 CALORIES=1UN","10",null,"0.1","8","111.3",null,"2","8","0","NA","NA"],
    [6087,"6087","Carrier D","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E2402","NEGATIVE PRESSURE WOUND THERAPY ELECT PUMP, STATIONARY OR PORTABLE","73",null,"0.014","40.3","77.8",null,"49","24","0","NA","NA"],
    [6088,"6088","Carrier D","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0601","CPAP DEVICE","1504",null,"0.001","12.6","26.4",null,"149","1355","0","NA","NA"],
    [6089,"6089","Carrier D","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE VISIT E&M EST PT, MODERATE MDM, 30-39 MINS","440","0.9909",null,"17.9","27",null,"36","404","0","NA","NA"],
    [6090,"6090","Carrier D","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E2103","NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER","223","0.713",null,"22","70.5",null,"26","197","0","NA","NA"],
    [6091,"6091","Carrier D","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4239","SPLY ALW NONADJUNC NONIMPL CGM 1 MO SPLY= 1 UOS","208","0.8558",null,"16.5","42.1",null,"84","124","0","NA","NA"],
    [6092,"6092","Carrier D","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97802","MED NUTRIT THRPY INIT ASSESS 15 MIN","133","1",null,"12.9","24.1",null,"8","125","0","NA","NA"],
    [6093,"6093","Carrier D","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4224","SUPPLIES FOR MAINTENANCE OF INSULIN INFUSION CATH, PER WEEK","87","0.977",null,"11.8","35.1",null,"60","27","0","NA","NA"],
    [6094,"6094","Carrier D","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0784","EXTERN AMBUL INSULIN INFUS PUMP","52","0.8462",null,"10","80.6",null,"2","50","0","NA","NA"],
    [6095,"6095","Carrier D","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","G0108","DIAB MGMT TRN PER INDIV","47","1",null,null,"43.7",null,"0","47","0","NA","NA"],
    [6096,"6096","Carrier D","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J9035","INJ BEVACIZUMAB 10 MG","47","1",null,"8.2","32.8",null,"5","42","0","NA","NA"],
    [6097,"6097","Carrier D","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A9276","SNSR;INVSV DISP USE NONDME INTRSTL CGM 1U=1D SPL","40","0.95",null,"18.3","45.9",null,"7","33","0","NA","NA"],
    [6098,"6098","Carrier D","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J0178","INJ AFLIBERCEPT (EYLEA) 1 MG","36","0.9444",null,"17.8","77",null,"6","30","0","NA","NA"],
    [6099,"6099","Carrier D","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97802","MED NUTRIT THRPY INIT ASSESS 15 MIN","133","1",null,"12.9","24.1",null,"8","125","0","NA","NA"],
    [6100,"6100","Carrier D","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","G0108","DIAB MGMT TRN PER INDIV","47","1",null,null,"43.7",null,"0","47","0","NA","NA"],
    [6101,"6101","Carrier D","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J9035","INJ BEVACIZUMAB 10 MG","47","1",null,"8.2","32.8",null,"5","42","0","NA","NA"],
    [6102,"6102","Carrier D","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A5500","DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE","34","1",null,null,"36.3",null,"0","34","0","NA","NA"],
    [6103,"6103","Carrier D","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4230","INFUS SET INSULIN PUMP NON NEEDLE","12","1",null,"10","32.5",null,"6","6","0","NA","NA"],
    [6104,"6104","Carrier D","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99202","OFFICE VISIT E&M NEW PT STRAIGHTFORWARD MDM, 15-29 MINS","11","1",null,"41","39.5",null,"1","10","0","NA","NA"],
    [6105,"6105","Carrier D","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","67228","DESTRUCT EXTENSIVE/PROG RETINOPATHY PHOTOCOAGULATN","10","1",null,"10","39.8",null,"1","9","0","NA","NA"],
    [6106,"6106","Carrier D","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A9274","EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA","10","1",null,"14","27.7",null,"1","9","0","NA","NA"],
    [6107,"6107","Carrier D","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A5501","DIABETIC CUSTOM MOLDED SHOE","9","1",null,null,"39.7",null,"0","9","0","NA","NA"],
    [6108,"6108","Carrier D","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A5513","FOR DIAB ONLY MX DNSITY INSRT CSTM MOLD CSTM EA","7","1",null,null,"38.1",null,"0","7","0","NA","NA"],
    [6109,"6109","Carrier D","2023","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","K0739","REPAIR OR NONROUTN SVC DME OTHER THAN O2 EQUIP,REQ TECH SKILL,PER 15 MINS","1",null,"1",null,"138",null,"0","1","0","NA","NA"],
    [6110,"6110","Carrier D","2023","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A4224","SUPPLIES FOR MAINTENANCE OF INSULIN INFUSION CATH, PER WEEK","87",null,"0.011","11.8","35.1",null,"60","27","0","NA","NA"],
    [6111,"6111","Carrier D","2023","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E2103","NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER","223",null,"0.004","22","70.5",null,"26","197","0","NA","NA"],
    [6112,"6112","Carrier D","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","1510","0.3033",null,"14","79",null,"53","1457","0","semaglutide","Ozempic, Rybelsus"],
    [6113,"6113","Carrier D","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","745","0.4242",null,"11","69",null,"43","702","0","lisdexamphetamine","Vyvanse"],
    [6114,"6114","Carrier D","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","397","0.0353",null,"18","85",null,"22","375","0","tirzepatide","MOUNJARO"],
    [6115,"6115","Carrier D","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","358","0.5223",null,"18","75",null,"8","350","0","liraglutide","VICTOZA"],
    [6116,"6116","Carrier D","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","349","0.5473",null,"19","59",null,"10","339","0","BUDESONIDE-FORMOTEROL","Symbicort"],
    [6117,"6117","Carrier D","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","338","0.932",null,"26","67",null,"4","334","0","empagliflozin","Jardiance"],
    [6118,"6118","Carrier D","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","322","0.7826",null,"13","41",null,"41","281","0","rivaroxaban","XARELTO"],
    [6119,"6119","Carrier D","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","319","0.7837",null,"8","56",null,"8","311","0","cyclosporine","Restasis, Cequa"],
    [6120,"6120","Carrier D","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","275","0.44",null,"15","72",null,"40","235","0","apixiban","ELIQUIS"],
    [6121,"6121","Carrier D","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","220","0",null,null,"71",null,null,"220","0","semaglutide","Wegovy"],
    [6122,"6122","Carrier D","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","16","1",null,null,"30",null,"0","16","0","Diazempam","Valtoco"],
    [6123,"6123","Carrier D","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","14","1",null,"2","45",null,"1","13","0","midazolam","Nayzilam"],
    [6124,"6124","Carrier D","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","12","1",null,"13","55",null,"2","10","0","LENALIDOMIDE","Revlamid"],
    [6125,"6125","Carrier D","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","10","1",null,null,"64",null,"0","10","0","enzalutamide","Xtandi"],
    [6126,"6126","Carrier D","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","9","1",null,null,"76",null,"0","9","0","Pioglitazone","Actos"],
    [6127,"6127","Carrier D","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,"2","80",null,"1","7","0","Pirfenidone","Esbriet"],
    [6128,"6128","Carrier D","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,null,"47",null,"0","7","0","Dofetilide","Tikosyn"],
    [6129,"6129","Carrier D","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,"0","71",null,"1","6","0","cannabidiol","Epidiolex"],
    [6130,"6130","Carrier D","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,null,"74",null,"0","7","0","pomalidomide","Pomalyst"],
    [6131,"6131","Carrier D","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,"2","63",null,"1","6","0","Posaconazole","Noxafil"],
    [6132,"6132","Carrier D","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","4",null,"0.25",null,"109",null,"0","4",null,"anakinra","Kineret"],
    [6133,"6133","Carrier D","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","33",null,"0.091","12","85",null,"9","24",null,"Buprenorphine","Butrans"],
    [6134,"6134","Carrier D","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","14",null,"0.071",null,"83",null,"0","14",null,"varenicline","Tyrvaya  Nasal Spray"],
    [6135,"6135","Carrier D","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","57",null,"0.035","1","90",null,"4","53",null,"upadacitinib","Rinvoq"],
    [6136,"6136","Carrier D","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","110",null,"0.009","4","91",null,"5","105",null,"rimegepant","Nurtec"],
    [6137,"6137","Carrier D","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","163",null,"0.006","14","70",null,"21","142",null,"Insuline Glargine","Basaglar, Lantus, Toujeo, Semglee"],
    [6138,"6138","Carrier D","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","745",null,"0.004","11","69",null,"43","702",null,"LISDEXAMFETAMINE","Vyvanse"],
    [6139,"6139","Carrier D","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1510",null,"0.001","14","79",null,"53","1457",null,"semaglutide","Ozempic, Rybelsus"],
    [6140,"6140","Carrier F","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","121","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Medical/Surgical/GYN","100","0.83",null,"21","35",null,"25","75",null,"NA","NA"],
    [6141,"6141","Carrier F","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","12","1",null,"10","32",null,"2","10",null,"NA","NA"],
    [6142,"6142","Carrier F","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20936","Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar fragments) obtained from same incision (List separately in addition to code for primary procedure)","8","1",null,"13","24",null,"3","5",null,"NA","NA"],
    [6143,"6143","Carrier F","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44207","Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)","7","0.8571",null,"1","42",null,"1","6",null,"NA","NA"],
    [6144,"6144","Carrier F","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20930","Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for primary procedure)","7","1",null,"10","26",null,"2","5",null,"NA","NA"],
    [6145,"6145","Carrier F","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","7","1",null,"3","26",null,"1","6",null,"NA","NA"],
    [6146,"6146","Carrier F","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63047","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","6","1",null,"3","28",null,"1","5",null,"NA","NA"],
    [6147,"6147","Carrier F","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","6","1",null,null,"22",null,"0","6",null,"NA","NA"],
    [6148,"6148","Carrier F","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22842","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)","6","1",null,"13","47",null,"3","3",null,"NA","NA"],
    [6149,"6149","Carrier F","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44204","Laparoscopy, surgical; colectomy, partial, with anastomosis","5","1",null,"16","38",null,"1","4",null,"NA","NA"],
    [6150,"6150","Carrier F","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","12","1",null,"10","32",null,"2","10",null,"NA","NA"],
    [6151,"6151","Carrier F","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","20936","Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar fragments) obtained from same incision (List separately in addition to code for primary procedure)","8","1",null,"13","24",null,"3","5",null,"NA","NA"],
    [6152,"6152","Carrier F","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","20930","Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for primary procedure)","7","1",null,"10","26",null,"2","5",null,"NA","NA"],
    [6153,"6153","Carrier F","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22558","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","7","1",null,"3","26",null,"1","6",null,"NA","NA"],
    [6154,"6154","Carrier F","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63047","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","6","1",null,"3","28",null,"1","5",null,"NA","NA"],
    [6155,"6155","Carrier F","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","6","1",null,null,"22",null,"0","6",null,"NA","NA"],
    [6156,"6156","Carrier F","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22842","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)","6","1",null,"13","47",null,"3","3",null,"NA","NA"],
    [6157,"6157","Carrier F","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44204","Laparoscopy, surgical; colectomy, partial, with anastomosis","5","1",null,"16","38",null,"1","4",null,"NA","NA"],
    [6158,"6158","Carrier F","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63052","Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment (List separately in addition to code for primary procedure)","5","1",null,"18","35",null,"1","4",null,"NA","NA"],
    [6159,"6159","Carrier F","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","69990","Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure)","5","1",null,null,"56",null,"0","5",null,"NA","NA"],
    [6160,"6160","Carrier F","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22850","Removal of posterior nonsegmental instrumentation (eg, Harrington rod)","2",null,"0.5",null,"23",null,"0","2",null,"NA","NA"],
    [6161,"6161","Carrier F","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27446","Arthroplasty, knee, condyle and plateau; medial OR lateral compartment","3",null,"0.33",null,"21",null,"0","3",null,"NA","NA"],
    [6162,"6162","Carrier F","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22585","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace (List separately in addition to code for primary procedure)","4",null,"0.25","3","21",null,"1","3",null,"NA","NA"],
    [6163,"6163","Carrier F","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22614","Arthrodesis, posterior or posterolateral technique, single interspace; each additional interspace (List separately in addition to code for primary procedure)","5",null,"0.2","35","40",null,"2","3",null,"NA","NA"],
    [6164,"6164","Carrier F","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22612","Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed)","5",null,"0.2","3","28",null,"1","4",null,"NA","NA"],
    [6165,"6165","Carrier F","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63047","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","6",null,"0.17","3","28",null,"1","5",null,"NA","NA"],
    [6166,"6166","Carrier F","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22842","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)","6",null,"0.17","13","47",null,"3","3",null,"NA","NA"],
    [6167,"6167","Carrier F","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22558","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","7",null,"0.14","3","26",null,"1","6",null,"NA","NA"],
    [6168,"6168","Carrier F","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","20930","Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for primary procedure)","7",null,"0.14","10","26",null,"2","5",null,"NA","NA"],
    [6169,"6169","Carrier F","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","12",null,"0.08","10","32",null,"2","10",null,"NA","NA"],
    [6170,"6170","Carrier F","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","Mental health partial hospitalization, treatment, less than 24 hours","1","0",null,null,"14",null,"0","1",null,"NA","NA"],
    [6171,"6171","Carrier F","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0017","Behavioral health; residential (hospital residential treatment program), without room and board, per diem","1","1",null,null,"3",null,"0","1",null,"NA","NA"],
    [6172,"6172","Carrier F","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0010","Alcohol and/or drug services; subacute detoxification (residential addiction program inpatient)","1","1",null,null,"91",null,"0","1",null,"NA","NA"],
    [6173,"6173","Carrier F","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","128","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation","1","1",null,null,"91",null,"0","1",null,"NA","NA"],
    [6174,"6174","Carrier F","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric","1","1",null,null,"22",null,"0","1",null,"NA","NA"],
    [6175,"6175","Carrier F","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0017","Behavioral health; residential (hospital residential treatment program), without room and board, per diem","1","1",null,null,"3",null,"0","1",null,"NA","NA"],
    [6176,"6176","Carrier F","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0010","Alcohol and/or drug services; subacute detoxification (residential addiction program inpatient)","1","1",null,null,"91",null,"0","1",null,"NA","NA"],
    [6177,"6177","Carrier F","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","128","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation","1","1",null,null,"91",null,"0","1",null,"NA","NA"],
    [6178,"6178","Carrier F","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric","1","1",null,null,"22",null,"0","1",null,"NA","NA"],
    [6179,"6179","Carrier F","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0035","Mental health partial hospitalization, treatment, less than 24 hours","1","0",null,null,"14",null,"0","1",null,"NA","NA"],
    [6180,"6180","Carrier F","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43239","Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple","381","0.9738",null,"10","19",null,"36","345",null,"NA","NA"],
    [6181,"6181","Carrier F","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43235","Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","353","0.9773",null,"11","21",null,"35","318",null,"NA","NA"],
    [6182,"6182","Carrier F","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45378","Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","124","0.8387",null,"12","22",null,"5","119",null,"NA","NA"],
    [6183,"6183","Carrier F","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","Colonoscopy, flexible; with biopsy, single or multiple","124","0.8629",null,"19","22",null,"7","117",null,"NA","NA"],
    [6184,"6184","Carrier F","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","66984","Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); without endoscopic cyclophotocoagulation","120","0.9",null,"20","62",null,"15","105",null,"NA","NA"],
    [6185,"6185","Carrier F","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45385","Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","95","0.8737",null,"11","20",null,"4","91",null,"NA","NA"],
    [6186,"6186","Carrier F","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","92","0.5435",null,"25","88",null,"26","66",null,"NA","NA"],
    [6187,"6187","Carrier F","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64483","Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, single level","89","0.9213",null,"29","75",null,"5","84",null,"NA","NA"],
    [6188,"6188","Carrier F","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99205","Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","80","0.3875",null,"28","83",null,"21","59",null,"NA","NA"],
    [6189,"6189","Carrier F","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27447","Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)","79","0.8987",null,"19","74",null,"5","74",null,"NA","NA"],
    [6190,"6190","Carrier F","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64493","Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level","57","1",null,"20","28",null,"11","46",null,"NA","NA"],
    [6191,"6191","Carrier F","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64494","Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level (List separately in addition to code for primary procedure)","39","1",null,"12","28",null,"4","35",null,"NA","NA"],
    [6192,"6192","Carrier F","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64635","Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint","22","1",null,"16","77",null,"2","20",null,"NA","NA"],
    [6193,"6193","Carrier F","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64636","Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional facet joint (List separately in addition to code for primary procedure)","18","1",null,"27","73",null,"1","17",null,"NA","NA"],
    [6194,"6194","Carrier F","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","76942","Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation","18","1",null,"35","74",null,"6","12",null,"NA","NA"],
    [6195,"6195","Carrier F","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J9035","Injection, bevacizumab, 10 mg","18","1",null,"19","58",null,"6","12",null,"NA","NA"],
    [6196,"6196","Carrier F","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64634","Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional facet joint (List separately in addition to code for primary procedure)","16","1",null,"19","79",null,"1","15",null,"NA","NA"],
    [6197,"6197","Carrier F","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","45381","Colonoscopy, flexible; with directed submucosal injection(s), any substance","13","1",null,"24","35",null,"1","12",null,"NA","NA"],
    [6198,"6198","Carrier F","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","91110","Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report","13","1",null,"46","112",null,"1","12",null,"NA","NA"],
    [6199,"6199","Carrier F","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","66982","Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device, suture support for intraocular lens, or primary posterior capsulorrhexis) or performed on patients in the amblyogenic developmental stage; without endoscopic cyclophotocoagulation","12","1",null,"27","46",null,"2","10",null,"NA","NA"],
    [6200,"6200","Carrier F","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","15822","Blepharoplasty, upper eyelid;","1",null,"1",null,"212",null,"0","1",null,"NA","NA"],
    [6201,"6201","Carrier F","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27496","Decompression fasciotomy, thigh and/or knee, 1 compartment (flexor or extensor or adductor);","1",null,"1","23",null,null,"1","0",null,"NA","NA"],
    [6202,"6202","Carrier F","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","36592","Collection of blood specimen using established central or peripheral catheter, venous, not otherwise specified","1",null,"1","29",null,null,"1","0",null,"NA","NA"],
    [6203,"6203","Carrier F","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","37248","Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; initial vein","1",null,"1",null,"102",null,"0","1",null,"NA","NA"],
    [6204,"6204","Carrier F","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","80069","Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus inorganic (phosphate) (84100) Potassium (84132) Sodium (84295) Urea nitrogen (BUN) (84520)","1",null,"1","29",null,null,"1","0",null,"NA","NA"],
    [6205,"6205","Carrier F","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","83615","Lactate dehydrogenase (LD), (LDH);","1",null,"1","29",null,null,"1","0",null,"NA","NA"],
    [6206,"6206","Carrier F","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","84100","Phosphorus inorganic (phosphate);","1",null,"1","29",null,null,"1","0",null,"NA","NA"],
    [6207,"6207","Carrier F","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","85730","Thromboplastin time, partial (PTT); plasma or whole blood","1",null,"1","29",null,null,"1","0",null,"NA","NA"],
    [6208,"6208","Carrier F","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","87497","Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification","1",null,"1","29",null,null,"1","0",null,"NA","NA"],
    [6209,"6209","Carrier F","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","54520","Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach","3",null,"0.6667",null,"118",null,"0","3",null,"NA","NA"],
    [6210,"6210","Carrier F","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","Mental health partial hospitalization, treatment, less than 24 hours","161","0.8944",null,"18","49",null,"11","150",null,"NA","NA"],
    [6211,"6211","Carrier F","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S9480","Intensive outpatient psychiatric services, per diem","68","0.7941",null,"21","47",null,"7","61",null,"NA","NA"],
    [6212,"6212","Carrier F","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","37","0.8649",null,"34","63",null,"6","31",null,"NA","NA"],
    [6213,"6213","Carrier F","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0015","Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education","35","0.7143",null,"22","75",null,"2","33",null,"NA","NA"],
    [6214,"6214","Carrier F","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","34","0.8529",null,"34","63",null,"6","28",null,"NA","NA"],
    [6215,"6215","Carrier F","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","29","0.8621",null,"31","67",null,"5","24",null,"NA","NA"],
    [6216,"6216","Carrier F","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan","23","0.8696",null,"30","77",null,"3","20",null,"NA","NA"],
    [6217,"6217","Carrier F","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S0201","Partial hospitalization services, less than 24 hours, per diem","21","0.8571",null,"38","44",null,"3","18",null,"NA","NA"],
    [6218,"6218","Carrier F","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","Psychotherapy, 60 minutes with patient","16","0.375",null,"33","64",null,"7","9",null,"NA","NA"],
    [6219,"6219","Carrier F","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97156","Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes","16","0.9375",null,"30","42",null,"3","13",null,"NA","NA"],
    [6220,"6220","Carrier F","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","G2083","Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self administration, includes 2 hours post administration observation","10","1",null,"25","56",null,"6","4",null,"NA","NA"],
    [6221,"6221","Carrier F","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","G2082","Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of up to 56 mg of esketamine nasal self administration, includes 2 hours post administration observation","8","1",null,"30","70",null,"5","3",null,"NA","NA"],
    [6222,"6222","Carrier F","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0031","Mental health assessment, by nonphysician","5","1",null,null,"99",null,"0","5",null,"NA","NA"],
    [6223,"6223","Carrier F","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S0013","Esketamine, nasal spray, 1 mg","5","1",null,"26","117",null,"4","1",null,"NA","NA"],
    [6224,"6224","Carrier F","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97158","Group adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, face-to-face with multiple patients, each 15 minutes","3","1",null,null,"42",null,"0","3",null,"NA","NA"],
    [6225,"6225","Carrier F","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99214","Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","3","1",null,null,"192",null,"0","3",null,"NA","NA"],
    [6226,"6226","Carrier F","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99215","Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","3","1",null,null,"192",null,"0","3",null,"NA","NA"],
    [6227,"6227","Carrier F","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96116","Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face-to-face time with the patient and time interpreting test results and preparing the report; first hour","2","1",null,null,"79",null,"0","2",null,"NA","NA"],
    [6228,"6228","Carrier F","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96121","Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face-to-face time with the patient and time interpreting test results and preparing the report; each additional hour (List separately in addition to code for primary procedure)","2","1",null,null,"79",null,"0","2",null,"NA","NA"],
    [6229,"6229","Carrier F","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99213","Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","1","1",null,null,"87",null,"0","1",null,"NA","NA"],
    [6230,"6230","Carrier F","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","G2082","Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of up to 56 mg of esketamine nasal self administration, includes 2 hours post administration observation","8",null,"0.13","30","70",null,"5","3",null,"NA","NA"],
    [6231,"6231","Carrier F","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","Continuous positive airway pressure (CPAP) device","25","0.32",null,"13","67",null,"3","22",null,"NA","NA"],
    [6232,"6232","Carrier F","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9276","Sensor; invasive (e.g., subcutaneous), disposable, for use with nondurable medical equipment interstitial continuous glucose monitoring system (CGM), one unit = 1 day supply","24","0.5",null,null,"100",null,"0","24",null,"NA","NA"],
    [6233,"6233","Carrier F","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2402","Negative pressure wound therapy electrical pump, stationary or portable","16","0.9375",null,"41","101",null,"1","15",null,"NA","NA"],
    [6234,"6234","Carrier F","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A6550","Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","15","0.9333",null,"41","99",null,"1","14",null,"NA","NA"],
    [6235,"6235","Carrier F","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A7000","Canister, disposable, used with suction pump, each","15","0.9333",null,"41","99",null,"1","14",null,"NA","NA"],
    [6236,"6236","Carrier F","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0562","Humidifier, heated, used with positive airway pressure device","14","0.1429",null,"14","68",null,"1","13",null,"NA","NA"],
    [6237,"6237","Carrier F","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1390","Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","10","0.7",null,null,"126",null,"0","10",null,"NA","NA"],
    [6238,"6238","Carrier F","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9277","Transmitter; external, for use with nondurable medical equipment interstitial continuous glucose monitoring system (CGM)","10","0.9",null,null,"87",null,"0","10",null,"NA","NA"],
    [6239,"6239","Carrier F","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A7037","Tubing used with positive airway pressure device","8","0.125",null,null,"93",null,"0","8",null,"NA","NA"],
    [6240,"6240","Carrier F","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0747","Osteogenesis stimulator, electrical, noninvasive, other than spinal applications","8","0.75",null,null,"107",null,"0","8",null,"NA","NA"],
    [6241,"6241","Carrier F","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0108","Wheelchair component or accessory, not otherwise specified","7","1",null,null,"82",null,"0","7",null,"NA","NA"],
    [6242,"6242","Carrier F","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L1852","Knee orthosis (KO), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","7","1",null,null,"73",null,"0","7",null,"NA","NA"],
    [6243,"6243","Carrier F","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0973","Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","6","1",null,null,"90",null,"0","6",null,"NA","NA"],
    [6244,"6244","Carrier F","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","External ambulatory infusion pump, insulin","6","1",null,null,"93",null,"0","6",null,"NA","NA"],
    [6245,"6245","Carrier F","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","V2624","Polishing/resurfacing of ocular prosthesis","5","1",null,null,"99",null,"0","5",null,"NA","NA"],
    [6246,"6246","Carrier F","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0739","Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","4","1",null,null,"67",null,"0","4",null,"NA","NA"],
    [6247,"6247","Carrier F","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","V2628","Fabrication and fitting of ocular conformer","4","1",null,null,"74",null,"0","4",null,"NA","NA"],
    [6248,"6248","Carrier F","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","B4088","Gastrostomy/jejunostomy tube, low-profile, any material, any type, each","3","1",null,null,"77",null,"0","3",null,"NA","NA"],
    [6249,"6249","Carrier F","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0465","Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","3","1",null,"28","68",null,"1","2",null,"NA","NA"],
    [6250,"6250","Carrier F","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0466","Home ventilator, any type, used with noninvasive interface, (e.g., mask, chest shell)","3","1",null,null,"75",null,"0","3",null,"NA","NA"],
    [6251,"6251","Carrier F","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E1012","Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","1",null,"1",null,"100",null,"0","1",null,"NA","NA"],
    [6252,"6252","Carrier F","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E1002","Wheelchair accessory, power seating system, tilt only","1",null,"1",null,"100",null,"0","1",null,"NA","NA"],
    [6253,"6253","Carrier F","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E2313","Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","1",null,"1",null,"100",null,"0","1",null,"NA","NA"],
    [6254,"6254","Carrier F","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E2311","Power wheelchair accessory, electronic connection between wheelchair controller and 2 or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","1",null,"1",null,"100",null,"0","1",null,"NA","NA"],
    [6255,"6255","Carrier F","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E1232","Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","1",null,"1",null,"119",null,"0","1",null,"NA","NA"],
    [6256,"6256","Carrier F","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0966","Manual wheelchair accessory, headrest extension, each","1",null,"1",null,"119",null,"0","1",null,"NA","NA"],
    [6257,"6257","Carrier F","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0960","Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","1",null,"1",null,"119",null,"0","1",null,"NA","NA"],
    [6258,"6258","Carrier F","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E2608","Skin protection and positioning wheelchair seat cushion, width 22 in or greater, any depth","1",null,"1",null,"100",null,"0","1",null,"NA","NA"],
    [6259,"6259","Carrier F","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","K0860","Power wheelchair, group 3 very heavy-duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","1",null,"1",null,"100",null,"0","1",null,"NA","NA"],
    [6260,"6260","Carrier F","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0955","Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","2",null,"0.5",null,"88",null,"0","2",null,"NA","NA"],
    [6261,"6261","Carrier F","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","Diabetes Supplies & Equip","47","0.7021",null,null,"96",null,"0","47","0","NA","NA"],
    [6262,"6262","Carrier F","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","Diabetes Supplies & Equip","47","0.7021",null,null,"96",null,"0","47","0","NA","NA"],
    [6263,"6263","Carrier F","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","198","0.4343",null,"2.03","17.82",null,"10","188","0","SEMAGLUTIDE","OZEMPIC"],
    [6264,"6264","Carrier F","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","58","0.5344",null,"0.07","21.23",null,"5","53","0","TIRZEPATIDE","MOUNJARO"],
    [6265,"6265","Carrier F","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","53","0.7547",null,"1.92","47.87",null,"8","45","0","RIMEGEPANT","NURTEC"],
    [6266,"6266","Carrier F","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","42","0.8095",null,"30.64","68.95",null,"10","32","0","DUPILUMAB","DUPIXENT"],
    [6267,"6267","Carrier F","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","39","0.8974",null,"1.07","25.83",null,"6","33","0","EVOLOCUMAB","REPATHA"],
    [6268,"6268","Carrier F","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","36","0.9722",null,"1.84","9.75",null,"3","33","0","EMPAGLIFLOZIN","JARDIANCE"],
    [6269,"6269","Carrier F","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","35","0.4857",null,"0.97","21.1",null,"4","31","0","LIRAGLUTIDE","VICTOZA"],
    [6270,"6270","Carrier F","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","32","0.3125",null,"1.63","21.83",null,"2","30","0","TIRZEPATIDE","MOUNJARO"],
    [6271,"6271","Carrier F","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","31","0.7419",null,"1.69","16.99",null,"3","28","0","EMPAGLIFLOZIN","JARDIANCE"],
    [6272,"6272","Carrier F","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","30","0.9",null,"6.1","13.18",null,"7","23","0","GALCANEZUMAB","EMGALITY"],
    [6273,"6273","Carrier F","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","18","1",null,"1.24","20.17",null,"4","14","0","ERENUMAB","AIMOVIG"],
    [6274,"6274","Carrier F","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","13","1",null,"0.11","17.86",null,"2","11","0","LISDEXAMFETAMINE","VYVANSE"],
    [6275,"6275","Carrier F","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","11","1",null,"4.64","35",null,"2","9","0","ETANERCEPT","ENBREL"],
    [6276,"6276","Carrier F","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","9","1",null,"7.02","11.62",null,"4","5","0","ONDANSETRON","ONDANSETRON"],
    [6277,"6277","Carrier F","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","7","1",null,"3","35.39",null,"5","2","0","CARIPRAZINE","VRAYLAR"],
    [6278,"6278","Carrier F","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","5","1",null,"2.12","30.44",null,"2","3","0","ACALABRUTINIB","CALQUENCE"],
    [6279,"6279","Carrier F","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","5","1",null,"0.12","10.63",null,"2","3","0","BREXPIPRAZOLE","REXULTI"],
    [6280,"6280","Carrier F","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","5","1",null,"4.35","32.86",null,"1","4","0","UBROGEPANT","UBRELVY"],
    [6281,"6281","Carrier F","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","4","1",null,"2.04","47.14",null,"2","2","0","BISMUTH-METRONIDAZOLE-TETRACYCLINE","BISMUTH-METRONIDAZOLE-TETRACYCLINE"],
    [6282,"6282","Carrier F","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","4","1",null,"0.03","0.13",null,"1","3","0","SACUBITRIL-VALSARTAN","ENTRESTO"],
    [6283,"6283","Carrier G","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22842","POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG","13","0.6923",null,"27","82.8","78.5","1","12","13","NA","NA"],
    [6284,"6284","Carrier G","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96416","CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP","12","0.9167",null,"5.3","59.5","29.9","7","5","12","NA","NA"],
    [6285,"6285","Carrier G","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15734","MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP TRUNK","9","0.7778",null,"8.5","30.1","11.6","6","3","9","NA","NA"],
    [6286,"6286","Carrier G","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","69990","MICROSURG TQS REQ USE OPERATING MICROSCOPE","8","0.875",null,"32.2","43.8","39.4","3","5","8","NA","NA"],
    [6287,"6287","Carrier G","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J9000","INJECTION DOXORUBICIN HCL 10 MG","8","0.75",null,"2.7","65.5","55","2","6","8","NA","NA"],
    [6288,"6288","Carrier G","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J9370","VINCRISTINE SULFATE 1 MG","8","0.875",null,"12.3","65.5","50.3","2","6","8","NA","NA"],
    [6289,"6289","Carrier G","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J9070","CYCLOPHOSPHAMIDE 100 MG","7","0.8571",null,"1.8","65.5","54.9","1","6","7","NA","NA"],
    [6290,"6290","Carrier G","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22614","ARTHRODESIS PST/PSTLAT TQ 1NTRSPC EA ADDL NTRSPC","7","0.5714",null,null,"77","77",null,"7","7","NA","NA"],
    [6291,"6291","Carrier G","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","32663","THORACOSCOPY W/LOBECTOMY SINGLE LOBE","7","0.8571",null,null,null,null,"3","4","7","NA","NA"],
    [6292,"6292","Carrier G","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY","7","1",null,"22.3","44.7","41.5","1","6","7","NA","NA"],
    [6293,"6293","Carrier G","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58150","TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY","7","1",null,"22.3","44.7","41.5","1","6","7","NA","NA"],
    [6294,"6294","Carrier G","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44207","LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST","6","1",null,"2.1","24.8","21","1","5","6","NA","NA"],
    [6295,"6295","Carrier G","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44213","LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLECTOMY","6","1",null,"2.7","21.2","18.1","1","5","6","NA","NA"],
    [6296,"6296","Carrier G","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93355","ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN","6","1",null,null,"23.2","23.2",null,"6","6","NA","NA"],
    [6297,"6297","Carrier G","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19364","BREAST RECONSTRUCTION W/FREE FLAP","5","1",null,null,"22.1","22.1",null,"5","5","NA","NA"],
    [6298,"6298","Carrier G","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22633","ARTHRODESIS COMBINED TQ 1NTRSPC LUMBAR","5","1",null,null,"37.8","37.8",null,"5","5","NA","NA"],
    [6299,"6299","Carrier G","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33533","CABG W/ARTERIAL GRAFT SINGLE ARTERIAL GRAFT","5","1",null,null,"159.8","159.8",null,"5","5","NA","NA"],
    [6300,"6300","Carrier G","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44205","LAPS COLECTOMY PRTL W/RMVL TERMINAL ILEUM","5","1",null,null,"25.6","25.6",null,"5","5","NA","NA"],
    [6301,"6301","Carrier G","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J9100","INJECTION CYTARABINE 100 MG","5","1",null,"1.4","47.3","19.8","3","2","5","NA","NA"],
    [6302,"6302","Carrier G","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27134","REVJ TOT HIP ARTHRP BTH W/WO AGRFT/ALGRFT","4","1",null,"1","28.7","21.8","1","3","4","NA","NA"],
    [6303,"6303","Carrier G","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","20937","AUTOGRAFT SPINE SURGERY MORSELIZED SEP INCISION","1",null,"1",null,"244.1","244.1",null,"1","1","NA","NA"],
    [6304,"6304","Carrier G","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22630","ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC LUMBAR","1",null,"1",null,"244.1","244.1",null,"1","1","NA","NA"],
    [6305,"6305","Carrier G","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27299","UNLISTED PROCEDURE PELVIS/HIP JOINT","1",null,"1",null,"24.1","24.1",null,"1","1","NA","NA"],
    [6306,"6306","Carrier G","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43645","LAPS GSTR RSTCV PX W/BYP and SM INT RCNSTJ","1",null,"1",null,"5.6","5.6",null,"1","1","NA","NA"],
    [6307,"6307","Carrier G","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","50546","LAPAROSCOPY NEPHRECTOMY W/PARTIAL URETERECT","1",null,"1",null,"78.4","78.4",null,"1","1","NA","NA"],
    [6308,"6308","Carrier G","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","47135","LVR ALTRNSPLJ ORTHOTOPIC PRTL/WHL DON ANY AGE","2",null,"0.5",null,"35.1","35.1",null,"2","2","NA","NA"],
    [6309,"6309","Carrier G","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27134","REVJ TOT HIP ARTHRP BTH W/WO AGRFT/ALGRFT","4",null,"0.25","1","28.7","21.8","1","3","4","NA","NA"],
    [6310,"6310","Carrier G","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63047","LAM FACETECTOMY  and  FORAMOTOMY 1 VRT SGM LUMBAR","7",null,"0.143","26.4","72.4","64.7","1","6","7","NA","NA"],
    [6311,"6311","Carrier G","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22853","INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD","17",null,"0.118","26.4","63","60.9","1","16","17","NA","NA"],
    [6312,"6312","Carrier G","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22558","ARTHRD ANT INTERBODY MIN DSC LUMBAR","10",null,"0.1","26.4","59","55.7","1","9","10","NA","NA"],
    [6313,"6313","Carrier G","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC and COLR D","1311","0.9268",null,"17.3","14.1","14.8","31","1280","1311","NA","NA"],
    [6314,"6314","Carrier G","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93015","CV STRS TST XERS and /OR RX CONT ECG W/SI and R","244","0.9385",null,null,"10.5","10.5",null,"244","244","NA","NA"],
    [6315,"6315","Carrier G","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","78452","MYOCARDIAL SPECT MULTIPLE STUDIES","227","0.9339",null,null,"17","17","2","225","227","NA","NA"],
    [6316,"6316","Carrier G","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93971","DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY","209","0.933",null,null,"12.8","12.8","24","185","209","NA","NA"],
    [6317,"6317","Carrier G","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J0585","BOTULINUM TOXIN TYPE A PER UNIT","188","0.7819",null,"31.5","95.7","90.8","13","175","188","NA","NA"],
    [6318,"6318","Carrier G","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93248","EXTERNAL ECG REC GT 7D LT 15D REVIEW  and  INTERPRETATION","161","0.9503",null,null,"11.8","11.8","2","159","161","NA","NA"],
    [6319,"6319","Carrier G","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","77334","TX DEVICES DESIGN  AND  CONSTRUCTION COMPLEX","152","0.9013",null,"8.3","155.3","57.3","31","121","152","NA","NA"],
    [6320,"6320","Carrier G","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","77336","CONTINUING MEDICAL PHYSICS CONSLTJ PR WK","147","0.8912",null,"10.8","92.7","59.9","26","121","147","NA","NA"],
    [6321,"6321","Carrier G","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93246","EXTERNAL ECG REC GT 7D LT 15D RECORDING","146","0.9658",null,null,"16","16","2","144","146","NA","NA"],
    [6322,"6322","Carrier G","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","77263","THERAPEUTIC RADIOLOGY TX PLANNING COMPLEX","145","0.8966",null,"17.5","107.2","81.6","26","119","145","NA","NA"],
    [6323,"6323","Carrier G","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","36471","INJECTION SCLEROSANT MULTIPLE INCMPTNT VEINS","42","1",null,null,null,null,null,"42","42","NA","NA"],
    [6324,"6324","Carrier G","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","36475","ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN","33","1",null,null,null,null,"1","32","33","NA","NA"],
    [6325,"6325","Carrier G","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93290","INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON","29","1",null,null,null,null,null,"29","29","NA","NA"],
    [6326,"6326","Carrier G","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93280","PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER","21","1",null,null,null,null,null,"21","21","NA","NA"],
    [6327,"6327","Carrier G","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93296","REM INTERROG PM/LDLS PM/IDS  LT 90 D TECH REVIEW","21","1",null,"17.8","32.2","28.6","1","20","21","NA","NA"],
    [6328,"6328","Carrier G","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93283","PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB","19","1",null,null,null,null,null,"19","19","NA","NA"],
    [6329,"6329","Carrier G","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93279","PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP","17","1",null,null,null,null,null,"17","17","NA","NA"],
    [6330,"6330","Carrier G","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93289","INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB","17","1",null,null,null,null,null,"17","17","NA","NA"],
    [6331,"6331","Carrier G","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93284","PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB","16","1",null,null,null,null,null,"16","16","NA","NA"],
    [6332,"6332","Carrier G","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93288","INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON","16","1",null,null,null,null,null,"16","16","NA","NA"],
    [6333,"6333","Carrier G","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","13151","REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM","1",null,"1","0","98",null,"0","1","1","NA","NA"],
    [6334,"6334","Carrier G","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","14061","ADJT TIS REARGMT EYE/NOSE/EAR/LIP 10.1-30.0 SQCM","1",null,"1","0","98",null,"0","1","1","NA","NA"],
    [6335,"6335","Carrier G","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","28306","OSTEOT W/WO LNGTH SHRT/CORRJ 1ST METAR","1",null,"1","0","20",null,"0","1","1","NA","NA"],
    [6336,"6336","Carrier G","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","47001","BX LVR NDL DONE PURPOSE TM OTH MAJOR PX","1",null,"1","0","67",null,"0","1","1","NA","NA"],
    [6337,"6337","Carrier G","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","55880","TRANSRECTAL ABLTJ MAL PRST8 TISSUE HIFU W/US","1",null,"1","0","29",null,"0","1","1","NA","NA"],
    [6338,"6338","Carrier G","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","59400","OB CARE ANTEPARTUM VAG DLVR  AND  POSTPARTUM","1",null,"1","0","863",null,"0","1","1","NA","NA"],
    [6339,"6339","Carrier G","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","59409","VAGINAL DELIVERY ONLY","1",null,"1","0","863",null,"0","1","1","NA","NA"],
    [6340,"6340","Carrier G","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","62321","NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN","1",null,"1","0","91",null,"0","1","1","NA","NA"],
    [6341,"6341","Carrier G","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64625","RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN","1",null,"1","0","23",null,"0","1","1","NA","NA"],
    [6342,"6342","Carrier G","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97129","THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES","1",null,"1","0","5",null,"0","1","1","NA","NA"],
    [6343,"6343","Carrier G","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96132","NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP 1ST HOUR","34","0.5588",null,"61","112.5","110.9","1","33","34","NA","NA"],
    [6344,"6344","Carrier G","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96133","NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR","34","0.5588",null,null,"115","115",null,"34","34","NA","NA"],
    [6345,"6345","Carrier G","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96116","NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR","28","0.5357",null,"61","120.7","118.6","1","27","28","NA","NA"],
    [6346,"6346","Carrier G","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96137","PSYCL/NRPSYCL TST PHYS/QHP 2 Plus  TST EA ADDL 30 MIN","21","0.5238",null,"61","110.7","108.3","1","20","21","NA","NA"],
    [6347,"6347","Carrier G","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96139","PSYCL/NRPSYCL TST TECH 2 Plus  TST EA ADDL 30 MIN","21","0.619",null,null,"113","113",null,"21","21","NA","NA"],
    [6348,"6348","Carrier G","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96138","PSYCL/NRPSYCL TST TECH 2 Plus  TST 1ST 30 MIN","20","0.6",null,null,"118.1","118.1",null,"20","20","NA","NA"],
    [6349,"6349","Carrier G","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY W/PATIENT 60 MINUTES","20","0.7",null,"84.5","67.8","70.1","2","18","20","NA","NA"],
    [6350,"6350","Carrier G","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96136","PSYL/NRPSYCL TST PHYS/QHP 2 Plus  TST 1ST 30 MIN","20","0.55",null,"61","106","103.8","1","19","20","NA","NA"],
    [6351,"6351","Carrier G","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVALUATION","18","0.6111",null,"67.5","82.7","80.9","2","16","18","NA","NA"],
    [6352,"6352","Carrier G","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","THERAP REPETITIVE TMS TX SUBSEQ DELIVERY  AND  MNG","13","0.8462",null,null,"88.1","88.1",null,"13","13","NA","NA"],
    [6353,"6353","Carrier G","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","S9480","INTENSIVE OP PSYCHIATRIC SERVICES PER DIEM","5","1",null,"64.5","45.67","53.2","2","3","5","NA","NA"],
    [6354,"6354","Carrier G","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H0020","ALCOHL  AND OR RX SRVC; METHADONE ADMIN  AND OR SERVICE","3","1",null,null,"103","103",null,"3","3","NA","NA"],
    [6355,"6355","Carrier G","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90870","ELECTROCONVULSIVE THERAPY","2","1",null,null,"68.5","68.5",null,"2","2","NA","NA"],
    [6356,"6356","Carrier G","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97153","ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN","1","1",null,null,null,null,null,"1","1","NA","NA"],
    [6357,"6357","Carrier G","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97156","FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN","1","1",null,null,null,null,null,"1","1","NA","NA"],
    [6358,"6358","Carrier G","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4239","SPLY ALW NONADJUNC NONIMPL CGM  1 MO SPLY Equal to  1 UOS","1","1",null,null,"121","121",null,"1","1","NA","NA"],
    [6359,"6359","Carrier G","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","G0480","DRUG TEST DEFINITV DR ID METH P DAY 1-7 DRUG CL","1","1",null,"45",null,"45","1","1","2","NA","NA"],
    [6360,"6360","Carrier G","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H0011","ALCOHOL  and / DRUG SERVICES; ACUTE DTOX RES PROG IP","1","1",null,null,"12","12",null,null,null,"NA","NA"],
    [6361,"6361","Carrier G","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H0019","BHVAL HEALTH; LONG-TERM RES W/O ROOM and BOARD-DIEM","1","1",null,"25",null,"25","1",null,"1","NA","NA"],
    [6362,"6362","Carrier G","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90867","REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL and M","12","0.9167",null,null,"92.4","92.4",null,"12","12","NA","NA"],
    [6363,"6363","Carrier G","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90792","PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES","2",null,"0.5",null,"7.7","7.7",null,"2","2","NA","NA"],
    [6364,"6364","Carrier G","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90870","ELECTROCONVULSIVE THERAPY","2",null,"0.5",null,"74","74",null,"2","2","NA","NA"],
    [6365,"6365","Carrier G","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90869","REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV  and  MN","9",null,"0.33",null,"100.4","100.4",null,"9","9","NA","NA"],
    [6366,"6366","Carrier G","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90867","REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL and M","12",null,"0.25",null,"99.2","99.2",null,"12","12","NA","NA"],
    [6367,"6367","Carrier G","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90868","THERAP REPETITIVE TMS TX SUBSEQ DELIVERY  AND  MNG","13",null,"0.23",null,"95.2","95.2",null,"13","13","NA","NA"],
    [6368,"6368","Carrier G","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","80307","DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE","6",null,"0.17",null,"30.8","30.8",null,"6","6","NA","NA"],
    [6369,"6369","Carrier G","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","96130","PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR","6",null,"0.17",null,"80.9","80.9",null,"6","6","NA","NA"],
    [6370,"6370","Carrier G","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","96138","PSYCL/NRPSYCL TST TECH 2 Plus  TST 1ST 30 MIN","20",null,"0.15",null,"124","124",null,"20","20","NA","NA"],
    [6371,"6371","Carrier G","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","96139","PSYCL/NRPSYCL TST TECH 2 Plus  TST EA ADDL 30 MIN","21",null,"0.14",null,"119.2","119.2",null,"21","21","NA","NA"],
    [6372,"6372","Carrier G","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","96131","PSYCHOLOGICAL TST EVAL SVC PHYS/QHP EA ADDL HOUR","7",null,"0.14","59.5","80.9","77.9","1","6","7","NA","NA"],
    [6373,"6373","Carrier G","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E1390","O2 CONC 1 DEL PORT 85 PCT  OR GT 02 CONC AT PRSC FLW RATE","64","0.7656",null,"18.4","65.6","48.5","21","43","64","NA","NA"],
    [6374,"6374","Carrier G","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E2402","NEG PRESS WOUND THERAPY ELEC PUMP STATION/PRTBLE","18","0.5556",null,"31.5","62.7","55.4","5","13","18","NA","NA"],
    [6375,"6375","Carrier G","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0470","RESP ASST DEVC BI-LEVL PRSS CAPABILITY W/O BACKU","17","0.7647",null,"4","76.6","71.4","1","16","17","NA","NA"],
    [6376,"6376","Carrier G","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A7000","CANISTER DISPOSABLE USED WITH SUCTION PUMP EACH","15","0.4667",null,"41.7","59.2","55.4","4","11","15","NA","NA"],
    [6377,"6377","Carrier G","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A6550","WND CARE SET NEG PRSS WND TX ELEC PUMP SPL","14","0.4286",null,"41.7","63.4","58.4","4","10","14","NA","NA"],
    [6378,"6378","Carrier G","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","V2624","POLISHING/RESURFACING OF OCULAR PROSTHESIS","13","0.9231",null,null,"8.5","8.5",null,"13","13","NA","NA"],
    [6379,"6379","Carrier G","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L1960","AFO POSTERIOR SOLID ANK PLASTIC CUSTOM FAB","12","0.8333",null,null,"22.1","22.1",null,"12","12","NA","NA"],
    [6380,"6380","Carrier G","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E1399","DURABLE MEDICAL EQUIPMENT MISCELLANEOUS","9","0.4444",null,null,"46","46",null,"9","9","NA","NA"],
    [6381,"6381","Carrier G","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","V2625","ENLARGEMENT OF OCULAR PROSTHESIS","8","1",null,null,"-160.9","-160.9",null,"8","8","NA","NA"],
    [6382,"6382","Carrier G","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L1970","AFO PLASTIC WITH ANKLE JOINT CUSTOM FABRICATED","8","0.875",null,null,"30.4","30.4",null,"8","8","NA","NA"],
    [6383,"6383","Carrier G","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4649","SURGICAL SUPPLY; MISCELLANEOUS","1","1",null,"17.8",null,"17.8","1",null,"1","NA","NA"],
    [6384,"6384","Carrier G","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A7524","TRACHEOSTOMA STENT/STUD/BUTTON EACH","1","1",null,null,"45.2","45.2",null,"1","1","NA","NA"],
    [6385,"6385","Carrier G","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A9513","LUTETIUM LU 177 DOTATATE THERAPEUTIC 1 MCI","1","1",null,null,"21.6","21.6",null,"1","1","NA","NA"],
    [6386,"6386","Carrier G","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0261","HOS BED SEMI-ELEC ANY TYPE SIDE RAIL W/O MATTRSS","1","1",null,null,"70.7","70.7",null,"1","1","NA","NA"],
    [6387,"6387","Carrier G","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0635","PATIENT LIFT ELECTRIC WITH SEAT OR SLING","1","1",null,"3.3",null,"3.3","1",null,"1","NA","NA"],
    [6388,"6388","Carrier G","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0652","PNEUMAT COMPRS SEG HOM MDL W/CALBRTD GRADNT PRSS","1","1",null,null,"119.8","119.8",null,"1","1","NA","NA"],
    [6389,"6389","Carrier G","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0656","SEG PNEUMAT APPLIANCE USE W/PNEUMAT COMPRS TRUNK","1","1",null,null,"119.8","119.8",null,"1","1","NA","NA"],
    [6390,"6390","Carrier G","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0667","SEG PNEUMAT APPLINC W/PNEUMAT COMPRS FULL LEG","1","1",null,null,"119.8","119.8",null,"1","1","NA","NA"],
    [6391,"6391","Carrier G","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0748","OSTOGNS STIMULATOR ELEC NONINVASV SPINAL APPLIC","1","1",null,null,"40.1","40.1",null,"1","1","NA","NA"],
    [6392,"6392","Carrier G","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E1226","WHLCHAIR ACCESS MANUAL FULL RECLINING BACK EACH","1","1",null,"3",null,"3","1",null,"1","NA","NA"],
    [6393,"6393","Carrier G","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0652","PNEUMAT COMPRS SEG HOM MDL W/CALBRTD GRADNT PRSS","1",null,"1",null,"120","120",null,"1","1","NA","NA"],
    [6394,"6394","Carrier G","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0656","SEG PNEUMAT APPLIANCE USE W/PNEUMAT COMPRS TRUNK","1",null,"1",null,"120","120",null,"1","1","NA","NA"],
    [6395,"6395","Carrier G","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0667","SEG PNEUMAT APPLINC W/PNEUMAT COMPRS FULL LEG","1",null,"1",null,"120","120",null,"1","1","NA","NA"],
    [6396,"6396","Carrier G","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","V2624","POLISHING/RESURFACING OF OCULAR PROSTHESIS","13",null,"0.08",null,"8.5","8.5",null,"13","13","NA","NA"],
    [6397,"6397","Carrier G","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A6550","WND CARE SET NEG PRSS WND TX ELEC PUMP SPL","14",null,"0.07","41.7","63.4","58.4","4","10","14","NA","NA"],
    [6398,"6398","Carrier G","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A7000","CANISTER DISPOSABLE USED WITH SUCTION PUMP EACH","15",null,"0.07","41.7","59.2","55.4","4","11","15","NA","NA"],
    [6399,"6399","Carrier G","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E2402","NEG PRESS WOUND THERAPY ELEC PUMP STATION/PRTBLE","18",null,"0.06","31.5","62.7","55.4","5","13","18","NA","NA"],
    [6400,"6400","Carrier G","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E1390","O2 CONC 1 DEL PORT 85 PCT  OR GT 02 CONC AT PRSC FLW RATE","64",null,"0.02","18.4","65.6","48.5","21","43","64","NA","NA"],
    [6401,"6401","Carrier G","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","11056","PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4","1",null,"0",null,null,null,null,"1","1","NA","NA"],
    [6402,"6402","Carrier G","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","11721","DEBRIDEMENT NAIL ANY METHOD 6 OR GT","1",null,"0",null,null,null,null,"1","1","NA","NA"],
    [6403,"6403","Carrier G","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0784","EXTERNAL AMBULATORY INFUSION PUMP INSULIN","16","1",null,"19.2","60.2","42.6","9","14","23","NA","NA"],
    [6404,"6404","Carrier G","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","K0553","SUPPLY ALLOW FOR TX CGM1 MO SPL  Equal to  1 U OF SERVICE","1","1",null,null,null,null,null,null,null,"NA","NA"],
    [6405,"6405","Carrier G","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A9277","TRANSMITTER; EXT  USE WITH NONDME INTRSTL CGM","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [6406,"6406","Carrier G","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A9277","TRANSMITTER; EXT  USE WITH NONDME INTRSTL CGM","1","0",null,null,null,null,null,null,null,"NA","NA"],
    [6407,"6407","Carrier G","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0784","EXTERNAL AMBULATORY INFUSION PUMP INSULIN","16","1",null,"19.2","60.16","42.6","9","14","23","NA","NA"],
    [6408,"6408","Carrier G","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","K0553","SUPPLY ALLOW FOR TX CGM1 MO SPL  Equal to  1 U OF SERVICE","1","1",null,null,null,null,null,null,null,"NA","NA"],
    [6409,"6409","Carrier G","2023","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0784","EXTERNAL AMBULATORY INFUSION PUMP INSULIN","23",null,null,null,"60.8","43.1","9","14","23","NA","NA"],
    [6410,"6410","Carrier G","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","1393","0.849",null,"13.3","52.3",null,"425","968",null,"AMPHETAMINE/DEXTROAMPHETAMINE","ADDERALL"],
    [6411,"6411","Carrier G","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","585","0.812",null,"14.2","55.9",null,"180","405",null,"METHYLPHENIDATE HCL","RITALIN"],
    [6412,"6412","Carrier G","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","457","0.499",null,"18.7","74.5",null,"143","314",null,"DEXCOM Receiver/Sensor/Transmiter","DEXCOM"],
    [6413,"6413","Carrier G","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","431","0.473",null,"13.7","56.3",null,"86","345",null,"SEMAGLUTIDE","OZEMPIC"],
    [6414,"6414","Carrier G","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","383","0.564",null,"22.1","73",null,"133","250",null,"LISDEXAMFETAMINE DIMESYLATE","VYVANSE"],
    [6415,"6415","Carrier G","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","278","0.522",null,"19.9","79",null,"95","183",null,"PREGABALIN","LYRICA"],
    [6416,"6416","Carrier G","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","268","0.575",null,"16.9","62.2",null,"103","165",null,"Hydrocodone/Acetaminophen","NORCO"],
    [6417,"6417","Carrier G","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","264","0.591",null,"16.2","66.8",null,"30","234",null,"ADALIMUMAB","HUMIRA"],
    [6418,"6418","Carrier G","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","210","0.567",null,"12.3","65.3",null,"105","105",null,"Oxycodone","OXYCONTIN"],
    [6419,"6419","Carrier G","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","188","0.739",null,"16","62.1",null,"66","122",null,"ATOMOXETINE HYDROCHLORIDE","STRATTERA"],
    [6420,"6420","Carrier G","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","55","0.891",null,"16.5","49.6",null,"18","37",null,"FILGRASTIM-SNDZ","ZARXIO"],
    [6421,"6421","Carrier G","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","1393","0.849",null,"13.3","52.3",null,"425","968",null,"AMPHETAMINE-DEXTROAMPHETAMINE","ADDERALL"],
    [6422,"6422","Carrier G","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","85","0.835",null,"11.3","60.9",null,"22","63",null,"INSULIN INFUSION DISPOSABLE PUMP","OMNIPOD 10 PACK"],
    [6423,"6423","Carrier G","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","54","0.815",null,"12.4","65.6",null,"16","38",null,"ISOTRETINOIN","ACCUTANE"],
    [6424,"6424","Carrier G","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","585","0.812",null,"14.2","55.9",null,"180","405",null,"METHYLPHENIDATE HCL","RITALIN"],
    [6425,"6425","Carrier G","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","143","0.811",null,"11.7","48.3",null,"48","95",null,"EMPAGLIFLOZIN","JARDIANCE"],
    [6426,"6426","Carrier G","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","111","0.793",null,"11.3","58.6",null,"33","78",null,"SACUBITRIL-VALSARTAN","ENTRESTO"],
    [6427,"6427","Carrier G","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","52","0.769",null,"17","63.1",null,"22","30",null,"MODAFINIL","PROVIGIL"],
    [6428,"6428","Carrier G","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","79","0.759",null,"9.6","66.9",null,"13","66",null,"GUANFACINE HCL (ADHD)","INTUNIV"],
    [6429,"6429","Carrier G","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","63","0.746",null,"21.3","58.4",null,"15","48",null,"GALCANEZUMAB-GNLM","EMGALITY"],
    [6430,"6430","Carrier G","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","63",null,"0.048","14.6","67.5",null,"25","67",null,"SECUKINUMAB","COSENTYX"],
    [6431,"6431","Carrier G","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","90",null,"0.022","17.9","59.1",null,"28","88",null,"EVOLOCUMAB","REPATHA"],
    [6432,"6432","Carrier G","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","138",null,"0.022","18.1","50.4",null,"39","156",null,"DUPILIMAB","DUPIXENT"],
    [6433,"6433","Carrier G","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","56",null,"0.018","20.3","51.9",null,"22","44",null,"VILAZODONE","VIIBRYD"],
    [6434,"6434","Carrier G","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","59",null,"0.017","19.4","40",null,"32","74",null,"DAPAGLIFLOZIN","FARXIGA"],
    [6435,"6435","Carrier G","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","60",null,"0.017","12.3","67",null,"7","49",null,"ERENUMAB-AOOE","AIMOVIG"],
    [6436,"6436","Carrier G","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","60",null,"0.017","16.9","52.3",null,"16","51",null,"ESCITALOPRAM","LEXIPRO"],
    [6437,"6437","Carrier G","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","62",null,"0.016","20.5","58.2",null,"24","63",null,"RIFAXIMIN","XIFAXAN"],
    [6438,"6438","Carrier G","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","62",null,"0.016","20.2","62.6",null,"28","69",null,"VENLAFAXINE","EFFEXOR"],
    [6439,"6439","Carrier G","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","62",null,"0.016","17","43.9",null,"4","54",null,"RISANKIZUMAB-RZAA","SKYRIZI"],
    [6440,"6440","Carrier H","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","121","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Medical/Surgical/GYN","78","0.7949",null,"24.2","39.7",null,"19","59",null,"NA","NA"],
    [6441,"6441","Carrier H","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43775","Laps Gstrc Rstrictiv Px Longitudinal Gastrectomy","53","0.8679",null,null,"63.7",null,"0","53",null,"NA","NA"],
    [6442,"6442","Carrier H","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","Total Abdominal Hysterectomy (Corpus And Cervix), With Or Without Removal Of Tube(S), With","41","0.9512",null,"4","56.9",null,"6","35",null,"NA","NA"],
    [6443,"6443","Carrier H","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43644","Laparoscopy, Surg, Gastric Restrictive Procedure; W Gastric Bypass And Roux-En-Y Gastroent","37","0.8649",null,null,"52",null,"0","37",null,"NA","NA"],
    [6444,"6444","Carrier H","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22614","Arthrodesis, Posterior Or Posterolateral Technique, Single Interspace; Each Additional Int","31","0.871",null,"48","73.7",null,"2","29",null,"NA","NA"],
    [6445,"6445","Carrier H","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22552","Arthrodesis, Anterior Interbody, Incl Disc Space Prep, Discectomy, Osteophytectomy & Decom","22","0.8636",null,"24","84",null,"2","20",null,"NA","NA"],
    [6446,"6446","Carrier H","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22585","Arthrodesis, Anterior/-Lateral,Ea Add.In","18","0.7222",null,null,"97.3",null,"0","18",null,"NA","NA"],
    [6447,"6447","Carrier H","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64999","Unlisted Procedure,Nervous System","13","0.9231",null,"24","82.9",null,"1","12",null,"NA","NA"],
    [6448,"6448","Carrier H","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22634","Arthrodesis, Combined Posterior Or Posterolateral Technique With Posterior Interbody Techn","12","0.9167",null,"48","82.9",null,"1","11",null,"NA","NA"],
    [6449,"6449","Carrier H","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20930","Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for primary procedure)","9","0.6667",null,"28","51.3",null,"3","6",null,"NA","NA"],
    [6450,"6450","Carrier H","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33361","Transcatheter Aortic Valve Replacement (Tavr/Tavi) With Prosthetic Valve; Percutaneous Fem","8","1",null,null,"75",null,"0","8",null,"NA","NA"],
    [6451,"6451","Carrier H","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","11971","Removal Of Tissue Expander Without Insertion Of Implant","8","1",null,null,"52",null,"0","8",null,"NA","NA"],
    [6452,"6452","Carrier H","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19371","Peri-Implant Capsulectomy, Breast, Complete, Including Removal Of All Intracapsular Conten","7","1",null,null,"28.8",null,"0","7",null,"NA","NA"],
    [6453,"6453","Carrier H","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27447","Replacement Knee Total","7","1",null,null,"75",null,"0","7",null,"NA","NA"],
    [6454,"6454","Carrier H","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19370","Revision Of Peri-Implant Capsule, Breast, Including Capsulotomy, Capsulorrhaphy, And/Or Pa","5","1",null,null,"28.8",null,"0","5",null,"NA","NA"],
    [6455,"6455","Carrier H","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","760","Ancillary Services - Specialty Services-General Classification","5","1",null,"42.3","45.8",null,"1","4",null,"NA","NA"],
    [6456,"6456","Carrier H","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43235","Esophagogastroduodenoscopy Flexible, Transoral; Diagnostic, Including Collection Of Specim","4","1",null,null,"72",null,"0","4",null,"NA","NA"],
    [6457,"6457","Carrier H","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33340","Percutaneous Transcatheter Closure Of The Left Atrial Appendage With Endocardial Implant,","4","1",null,null,"54",null,"0","4",null,"NA","NA"],
    [6458,"6458","Carrier H","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33477","Transcatheter Pulmonary Valve Implantation, Percutaneous Approach, Including Pre-Stenting","4","1",null,null,"48",null,"0","4",null,"NA","NA"],
    [6459,"6459","Carrier H","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19303","Mastectomy Simple Complete","4","1",null,null,"54",null,"0","4",null,"NA","NA"],
    [6460,"6460","Carrier H","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43775","Laps Gstrc Rstrictiv Px Longitudinal Gastrectomy","53",null,"1",null,"63.7",null,"0","53",null,"NA","NA"],
    [6461,"6461","Carrier H","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","58150","Total Abdominal Hysterectomy (Corpus And Cervix), With Or Without Removal Of Tube(S), With","41",null,"1","4","56.9",null,"6","35",null,"NA","NA"],
    [6462,"6462","Carrier H","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22552","Arthrodesis, Anterior Interbody, Incl Disc Space Prep, Discectomy, Osteophytectomy & Decom","22",null,"1","24","84",null,"2","20",null,"NA","NA"],
    [6463,"6463","Carrier H","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","33361","Transcatheter Aortic Valve Replacement (Tavr/Tavi) With Prosthetic Valve; Percutaneous Fem","8",null,"1",null,"75",null,"0","8",null,"NA","NA"],
    [6464,"6464","Carrier H","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43235","Esophagogastroduodenoscopy Flexible, Transoral; Diagnostic, Including Collection Of Specim","4",null,"1",null,"72",null,"0","4",null,"NA","NA"],
    [6465,"6465","Carrier H","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","33418","Transcatheter Mitral Valve Repair, Percutaneous Approach, Including Transseptal Puncture W","4",null,"1",null,"54",null,"0","4",null,"NA","NA"],
    [6466,"6466","Carrier H","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63053","Laminectomy, Facetectomy, Or Foraminotomy During Posterior Interbody Arthrodesis, Lumbar;","4",null,"1",null,"78",null,"0","4",null,"NA","NA"],
    [6467,"6467","Carrier H","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63048","Laminectomy, Facetectomy & Foraminotomy (Unilateral Or Bilateral W/ Decompression Of Spina","2",null,"1",null,"84",null,"0","2",null,"NA","NA"],
    [6468,"6468","Carrier H","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","33419","Transcatheter Mitral Valve Repair, Percutaneous Approach, Including Transseptal Puncture W","2",null,"1",null,"48",null,"0","2",null,"NA","NA"],
    [6469,"6469","Carrier H","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","58999","Unlisted Procedure Female Genital System Nonobstetrical","1",null,"1",null,"24",null,"0","1",null,"NA","NA"],
    [6470,"6470","Carrier H","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","128","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation","7","0.2857",null,"15.4","55.7",null,"4","3",null,"NA","NA"],
    [6471,"6471","Carrier H","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0017","Behavioral health; residential (hospital residential treatment program), without room and board, per diem","2","0",null,"17.6","1.3",null,"1","1",null,"NA","NA"],
    [6472,"6472","Carrier H","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric","1","1",null,null,"49.5",null,"0","1",null,"NA","NA"],
    [6473,"6473","Carrier H","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric","1","1",null,null,"49.5",null,"0","1",null,"NA","NA"],
    [6474,"6474","Carrier H","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","128","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation","7","0.2857",null,"15.4","55.7",null,"4","3",null,"NA","NA"],
    [6475,"6475","Carrier H","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0017","Behavioral health; residential (hospital residential treatment program), without room and board, per diem","2","0",null,"17.6","1.3",null,"1","1",null,"NA","NA"],
    [6476,"6476","Carrier H","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","Echo, Transthoracic W/Doppler, Complete","36002","0.9176",null,"1.3","5.3",null,"18","35984",null,"NA","NA"],
    [6477,"6477","Carrier H","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","Continuous Airway Pressure (Cpap) Device [May Be Used For Either Cpap Or Apap]","32416","0.9632",null,"0","2.4",null,"1","32415",null,"NA","NA"],
    [6478,"6478","Carrier H","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","Mri, Lower Extremity Any Joint; Wo Contr","26621","0.8688",null,"3.5","7.1",null,"55","26566",null,"NA","NA"],
    [6479,"6479","Carrier H","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","MSMPT","Physical Therapy","21069","0.69",null,"4","11",null,null,null,null,"NA","NA"],
    [6480,"6480","Carrier H","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72148","Mri Of Lumbar Spine","18789","0.8605",null,"3.6","7.4",null,"20","18769",null,"NA","NA"],
    [6481,"6481","Carrier H","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","Mri Of Brain And Further Sequences","16630","0.9196",null,"13.8","4.9",null,"33","16597",null,"NA","NA"],
    [6482,"6482","Carrier H","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74177","Ct Abd & Pelv W Contrast","16107","0.909",null,"2.6","5.6",null,"82","16025",null,"NA","NA"],
    [6483,"6483","Carrier H","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73221","Mri, Any Joint Of Upper Extremity; Wo Co","13081","0.8606",null,"3","7.6",null,"16","13065",null,"NA","NA"],
    [6484,"6484","Carrier H","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72141","Mri Of Cervical Spine","11142","0.8577",null,"5.3","7.7",null,"18","11124",null,"NA","NA"],
    [6485,"6485","Carrier H","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70551","Mri Of Brain","9629","0.8909",null,"4.5","6.5",null,"16","9613",null,"NA","NA"],
    [6486,"6486","Carrier H","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15772","Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk, Breasts, Scalp, Ar","57","1",null,null,"63.8",null,"0","57",null,"NA","NA"],
    [6487,"6487","Carrier H","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","92250","Fundus photography with interpretation and report","29","1",null,"22","13.2",null,"1","28",null,"NA","NA"],
    [6488,"6488","Carrier H","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29870","Arthroscopy,Knee,Dx,W/Wo Syn.Bx","22","1",null,"24","62.9",null,"1","21",null,"NA","NA"],
    [6489,"6489","Carrier H","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64590","I & Plcmt. Peripheral Generator/Rec","17","1",null,null,"181.5",null,"0","17",null,"NA","NA"],
    [6490,"6490","Carrier H","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64479","Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or thoracic, single level","14","1",null,"22","71.7",null,"2","12",null,"NA","NA"],
    [6491,"6491","Carrier H","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64491","Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; second level (List separately in addition to code for primary procedure)","14","1",null,"20.6","75.9",null,"1","13",null,"NA","NA"],
    [6492,"6492","Carrier H","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","31267","Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus","14","1",null,"17.9","83.2",null,"1","13",null,"NA","NA"],
    [6493,"6493","Carrier H","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64484","Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, each additional level (List separately in addition to code for primary procedure)","13","1",null,null,"68.6",null,"0","13",null,"NA","NA"],
    [6494,"6494","Carrier H","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15771","Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; 50 cc or less injectate","10","1",null,null,"82.6",null,"0","10",null,"NA","NA"],
    [6495,"6495","Carrier H","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63030","Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar","9","1",null,"45.3","80.3",null,"1","8",null,"NA","NA"],
    [6496,"6496","Carrier H","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27447","Replacement Knee Total","160",null,"1","0","64.3",null,"1","159",null,"NA","NA"],
    [6497,"6497","Carrier H","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27130","Replacement Hip Total Simple","116",null,"1","8","63",null,"3","113",null,"NA","NA"],
    [6498,"6498","Carrier H","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","36482","Endovenous Ablation Therapy Of Incompetent Vein, Extremity, By Transcatheter Delivery Of A","78",null,"1",null,"71.1",null,"0","78",null,"NA","NA"],
    [6499,"6499","Carrier H","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","36470","Injection Of Sclerosant; Single Incompetent Vein (Other Than Telangiectasia)","39",null,"1",null,"69.7",null,"0","39",null,"NA","NA"],
    [6500,"6500","Carrier H","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","19303","Mastectomy Simple Complete","38",null,"1","0","45.9",null,"2","36",null,"NA","NA"],
    [6501,"6501","Carrier H","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64615","Chemodenervation Of Muscle(S); Muscle(S) Innervated By Facial, Trigeminal, Cervical Spinal","33",null,"1",null,"14.9",null,"0","33",null,"NA","NA"],
    [6502,"6502","Carrier H","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","17106","Dest Cut Vasc Proliferative Les To 10 Sq","20",null,"1",null,"75.6",null,"0","20",null,"NA","NA"],
    [6503,"6503","Carrier H","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","19350","Reconstruct Nipple/Areolar Unil","17",null,"1",null,"46.4",null,"0","17",null,"NA","NA"],
    [6504,"6504","Carrier H","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64590","I & Plcmt. Peripheral Generator/Rec","17",null,"1",null,"181.5",null,"0","17",null,"NA","NA"],
    [6505,"6505","Carrier H","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22614","Arthrodesis, Posterior Or Posterolateral Technique, Single Interspace; Each Additional Int","9",null,"1",null,"88",null,"0","9",null,"NA","NA"],
    [6506,"6506","Carrier H","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Therapeutic Repetitive Transcranial Magnetic Simulation (Tms) Treatment; Initial, Includin","264","0.88",null,"14.2","510.1",null,"25","239",null,"NA","NA"],
    [6507,"6507","Carrier H","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","Therapeutic Repetitive Transcranial Magnetic Stimulation (Tms) Treatment; Subsequent Motor","168","0.9107",null,"10.3","48.2",null,"14","154",null,"NA","NA"],
    [6508,"6508","Carrier H","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","Therapeutic Repetitive Transcranial Magnetic Simulation (Tms) Treatment; Including Cortica","165","0.8848",null,"10","43.1",null,"12","153",null,"NA","NA"],
    [6509,"6509","Carrier H","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","Mental health partial hospitalization, treatment, less than 24 hours","135","0.8593",null,"28.2","50.1",null,"12","123",null,"NA","NA"],
    [6510,"6510","Carrier H","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan","102","0.8137",null,"32.6","67.9",null,"8","94",null,"NA","NA"],
    [6511,"6511","Carrier H","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97155","Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes","90","0.8333",null,"23.7","68.4",null,"8","82",null,"NA","NA"],
    [6512,"6512","Carrier H","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97156","Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes","87","0.8736",null,"24.2","69.1",null,"8","79",null,"NA","NA"],
    [6513,"6513","Carrier H","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97153","Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes","79","0.8354",null,"17.8","70",null,"7","72",null,"NA","NA"],
    [6514,"6514","Carrier H","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S9480","Intensive outpatient psychiatric services, per diem","73","0.8356",null,"18.5","56.3",null,"9","64",null,"NA","NA"],
    [6515,"6515","Carrier H","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0032","Mental health service plan development by nonphysician","58","0.8103",null,"43","53",null,"2","56",null,"NA","NA"],
    [6516,"6516","Carrier H","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S9480","Intensive Outpatient Psychiatric Services Per Diem","15","1",null,null,"41.6",null,"0","15",null,"NA","NA"],
    [6517,"6517","Carrier H","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97151","Behavior Identification Assessment, Administered By A Physician Or Other Qualified Health","6","1",null,null,"4",null,"0","6",null,"NA","NA"],
    [6518,"6518","Carrier H","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97156","Family Adptve Bhvr Trtmnt Guidance, Admnstrd By Phys Or Other Qualified Hlth Care Profess","5","1",null,null,"4.8",null,"0","5",null,"NA","NA"],
    [6519,"6519","Carrier H","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97153","Adaptive Behavior Treatment By Protocol, Admnstrd By Tech Under The Direction Of A Phys Or","5","1",null,null,"4.8",null,"0","5",null,"NA","NA"],
    [6520,"6520","Carrier H","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97155","Adptve Bhvr Trtmnt W/ Protocol Modifictn, Admnstrd By Phys Or Other Qualified Hlth Care Pr","5","1",null,null,"4.8",null,"0","5",null,"NA","NA"],
    [6521,"6521","Carrier H","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0035","Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours","3","1",null,"48","96",null,"1","2",null,"NA","NA"],
    [6522,"6522","Carrier H","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97152","Behavior identification-supporting assessment, administered by one technician under the direction of a physician or other qualified health care professional, face-to-face with the patient, each 15 minutes","2","1",null,null,"16",null,"0","2",null,"NA","NA"],
    [6523,"6523","Carrier H","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90870","Electroconvulsive therapy (includes necessary monitoring)","2","1",null,"3.2","90.7",null,"1","1",null,"NA","NA"],
    [6524,"6524","Carrier H","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","G0283","Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care","2","1",null,"45.3",null,null,"2","0",null,"NA","NA"],
    [6525,"6525","Carrier H","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97154","Grp Adptve Bhvior Trtmnt By Protocol, Admnstrd By Tech Under The Drction Of A Phys Or Othe","1","1",null,null,"0",null,"0","1",null,"NA","NA"],
    [6526,"6526","Carrier H","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90868","Therapeutic Repetitive Transcranial Magnetic Simulation (Tms) Treatment; Initial, Includin","203",null,"1","11.3","47.6",null,"17","186",null,"NA","NA"],
    [6527,"6527","Carrier H","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90869","Therapeutic Repetitive Transcranial Magnetic Stimulation (Tms) Treatment; Subsequent Motor","168",null,"1","10.3","48.2",null,"14","154",null,"NA","NA"],
    [6528,"6528","Carrier H","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90867","Therapeutic Repetitive Transcranial Magnetic Simulation (Tms) Treatment; Including Cortica","165",null,"1","10","43.1",null,"12","153",null,"NA","NA"],
    [6529,"6529","Carrier H","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","S0013","Esketamine, Nasal Spray, 1 Mg","31",null,"1","16.8","60.6",null,"10","21",null,"NA","NA"],
    [6530,"6530","Carrier H","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90837","Psychotherapy, 60 minutes with patient","11",null,"0.091","41.5","107.1",null,"2","9",null,"NA","NA"],
    [6531,"6531","Carrier H","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97151","Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan","102",null,"0.01","32.6","67.9",null,"8","94",null,"NA","NA"],
    [6532,"6532","Carrier H","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0486","Adjustable, Custom Fabricated, Includes Fitting And Adjustment","258","0.938",null,"21.8","9",null,"3","1587",null,"NA","NA"],
    [6533,"6533","Carrier H","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0108","Wheelchair Component Or Accessory, Not Otherwise Specified","110","0.8182",null,null,"66.9",null,"0","110",null,"NA","NA"],
    [6534,"6534","Carrier H","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S1040","Cranial Remolding Orthosis, Rigid, With Soft Interface Material, Custom Fabricated, Includ","63","0.9365",null,null,"58.6",null,"0","63",null,"NA","NA"],
    [6535,"6535","Carrier H","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L8680","Implantable Neurostimulator Electrode Each","46","0.913",null,null,"105.7",null,"1","45",null,"NA","NA"],
    [6536,"6536","Carrier H","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0005","Ultralightweight Wheelchair","37","0.8919",null,null,"74.9",null,"0","37",null,"NA","NA"],
    [6537,"6537","Carrier H","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0748","Osteogenic Stimulator, Noninvasive, Spinal Applications","32","0.3125",null,null,"150",null,"0","32",null,"NA","NA"],
    [6538,"6538","Carrier H","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0739","Pneumatic Compressor, Segmental Home Model With Calibrated Gradient Pr","29","0.8621",null,null,"107.6",null,"0","29",null,"NA","NA"],
    [6539,"6539","Carrier H","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0652","Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","29","0.6207",null,null,"70.3",null,"1","28",null,"NA","NA"],
    [6540,"6540","Carrier H","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L1846","Ko, Double Upright, Thigh And Calf, With Adjustable Flexion And Extens","28","0.5357",null,null,"74.6",null,"0","28",null,"NA","NA"],
    [6541,"6541","Carrier H","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L2755","Addition To Lower Extremity Orthosis Carbon Graphite Lamination","27","0.8889",null,null,"69.3",null,"0","27",null,"NA","NA"],
    [6542,"6542","Carrier H","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0766","Electrical Stimulation Device Used For Cancer Treatment, Includes All Accessories, Any Typ","14","1",null,"0","51.7",null,"1","13",null,"NA","NA"],
    [6543,"6543","Carrier H","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2607","Skin Protection And Positioning Wheelchair Seat Cushion, Width Less Than 22","7","1",null,null,"96",null,"0","7",null,"NA","NA"],
    [6544,"6544","Carrier H","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0260","Hospital Bed, Seimi-Electric (Head And Foot Adjustment), With Any Type","7","1",null,null,"80",null,"0","7",null,"NA","NA"],
    [6545,"6545","Carrier H","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0973","Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","6","1",null,null,"106.1",null,"0","6",null,"NA","NA"],
    [6546,"6546","Carrier H","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0040","Adjustable angle footplate, each","5","1",null,null,"101",null,"0","5",null,"NA","NA"],
    [6547,"6547","Carrier H","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0978","Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","5","1",null,null,"117.3",null,"0","5",null,"NA","NA"],
    [6548,"6548","Carrier H","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2613","Positioning Wheelchair Back Cushion, Posterior, Width Less Than 22 Inches, Any","5","1",null,null,"52.8",null,"0","5",null,"NA","NA"],
    [6549,"6549","Carrier H","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8690","Aud Osseo Dev, Int/Ext Comp","5","1",null,null,"144",null,"0","5",null,"NA","NA"],
    [6550,"6550","Carrier H","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0261","Hospital Bed, Semi-Electric (Head And Foot Adjustment), With Any Type","5","1",null,null,"57.6",null,"0","5",null,"NA","NA"],
    [6551,"6551","Carrier H","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5856","Addition To Lower Extremity Prosthesis, Endoskeletal Knee-Shin System,","5","1",null,null,"110.4",null,"0","5",null,"NA","NA"],
    [6552,"6552","Carrier H","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0486","Adjustable, Custom Fabricated, Includes Fitting And Adjustment","250",null,"1",null,"0",null,"0","250",null,"NA","NA"],
    [6553,"6553","Carrier H","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","K0005","Ultralightweight Wheelchair","37",null,"1",null,"74.9",null,"0","37",null,"NA","NA"],
    [6554,"6554","Carrier H","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L2755","Addition To Lower Extremity Orthosis Carbon Graphite Lamination","27",null,"1",null,"69.3",null,"0","27",null,"NA","NA"],
    [6555,"6555","Carrier H","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0766","Electrical Stimulation Device Used For Cancer Treatment, Includes All Accessories, Any Typ","14",null,"1",null,"51.7",null,"1","13",null,"NA","NA"],
    [6556,"6556","Carrier H","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E2622","Skin Protection Wheelchair Seat Cushion, Adjustable, Width Less Than 22 Inches, Any Depth","10",null,"1",null,"61.3",null,"1","9",null,"NA","NA"],
    [6557,"6557","Carrier H","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E2613","Positioning Wheelchair Back Cushion, Posterior, Width Less Than 22 Inches, Any","5",null,"1",null,"52.8",null,"0","5",null,"NA","NA"],
    [6558,"6558","Carrier H","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L5856","Addition To Lower Extremity Prosthesis, Endoskeletal Knee-Shin System,","5",null,"1",null,"110.4",null,"0","5",null,"NA","NA"],
    [6559,"6559","Carrier H","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L5973","Endoskeletal Ankle Foot System, Microprocessor Controlled Feature, Dorsiflexion","3",null,"1",null,"112",null,"0","3",null,"NA","NA"],
    [6560,"6560","Carrier H","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","K0825","Pwc Gp 2 Hd Cap Chair","1",null,"1",null,"48",null,"0","1",null,"NA","NA"],
    [6561,"6561","Carrier H","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0483","High Frequency Chest Wall Oscillation System, With Full Anterior And/Or Posterior Thoracic","16",null,"0.5","48","60",null,"1","15",null,"NA","NA"],
    [6562,"6562","Carrier H","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","Diabetes Supplies & Equip","71","0.6619",null,"1.6","22.2",null,"14","57","0","NA","NA"],
    [6563,"6563","Carrier H","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","Diabetes Supplies & Equip","71","0.6619",null,"1.6","22.2",null,"14","57","0","NA","NA"],
    [6564,"6564","Carrier H","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","2150","0.4632",null,"1.7","16.53",null,"258","1892","0","SEMAGLUTIDE","OZEMPIC"],
    [6565,"6565","Carrier H","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","1144","0.4274",null,"2.79","19.4",null,"141","1003","0","TIRZEPATIDE","MOUNJARO"],
    [6566,"6566","Carrier H","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","861","0.3217",null,"2.62","29.53",null,"76","785","0","SEMAGLUTIDE","OZEMPIC"],
    [6567,"6567","Carrier H","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","850","0.6529",null,"4.48","45.24",null,"166","684","0","RIMEGEPANT","NURTEC ODT"],
    [6568,"6568","Carrier H","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","596","0.7399",null,"14.48","56.57",null,"99","497","0","DUPILUMAB","DUPIXENT"],
    [6569,"6569","Carrier H","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","460","0.737",null,"6.9","45.24",null,"113","347","0","UBROGEPANT","UBRELVY"],
    [6570,"6570","Carrier H","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","455","0.6615",null,"3.51","20.49",null,"48","407","0","SEMAGLUTIDE","WEGOVY"],
    [6571,"6571","Carrier H","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","451","0.8448",null,"1.42","13.66",null,"80","371","0","EMPAGLIFLOZIN","JARDIANCE"],
    [6572,"6572","Carrier H","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","412","0.4879",null,"3.7","15.51",null,"53","359","0","TIRZEPATIDE","MOUNJARO"],
    [6573,"6573","Carrier H","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","411","0.5401",null,"1.7","17.03",null,"57","354","0","SEMAGLUTIDE","OZEMPIC"],
    [6574,"6574","Carrier H","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","24","1",null,"7.85","5.19",null,"20","4","0","ONDANSETRON HCL","ZOFRAN"],
    [6575,"6575","Carrier H","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","13","1",null,"6.28","22.35",null,"4","9","0","METHYLPHENIDATE","CONCERTA"],
    [6576,"6576","Carrier H","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","11","1",null,"0.01","0.01",null,"3","8","0","DESVENLAFAXINE SUCCINATE","DESVENLAFAXINE ER"],
    [6577,"6577","Carrier H","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","11","1",null,"0.01","21.41",null,"2","9","0","EMPAGLIFLOZIN AND METFORMIN","SYNJARDY"],
    [6578,"6578","Carrier H","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","11","1",null,"2.33","17.18",null,"5","6","0","NALTREXONE","VIVITROL"],
    [6579,"6579","Carrier H","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","11","1",null,"1.12","33.31",null,"8","3","0","ENZALUTAMIDE","XTANDI"],
    [6580,"6580","Carrier H","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","10","1",null,"0.02","12.62",null,"1","9","0","LURASIDONE HYDROCHLORIDE","LATUDA"],
    [6581,"6581","Carrier H","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","9","1",null,"5.38","14.75",null,"7","2","0","LENVATINIB","LENVIMA"],
    [6582,"6582","Carrier H","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","8","1",null,"10.35","13.35",null,"2","6","0","DEXLANSOPRAZOLE","DEXILANT"],
    [6583,"6583","Carrier H","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","8","1",null,"12.03","0.01",null,"2","6","0","CARIPRAZINE","VRAYLAR"],
    [6584,"6584","Carrier H","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","2",null,"1","4.03","25.49",null,"1","1","0","ADALIMUMAB","HUMIRA"],
    [6585,"6585","Carrier H","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","1",null,"1",null,"69.77",null,"0","1","0","TRAMETINIB","MEKINIST"],
    [6586,"6586","Carrier H","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","1",null,"1","20.47",null,null,"1","0","0","ALPELISIB","PIQRAY"],
    [6587,"6587","Carrier H","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","1",null,"1","3",null,null,"1","0","0","SECUKINUMAB","COSENTYX"],
    [6588,"6588","Carrier H","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","1",null,"1","1.33",null,null,"1","0","0","ABIRATERONE ACETATE","ZYTIGA"],
    [6589,"6589","Carrier H","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","1",null,"1",null,"91.66",null,"0","1","0","NEBIVOLOL HYDROCHLORIDE","BYSTOLIC"],
    [6590,"6590","Carrier H","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","1",null,"1","3.19",null,null,"1","0","0","AMBRISENTAN","LETAIRIS"],
    [6591,"6591","Carrier H","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","1",null,"1","20.99",null,null,"1","0","0","TOPIRAMATE","TROKENDI"],
    [6592,"6592","Carrier H","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","1",null,"1",null,"67.42",null,"0","1","0","DROXIDOPA","NORTHERA"],
    [6593,"6593","Carrier H","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","1",null,"1",null,"73.6",null,"0","1","0","MARAVIROC","SELZENTRY"],
    [6594,"6594","Carrier I","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","6","0.8333",null,null,"48.46",null,null,"6",null,"NA","NA"],
    [6595,"6595","Carrier I","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","69990","Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure)","5","0",null,"0.09","12.5",null,"1","4",null,"NA","NA"],
    [6596,"6596","Carrier I","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","5","0.8",null,null,"30.97",null,null,"5",null,"NA","NA"],
    [6597,"6597","Carrier I","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","61781","Stereotactic computer-assisted (navigational) procedure; cranial, intradural (List separately in addition to code for primary procedure)","4","0",null,"0.09","16.66",null,"1","3",null,"NA","NA"],
    [6598,"6598","Carrier I","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44207","Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)","4","0",null,null,"1.41",null,null,"4",null,"NA","NA"],
    [6599,"6599","Carrier I","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44205","Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomy","4","0",null,null,"1.41",null,null,"4",null,"NA","NA"],
    [6600,"6600","Carrier I","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","38562","Limited lymphadenectomy for staging (separate procedure); pelvic and para-aortic","4","0",null,"0.6","0.47",null,"3","1",null,"NA","NA"],
    [6601,"6601","Carrier I","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44204","Laparoscopy, surgical; colectomy, partial, with anastomosis","4","0",null,null,"1.39",null,null,"4",null,"NA","NA"],
    [6602,"6602","Carrier I","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22612","Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)","3","0.6667",null,null,"65.03",null,null,"3",null,"NA","NA"],
    [6603,"6603","Carrier I","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45330","Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","3","0",null,null,"0.09",null,null,"3",null,"NA","NA"],
    [6604,"6604","Carrier I","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44206","Laparoscopy, surgical; colectomy, partial, with end colostomy and closure of distal segment (Hartmann type procedure)","3","0",null,null,"1.85",null,null,"3",null,"NA","NA"],
    [6605,"6605","Carrier I","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63047","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","2","1",null,null,"72.21",null,null,"2",null,"NA","NA"],
    [6606,"6606","Carrier I","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22633","Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar","2","1",null,null,"26.16",null,null,"2",null,"NA","NA"],
    [6607,"6607","Carrier I","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27447","Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)","1","1",null,null,"0.22",null,null,"1",null,"NA","NA"],
    [6608,"6608","Carrier I","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27487","Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component","1","1",null,null,"0.04",null,null,"1",null,"NA","NA"],
    [6609,"6609","Carrier I","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22808","Arthrodesis, anterior, for spinal deformity, with or without cast; 2 to 3 vertebral segments","1","1",null,null,"2.41",null,null,"1",null,"NA","NA"],
    [6610,"6610","Carrier I","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63048","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure)","1","1",null,null,"88.71",null,null,"1",null,"NA","NA"],
    [6611,"6611","Carrier I","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","31299","Unlisted procedure, accessory sinuses","1","1",null,null,"77.77",null,null,"1",null,"NA","NA"],
    [6612,"6612","Carrier I","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63046","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; thoracic","1","1",null,null,"0.05",null,null,"1",null,"NA","NA"],
    [6613,"6613","Carrier I","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64999","Unlisted procedure, nervous system","1","1",null,null,"77.77",null,null,"1",null,"NA","NA"],
    [6614,"6614","Carrier I","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","38206","Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous","1","1",null,null,"45.21",null,null,"1",null,"NA","NA"],
    [6615,"6615","Carrier I","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","38241","Hematopoietic progenitor cell (HPC); autologous transplantation","1","1",null,null,"45.21",null,null,"1",null,"NA","NA"],
    [6616,"6616","Carrier I","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15769","Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia)","1","1",null,null,"77.77",null,null,"1",null,"NA","NA"],
    [6617,"6617","Carrier I","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27134","Revision of total hip arthroplasty; both components, with or without autograft or allograft","1","1",null,null,"0.38",null,null,"1",null,"NA","NA"],
    [6618,"6618","Carrier I","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","61736","Laser interstitial thermal therapy of a simple single intracranial lesion","1","1",null,null,"52.42",null,null,"1",null,"NA","NA"],
    [6619,"6619","Carrier I","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27137","Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft","1","1",null,null,"0.38",null,null,"1",null,"NA","NA"],
    [6620,"6620","Carrier I","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63200","Laminectomy, with release of tethered spinal cord, lumbar","1","1",null,null,"0.01",null,null,"1",null,"NA","NA"],
    [6621,"6621","Carrier I","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22630","Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; lumbar","1","1",null,null,"41.27",null,null,"1",null,"NA","NA"],
    [6622,"6622","Carrier I","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","47379","Unlisted laparoscopic procedure, liver","1","1",null,null,"66.71",null,null,"1",null,"NA","NA"],
    [6623,"6623","Carrier I","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22850","Removal of posterior nonsegmental instrumentation (eg, Harrington rod)","1","1",null,null,"0.02",null,null,"1",null,"NA","NA"],
    [6624,"6624","Carrier I","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","ECHO, transthoracic w/doppler, complete","241","0.9295",null,null,"3.65",null,null,"241",null,"NA","NA"],
    [6625,"6625","Carrier I","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","MRI of brain and further sequences","180","0.9333",null,null,"5.65",null,null,"180",null,"NA","NA"],
    [6626,"6626","Carrier I","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74177","CT abd & pelv w contrast","162","0.9198",null,null,"4.16",null,null,"162",null,"NA","NA"],
    [6627,"6627","Carrier I","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","MRI, lower extremity any joint; wo contr","137","0.854",null,null,"6.32",null,null,"137",null,"NA","NA"],
    [6628,"6628","Carrier I","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72148","MRI of lumbar spine","135","0.8",null,null,"15.32",null,null,"135",null,"NA","NA"],
    [6629,"6629","Carrier I","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","Colonoscopy, flexible; with biopsy, single or multiple","100","0.93",null,"0.01","3.54",null,"1","99",null,"NA","NA"],
    [6630,"6630","Carrier I","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45378","Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","99","0.9293",null,null,"3.57","468",null,"99","2","NA","NA"],
    [6631,"6631","Carrier I","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71250","DIAGNOSTIC CT THORAX W/O CNTRST","95","0.8842",null,null,"3.9",null,null,"95",null,"NA","NA"],
    [6632,"6632","Carrier I","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73221","MRI, any joint of upper extremity; wo co","90","0.7444",null,"0.14","12.65",null,"1","89",null,"NA","NA"],
    [6633,"6633","Carrier I","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45385","Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","89","0.9326",null,"0.01","2.62",null,"1","88",null,"NA","NA"],
    [6634,"6634","Carrier I","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","71271","CT THORAX LW DOSE LNG CA SCR C-","63","1",null,null,"0",null,null,"63",null,"NA","NA"],
    [6635,"6635","Carrier I","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93303","ECHO, transthoracic, complete cng","42","1",null,null,"3.74",null,null,"42",null,"NA","NA"],
    [6636,"6636","Carrier I","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72158","MRI of lumbar spine","15","1",null,null,"9.2",null,null,"15",null,"NA","NA"],
    [6637,"6637","Carrier I","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93308","ECHO, transthoracic, heart, limited","12","1",null,null,"2.55",null,null,"12",null,"NA","NA"],
    [6638,"6638","Carrier I","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","75574","CTA heart w/3d image","12","1",null,null,"0.36",null,null,"12",null,"NA","NA"],
    [6639,"6639","Carrier I","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","71275","CTA chest (noncoronary)","12","1",null,null,"0.35",null,null,"12",null,"NA","NA"],
    [6640,"6640","Carrier I","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","45381","Colonoscopy, flexible; with directed submucosal injection(s), any substance","11","1",null,null,"0.52",null,null,"11",null,"NA","NA"],
    [6641,"6641","Carrier I","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","74181","MRI, abdomen; wo contrast material(s)","10","1",null,null,"5.54",null,null,"10",null,"NA","NA"],
    [6642,"6642","Carrier I","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93312","ECHO, transesophageal, heart, compl","10","1",null,null,"0",null,null,"10",null,"NA","NA"],
    [6643,"6643","Carrier I","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","62323","Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (ie, fluoroscopy or CT)","10","1",null,"0.19","8.1","216","1","9","1","NA","NA"],
    [6644,"6644","Carrier I","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","73220","MRI, upper extremity, other than joint;","11",null,"0.0909",null,"13.99",null,null,"11",null,"NA","NA"],
    [6645,"6645","Carrier I","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","73700","CT, lower extremity wo contrast","22",null,"0.0455",null,"24.34",null,null,"22",null,"NA","NA"],
    [6646,"6646","Carrier I","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","78815","Imaging PET/CT skul-thigh","47",null,"0.0213",null,"9.65",null,null,"47",null,"NA","NA"],
    [6647,"6647","Carrier I","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","73721","MRI, lower extremity any joint; wo contr","137",null,"0.0146",null,"6.32",null,null,"137",null,"NA","NA"],
    [6648,"6648","Carrier I","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","74177","CT abd & pelv w contrast","162",null,"0.0123",null,"4.16",null,null,"162",null,"NA","NA"],
    [6649,"6649","Carrier I","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","71260","DIAGNOSTIC CT THORAX W/CONTRAST","88",null,"0.0114",null,"4.72",null,null,"88",null,"NA","NA"],
    [6650,"6650","Carrier I","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","70553","MRI of brain and further sequences","180",null,"0.0056",null,"5.65",null,null,"180",null,"NA","NA"],
    [6651,"6651","Carrier I","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1002","Residential treatment, Substance Use Disorder","4","1",null,"19.11","42.93",null,"2","2",null,"NA","NA"],
    [6652,"6652","Carrier I","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1001","Residential treatment, Psychiatric","2","1",null,null,"6.84",null,null,"2",null,"NA","NA"],
    [6653,"6653","Carrier I","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","Room and board, Semi-Private, Psychiatric","1","1",null,null,"66.66",null,null,"1",null,"NA","NA"],
    [6654,"6654","Carrier I","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1002","Residential treatment, Substance Use Disorder","4","1",null,"19.11","42.93",null,"2","2",null,"NA","NA"],
    [6655,"6655","Carrier I","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1001","Residential treatment, Psychiatric","2","1",null,null,"6.84",null,null,"2",null,"NA","NA"],
    [6656,"6656","Carrier I","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","Room and board, Semi-Private, Psychiatric","1","1",null,null,"66.66",null,null,"1",null,"NA","NA"],
    [6657,"6657","Carrier I","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","9","1",null,null,"9.08",null,null,"9",null,"NA","NA"],
    [6658,"6658","Carrier I","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","9","1",null,null,"9.08",null,null,"9",null,"NA","NA"],
    [6659,"6659","Carrier I","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19350","Nipple/areola reconstruction","9","1",null,null,"36.39",null,null,"9",null,"NA","NA"],
    [6660,"6660","Carrier I","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","9","1",null,null,"9.08",null,null,"9",null,"NA","NA"],
    [6661,"6661","Carrier I","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours","8","1",null,"39.85","32.01",null,"1","7",null,"NA","NA"],
    [6662,"6662","Carrier I","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H2036","Alcohol and/or other drug treatment program, per diem","6","1",null,null,"29.68",null,null,"6",null,"NA","NA"],
    [6663,"6663","Carrier I","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","6","1",null,"13.53","10.53",null,"2","4",null,"NA","NA"],
    [6664,"6664","Carrier I","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19303","Mastectomy, simple, complete","6","1",null,null,"35.17",null,null,"6",null,"NA","NA"],
    [6665,"6665","Carrier I","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19318","Breast reduction","5","1",null,null,"28.3",null,null,"5",null,"NA","NA"],
    [6666,"6666","Carrier I","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71271","CT THORAX LW DOSE LNG CA SCR C-","3","0.6667",null,null,"0",null,null,"3",null,"NA","NA"],
    [6667,"6667","Carrier I","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","9","1",null,null,"9.08",null,null,"9",null,"NA","NA"],
    [6668,"6668","Carrier I","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","9","1",null,null,"9.08",null,null,"9",null,"NA","NA"],
    [6669,"6669","Carrier I","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19350","Nipple/areola reconstruction","9","1",null,null,"36.39",null,null,"9",null,"NA","NA"],
    [6670,"6670","Carrier I","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","9","1",null,null,"9.08",null,null,"9",null,"NA","NA"],
    [6671,"6671","Carrier I","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0035","Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours","8","1",null,"39.85","32.01",null,"1","7",null,"NA","NA"],
    [6672,"6672","Carrier I","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H2036","Alcohol and/or other drug treatment program, per diem","6","1",null,null,"29.68",null,null,"6",null,"NA","NA"],
    [6673,"6673","Carrier I","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","6","1",null,"13.53","10.53",null,"2","4",null,"NA","NA"],
    [6674,"6674","Carrier I","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19303","Mastectomy, simple, complete","6","1",null,null,"35.17",null,null,"6",null,"NA","NA"],
    [6675,"6675","Carrier I","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19318","Breast reduction","5","1",null,null,"28.3",null,null,"5",null,"NA","NA"],
    [6676,"6676","Carrier I","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70551","MRI of brain","2","1",null,null,"0",null,null,"2",null,"NA","NA"],
    [6677,"6677","Carrier I","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]","278","0.964",null,null,"1.68",null,null,"278",null,"NA","NA"],
    [6678,"6678","Carrier I","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","8","0.875",null,null,"3.2",null,null,"8",null,"NA","NA"],
    [6679,"6679","Carrier I","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","3","1",null,null,"0",null,null,"3",null,"NA","NA"],
    [6680,"6680","Carrier I","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0108","W/C Component-Accessory Nos","3","0.3333",null,null,"23.72",null,null,"3",null,"NA","NA"],
    [6681,"6681","Carrier I","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0739","Repair/svc DME non-oxygen eq","1","0",null,null,"0.09",null,null,"1",null,"NA","NA"],
    [6682,"6682","Carrier I","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","3","1",null,null,"0",null,null,"3",null,"NA","NA"],
    [6683,"6683","Carrier I","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0601","Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]","278","0.964",null,null,"1.68",null,null,"278",null,"NA","NA"],
    [6684,"6684","Carrier I","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","8","0.875",null,null,"3.2",null,null,"8",null,"NA","NA"],
    [6685,"6685","Carrier I","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0108","W/C Component-Accessory Nos","3","0.3333",null,null,"23.72",null,null,"3",null,"NA","NA"],
    [6686,"6686","Carrier I","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0739","Repair/svc DME non-oxygen eq","1","0",null,null,"0.09",null,null,"1",null,"NA","NA"],
    [6687,"6687","Carrier I","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","2","1",null,null,"35.69",null,null,"2",null,"NA","NA"],
    [6688,"6688","Carrier I","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4216","Sterile water/saline, 10 ml","1","0",null,null,"0.09",null,null,"1",null,"NA","NA"],
    [6689,"6689","Carrier I","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","2","1",null,null,"35.69",null,null,"2",null,"NA","NA"],
    [6690,"6690","Carrier I","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4216","Sterile water/saline, 10 ml","1","0",null,null,"0.09",null,null,"1",null,"NA","NA"],
    [6691,"6691","Carrier I","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","43","0.2326",null,"5.41","1.51",null,"4","39",null,"SEMAGLUTIDE","OZEMPIC, RYBELSUS"],
    [6692,"6692","Carrier I","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","36","0.8056",null,"1.32","66.59",null,"4","32",null,"CYCLOSPORINE (OPHTH)","CEQUA, CYCLOSPORINE, RESTASIS"],
    [6693,"6693","Carrier I","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","35","1",null,"5.24","39.93",null,"6","29",null,"ADALIMUMAB","HUMIRA"],
    [6694,"6694","Carrier I","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","31","0.5484",null,"29.41","116.08",null,"8","23",null,"HYDROCODONE-ACETAMINOPHEN","HYDROCODONE-ACETAMINOPHEN"],
    [6695,"6695","Carrier I","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","29","0.8276",null,"4.5","22.42",null,"11","18",null,"OXYCODONE HCL","OXYCODONE HCL, OXYCONTIN"],
    [6696,"6696","Carrier I","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","26","1",null,"6.8","31.85",null,"7","19",null,"RISANKIZUMAB-RZAA","SKYRIZI"],
    [6697,"6697","Carrier I","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","22","0.8182",null,"16.77","127.82",null,"1","21",null,"DUPILUMAB","DUPIXENT, DUPIXENT DUPILUMAB"],
    [6698,"6698","Carrier I","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","20","0",null,"5.18","12.71",null,"5","15",null,"SEMAGLUTIDE (WEIGHT MANAGEMENT)","WEGOVY"],
    [6699,"6699","Carrier I","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","19","0.2632",null,"13.81","36.55",null,"1","18",null,"TIRZEPATIDE","MOUNJARO"],
    [6700,"6700","Carrier I","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","14","1",null,"48.43","126.02",null,"3","11",null,"FREMANEZUMAB-VFRM","AJOVY"],
    [6701,"6701","Carrier I","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","35","1",null,"5.24","39.93",null,"6","29",null,"ADALIMUMAB","HUMIRA"],
    [6702,"6702","Carrier I","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","26","1",null,"6.8","31.85",null,"7","19",null,"RISANKIZUMAB-RZAA","SKYRIZI"],
    [6703,"6703","Carrier I","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","14","1",null,"48.43","126.02",null,"3","11",null,"FREMANEZUMAB-VFRM","AJOVY"],
    [6704,"6704","Carrier I","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,null,"18.19",null,"0","8",null,"LIFITEGRAST","XIIDRA"],
    [6705,"6705","Carrier I","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,null,"36.38",null,"0","7",null,"GUSELKUMAB","TREMFYA"],
    [6706,"6706","Carrier I","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","5","1",null,"1.82","17.05",null,"3","2",null,"HYDROMORPHONE HCL","HYDROMORPHONE HCL"],
    [6707,"6707","Carrier I","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","5","1",null,"1.77","39.93",null,"1","4",null,"RUXOLITINIB PHOSPHATE (TOPICAL)","OPZELURA"],
    [6708,"6708","Carrier I","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","4","1",null,null,"31.25",null,"0","4",null,"APREMILAST","OTEZLA"],
    [6709,"6709","Carrier I","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","4","1",null,null,"7.86",null,"0","4",null,"FEZOLINETANT","VEOZAH"],
    [6710,"6710","Carrier I","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","4","1",null,"3.58","39.14",null,"2","2",null,"ABEMACICLIB","VERZENIO"],
    [6711,"6711","Carrier I","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1","44.17",null,null,"1","0",null,"IVABRADINE HCL","CORLANOR"],
    [6712,"6712","Carrier I","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1","5.72",null,null,"1","0",null,"RIMEGEPANT SULFATE","NURTEC"],
    [6713,"6713","Carrier I","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1",null,"92.92",null,"0","1",null,"UPADACITINIB","RINVOQ ER"],
    [6714,"6714","Carrier I","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1","19.67",null,null,"1","0",null,"RIBOCICLIB SUCCINATE","KISQALI"],
    [6715,"6715","Carrier I","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1",null,"81.75",null,"0","1",null,"ERENUMAB-AOOE","AIMOVIG"],
    [6716,"6716","Carrier I","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1","15.68",null,null,"1","0",null,"ELAGOLIX SODIUM","ORILISSA"],
    [6717,"6717","Carrier I","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"0.5",null,"87.67",null,"0","2",null,"DUPILUMAB","DUPIXENT, DUPIXENT DUPILUMAB"],
    [6718,"6718","Carrier I","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"0.5","27.45",null,null,"1","0",null,"AXITINIB","INLYTA"],
    [6719,"6719","Carrier I","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"0.25","22.95",null,null,"1","0",null,"EVOLOCUMAB","REPATHA SURECLICK"],
    [6720,"6720","Carrier I","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"0.125",null,"283.82",null,"0","1",null,"RIFAXIMIN","XIFAXAN"],
    [6721,"6721","Carrier J","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","54","0.7778",null,"4.67","64.65",null,"6","48","11","NA","NA"],
    [6722,"6722","Carrier J","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96416","Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours), requiring use of a portable or implantable pump","36","0",null,"1","5.73",null,"20","16",null,"NA","NA"],
    [6723,"6723","Carrier J","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22842","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)","32","0.75",null,"1.2","64.05",null,"2","30","6","NA","NA"],
    [6724,"6724","Carrier J","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","32","0.7813",null,"29.65","67.06",null,"3","29","10","NA","NA"],
    [6725,"6725","Carrier J","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22633","Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar","28","0.8214",null,"22.26","75.23",null,"4","24","5","NA","NA"],
    [6726,"6726","Carrier J","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44204","Laparoscopy, surgical; colectomy, partial, with anastomosis","28","0",null,"0.63","6.3",null,"4","24",null,"NA","NA"],
    [6727,"6727","Carrier J","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44207","Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)","27","0",null,"2.43","5.85",null,"5","22",null,"NA","NA"],
    [6728,"6728","Carrier J","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","27","0.8519",null,null,"55.22",null,null,"27","4","NA","NA"],
    [6729,"6729","Carrier J","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);","26","0.0385",null,"0.76","4.83",null,"5","21",null,"NA","NA"],
    [6730,"6730","Carrier J","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22612","Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)","25","0.84",null,"0.1","46.46",null,"1","24","8","NA","NA"],
    [6731,"6731","Carrier J","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22552","Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2, each additional interspace (List separately in addition to code for separate procedure)","8","1",null,"0.74","102.13",null,"3","5",null,"NA","NA"],
    [6732,"6732","Carrier J","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33340","Percutaneous transcatheter closure of the left atrial appendage with endocardial implant, including fluoroscopy, transseptal puncture, catheter placement(s), left atrial angiography, left atrial appendage angiography, when performed, and radiological supervision and interpretation","7","1",null,"1.21","60.72",null,"1","6",null,"NA","NA"],
    [6733,"6733","Carrier J","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27447","Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)","7","1",null,null,"45.89",null,null,"7",null,"NA","NA"],
    [6734,"6734","Carrier J","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","47379","Unlisted laparoscopic procedure, liver","5","1",null,null,"82.33",null,null,"5",null,"NA","NA"],
    [6735,"6735","Carrier J","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22325","Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; lumbar","5","1",null,null,"21.26","480",null,"5","1","NA","NA"],
    [6736,"6736","Carrier J","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22843","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in addition to code for primary procedure)","5","1",null,null,"17.61",null,null,"5",null,"NA","NA"],
    [6737,"6737","Carrier J","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22848","Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures) other than sacrum (List separately in addition to code for primary procedure)","5","1",null,"0.1","33.79",null,"1","4",null,"NA","NA"],
    [6738,"6738","Carrier J","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","61867","Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative microelectrode recording; first array","3","1",null,null,"37.84",null,null,"3",null,"NA","NA"],
    [6739,"6739","Carrier J","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63285","Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical","3","1",null,null,"21.67",null,null,"3",null,"NA","NA"],
    [6740,"6740","Carrier J","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63052","Laminectomy, facetectomy, or foraminotomy with lumbar decompression of spinal cord, cauda equina and/or nerve root during posterior interbody arthrodesis, single segment","3","1",null,null,"100.03",null,null,"3","5","NA","NA"],
    [6741,"6741","Carrier J","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15734","Muscle, myocutaneous, or fasciocutaneous flap; trunk","3","1",null,null,"100.65",null,null,"3",null,"NA","NA"],
    [6742,"6742","Carrier J","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27487","Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component","3","1",null,null,"54.07",null,null,"3",null,"NA","NA"],
    [6743,"6743","Carrier J","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22632","Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; each additional interspace (List separately in addition to code for primary procedure)","1",null,"1",null,"115.39",null,null,"1",null,"NA","NA"],
    [6744,"6744","Carrier J","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43644","Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy (roux limb 150 cm or less)","1",null,"1",null,null,null,null,"1",null,"NA","NA"],
    [6745,"6745","Carrier J","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63267","Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar","1",null,"1",null,"115.39","192",null,"1","1","NA","NA"],
    [6746,"6746","Carrier J","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63081","Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, single segment","2",null,"0.5",null,"61.1","720",null,"2","2","NA","NA"],
    [6747,"6747","Carrier J","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63042","Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumbar","3",null,"0.3333",null,"45.11",null,null,"3",null,"NA","NA"],
    [6748,"6748","Carrier J","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22216","Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; each additional vertebral segment (List separately in addition to primary procedure)","3",null,"0.3333",null,"51.12","720",null,"3","2","NA","NA"],
    [6749,"6749","Carrier J","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22214","Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar","3",null,"0.3333",null,"57.08",null,null,"3",null,"NA","NA"],
    [6750,"6750","Carrier J","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22630","Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; lumbar","7",null,"0.2857",null,"54.87",null,null,"7",null,"NA","NA"],
    [6751,"6751","Carrier J","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22848","Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures) other than sacrum (List separately in addition to code for primary procedure)","5",null,"0.2","0.1","33.79",null,"1","4",null,"NA","NA"],
    [6752,"6752","Carrier J","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22325","Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; lumbar","5",null,"0.2",null,"21.26","480",null,"5","1","NA","NA"],
    [6753,"6753","Carrier J","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97530","Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","5468","0.6831",null,"24.91","29.84","908.8","8","5460","10","NA","NA"],
    [6754,"6754","Carrier J","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","5182","0.682",null,"18.09","29.51",null,"10","5172","6","NA","NA"],
    [6755,"6755","Carrier J","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97112","Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities","4521","0.6713",null,"35.49","29.66","931.2","6","4515","5","NA","NA"],
    [6756,"6756","Carrier J","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97140","Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes","4282","0.6747",null,"9.83","30.4",null,"8","4274","6","NA","NA"],
    [6757,"6757","Carrier J","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","ECHO, transthoracic w/doppler, complete","3435","0.9613",null,"0.2","3.88","320","2","3433","3","NA","NA"],
    [6758,"6758","Carrier J","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","Colonoscopy, flexible; with biopsy, single or multiple","2909","0.9636",null,"3.82","5.94","857.6","125","2784","15","NA","NA"],
    [6759,"6759","Carrier J","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","MRI, lower extremity any joint; wo contr","2831","0.8859",null,"1.13","8.13","444","2","2829","2","NA","NA"],
    [6760,"6760","Carrier J","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45378","Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","2599","0.9604",null,"4.38","7.1","884","117","2482","6","NA","NA"],
    [6761,"6761","Carrier J","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45385","Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","2481","0.973",null,"3.46","5.57","712.5","98","2383","16","NA","NA"],
    [6762,"6762","Carrier J","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74177","CT abd & pelv w contrast","2315","0.9525",null,"2.63","4.07","604.8","14","2301","5","NA","NA"],
    [6763,"6763","Carrier J","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70460","Contrast CAT scan of head/brain","30","1",null,null,"3.93",null,null,"30",null,"NA","NA"],
    [6764,"6764","Carrier J","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29898","Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive","24","1",null,"0.16","0.05",null,"1","23","3","NA","NA"],
    [6765,"6765","Carrier J","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93924","Physiologic Arterial Extremity","22","1",null,null,"0.76",null,null,"22",null,"NA","NA"],
    [6766,"6766","Carrier J","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63042","Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumbar","20","1",null,"0.15","74.99",null,"3","17","2","NA","NA"],
    [6767,"6767","Carrier J","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","38222","Diagnostic bone marrow; biopsy(ies) and aspiration(s)","20","1",null,"2.38","18.46",null,"3","17",null,"NA","NA"],
    [6768,"6768","Carrier J","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43250","Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","20","1",null,null,"1.41",null,null,"20",null,"NA","NA"],
    [6769,"6769","Carrier J","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43242","Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examined distal to the anastomosis)","19","1",null,"0.02","7.52",null,"3","16",null,"NA","NA"],
    [6770,"6770","Carrier J","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43254","Esophagogastroduodenoscopy, flexible, transoral; with endoscopic mucosal resection","19","1",null,"0.01","8.25",null,"1","18",null,"NA","NA"],
    [6771,"6771","Carrier J","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72196","MRI, pelvis; with contrast material(s)","18","1",null,null,"7.36",null,null,"18",null,"NA","NA"],
    [6772,"6772","Carrier J","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","76391","MR elastography","18","1",null,null,"0.01",null,null,"18",null,"NA","NA"],
    [6773,"6773","Carrier J","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","72295","Discography, lumbar, radiological supervision and interpretation","8",null,"0.25","0.26","100.09",null,"1","7",null,"NA","NA"],
    [6774,"6774","Carrier J","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","29873","Arthroscopy, knee, surgical; with lateral release","4",null,"0.25",null,"9.25",null,null,"4",null,"NA","NA"],
    [6775,"6775","Carrier J","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","29825","Arthroscopy, shoulder, surgical; with lysis and resection of adhesions, with or without manipulation","5",null,"0.2",null,"143.81",null,null,"5",null,"NA","NA"],
    [6776,"6776","Carrier J","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","62290","Injection procedure for discography, each level; lumbar","11",null,"0.1818","0.26","77",null,"1","10",null,"NA","NA"],
    [6777,"6777","Carrier J","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63685","Insertion or replacement of spinal neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver","13",null,"0.1538",null,"21.72",null,null,"13",null,"NA","NA"],
    [6778,"6778","Carrier J","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","28297","Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with first metatarsal and medial cuneiform joint arthrodesis, any method","8",null,"0.125",null,"8.99",null,null,"8",null,"NA","NA"],
    [6779,"6779","Carrier J","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63045","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; cervical","13",null,"0.0769",null,"75.42",null,null,"13","4","NA","NA"],
    [6780,"6780","Carrier J","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63650","Percutaneous implantation of neurostimulator electrode array, epidural","30",null,"0.0667",null,"31.27",null,null,"30",null,"NA","NA"],
    [6781,"6781","Carrier J","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","G0260","Injection Procedure For Sacroiliac Joint; Provision Of Anesthetic, Ste","52",null,"0.0577",null,"58.34",null,null,"52","21","NA","NA"],
    [6782,"6782","Carrier J","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64405","Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve","123",null,"0.0569","1.42","58.43",null,"1","122",null,"NA","NA"],
    [6783,"6783","Carrier J","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1002","Residential treatment, Substance Use Disorder","110","0.9727",null,"14.43","36.12",null,"3","107",null,"NA","NA"],
    [6784,"6784","Carrier J","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1001","Residential treatment, Psychiatric","24","0.625",null,"16.99","29.22",null,"3","21","3","NA","NA"],
    [6785,"6785","Carrier J","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","Room and board, Semi-Private, Psychiatric","17","0.9412",null,null,"84.53",null,null,"17",null,"NA","NA"],
    [6786,"6786","Carrier J","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","54125","Amputation of penis; complete","3","1",null,null,"85.26",null,null,"3",null,"NA","NA"],
    [6787,"6787","Carrier J","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","56805","Clitoroplasty for intersex state","3","1",null,null,"85.26",null,null,"3",null,"NA","NA"],
    [6788,"6788","Carrier J","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","57335","Vaginoplasty for intersex state","3","1",null,null,"85.26",null,null,"3",null,"NA","NA"],
    [6789,"6789","Carrier J","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","53430","Urethroplasty, reconstruction of female urethra","3","1",null,null,"85.26",null,null,"3",null,"NA","NA"],
    [6790,"6790","Carrier J","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","54520","Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach","3","1",null,null,"85.26",null,null,"3",null,"NA","NA"],
    [6791,"6791","Carrier J","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","55175","Scrotoplasty; simple","2","1",null,null,"84.38",null,null,"2",null,"NA","NA"],
    [6792,"6792","Carrier J","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99223","Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.","1","0",null,null,"0.09",null,null,"1",null,"NA","NA"],
    [6793,"6793","Carrier J","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15750","Flap; neurovascular pedicle","1","0",null,null,"1.63",null,null,"1",null,"NA","NA"],
    [6794,"6794","Carrier J","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0019","Alcohol And/Or Drug Services","1","0",null,null,"0",null,null,"1",null,"NA","NA"],
    [6795,"6795","Carrier J","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64400","Injection(s), anesthetic agent(s) and/or steroid; trigeminal nerve, each branch (ie, ophthalmic, maxillary, mandibular)","1","0",null,null,"10.89",null,null,"1",null,"NA","NA"],
    [6796,"6796","Carrier J","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64505","Injection, anesthetic agent; sphenopalatine ganglion","1","0",null,null,"10.89",null,null,"1",null,"NA","NA"],
    [6797,"6797","Carrier J","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97605","Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (DME), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area less than or equal to 50 square centimeters","1","1",null,null,"22.43",null,null,"1",null,"NA","NA"],
    [6798,"6798","Carrier J","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","55970","Intersex surgery; male to female","1","1",null,null,"23.1",null,null,"1",null,"NA","NA"],
    [6799,"6799","Carrier J","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0009","Alcohol And/Or Drug Services","1","0",null,null,"3.73",null,null,"1",null,"NA","NA"],
    [6800,"6800","Carrier J","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","31899","Unlisted procedure, trachea, bronchi","1","1",null,null,"23.1",null,null,"1",null,"NA","NA"],
    [6801,"6801","Carrier J","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","14302","Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof (List separately in addition to code for primary procedure)","1","0",null,null,"1.63",null,null,"1",null,"NA","NA"],
    [6802,"6802","Carrier J","2023","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","14301","Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm","1","0",null,null,"1.63",null,null,"1",null,"NA","NA"],
    [6803,"6803","Carrier J","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","54125","Amputation of penis; complete","3","1",null,null,"85.26",null,null,"3",null,"NA","NA"],
    [6804,"6804","Carrier J","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","56805","Clitoroplasty for intersex state","3","1",null,null,"85.26",null,null,"3",null,"NA","NA"],
    [6805,"6805","Carrier J","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","57335","Vaginoplasty for intersex state","3","1",null,null,"85.26",null,null,"3",null,"NA","NA"],
    [6806,"6806","Carrier J","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","53430","Urethroplasty, reconstruction of female urethra","3","1",null,null,"85.26",null,null,"3",null,"NA","NA"],
    [6807,"6807","Carrier J","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","54520","Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach","3","1",null,null,"85.26",null,null,"3",null,"NA","NA"],
    [6808,"6808","Carrier J","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","55175","Scrotoplasty; simple","2","1",null,null,"84.38",null,null,"2",null,"NA","NA"],
    [6809,"6809","Carrier J","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97605","Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (DME), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area less than or equal to 50 square centimeters","1","1",null,null,"22.43",null,null,"1",null,"NA","NA"],
    [6810,"6810","Carrier J","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","55970","Intersex surgery; male to female","1","1",null,null,"23.1",null,null,"1",null,"NA","NA"],
    [6811,"6811","Carrier J","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","31899","Unlisted procedure, trachea, bronchi","1","1",null,null,"23.1",null,null,"1",null,"NA","NA"],
    [6812,"6812","Carrier J","2023","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1002","Residential treatment, Substance Use Disorder","110","0.9727",null,"14.43","36.12",null,"3","107",null,"NA","NA"],
    [6813,"6813","Carrier J","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71271","CT THORAX LW DOSE LNG CA SCR C-","304","0.9539",null,null,"3.13",null,null,"304",null,"NA","NA"],
    [6814,"6814","Carrier J","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","92507","Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual","249","0.743",null,null,"41.89",null,null,"249",null,"NA","NA"],
    [6815,"6815","Carrier J","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","H0015","Alcohol And/Or Drug Services","223","1",null,"2.77","13.02",null,"9","214",null,"NA","NA"],
    [6816,"6816","Carrier J","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","H0035","Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours","161","0.8758",null,"22.5","38.85",null,"2","159",null,"NA","NA"],
    [6817,"6817","Carrier J","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","136","0.9044",null,"10.4","24.63",null,"9","127",null,"NA","NA"],
    [6818,"6818","Carrier J","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","132","0.9015",null,"11.47","24.57",null,"8","124",null,"NA","NA"],
    [6819,"6819","Carrier J","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","101","0.8911",null,"10.4","23.41",null,"9","92",null,"NA","NA"],
    [6820,"6820","Carrier J","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","H2036","Alcohol and/or other drug treatment program, per diem","81","0.9383",null,null,"34.8",null,null,"81",null,"NA","NA"],
    [6821,"6821","Carrier J","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19350","Nipple/areola reconstruction","45","0.9556",null,"16.64","37.63",null,"1","44",null,"NA","NA"],
    [6822,"6822","Carrier J","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19303","Mastectomy, simple, complete","43","0.9535",null,"16.64","39.84",null,"1","42",null,"NA","NA"],
    [6823,"6823","Carrier J","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","223","1",null,"2.77","13.02",null,"9","214",null,"NA","NA"],
    [6824,"6824","Carrier J","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70551","MRI of brain","30","1",null,null,"0.62",null,null,"30",null,"NA","NA"],
    [6825,"6825","Carrier J","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70553","MRI of brain and further sequences","12","1",null,null,"4.52",null,null,"12",null,"NA","NA"],
    [6826,"6826","Carrier J","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81229","Cytogenomic constitutional (genome-wide) microarray analysis; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants for chromosomal abnormalities","10","1",null,"3.22","24.02",null,"1","9",null,"NA","NA"],
    [6827,"6827","Carrier J","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81243","FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability [XLID]) gene analysis; evaluation to detect abnormal (eg, expanded) alleles","10","1",null,"3.22","21.29",null,"1","9",null,"NA","NA"],
    [6828,"6828","Carrier J","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","17380","Electrolysis epilation, each 30 minutes","6","1",null,null,"46.88",null,null,"6",null,"NA","NA"],
    [6829,"6829","Carrier J","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19325","Breast augmentation with implant","5","1",null,null,"41.11",null,null,"5",null,"NA","NA"],
    [6830,"6830","Carrier J","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","41899","Unlisted procedure, dentoalveolar structures","4","1",null,"2.7","49.17",null,"1","3",null,"NA","NA"],
    [6831,"6831","Carrier J","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70450","CT, head or brain wo contrast","3","1",null,null,"1.02",null,null,"3",null,"NA","NA"],
    [6832,"6832","Carrier J","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","78608","Brain imaging, PET, metabolic eval","3","1",null,null,"16.21",null,null,"3",null,"NA","NA"],
    [6833,"6833","Carrier J","2023","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","78608","Brain imaging, PET, metabolic eval","3",null,"0.3333",null,"16.21",null,null,"3",null,"NA","NA"],
    [6834,"6834","Carrier J","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]","4242","0.943",null,null,"2.52","252",null,"4242","2","NA","NA"],
    [6835,"6835","Carrier J","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","204","0.9755",null,null,"1.63",null,null,"204",null,"NA","NA"],
    [6836,"6836","Carrier J","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","95","0.9263",null,null,"2.93","384",null,"95","1","NA","NA"],
    [6837,"6837","Carrier J","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0108","W/C Component-Accessory Nos","26","0.3846",null,null,"68.58",null,null,"26",null,"NA","NA"],
    [6838,"6838","Carrier J","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2402","Negative pressure wound therapy electrical pump, stationary or portable","26","0.2308",null,"45.76","102.4",null,"2","24",null,"NA","NA"],
    [6839,"6839","Carrier J","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0739","Repair/svc DME non-oxygen eq","14","0",null,"0.09","5.47",null,"1","13",null,"NA","NA"],
    [6840,"6840","Carrier J","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0748","Elec Osteogen Stim Spinal","12","0.4167",null,null,"86.02",null,null,"12",null,"NA","NA"],
    [6841,"6841","Carrier J","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0861","PWC gp 3 std mult pow opt s/b","7","1",null,null,"32.2",null,null,"7",null,"NA","NA"],
    [6842,"6842","Carrier J","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0005","Ultralightweight Wheelchair","6","0",null,null,"5.83",null,null,"6",null,"NA","NA"],
    [6843,"6843","Carrier J","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0040","Adjustable Angle Footplate","6","0",null,null,"29.68",null,null,"6",null,"NA","NA"],
    [6844,"6844","Carrier J","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2620","WC planar back cush wd <22in","6","0",null,null,"3.91",null,null,"6",null,"NA","NA"],
    [6845,"6845","Carrier J","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0861","PWC gp 3 std mult pow opt s/b","7","1",null,null,"32.2",null,null,"7",null,"NA","NA"],
    [6846,"6846","Carrier J","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","204","0.9755",null,null,"1.63",null,null,"204",null,"NA","NA"],
    [6847,"6847","Carrier J","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0601","Continuous airway pressure (CPAP) device [may be used for either CPAP or APAP]","4242","0.943",null,null,"2.52","252",null,"4242","2","NA","NA"],
    [6848,"6848","Carrier J","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","95","0.9263",null,null,"2.93","384",null,"95","1","NA","NA"],
    [6849,"6849","Carrier J","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0748","Elec Osteogen Stim Spinal","12","0.4167",null,null,"86.02",null,null,"12",null,"NA","NA"],
    [6850,"6850","Carrier J","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0108","W/C Component-Accessory Nos","26","0.3846",null,null,"68.58",null,null,"26",null,"NA","NA"],
    [6851,"6851","Carrier J","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2402","Negative pressure wound therapy electrical pump, stationary or portable","26","0.2308",null,"45.76","102.4",null,"2","24",null,"NA","NA"],
    [6852,"6852","Carrier J","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0739","Repair/svc DME non-oxygen eq","14","0",null,"0.09","5.47",null,"1","13",null,"NA","NA"],
    [6853,"6853","Carrier J","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0005","Ultralightweight Wheelchair","6","0",null,null,"5.83",null,null,"6",null,"NA","NA"],
    [6854,"6854","Carrier J","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0040","Adjustable Angle Footplate","6","0",null,null,"29.68",null,null,"6",null,"NA","NA"],
    [6855,"6855","Carrier J","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2620","WC planar back cush wd <22in","6","0",null,null,"3.91",null,null,"6",null,"NA","NA"],
    [6856,"6856","Carrier J","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","16","0.9375",null,null,"9.3",null,null,"16",null,"NA","NA"],
    [6857,"6857","Carrier J","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4216","Sterile water/saline, 10 ml","14","0",null,"1.1","2.36",null,"3","11",null,"NA","NA"],
    [6858,"6858","Carrier J","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A5513","For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","2","0",null,null,"6.14",null,null,"2",null,"NA","NA"],
    [6859,"6859","Carrier J","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A5500","Diab Shoe For Density Insert","2","0",null,null,"6.14",null,null,"2",null,"NA","NA"],
    [6860,"6860","Carrier J","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4217","Sterile water/saline, 500 ml","1","0",null,"0.09",null,null,"1",null,null,"NA","NA"],
    [6861,"6861","Carrier J","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9276","Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply","1","0",null,null,"29.1",null,null,"1",null,"NA","NA"],
    [6862,"6862","Carrier J","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","16","0.9375",null,null,"9.3",null,null,"16",null,"NA","NA"],
    [6863,"6863","Carrier J","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4216","Sterile water/saline, 10 ml","14","0",null,"1.1","2.36",null,"3","11",null,"NA","NA"],
    [6864,"6864","Carrier J","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A5513","For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","2","0",null,null,"6.14",null,null,"2",null,"NA","NA"],
    [6865,"6865","Carrier J","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A5500","Diab Shoe For Density Insert","2","0",null,null,"6.14",null,null,"2",null,"NA","NA"],
    [6866,"6866","Carrier J","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4217","Sterile water/saline, 500 ml","1","0",null,"0.09",null,null,"1",null,null,"NA","NA"],
    [6867,"6867","Carrier J","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9276","Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply","1","0",null,null,"29.1",null,null,"1",null,"NA","NA"],
    [6868,"6868","Carrier J","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","769","0.3121",null,"22.04","43.29",null,"104","665",null,"SEMAGLUTIDE","OZEMPIC, RYBELSUS"],
    [6869,"6869","Carrier J","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","515","0.9359",null,"8.72","46.22",null,"128","387",null,"ADALIMUMAB","HUMIRA"],
    [6870,"6870","Carrier J","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","506","0.332",null,"15.03","37.9",null,"70","436",null,"TIRZEPATIDE","MOUNJARO"],
    [6871,"6871","Carrier J","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","356","0.6854",null,"15.77","67.87",null,"112","244",null,"HYDROCODONE-ACETAMINOPHEN","HYDROCODONE-ACETAMINOPHEN"],
    [6872,"6872","Carrier J","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","335","0.006",null,"6.03","14.93",null,"33","302",null,"SEMAGLUTIDE (WEIGHT MANAGEMENT)","WEGOVY"],
    [6873,"6873","Carrier J","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","325","0.8554",null,"9.08","40.39",null,"36","289",null,"CYCLOSPORINE (OPHTH)","CEQUA, CYCLOSPORINE, RESTASIS, VEVYE"],
    [6874,"6874","Carrier J","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","303","0.8482",null,"48.93","77.6",null,"63","240",null,"DUPILUMAB","DUPIXENT, DUPIXENT DUPILUMAB"],
    [6875,"6875","Carrier J","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","289","0.7163",null,"13.68","47.47",null,"111","178",null,"OXYCODONE HCL","OXYCODONE HCL, OXYCONTIN"],
    [6876,"6876","Carrier J","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","222","0.2928",null,"15.16","86.28",null,"49","173",null,"RIFAXIMIN","XIFAXAN"],
    [6877,"6877","Carrier J","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","218","0.867",null,"42.99","90.41",null,"83","135",null,"GALCANEZUMAB-GNLM","EMGALITY"],
    [6878,"6878","Carrier J","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","28","1",null,"25.06","33.74",null,"9","19",null,"ABATACEPT","ORENCIA"],
    [6879,"6879","Carrier J","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","24","1",null,"3.53","35.41",null,"10","14",null,"LEVALBUTEROL TARTRATE","LEVALBUTEROL TARTRATE, XOPENEX"],
    [6880,"6880","Carrier J","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","24","1",null,"10.77","54.22",null,"6","18",null,"LISDEXAMFETAMINE DIMESYLATE","LISDEXAMFETAMINE DIMESYLATE, VYVANSE"],
    [6881,"6881","Carrier J","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","12","1",null,"8.41","86.97",null,"3","9",null,"NALOXEGOL OXALATE","MOVANTIK"],
    [6882,"6882","Carrier J","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","10","1",null,"2.31","13.82",null,"3","7",null,"FLUOXETINE HCL","FLUOXETINE HCL"],
    [6883,"6883","Carrier J","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,"3.76","275.74",null,"4","4",null,"ELAGOLIX SODIUM","ORILISSA"],
    [6884,"6884","Carrier J","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,"8.12","9.21",null,"6","2",null,"CARBIDOPA-LEVODOPA","RYTARY"],
    [6885,"6885","Carrier J","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,"2.55","1.52",null,"6","1",null,"ACALABRUTINIB MALEATE","CALQUENCE"],
    [6886,"6886","Carrier J","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,"7.01","1.26",null,"2","5",null,"BIMEKIZUMAB-BKZX","BIMZELX"],
    [6887,"6887","Carrier J","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,"1.46","7.45",null,"1","6",null,"CONTINUOUS GLUCOSE SYSTEM SENSOR","DEXCOM, FREESTYLE LIBRE"],
    [6888,"6888","Carrier J","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1","4.05",null,null,"1","0",null,"LUMATEPERONE TOSYLATE","CAPLYTA"],
    [6889,"6889","Carrier J","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1","30.07",null,null,"1","0",null,"METYROSINE","METYROSINE"],
    [6890,"6890","Carrier J","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1",null,"238.58",null,"0","1",null,"SARILUMAB","KEVZARA"],
    [6891,"6891","Carrier J","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1","13.36",null,null,"1","0",null,"CANNABIDIOL","EPIDIOLEX"],
    [6892,"6892","Carrier J","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1","1.79",null,null,"1","0",null,"GOLIMUMAB","SIMPONI"],
    [6893,"6893","Carrier J","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1",null,"160.78",null,"0","1",null,"RITLECITINIB TOSYLATE","LITFULO"],
    [6894,"6894","Carrier J","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"0.6667","9.45",null,null,"2","0",null,"LENVATINIB MESYLATE","LENVIMA"],
    [6895,"6895","Carrier J","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"0.6667","2.3","280.94",null,"1","1",null,"ABEMACICLIB","VERZENIO"],
    [6896,"6896","Carrier J","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3",null,"0.6","24.45","165.45",null,"2","1",null,"RISANKIZUMAB-RZAA (CROHN'S)","SKYRIZI"],
    [6897,"6897","Carrier J","2023","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"0.5",null,"59.96",null,"0","2",null,"DIROXIMEL FUMARATE","VUMERITY"],
    [6898,"6898","Carrier L","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43775","LAPS GSTRC RSTRICTIV PX LONGITUDINAL GASTRECTOMY","5","1",null,null,"35.9",null,"0","5",null,"NA","NA"],
    [6899,"6899","Carrier L","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY","5","1",null,"20.3","62.3",null,"3","2",null,"NA","NA"],
    [6900,"6900","Carrier L","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","55866","LAPS SURG PRST8ECT RPBIC RAD W/NRV SPARING ROBOT","3","0.6667",null,null,"87.7",null,"0","3",null,"NA","NA"],
    [6901,"6901","Carrier L","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44145","COLECTOMY PRTL W/COLOPROCTOSTOMY","2","1",null,"19.9","40.5",null,"1","1",null,"NA","NA"],
    [6902,"6902","Carrier L","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","49255","OMNTC EPIPLOECTOMY RESCJ OMENTUM SPX","2","1",null,"19.9","40.5",null,"1","1",null,"NA","NA"],
    [6903,"6903","Carrier L","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58720","SALPINGO-OOPHORECTOMY COMPL/PRTL UNI/BI SPX","2","1",null,null,"40.7",null,"0","2",null,"NA","NA"],
    [6904,"6904","Carrier L","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99223","1ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES","2","1",null,null,"103.1",null,"0","2",null,"NA","NA"],
    [6905,"6905","Carrier L","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","11043","DEBRIDEMENT MUSCLE &/FASCIA 1ST 20 SQ CM/<","1","1",null,"40.5",null,null,"1","0",null,"NA","NA"],
    [6906,"6906","Carrier L","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","11046","DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM","1","1",null,"40.5",null,null,"1","0",null,"NA","NA"],
    [6907,"6907","Carrier L","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","14301","ADJNT TIS TRNSFR/REARGMT ANY AREA 30.1-60 SQ CM","1","1",null,null,"35.9",null,"0","5",null,"NA","NA"],
    [6908,"6908","Carrier L","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43775","LAPS GSTRC RSTRICTIV PX LONGITUDINAL GASTRECTOMY","5","1",null,"20.3","62.3",null,"3","2",null,"NA","NA"],
    [6909,"6909","Carrier L","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58150","TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY","5","1",null,"19.9","40.5",null,"1","1",null,"NA","NA"],
    [6910,"6910","Carrier L","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44145","COLECTOMY PRTL W/COLOPROCTOSTOMY","2","1",null,"19.9","40.5",null,"1","1",null,"NA","NA"],
    [6911,"6911","Carrier L","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","49255","OMNTC EPIPLOECTOMY RESCJ OMENTUM SPX","2","1",null,null,"40.7",null,"0","2",null,"NA","NA"],
    [6912,"6912","Carrier L","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58720","SALPINGO-OOPHORECTOMY COMPL/PRTL UNI/BI SPX","2","1",null,null,"103.1",null,"0","2",null,"NA","NA"],
    [6913,"6913","Carrier L","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99223","1ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES","2","1",null,"40.5",null,null,"1","0",null,"NA","NA"],
    [6914,"6914","Carrier L","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","11043","DEBRIDEMENT MUSCLE &/FASCIA 1ST 20 SQ CM/<","1","1",null,"40.5",null,null,"1","0",null,"NA","NA"],
    [6915,"6915","Carrier L","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","11046","DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM","1","1",null,null,"3.5",null,"0","1",null,"NA","NA"],
    [6916,"6916","Carrier L","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","14301","ADJNT TIS TRNSFR/REARGMT ANY AREA 30.1-60 SQ CM","1","1",null,null,"3.5",null,"0","1",null,"NA","NA"],
    [6917,"6917","Carrier L","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15756","FREE MUSCLE/MYOCUTANEOUS FLAP W/MVASC ANAST","1","1",null,null,null,null,null,null,null,"NA","NA"],
    [6918,"6918","Carrier L","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21085","IMPRESSION & PREPARATION ORAL SURGICAL SPLINT","1",null,null,null,"68",null,"0","1",null,"NA","NA"],
    [6919,"6919","Carrier L","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21196","RCNSTJ MNDBLR RAMI&/BDY SGTL SPLT W/INT RGD FI","1",null,null,null,"68",null,"0","1",null,"NA","NA"],
    [6920,"6920","Carrier L","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","26210","EXCISION/CURETTAGE CYST/TUMOR PHALANX FINGER","1",null,null,"50.2",null,null,"1","0",null,"NA","NA"],
    [6921,"6921","Carrier L","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","32555","THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING","1",null,null,"46",null,null,"1","0",null,"NA","NA"],
    [6922,"6922","Carrier L","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","55970","INTERSEX SURG MALE FEMALE","1",null,"1",null,"139.4",null,"0","1",null,"NA","NA"],
    [6923,"6923","Carrier L","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","61885","INSJ/RPLCMT CRANIAL NEUROSTIM PULSE GENERATOR","1",null,null,null,"40.6",null,"0","1",null,"NA","NA"],
    [6924,"6924","Carrier L","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64568","OPEN IMPLANTATION CRANIAL NERVE NEA & PULSE GEN","1",null,null,null,"40.6",null,"0","1",null,"NA","NA"],
    [6925,"6925","Carrier L","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","95976","ELEC ALYS IMPLT SMPL CN NPGT PRGRMG","1",null,null,null,"40.6",null,"0","1",null,"NA","NA"],
    [6926,"6926","Carrier L","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","95977","ELEC ALYS IMPLT CPLX CN NPGT PRGRMG","1",null,null,null,"40.6",null,"0","1",null,"NA","NA"],
    [6927,"6927","Carrier L","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","C1767","GENERATOR NEUROSTIMULATOR NONRECHARGEABLE","1",null,null,null,"40.6",null,"0","1",null,"NA","NA"],
    [6928,"6928","Carrier L","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","81479","Unlisted molecular pathology procedure","156","0.8846",null,null,"20.6",null,"0","156",null,"NA","NA"],
    [6929,"6929","Carrier L","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","Colonoscopy, flexible; with biopsy, single or multiple","144","0.9167",null,"0.1","8.4",null,"1","143",null,"NA","NA"],
    [6930,"6930","Carrier L","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45385","Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","120","0.9083",null,"0.1","9.1",null,"1","119",null,"NA","NA"],
    [6931,"6931","Carrier L","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45378","Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","113","0.9292",null,"0.1","8",null,"2","111",null,"NA","NA"],
    [6932,"6932","Carrier L","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95810","Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","89","0.6404",null,"17.8","47.3",null,"4","85",null,"NA","NA"],
    [6933,"6933","Carrier L","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","81420","Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21","67","0.9552",null,null,"23.9",null,"0","67",null,"NA","NA"],
    [6934,"6934","Carrier L","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95811","POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND","61","0.6557",null,"24.5","48.4",null,"3","58",null,"NA","NA"],
    [6935,"6935","Carrier L","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","G0121","Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk","57","0.8596",null,null,"11.9",null,"0","57",null,"NA","NA"],
    [6936,"6936","Carrier L","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43239","Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple","51","1",null,null,"2",null,"0","51",null,"NA","NA"],
    [6937,"6937","Carrier L","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43235","Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","49","1",null,null,"2.6",null,"0","49",null,"NA","NA"],
    [6938,"6938","Carrier L","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43239","Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple","51","1",null,null,"2",null,"0","51",null,"NA","NA"],
    [6939,"6939","Carrier L","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43235","Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","49","1",null,null,"2.6",null,"0","49",null,"NA","NA"],
    [6940,"6940","Carrier L","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","87799","IADNA NOS QUANTIFICATION EACH ORGANISM","31","1",null,null,"21.8",null,"0","31",null,"NA","NA"],
    [6941,"6941","Carrier L","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81374","HLA I LOW RESOLUTION ONE ANTIGEN EQUIVALENT EACH","29","1",null,null,"2",null,"0","29",null,"NA","NA"],
    [6942,"6942","Carrier L","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58558","HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C","27","1",null,"0.2","4.5",null,"1","26",null,"NA","NA"],
    [6943,"6943","Carrier L","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81256","HFE HEMOCHROMATOSIS GENE ANAL COMMON VARIANTS","21","1",null,null,"15.3",null,"0","21",null,"NA","NA"],
    [6944,"6944","Carrier L","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","52356","CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT","20","1",null,"0.1","2",null,"5","15",null,"NA","NA"],
    [6945,"6945","Carrier L","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43249","EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM","18","1",null,null,"0.2",null,"0","18",null,"NA","NA"],
    [6946,"6946","Carrier L","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93656","COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION","17","1",null,"7.7","61.4",null,"4","13",null,"NA","NA"],
    [6947,"6947","Carrier L","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","45390","COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION","13","1",null,null,"6.8",null,"0","13",null,"NA","NA"],
    [6948,"6948","Carrier L","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","95810","Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","89",null,"0.01","17.8","47.3",null,"4","85",null,"NA","NA"],
    [6949,"6949","Carrier L","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","95811","POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND","61",null,null,"24.5","48.4",null,"3","58",null,"NA","NA"],
    [6950,"6950","Carrier L","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","81479","Unlisted molecular pathology procedure","156",null,null,null,"20.6",null,"0","156",null,"NA","NA"],
    [6951,"6951","Carrier L","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","36475","ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN","38",null,null,null,"64.5",null,"0","38",null,"NA","NA"],
    [6952,"6952","Carrier L","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","45380","Colonoscopy, flexible; with biopsy, single or multiple","144",null,null,"0.1","8.4",null,"1","143",null,"NA","NA"],
    [6953,"6953","Carrier L","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","45385","Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","120",null,null,"0.1","9.1",null,"1","119",null,"NA","NA"],
    [6954,"6954","Carrier L","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","31267","NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS","22",null,"0.0004",null,"76.6",null,"0","22",null,"NA","NA"],
    [6955,"6955","Carrier L","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","30465","REPAIR NASAL VESTIBULAR STENOSIS","12",null,"0.08",null,"116.3",null,"0","12",null,"NA","NA"],
    [6956,"6956","Carrier L","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","31256","NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY","21",null,null,null,"89.9",null,"0","21",null,"NA","NA"],
    [6957,"6957","Carrier L","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","G0121","Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk","57",null,null,null,"11.9",null,"0","57",null,"NA","NA"],
    [6958,"6958","Carrier L","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1399","DURABLE MEDICAL EQUIPMENT MISCELLANEOUS","13","0",null,null,"46.7",null,"0","13",null,"NA","NA"],
    [6959,"6959","Carrier L","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1028","WC ACCSS MANL SWINGAWAY OTH CNTRL INTRFCE/PSTN","11","0.4545",null,"40.7","108.4",null,"2","9",null,"NA","NA"],
    [6960,"6960","Carrier L","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0108","OTHER ACCESSORIES","5","0",null,null,"98",null,"0","5",null,"NA","NA"],
    [6961,"6961","Carrier L","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0955","WC ACSS HEADREST CUSHNED FIX MOUNT HARDWARE EA","4","0.5",null,"40.7","108.4",null,"1","3",null,"NA","NA"],
    [6962,"6962","Carrier L","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0956","WC ACSS LAT TRNK/HIP SUPP FIX MOUNT HARDWARE EA","4","0.5",null,null,"105.7",null,"0","4",null,"NA","NA"],
    [6963,"6963","Carrier L","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0978","WHLCHAIR ACSS PSTN BELT/SFTY BELT/PELV STRAP EA","4","0.25",null,"40.7","100.3",null,"1","3",null,"NA","NA"],
    [6964,"6964","Carrier L","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0562","HUMDIFIR HEATED USED W/POS ARWAY PRESSURE DEVICE","3","0.6667",null,null,"36.3",null,"0","3",null,"NA","NA"],
    [6965,"6965","Carrier L","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0953","WHEELCHAIR AC LAT THIGH/KNEE SUPP ANY TYPE EA","3","0",null,null,"97.7",null,"0","3",null,"NA","NA"],
    [6966,"6966","Carrier L","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0960","WC ACSS SHLDR HRNSS/STRAPS/CHST STRAP W/TYPE MOU","3","0.6667",null,"40.7","105.7",null,"1","2",null,"NA","NA"],
    [6967,"6967","Carrier L","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2402","NEG PRESS WOUND THERAPY ELEC PUMP STATION/PRTBLE","3","0.6667",null,null,"46",null,"0","3",null,"NA","NA"],
    [6968,"6968","Carrier L","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0040","ADJUSTABLE ANGLE FOOTPLATE EACH","3","0.6667",null,"40.7","105.7",null,"1","2",null,"NA","NA"],
    [6969,"6969","Carrier L","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S1040","CRANIAL REMOLDING ORTHOTIC PED RIGID CUSTOM FAB","3","1",null,null,"39.5",null,"0","3",null,"NA","NA"],
    [6970,"6970","Carrier L","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S1040","CRANIAL REMOLDING ORTHOTIC PED RIGID CUSTOM FAB","3","1",null,null,"39.5",null,"0","3",null,"NA","NA"],
    [6971,"6971","Carrier L","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0471","RAD BACKUP NON INV INTRFC NASAL/FACIAL MASK","2","1",null,null,"33.6",null,"0","2",null,"NA","NA"],
    [6972,"6972","Carrier L","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0486","ORL DEVC/APPL RDUC UP AIRWAY COLLAPSIBILITY CSTM","2","1",null,null,"15.3",null,"0","2",null,"NA","NA"],
    [6973,"6973","Carrier L","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L1852","KNEE ORTHOSIS DOUBLE UPRIGHT THIGH AND CALF","2","1",null,null,"43.1",null,"0","2",null,"NA","NA"],
    [6974,"6974","Carrier L","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5301","BELOW KNEE MOLD SOCKET SHIN SACH FT ENDOSKEL SYS","2","1",null,null,"69.2",null,"0","2",null,"NA","NA"],
    [6975,"6975","Carrier L","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5620","ADDITION LOWER EXTREMITY TEST SOCKET BELOW KNEE","2","1",null,null,"68.9",null,"0","2",null,"NA","NA"],
    [6976,"6976","Carrier L","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5637","ADDITION LOWER EXTREMITY BELOW KNEE TOTAL CONTCT","2","1",null,null,"68.9",null,"0","2",null,"NA","NA"],
    [6977,"6977","Carrier L","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5679","ADD LW EXT BK/AK CSTM MOLD/PRFAB NOT W/LOCK MECH","2","1",null,null,"68.9",null,"0","2",null,"NA","NA"],
    [6978,"6978","Carrier L","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5685","ADD LOW EXT PROS BELW KNEE SUSP/SEAL SLEEVE EA","2","1",null,null,"68.9",null,"0","2",null,"NA","NA"],
    [6979,"6979","Carrier L","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5910","ADD ENDOSKEL SYSTEM BELOW KNEE ALIGNABLE SYSTEM","2","1",null,null,"68.9",null,"0","2",null,"NA","NA"],
    [6980,"6980","Carrier L","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8420","PROSTHETIC SOCK MULTIPLE PLY BELOW KNEE BK EACH","2","1",null,null,"68.9",null,"0","2",null,"NA","NA"],
    [6981,"6981","Carrier L","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8470","PROSTHETIC SOCK SINGLE PLY FITTING BELOW KNEE EA","2","1",null,null,"68.9",null,"0","2",null,"NA","NA"],
    [6982,"6982","Carrier L","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E1399","DURABLE MEDICAL EQUIPMENT MISCELLANEOUS","13",null,null,null,"46.7",null,"0","13",null,"NA","NA"],
    [6983,"6983","Carrier L","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E1028","WC ACCSS MANL SWINGAWAY OTH CNTRL INTRFCE/PSTN","11",null,null,"40.7","108.4",null,"2","9",null,"NA","NA"],
    [6984,"6984","Carrier L","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","K0108","OTHER ACCESSORIES","5",null,null,null,"97.9",null,"0","5",null,"NA","NA"],
    [6985,"6985","Carrier L","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0953","WHEELCHAIR AC LAT THIGH/KNEE SUPP ANY TYPE EA","3",null,null,null,"97.7",null,"0","3",null,"NA","NA"],
    [6986,"6986","Carrier L","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0978","WHLCHAIR ACSS PSTN BELT/SFTY BELT/PELV STRAP EA","4",null,null,"40.7","100.3",null,"1","3",null,"NA","NA"],
    [6987,"6987","Carrier L","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0747","OSTOGNS STIM ELEC NONINVASV OTH THAN SP APPLIC","2",null,null,null,"83.7",null,"0","2",null,"NA","NA"],
    [6988,"6988","Carrier L","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0950","WHEELCHAIR ACCESSORY TRAY EACH","2",null,null,null,"105.6",null,"0","2",null,"NA","NA"],
    [6989,"6989","Carrier L","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0955","WC ACSS HEADREST CUSHNED FIX MOUNT HARDWARE EA","4",null,null,"40.7","108.4",null,"1","3",null,"NA","NA"],
    [6990,"6990","Carrier L","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0956","WC ACSS LAT TRNK/HIP SUPP FIX MOUNT HARDWARE EA","4",null,null,null,"105.7",null,"0","4",null,"NA","NA"],
    [6991,"6991","Carrier L","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0466","HOME VENTILATOR ANY TYPE USED W/NON-INVASV INTF","1",null,null,null,"134",null,"0","1",null,"NA","NA"],
    [6992,"6992","Carrier L","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","External ambulatory infusion pump, insulin","11","1",null,"1.7","4.7",null,"1","10",null,"NA","NA"],
    [6993,"6993","Carrier L","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4239","SPLY ALW NONADJUNC NONIMPL CGM  1 MO SPLY= 1 UOS","4","0.5",null,null,"48.5",null,"0","4",null,"NA","NA"],
    [6994,"6994","Carrier L","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9274","External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories","1","1",null,null,"0.1",null,"0","1",null,"NA","NA"],
    [6995,"6995","Carrier L","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9277","TRANSMITTER; EXT  USE WITH NONDME INTRSTL CGM","1","1",null,null,"20.9",null,"0","1",null,"NA","NA"],
    [6996,"6996","Carrier L","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9276","SNSR;INVSV DISP USE NONDME INTRSTL CGM 1U=1D SPL","1","1",null,null,"20.9",null,"0","1",null,"NA","NA"],
    [6997,"6997","Carrier L","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2103","NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER","1","0",null,null,"72.3",null,"0","1",null,"NA","NA"],
    [6998,"6998","Carrier L","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","External ambulatory infusion pump, insulin","11","1",null,"1.7","4.7",null,"1","10",null,"NA","NA"],
    [6999,"6999","Carrier L","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9274","External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories","1","1",null,null,"0.1",null,"0","1",null,"NA","NA"],
    [7000,"7000","Carrier L","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9277","TRANSMITTER; EXT  USE WITH NONDME INTRSTL CGM","1","1",null,null,"20.9",null,"0","1",null,"NA","NA"],
    [7001,"7001","Carrier L","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9276","SNSR;INVSV DISP USE NONDME INTRSTL CGM 1U=1D SPL","1","1",null,null,"20.9",null,"0","1",null,"NA","NA"],
    [7002,"7002","Carrier L","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4239","SPLY ALW NONADJUNC NONIMPL CGM  1 MO SPLY= 1 UOS","4","0.5",null,null,"48.5",null,"0","4",null,"NA","NA"],
    [7003,"7003","Carrier L","2023","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","A4239","SPLY ALW NONADJUNC NONIMPL CGM  1 MO SPLY= 1 UOS","4",null,null,null,"48.5",null,"0","4",null,"NA","NA"],
    [7004,"7004","Carrier L","2023","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E2103","NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER","1",null,null,null,"72.3",null,"0","1",null,"NA","NA"],
    [7005,"7005","Carrier L","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","46","0.5652",null,"8","13",null,null,"40",null,"SEMAGLUTIDE","OZEMPIC, RYBELSUS"],
    [7006,"7006","Carrier L","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","32","0.75",null,"0","4",null,null,"29",null,"CONTINUOUS GLUCOSE SYSTEM SENSOR","FREESTYLE LIBRE 2/SENSOR/FLASH GLUCOSE MONITORING SYSTEM, DEXCOM G7 SENSOR, DEXCOM G6 SENSOR, FREESTYLE LIBRE 14 DAY/SENSOR/FLASH MONITORING SYSTEM, FREESTYLE LIBRE 3/SENSOR/GLUCOSE MONITORING SYSTEM"],
    [7007,"7007","Carrier L","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","22","0.3182",null,"0","18",null,null,"21",null,"TIRZEPATIDE","MOUNJARO"],
    [7008,"7008","Carrier L","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","13","0.6923",null,"0","3",null,null,"10",null,"SACUBITRIL-VALSARTAN","ENTRESTO"],
    [7009,"7009","Carrier L","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","12","0.3333",null,"1","2",null,null,"10",null,"VARENICLINE TARTRATE","VARENICLINE STARTING MONTH BOX, VARENICLINE TARTRATE"],
    [7010,"7010","Carrier L","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","12","0.9167",null,"2","1",null,null,"8",null,"CYCLOSPORINE (OPHTH)","RESTASIS, CEQUA, CYCLOSPORINE"],
    [7011,"7011","Carrier L","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","11","0.4545",null,"0","6",null,null,"11",null,"TESTOSTERONE","TESTOSTERONE, ANDRODERM, TESTOSTERONE PUMP, TESTIM"],
    [7012,"7012","Carrier L","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","11","0.7273",null,"0","13",null,null,"9",null,"DULAGLUTIDE","TRULICITY"],
    [7013,"7013","Carrier L","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","11","0",null,"0","0",null,null,"11",null,"SEMAGLUTIDE (WEIGHT MANAGEMENT)","WEGOVY"],
    [7014,"7014","Carrier L","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","9","1",null,"2","8",null,null,"5",null,"ADALIMUMAB, ADALIMUMAB INJ KIT","HUMIRA PEN, HUMIRA PEN-CD/UC/HS STARTER, HUMIRA"],
    [7015,"7015","Carrier L","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","46","0.5652",null,"8","13",null,null,"40",null,"SEMAGLUTIDE","OZEMPIC, RYBELSUS"],
    [7016,"7016","Carrier L","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","32","0.75",null,"0","4",null,null,"29",null,"CONTINUOUS GLUCOSE SYSTEM SENSOR","FREESTYLE LIBRE 2/SENSOR/FLASH GLUCOSE MONITORING SYSTEM, DEXCOM G7 SENSOR, DEXCOM G6 SENSOR, FREESTYLE LIBRE 14 DAY/SENSOR/FLASH MONITORING SYSTEM, FREESTYLE LIBRE 3/SENSOR/GLUCOSE MONITORING SYSTEM"],
    [7017,"7017","Carrier L","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","12","0.9167",null,"2","1",null,null,"8",null,"CYCLOSPORINE (OPHTH)","RESTASIS, CEQUA, CYCLOSPORINE"],
    [7018,"7018","Carrier L","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","9","1",null,"2","8",null,null,"5",null,"ADALIMUMAB, ADALIMUMAB INJ KIT","HUMIRA PEN, HUMIRA PEN-CD/UC/HS STARTER, HUMIRA"],
    [7019,"7019","Carrier L","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","13","0.6923",null,"0","3",null,null,"10",null,"SACUBITRIL-VALSARTAN","ENTRESTO"],
    [7020,"7020","Carrier L","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","11","0.7273",null,"0","13",null,null,"9",null,"DULAGLUTIDE","TRULICITY"],
    [7021,"7021","Carrier L","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","22","0.3182",null,"0","18",null,null,"21",null,"TIRZEPATIDE","MOUNJARO"],
    [7022,"7022","Carrier L","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","0.8571",null,"0","3",null,null,"5",null,"MESALAMINE","DELZICOL, MESALAMINE DR, MESALAMINE ER"],
    [7023,"7023","Carrier L","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","0.75",null,"1","4",null,null,"4",null,"LIRAGLUTIDE, LIRAGLUTIDE INJ","VICTOZA"],
    [7024,"7024","Carrier L","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","11","0.4545",null,"0","6",null,null,"11",null,"TESTOSTERONE","TESTOSTERONE, ANDRODERM, TESTOSTERONE PUMP, TESTIM"],
    [7025,"7025","Carrier K","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15740","FLAP ISLAND PEDICLE ANATOMIC NAMED AXIAL ARTERY","2","0.5",null,null,"125.7",null,"0","2",null,"NA","NA"],
    [7026,"7026","Carrier K","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15769","GRAFTING OF AUTOLOGOUS SOFT TISS BY DIRECT EXC","2","0.5",null,null,"125.7",null,"0","2",null,"NA","NA"],
    [7027,"7027","Carrier K","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","21196","RCNSTJ MNDBLR RAMI&/BDY SGTL SPLT W/INT RGD FI","2","0",null,null,"119.5",null,"0","2",null,"NA","NA"],
    [7028,"7028","Carrier K","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","30520","SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF","2","0",null,null,"119.5",null,"0","2",null,"NA","NA"],
    [7029,"7029","Carrier K","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","30802","ABLTJ SOF TISS INF TURBS UNI/BI SUPFC INTRAMURAL","2","0",null,null,"119.5",null,"0","2",null,"NA","NA"],
    [7030,"7030","Carrier K","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","61580","CRANIOFACIAL ANT CRANIAL FOSSA W/O ORBITAL EXNTJ","2","0.5",null,null,"125.7",null,"0","2",null,"NA","NA"],
    [7031,"7031","Carrier K","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","61608","RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB IDRL","2","0.5",null,null,"125.7",null,"0","2",null,"NA","NA"],
    [7032,"7032","Carrier K","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","62272","THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF","2","0.5",null,null,"125.7",null,"0","2",null,"NA","NA"],
    [7033,"7033","Carrier K","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64999","UNLISTED PROCEDURE NERVOUS SYSTEM","2","0",null,null,"125.7",null,"0","2",null,"NA","NA"],
    [7034,"7034","Carrier K","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96416","CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP","2","1",null,"23.5",null,null,"2","0",null,"NA","NA"],
    [7035,"7035","Carrier K","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J9000","INJECTION DOXORUBICIN HCL 10 MG","2","1",null,"23.5",null,null,"2","0",null,"NA","NA"],
    [7036,"7036","Carrier K","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J9208","INJECTION IFOSFAMIDE 1 G","2","1",null,"23.5",null,null,"2","0",null,"NA","NA"],
    [7037,"7037","Carrier K","2023","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J9209","INJECTION MESNA 200 MG","2","1",null,"23.5",null,null,"2","0",null,"NA","NA"],
    [7038,"7038","Carrier K","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96416","CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP","2","1",null,"23.5",null,null,"2","0",null,"NA","NA"],
    [7039,"7039","Carrier K","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J9000","INJECTION DOXORUBICIN HCL 10 MG","2","1",null,"23.5",null,null,"2","0",null,"NA","NA"],
    [7040,"7040","Carrier K","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J9208","INJECTION IFOSFAMIDE 1 G","2","1",null,"23.5",null,null,"2","0",null,"NA","NA"],
    [7041,"7041","Carrier K","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J9209","INJECTION MESNA 200 MG","2","1",null,"23.5",null,null,"2","0",null,"NA","NA"],
    [7042,"7042","Carrier K","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15860","Intravenous injection of agent (eg, fluorescein) to test vascular flow in flap or graft�","1","1",null,null,"18",null,"0","1",null,"NA","NA"],
    [7043,"7043","Carrier K","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19364","Breast reconstruction; with free flap","1","1",null,null,"18",null,"0","1",null,"NA","NA"],
    [7044,"7044","Carrier K","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33361","REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH","1","1",null,"17.5",null,null,"1","0",null,"NA","NA"],
    [7045,"7045","Carrier K","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33427","VLVP MITRAL VALVE W/BYPASS RAD RCNSTJ W/WO RING","1","1",null,null,"138.9",null,"0","1",null,"NA","NA"],
    [7046,"7046","Carrier K","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33477","TCAT PULMONARY VALVE IMPLANTATION PRQ APPROACH","1","1",null,null,"94.6",null,"0","1",null,"NA","NA"],
    [7047,"7047","Carrier K","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58720","SALPINGO-OOPHORECTOMY COMPL/PRTL UNI/BI SPX","1","1",null,null,"73.6",null,"0","1",null,"NA","NA"],
    [7048,"7048","Carrier K","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95714","Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; unmonitored�","1","1",null,null,"215.6",null,"0","1",null,"NA","NA"],
    [7049,"7049","Carrier K","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95720","Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of EEG recording, interpretation and report after each 24-hour period; with video (VEEG)","1","1",null,null,"215.6",null,"0","1",null,"NA","NA"],
    [7050,"7050","Carrier K","2023","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99221","Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","1","1",null,null,"215.6",null,"0","1",null,"NA","NA"],
    [7051,"7051","Carrier K","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21196","RCNSTJ MNDBLR RAMI&/BDY SGTL SPLT W/INT RGD FI","2",null,null,null,"119.5",null,"0","2",null,"NA","NA"],
    [7052,"7052","Carrier K","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","30520","SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF","2",null,"0.5",null,"119.5",null,"0","2",null,"NA","NA"],
    [7053,"7053","Carrier K","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","30802","ABLTJ SOF TISS INF TURBS UNI/BI SUPFC INTRAMURAL","2",null,null,null,"119.5",null,"0","2",null,"NA","NA"],
    [7054,"7054","Carrier K","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64999","UNLISTED PROCEDURE NERVOUS SYSTEM","2",null,null,null,"125.7",null,"0","2",null,"NA","NA"],
    [7055,"7055","Carrier K","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21121","GENIOPLASTY SLIDING OSTEOTOMY SINGLE PIECE","1",null,null,null,"141.6",null,"0","1",null,"NA","NA"],
    [7056,"7056","Carrier K","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21146","RCNSTJ MIDFACE LEFORT I 2 PIECES W/BONE GRAFTS","1",null,null,null,"97.3",null,"0","1",null,"NA","NA"],
    [7057,"7057","Carrier K","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21147","RCNSTJ MIDFACE LEFORT I 3/> PIECE W/BONE GRAFTS","1",null,null,null,"141.6",null,"0","1",null,"NA","NA"],
    [7058,"7058","Carrier K","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","38724","CERVICAL LYMPHADEC MODIFIED RADICAL NECK DSJ","1",null,null,"47.3",null,null,"1","0",null,"NA","NA"],
    [7059,"7059","Carrier K","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","15740","FLAP ISLAND PEDICLE ANATOMIC NAMED AXIAL ARTERY","2",null,null,null,"125.7",null,"0","2",null,"NA","NA"],
    [7060,"7060","Carrier K","2023","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","15769","GRAFTING OF AUTOLOGOUS SOFT TISS BY DIRECT EXC","2",null,null,null,"125.7",null,"0","2",null,"NA","NA"],
    [7061,"7061","Carrier K","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","81479","Unlisted molecular pathology procedure","51","0.8039",null,null,"20.5",null,"0","51",null,"NA","NA"],
    [7062,"7062","Carrier K","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","Colonoscopy, flexible; with biopsy, single or multiple","46","0.9348",null,"27.5","6.3",null,"1","45",null,"NA","NA"],
    [7063,"7063","Carrier K","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45385","Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","42","0.9286",null,null,"6.9",null,"0","42",null,"NA","NA"],
    [7064,"7064","Carrier K","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45378","Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","40","0.925",null,null,"8.7",null,"0","40",null,"NA","NA"],
    [7065,"7065","Carrier K","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95810","Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","32","0.8438",null,"0.1","20.7",null,"1","31",null,"NA","NA"],
    [7066,"7066","Carrier K","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","81420","Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21","25","0.96",null,null,"33.6",null,"0","25",null,"NA","NA"],
    [7067,"7067","Carrier K","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","G0121","Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk","19","0.8421",null,null,"14.1",null,"0","19",null,"NA","NA"],
    [7068,"7068","Carrier K","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64493","NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL","18","1",null,null,"16.6",null,"0","18",null,"NA","NA"],
    [7069,"7069","Carrier K","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45384","Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","17","0.9412",null,null,"3.5",null,"0","17",null,"NA","NA"],
    [7070,"7070","Carrier K","2023","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64483","NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL","16","1",null,null,"83",null,"0","16",null,"NA","NA"],
    [7071,"7071","Carrier K","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64493","NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL","18","1",null,null,"16.6",null,"0","18",null,"NA","NA"],
    [7072,"7072","Carrier K","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64483","NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL","16","1",null,null,"83",null,"0","16",null,"NA","NA"],
    [7073,"7073","Carrier K","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43235","Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","11","1",null,null,"0.1",null,"0","11",null,"NA","NA"],
    [7074,"7074","Carrier K","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43239","Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple","9","1",null,null,"0.1",null,"0","9",null,"NA","NA"],
    [7075,"7075","Carrier K","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","52000","CYSTOURETHROSCOPY","9","1",null,null,"25.4",null,"0","9",null,"NA","NA"],
    [7076,"7076","Carrier K","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58558","HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C","9","1",null,null,"4.8",null,"0","9",null,"NA","NA"],
    [7077,"7077","Carrier K","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","38525","BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE","6","1",null,"11.2","10.4",null,"2","4",null,"NA","NA"],
    [7078,"7078","Carrier K","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","52332","Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type)","6","1",null,null,"0.2",null,"0","6",null,"NA","NA"],
    [7079,"7079","Carrier K","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","52356","CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT","6","1",null,"0.1","0.1",null,"1","5",null,"NA","NA"],
    [7080,"7080","Carrier K","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58563","HYSTEROSCOPY ENDOMETRIAL ABLATION","6","1",null,null,"11.8",null,"0","6",null,"NA","NA"],
    [7081,"7081","Carrier K","2023","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64484","NJX AA&/STRD TFRML EPI LUMBAR/SACRAL EA ADDL","6","1",null,null,"40.9",null,"0","6",null,"NA","NA"],
    [7082,"7082","Carrier K","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","81479","Unlisted molecular pathology procedure","51",null,null,null,"20.5",null,"0","51",null,"NA","NA"],
    [7083,"7083","Carrier K","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","95810","Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","32",null,"0.03","0.1","20.7",null,"1","31",null,"NA","NA"],
    [7084,"7084","Carrier K","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","31276","NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS","4",null,null,null,"132.2",null,"0","4",null,"NA","NA"],
    [7085,"7085","Carrier K","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","31257","NASAL/SINUS NDSC TOTAL WITH SPHENOIDOTOMY","6",null,null,null,"131",null,"0","6",null,"NA","NA"],
    [7086,"7086","Carrier K","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","31256","NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY","7",null,null,null,"112.3",null,"0","7",null,"NA","NA"],
    [7087,"7087","Carrier K","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","0340U","ONC PAN CANCER ANALYSIS MRD FROM PLASMA","3",null,null,null,"95.4",null,"0","3",null,"NA","NA"],
    [7088,"7088","Carrier K","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","30117","EXCISION/DESTRUCTION INTRANASAL LESION INT APPR","3",null,"0.33",null,"130.2",null,"0","3",null,"NA","NA"],
    [7089,"7089","Carrier K","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","14060","ADJT TIS TRNSFR/REARRGMT E/N/E/L DFCT 10 SQ CM/<","5",null,null,null,"101.6",null,"0","5",null,"NA","NA"],
    [7090,"7090","Carrier K","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21085","IMPRESSION & PREPARATION ORAL SURGICAL SPLINT","5",null,null,null,"110.1",null,"0","5",null,"NA","NA"],
    [7091,"7091","Carrier K","2023","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","30465","REPAIR NASAL VESTIBULAR STENOSIS","6",null,null,null,"99.3",null,"0","6",null,"NA","NA"],
    [7092,"7092","Carrier K","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99499","Chiropractic Care","42","0.996",null,null,null,null,null,"42",null,"NA","NA"],
    [7093,"7093","Carrier K","2023","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99499","Therapy Care","222","0.996",null,null,null,null,null,"222",null,"NA","NA"],
    [7094,"7094","Carrier K","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99499","Chiropractic Care","42","0.996",null,null,null,null,null,"42",null,"NA","NA"],
    [7095,"7095","Carrier K","2023","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99499","Therapy Care","222","0.996",null,null,null,null,null,"222",null,"NA","NA"],
    [7096,"7096","Carrier K","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S1040","CRANIAL REMOLDING ORTHOTIC PED RIGID CUSTOM FAB","4","1",null,null,"34.1",null,"0","4",null,"NA","NA"],
    [7097,"7097","Carrier K","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0766","Electrical stimulation device used for cancer treatment, includes all accessories, any type","3","1",null,null,"48.3",null,"0","3",null,"NA","NA"],
    [7098,"7098","Carrier K","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0471","RAD BACKUP NON INV INTRFC NASAL/FACIAL MASK","2","0.5",null,"1.7","95.7",null,"1","1",null,"NA","NA"],
    [7099,"7099","Carrier K","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0760","OSTOGNS STIM LOW INTENS ULTRASOUND NON-INVASV","2","1",null,null,"10.8",null,"0","2",null,"NA","NA"],
    [7100,"7100","Carrier K","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0978","WHLCHAIR ACSS PSTN BELT/SFTY BELT/PELV STRAP EA","2","0.5",null,null,"62.6",null,"1","1",null,"NA","NA"],
    [7101,"7101","Carrier K","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2402","NEG PRESS WOUND THERAPY ELEC PUMP STATION/PRTBLE","2","1",null,null,"47",null,"0","2",null,"NA","NA"],
    [7102,"7102","Carrier K","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L1833","KNEE ORTHOSIS ADJUSTABLE JOINT RIGD SUPP PREFAB","2","0",null,null,"104.5",null,"0","2",null,"NA","NA"],
    [7103,"7103","Carrier K","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","B4149","Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","1","0",null,null,"134.1",null,"0","1",null,"NA","NA"],
    [7104,"7104","Carrier K","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","B9998","NOC FOR ENTERAL SUPPLIES","1","0",null,null,"134.1",null,"0","1",null,"NA","NA"],
    [7105,"7105","Carrier K","2023","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0748","OSTOGNS STIMULATOR ELEC NONINVASV SPINAL APPLIC","1","1",null,null,"92.4",null,"0","1",null,"NA","NA"],
    [7106,"7106","Carrier K","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S1040","CRANIAL REMOLDING ORTHOTIC PED RIGID CUSTOM FAB","4","1",null,null,"34.1",null,"0","4",null,"NA","NA"],
    [7107,"7107","Carrier K","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0766","Electrical stimulation device used for cancer treatment, includes all accessories, any type","3","1",null,null,"48.3",null,"0","3",null,"NA","NA"],
    [7108,"7108","Carrier K","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0760","OSTOGNS STIM LOW INTENS ULTRASOUND NON-INVASV","2","1",null,null,"10.8",null,"0","2",null,"NA","NA"],
    [7109,"7109","Carrier K","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2402","NEG PRESS WOUND THERAPY ELEC PUMP STATION/PRTBLE","2","1",null,null,"47",null,"0","2",null,"NA","NA"],
    [7110,"7110","Carrier K","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0748","OSTOGNS STIMULATOR ELEC NONINVASV SPINAL APPLIC","1","1",null,null,"92.4",null,"0","1",null,"NA","NA"],
    [7111,"7111","Carrier K","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2510","SPCH GEN DEVC SYNTHESIZD MX METH MESS&DEVC ACCSS","1","1",null,null,"28.7",null,"0","1",null,"NA","NA"],
    [7112,"7112","Carrier K","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0108","OTHER ACCESSORIES","1","1",null,null,"96.6",null,"0","1",null,"NA","NA"],
    [7113,"7113","Carrier K","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0739","REPR/SRVC DME NOT O2 RQR TECH CMPNT PER 15 MINS","1","1",null,null,"96.6",null,"0","1",null,"NA","NA"],
    [7114,"7114","Carrier K","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L0457","TLSO FLX SC JUNC TERM INF TO SCAP SPINE PREFAB","1","1",null,null,"38.9",null,"0","1",null,"NA","NA"],
    [7115,"7115","Carrier K","2023","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L1843","KNEE ORTHOSIS SINGLE UPRIGHT THIGH & CALF PREFAB","1","1",null,null,"89.9",null,"0","1",null,"NA","NA"],
    [7116,"7116","Carrier K","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L1833","KNEE ORTHOSIS ADJUSTABLE JOINT RIGD SUPP PREFAB","2",null,null,null,"104.5",null,"0","2",null,"NA","NA"],
    [7117,"7117","Carrier K","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0471","RAD BACKUP NON INV INTRFC NASAL/FACIAL MASK","2",null,null,"1.7","95.7",null,"1","1",null,"NA","NA"],
    [7118,"7118","Carrier K","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0978","WHLCHAIR ACSS PSTN BELT/SFTY BELT/PELV STRAP EA","2",null,null,null,"62.6",null,"0","2",null,"NA","NA"],
    [7119,"7119","Carrier K","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","B4149","Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","1",null,null,null,"134.1",null,"0","1",null,"NA","NA"],
    [7120,"7120","Carrier K","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","B9998","NOC FOR ENTERAL SUPPLIES","1",null,null,null,"134.1",null,"0","1",null,"NA","NA"],
    [7121,"7121","Carrier K","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E1399","DURABLE MEDICAL EQUIPMENT MISCELLANEOUS","1",null,null,null,"72.2",null,"0","1",null,"NA","NA"],
    [7122,"7122","Carrier K","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L1845","KNEE ORTHOSIS DOUBLE UPRIGHT THIGH & CALF PREFAB","1",null,null,null,"150.4",null,"0","1",null,"NA","NA"],
    [7123,"7123","Carrier K","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L1960","AFO POSTERIOR SOLID ANK PLASTIC CUSTOM FAB","1",null,"1",null,"160.6",null,"0","1",null,"NA","NA"],
    [7124,"7124","Carrier K","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L2330","ADD LOW EXT LACER MOLD PT MDL CSTM ORTHOSIS ONLY","1",null,null,null,"160.6",null,"0","1",null,"NA","NA"],
    [7125,"7125","Carrier K","2023","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L2350","ADD LOW EXTREM PROSTHETIC TYPE SOCKT MOLD PT MDL","1",null,null,null,"160.6",null,"0","1",null,"NA","NA"],
    [7126,"7126","Carrier K","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","External ambulatory infusion pump, insulin","2","1",null,null,"14.1",null,"0","2",null,"NA","NA"],
    [7127,"7127","Carrier K","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9276","SNSR;INVSV DISP USE NONDME INTRSTL CGM 1U=1D SPL","1","0",null,null,"96.7",null,"0","1",null,"NA","NA"],
    [7128,"7128","Carrier K","2023","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9274","External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories","1","1",null,null,"0.2",null,"0","1",null,"NA","NA"],
    [7129,"7129","Carrier K","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","External ambulatory infusion pump, insulin","2","1",null,null,"14.1",null,"0","2",null,"NA","NA"],
    [7130,"7130","Carrier K","2023","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9274","External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories","1","1",null,null,"0.2",null,"0","1",null,"NA","NA"],
    [7131,"7131","Carrier K","2023","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","A9276","SNSR;INVSV DISP USE NONDME INTRSTL CGM 1U=1D SPL","1",null,null,null,"96.7",null,"0","1",null,"NA","NA"],
    [7132,"7132","Carrier K","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","75","0.3867",null,"6","8",null,null,"67",null,"SEMAGLUTIDE","OZEMPIC, RYBELSUS"],
    [7133,"7133","Carrier K","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","36","0",null,"0","3",null,null,"36",null,"SEMAGLUTIDE (WEIGHT MANAGEMENT)","WEGOVY"],
    [7134,"7134","Carrier K","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","29","0.7241",null,"0","16",null,null,"18",null,"LISDEXAMFETAMINE DIMESYLATE","VYVANSE, LISDEXAMFETAMINE DIMESYLATE"],
    [7135,"7135","Carrier K","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","24","0.625",null,"3","12",null,null,"20",null,"CONTINUOUS GLUCOSE SYSTEM SENSOR","FREESTYLE LIBRE 2/SENSOR/FLASH GLUCOSE MONITORING SYSTEM, DEXCOM G7 SENSOR, DEXCOM G6 SENSOR, FREESTYLE LIBRE 14 DAY/SENSOR/FLASH MONITORING SYSTEM, FREESTYLE LIBRE 3/SENSOR/GLUCOSE MONITORING SYSTEM"],
    [7136,"7136","Carrier K","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","20","0.15",null,"27","8",null,null,"19",null,"TIRZEPATIDE","MOUNJARO"],
    [7137,"7137","Carrier K","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","19","0.5263",null,"1","4",null,null,"16",null,"DULAGLUTIDE","TRULICITY"],
    [7138,"7138","Carrier K","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","17","0.7647",null,"1","11",null,null,"11",null,"ADALIMUMAB INJ KIT, ADALIMUMAB","HUMIRA PEN, HUMIRA PEN-PS/UV STARTER, HUMIRA"],
    [7139,"7139","Carrier K","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","16","0.1875",null,"1","15",null,null,"15",null,"VARENICLINE TARTRATE","VARENICLINE STARTING MONTH BOX, VARENICLINE TARTRATE, CHANTIX STARTING MONTH PAK"],
    [7140,"7140","Carrier K","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","13","0.4615",null,"5","8",null,null,"8",null,"AMPHETAMINE-DEXTROAMPHETAMINE","MYDAYIS, ADDERALL, AMPHETAMINE/DEXTROAMPHETAMINE"],
    [7141,"7141","Carrier K","2023","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","11","0",null,"0","2",null,null,"11",null,"LIRAGLUTIDE (WEIGHT MANAGEMENT)","SAXENDA"],
    [7142,"7142","Carrier K","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","75","0.3867",null,"6","8",null,null,"67",null,"SEMAGLUTIDE","OZEMPIC, RYBELSUS"],
    [7143,"7143","Carrier K","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","29","0.7241",null,"0","16",null,null,"18",null,"LISDEXAMFETAMINE DIMESYLATE","VYVANSE, LISDEXAMFETAMINE DIMESYLATE"],
    [7144,"7144","Carrier K","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","24","0.625",null,"3","12",null,null,"20",null,"CONTINUOUS GLUCOSE SYSTEM SENSOR","FREESTYLE LIBRE 2/SENSOR/FLASH GLUCOSE MONITORING SYSTEM, DEXCOM G7 SENSOR, DEXCOM G6 SENSOR, FREESTYLE LIBRE 14 DAY/SENSOR/FLASH MONITORING SYSTEM, FREESTYLE LIBRE 3/SENSOR/GLUCOSE MONITORING SYSTEM"],
    [7145,"7145","Carrier K","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","17","0.7647",null,"1","11",null,null,"11",null,"ADALIMUMAB, ADALIMUMAB INJ KIT","HUMIRA PEN, HUMIRA PEN-PS/UV STARTER, HUMIRA"],
    [7146,"7146","Carrier K","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","19","0.5263",null,"1","4",null,null,"16",null,"DULAGLUTIDE","TRULICITY"],
    [7147,"7147","Carrier K","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","13","0.4615",null,"5","8",null,null,"8",null,"AMPHETAMINE-DEXTROAMPHETAMINE","MYDAYIS, ADDERALL, AMPHETAMINE/DEXTROAMPHETAMINE"],
    [7148,"7148","Carrier K","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","0.8571",null,"0","23",null,null,"3",null,"INSULIN INFUSION DISPOSABLE PUMP","OMNIPOD DASH PODS (GEN 4), OMNIPOD 5 G6 INTRO KIT (GEN 5), OMNIPOD 5 G6 PODS (GEN 5)"],
    [7149,"7149","Carrier K","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","5","1",null,"1","7",null,null,"3",null,"MORPHINE SULFATE","MORPHINE SULFATE ER"],
    [7150,"7150","Carrier K","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","10","0.5",null,"1","13",null,null,"6",null,"TESTOSTERONE","TESTOSTERONE, TESTOSTERONE PUMP, TESTIM"],
    [7151,"7151","Carrier K","2023","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","6","0.8333",null,"0","7",null,null,"6",null,"LINACLOTIDE","LINZESS"],
    [7152,"7152","Carrier M","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20930","ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED","16","0.5",null,"26.76278","100.4024",null,"1","15",null,"NA","NA"],
    [7153,"7153","Carrier M","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD","15","0.3333",null,"26.76278","107.1667",null,"1","14",null,"NA","NA"],
    [7154,"7154","Carrier M","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20936","AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION","13","0.7692",null,"7.578055","113.4715",null,"1","12",null,"NA","NA"],
    [7155,"7155","Carrier M","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","ARTHRODESIS ANTERIOR INTERBODY LUMBAR","12","0.1667",null,"26.76278","86.34995",null,"1","11",null,"NA","NA"],
    [7156,"7156","Carrier M","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22612","ARTHRD PST TQ 1NTRSPC LUMBAR","12","0.3333",null,"26.76278","79.453",null,"1","11",null,"NA","NA"],
    [7157,"7157","Carrier M","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44204","LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS","11","1",null,"10.25722","6.650667",null,"1","10",null,"NA","NA"],
    [7158,"7158","Carrier M","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22614","ARTHRD PST TQ 1NTRSPC EA ADD","11","0.3636",null,"17.17778","100.8584",null,"2","9",null,"NA","NA"],
    [7159,"7159","Carrier M","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","61781","STRTCTC CPTR ASSTD PX CRANIAL INTRADURAL","11","1",null,"0.355","25.17664",null,"1","10",null,"NA","NA"],
    [7160,"7160","Carrier M","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY","10","1",null,"1.0975","4.566266",null,"1","9",null,"NA","NA"],
    [7161,"7161","Carrier M","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","69990","MICROSURG TQS REQ USE OPERATING MICROSCOPE","10","0.9",null,null,"33.07558",null,"0","10",null,"NA","NA"],
    [7162,"7162","Carrier M","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44204","LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS","11","1",null,"10.25722","6.650667",null,"1","10",null,"NA","NA"],
    [7163,"7163","Carrier M","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","61781","STRTCTC CPTR ASSTD PX CRANIAL INTRADURAL","11","1",null,"0.355","25.17664",null,"1","10",null,"NA","NA"],
    [7164,"7164","Carrier M","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58150","TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY","10","1",null,"1.0975","4.566266",null,"1","9",null,"NA","NA"],
    [7165,"7165","Carrier M","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44207","LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST","10","1",null,"1.01","8.053858",null,"1","9",null,"NA","NA"],
    [7166,"7166","Carrier M","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95720","Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of EEG recording, interpretation and report after each 24-hour period with video","10","1",null,null,"13.22289",null,"0","10",null,"NA","NA"],
    [7167,"7167","Carrier M","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","61510","CRANIEC TREPHINE BONE FLP BRAIN TUMOR SUPRTENTOR","8","1",null,"0.5844445","5.328849",null,"1","7",null,"NA","NA"],
    [7168,"7168","Carrier M","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43775","LAP SLEEVE GASTRECTOMY","8","1",null,null,"57.6466",null,"0","8",null,"NA","NA"],
    [7169,"7169","Carrier M","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","50543","LAPAROSCOPY SURG PARTIAL NEPHRECTOMY","6","1",null,null,"5.86463",null,"0","6",null,"NA","NA"],
    [7170,"7170","Carrier M","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96416","CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP","6","1",null,"12.29333","39.62324",null,"3","3",null,"NA","NA"],
    [7171,"7171","Carrier M","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","61624","TCAT PERMANENT OCCLUSION/EMBOLIZATION PRQ CNS","4","1",null,"23.385","45.48653",null,"2","2",null,"NA","NA"],
    [7172,"7172","Carrier M","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","20939","BONE MARROW ASPIRATION BONE GRFG SPI SURG ONLY","4",null,"0","26.76278","27.54981",null,"1","3",null,"NA","NA"],
    [7173,"7173","Carrier M","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63047","LAM FACETECTOMY & FORAMOTOMY 1 SEGMENT LUMBAR","3",null,"0.3333","26.76278","97.88",null,"1","2",null,"NA","NA"],
    [7174,"7174","Carrier M","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","20937","AUTOGRAFT SPINE SURGERY MORSELIZED SEP INCISION","3",null,"0",null,"127.3089",null,"0","3",null,"NA","NA"],
    [7175,"7175","Carrier M","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","63053","LAM FACTC/FRMT ARTHRD LUM EA","2",null,"0.5",null,"93.22874",null,"0","2",null,"NA","NA"],
    [7176,"7176","Carrier M","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","53410","URETHROPLASTY 1 STG RECNST MALE ANTERIOR URETHRA","2",null,"0.5",null,"101.5028",null,"0","2",null,"NA","NA"],
    [7177,"7177","Carrier M","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27280","ARTHR SI JT OPN B1GRF INSTRM","2",null,"0",null,"23.48486",null,"0","2",null,"NA","NA"],
    [7178,"7178","Carrier M","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","23472","ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER","1",null,"0",null,"43.0525",null,"0","1",null,"NA","NA"],
    [7179,"7179","Carrier M","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22533","ARTHRODESIS LATERAL EXTRACAVITARY LUMBAR","1",null,"1",null,"51.40167",null,"0","1",null,"NA","NA"],
    [7180,"7180","Carrier M","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","S2900","ROBOTIC SURGICAL SYSTEM","1",null,"0",null,"75.52306",null,"0","1",null,"NA","NA"],
    [7181,"7181","Carrier M","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21497","INTERDENTAL WIRING OTHER THAN FRACTURE","1",null,"0",null,"168.3928",null,"0","1",null,"NA","NA"],
    [7182,"7182","Carrier M","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material","953","0.82",null,"3","35","0","28","925","0","NA","NA"],
    [7183,"7183","Carrier M","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74177","Computed tomography, abdomen and pelvis; with contrast material(s)","803","0.86",null,"5","46","0","74","729","0","NA","NA"],
    [7184,"7184","Carrier M","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences","704","0.89",null,"0","28","0","17","687","0","NA","NA"],
    [7185,"7185","Carrier M","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72148","Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material","704","0.65",null,"3","63","0","15","689","0","NA","NA"],
    [7186,"7186","Carrier M","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71260","Computed tomography, thorax, diagnostic; with contrast material(s)","459","0.84",null,"13","47","0","24","435","0","NA","NA"],
    [7187,"7187","Carrier M","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73221","Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)","452","0.67",null,"7","61","0","17","435","0","NA","NA"],
    [7188,"7188","Carrier M","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72141","Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material","419","0.6",null,"73","94","0","14","405","0","NA","NA"],
    [7189,"7189","Carrier M","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70486","Computed tomography, maxillofacial area; without contrast material","389","0.85",null,"20","30","0","5","384","0","NA","NA"],
    [7190,"7190","Carrier M","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","77049","Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (CAD real-time lesion detection, characterization and pharmacokinetic analysis), when performed; bilateral","365","0.76",null,"10","66","0","7","358","0","NA","NA"],
    [7191,"7191","Carrier M","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71250","Computed tomography, thorax, diagnostic; without contrast material","345","0.76",null,"13","67","0","7","338","0","NA","NA"],
    [7192,"7192","Carrier M","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43239","UPPER NDSC BIOPSY SINGLE/MULTIPLE","172","1",null,null,"31.55444",null,"0","172",null,"NA","NA"],
    [7193,"7193","Carrier M","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43235","UPPER GI NDSC DX W/WO COLLECTION SPECIMEN","162","1",null,null,"6.066759",null,"0","162",null,"NA","NA"],
    [7194,"7194","Carrier M","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43251","UPR GI NDSC RMVL TUM POLYP/OTH LES SNARE TQ","30","1",null,null,"8.463657",null,"0","30",null,"NA","NA"],
    [7195,"7195","Carrier M","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99417","PROLNG OP E/M EACH 15 MIN","30","1",null,null,"18.04383",null,"0","30",null,"NA","NA"],
    [7196,"7196","Carrier M","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43248","UPR GI NDSC INSJ GUIDE WIRE DILAT ESOPHAGUS","29","1",null,null,"7.726743",null,"0","29",null,"NA","NA"],
    [7197,"7197","Carrier M","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","52356","CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT","28","1",null,null,"28.08507",null,"0","28",null,"NA","NA"],
    [7198,"7198","Carrier M","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43249","UPR GI NDSC BALLOON DILAT ESOPH <30 MM DIAM","28","1",null,null,"12.11938",null,"0","28",null,"NA","NA"],
    [7199,"7199","Carrier M","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","69436","TYMPANOSTOMY GENERAL ANESTHESIA","26","1",null,null,"12.2081",null,"0","26",null,"NA","NA"],
    [7200,"7200","Carrier M","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","37765","STAB PHLEBT VARICOSE VEINS 1 XTR 10-20 STAB INCS","24","1",null,null,"17.09997",null,"0","24",null,"NA","NA"],
    [7201,"7201","Carrier M","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58322","ARTIFICIAL INSEMINATION INTRA-UTERINE","24","1",null,null,"35.0264",null,"0","24",null,"NA","NA"],
    [7202,"7202","Carrier M","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","37227","Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when performed","1",null,"1","2",null,"0","1","0","0","NA","NA"],
    [7203,"7203","Carrier M","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64495","Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; third and any additional level(s) (List separately in addition to code for primary procedure)","2",null,"0.5",null,"5","0","0","1","0","NA","NA"],
    [7204,"7204","Carrier M","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","78814","Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck)","2",null,"0.5",null,"78","0","0","1","0","NA","NA"],
    [7205,"7205","Carrier M","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","77021","Magnetic resonance imaging guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation","2",null,"0.5",null,"141","0","0","1","0","NA","NA"],
    [7206,"7206","Carrier M","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","75635","Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing","3",null,"0.33",null,"79","0","0","1","0","NA","NA"],
    [7207,"7207","Carrier M","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","73719","Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s)","3",null,"0.33",null,"49","0","0","1","0","NA","NA"],
    [7208,"7208","Carrier M","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","73225","Magnetic resonance angiography, upper extremity, with or without contrast material(s)","3",null,"0.33",null,"1087","0","0","1","0","NA","NA"],
    [7209,"7209","Carrier M","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","70481","Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s)","4",null,"0.25",null,"1","0","0","1","0","NA","NA"],
    [7210,"7210","Carrier M","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","93454","Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation","4",null,"0.25",null,"90","0","0","1","0","NA","NA"],
    [7211,"7211","Carrier M","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","89346","STORAGE PER YEAR OOCYTE","9",null,"0.1111","74.2925","63.65142",null,"1","8",null,"NA","NA"],
    [7212,"7212","Carrier M","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","Chemical Dependency Residential Treatment Facility","22","1",null,"22.508","10.25067",null,"10","12",null,"NA","NA"],
    [7213,"7213","Carrier M","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","Mental Health Inpatient","15","1",null,"1.560833","2.576795",null,"2","13",null,"NA","NA"],
    [7214,"7214","Carrier M","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","Mental Health Residential Treatment Facility","4","0.5",null,"60.47426","13.51194",null,"3","1",null,"NA","NA"],
    [7215,"7215","Carrier M","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","Detoxification","3","1",null,null,"0.1572222",null,"0","3",null,"NA","NA"],
    [7216,"7216","Carrier M","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","Chemical Dependency Residential Treatment Facility","22","1",null,"22.508","10.25067",null,"10","12",null,"NA","NA"],
    [7217,"7217","Carrier M","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","Mental Health Inpatient","15","1",null,"1.560833","2.576795",null,"2","13",null,"NA","NA"],
    [7218,"7218","Carrier M","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","Detoxification","4","0.5",null,"60.47426","13.51194",null,"3","1",null,"NA","NA"],
    [7219,"7219","Carrier M","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","Mental Health Residential Treatment Facility","3","1",null,null,"0.1572222",null,"0","3",null,"NA","NA"],
    [7220,"7220","Carrier M","2024","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NA","NA","Mental Health Residential Treatment Facility","4",null,"0.5","60.47426","13.51194",null,"3","1",null,"NA","NA"],
    [7221,"7221","Carrier M","2024","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NA","NA","Chemical Dependency Residential Treatment Facility","22",null,"1","22.508","10.25067",null,"10","12",null,"NA","NA"],
    [7222,"7222","Carrier M","2024","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NA","NA","Mental Health Inpatient","15",null,"1","1.560833","2.576795",null,"2","13",null,"NA","NA"],
    [7223,"7223","Carrier M","2024","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NA","NA","Detoxification","3",null,"1",null,"0.1572222",null,"0","3",null,"NA","NA"],
    [7224,"7224","Carrier M","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","H0035","MH PARTIAL HOSP TX UNDER 24H","89","0.9888",null,"0.4312037","16.10623",null,"3","86",null,"NA","NA"],
    [7225,"7225","Carrier M","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN","65","0.9846",null,null,"61.60067",null,"0","65",null,"NA","NA"],
    [7226,"7226","Carrier M","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY PATIENT &/ FAMILY 60 MINUTES","60","0.9833",null,null,"43.69807",null,"0","60",null,"NA","NA"],
    [7227,"7227","Carrier M","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG","54","0.4074",null,null,"59.56004",null,"0","54",null,"NA","NA"],
    [7228,"7228","Carrier M","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97155","ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN","48","0.9167",null,null,"82.30007",null,"0","48",null,"NA","NA"],
    [7229,"7229","Carrier M","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV & MN","48","0.4167",null,null,"91.12401",null,"0","48",null,"NA","NA"],
    [7230,"7230","Carrier M","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M","48","0.4375",null,null,"58.95856",null,"0","48",null,"NA","NA"],
    [7231,"7231","Carrier M","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97156","FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN","46","0.9783",null,null,"80.21806",null,"0","46",null,"NA","NA"],
    [7232,"7232","Carrier M","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97153","ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN","44","0.9091",null,null,"79.24001",null,"0","44",null,"NA","NA"],
    [7233,"7233","Carrier M","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","H2036","A/D TX PROGRAM, PER DIEM","41","1",null,"0.3673055","10.12899",null,"10","31",null,"NA","NA"],
    [7234,"7234","Carrier M","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H2036","A/D TX PROGRAM, PER DIEM","41","1",null,"0.3673055","10.12899",null,"10","31",null,"NA","NA"],
    [7235,"7235","Carrier M","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90834","PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES","20","1",null,null,"23.74197",null,"0","20",null,"NA","NA"],
    [7236,"7236","Carrier M","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVALUATION","16","1",null,null,"36.42144",null,"0","16",null,"NA","NA"],
    [7237,"7237","Carrier M","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99214","OFFICE O/P EST MOD 30 MIN","10","1",null,null,"38.19147",null,"0","10",null,"NA","NA"],
    [7238,"7238","Carrier M","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99215","OFFICE O/P EST HI 40 MIN","7","1",null,null,"46.94278",null,"0","7",null,"NA","NA"],
    [7239,"7239","Carrier M","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90833","PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 30 MIN","6","1",null,null,"46.65949",null,"0","6",null,"NA","NA"],
    [7240,"7240","Carrier M","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99205","OFFICE O/P NEW HI 60 MIN","5","1",null,null,"46.56316",null,"0","5",null,"NA","NA"],
    [7241,"7241","Carrier M","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96136","PSYL/NRPSYCL TST PHYS/QHP 2+ TST 1ST 30 MIN","4","1",null,null,"27.83681",null,"0","4",null,"NA","NA"],
    [7242,"7242","Carrier M","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96137","PSYCL/NRPSYCL TST PHYS/QHP 2+ TST EA ADDL 30 MIN","4","1",null,null,"27.85792",null,"0","4",null,"NA","NA"],
    [7243,"7243","Carrier M","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96133","NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR","3","1",null,null,"36.81065",null,"0","3",null,"NA","NA"],
    [7244,"7244","Carrier M","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97154","GROUP ADAPTIVE BHV TX BY PROTOCOL TECH EA 15 MIN","8",null,"0.875",null,"135.4883",null,"0","8",null,"NA","NA"],
    [7245,"7245","Carrier M","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97152","BEHAVIOR ID SUPPORT ASSMT BY 1 TECH EA 15 MIN","8",null,"0.875",null,"104.1307",null,"0","8",null,"NA","NA"],
    [7246,"7246","Carrier M","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97158","GRP ADAPT BHV PRTCL MODIFCAJ PHYS/QHP EA 15 MIN","6",null,"0.8333",null,"184.8687",null,"0","6",null,"NA","NA"],
    [7247,"7247","Carrier M","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90847","FAMILY PSYCHOTHERAPY W/PATIENT PRESENT","6",null,"0.8333",null,"60.98616",null,"0","6",null,"NA","NA"],
    [7248,"7248","Carrier M","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97157","MULTIPLE FAM GROUP BHV TX GDN PHYS/QHP EA 15 MIN","5",null,"0.8",null,"161.0866",null,"0","5",null,"NA","NA"],
    [7249,"7249","Carrier M","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90867","REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M","48",null,"0.4375",null,"58.95856",null,"0","48",null,"NA","NA"],
    [7250,"7250","Carrier M","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90869","REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV & MN","48",null,"0.4167",null,"91.12401",null,"0","48",null,"NA","NA"],
    [7251,"7251","Carrier M","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90868","THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG","54",null,"0.4074",null,"59.56004",null,"0","54",null,"NA","NA"],
    [7252,"7252","Carrier M","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","0373T","ADAPT BHV TX PRTCL MODIFICAJ EA 15 MIN TECH TIME","1",null,"0",null,"185.9483",null,"0","1",null,"NA","NA"],
    [7253,"7253","Carrier M","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","0362T","BEHAVIOR ID SUPPORT ASSMT EA 15 MIN TECH TIME","1",null,"0",null,"185.9483",null,"0","1",null,"NA","NA"],
    [7254,"7254","Carrier M","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","V2623","PLASTIC EYE PROSTH CUSTOM","1","1",null,null,"119.0292",null,"0","1",null,"NA","NA"],
    [7255,"7255","Carrier M","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0766","Elec stim cancer treatment","1","1",null,null,"70.73473",null,"0","1",null,"NA","NA"],
    [7256,"7256","Carrier M","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E2365","U1 SEALED LEADACID BATTERY","1","1",null,null,"9.833333",null,"0","1",null,"NA","NA"],
    [7257,"7257","Carrier M","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","K0831","PWC GP2 STD SEAT ELEVATE CAP","1","1",null,null,"9.833333",null,"0","1",null,"NA","NA"],
    [7258,"7258","Carrier M","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0955","CUSHIONED HEADREST","1","1",null,null,"16.56583",null,"0","1",null,"NA","NA"],
    [7259,"7259","Carrier M","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E1007","PWR SEAT COMBO W/SHEAR","1","1",null,null,"20.69833",null,"0","1",null,"NA","NA"],
    [7260,"7260","Carrier M","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E2300","PWR SEAT ELEVATION SYS","1","1",null,null,"16.54333",null,"0","1",null,"NA","NA"],
    [7261,"7261","Carrier M","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0973","W/CH ACCESS DET ADJ ARMREST","1","1",null,null,"9.833333",null,"0","1",null,"NA","NA"],
    [7262,"7262","Carrier M","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","V2628","FABRICATION & FITTING","1","1",null,null,"119.0442",null,"0","1",null,"NA","NA"],
    [7263,"7263","Carrier M","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E1028","W/C MANUAL SWINGAWAY","1","1",null,null,"9.833333",null,"0","1",null,"NA","NA"],
    [7264,"7264","Carrier M","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","V2623","PLASTIC EYE PROSTH CUSTOM","1","1",null,null,"119.0292",null,"0","1",null,"NA","NA"],
    [7265,"7265","Carrier M","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0766","Elec stim cancer treatment","1","1",null,null,"70.73473",null,"0","1",null,"NA","NA"],
    [7266,"7266","Carrier M","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E2365","U1 SEALED LEADACID BATTERY","1","1",null,null,"9.833333",null,"0","1",null,"NA","NA"],
    [7267,"7267","Carrier M","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","K0831","PWC GP2 STD SEAT ELEVATE CAP","1","1",null,null,"9.833333",null,"0","1",null,"NA","NA"],
    [7268,"7268","Carrier M","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0955","CUSHIONED HEADREST","1","1",null,null,"16.56583",null,"0","1",null,"NA","NA"],
    [7269,"7269","Carrier M","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E1007","PWR SEAT COMBO W/SHEAR","1","1",null,null,"20.69833",null,"0","1",null,"NA","NA"],
    [7270,"7270","Carrier M","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E2300","PWR SEAT ELEVATION SYS","1","1",null,null,"16.54333",null,"0","1",null,"NA","NA"],
    [7271,"7271","Carrier M","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0973","W/CH ACCESS DET ADJ ARMREST","1","1",null,null,"9.833333",null,"0","1",null,"NA","NA"],
    [7272,"7272","Carrier M","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","V2628","FABRICATION & FITTING","1","1",null,null,"119.0442",null,"0","1",null,"NA","NA"],
    [7273,"7273","Carrier M","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E1028","W/C MANUAL SWINGAWAY","1","1",null,null,"9.833333",null,"0","1",null,"NA","NA"],
    [7274,"7274","Carrier M","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","V2623","PLASTIC EYE PROSTH CUSTOM","1",null,"1",null,"119.0292",null,"0","1",null,"NA","NA"],
    [7275,"7275","Carrier M","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0766","Elec stim cancer treatment","1",null,"1",null,"70.73473",null,"0","1",null,"NA","NA"],
    [7276,"7276","Carrier M","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E2365","U1 SEALED LEADACID BATTERY","1",null,"1",null,"9.833333",null,"0","1",null,"NA","NA"],
    [7277,"7277","Carrier M","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","K0831","PWC GP2 STD SEAT ELEVATE CAP","1",null,"1",null,"9.833333",null,"0","1",null,"NA","NA"],
    [7278,"7278","Carrier M","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0955","CUSHIONED HEADREST","1",null,"1",null,"16.56583",null,"0","1",null,"NA","NA"],
    [7279,"7279","Carrier M","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E1007","PWR SEAT COMBO W/SHEAR","1",null,"1",null,"20.69833",null,"0","1",null,"NA","NA"],
    [7280,"7280","Carrier M","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E2300","PWR SEAT ELEVATION SYS","1",null,"1",null,"16.54333",null,"0","1",null,"NA","NA"],
    [7281,"7281","Carrier M","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0973","W/CH ACCESS DET ADJ ARMREST","1",null,"1",null,"9.833333",null,"0","1",null,"NA","NA"],
    [7282,"7282","Carrier M","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","V2628","FABRICATION & FITTING","1",null,"1",null,"119.0442",null,"0","1",null,"NA","NA"],
    [7283,"7283","Carrier M","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E1028","W/C MANUAL SWINGAWAY","1",null,"1",null,"9.833333",null,"0","1",null,"NA","NA"],
    [7284,"7284","Carrier M","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","665","0.5985",null,"5.52","4.81","0","126","539","0","Ozempic (0.25 or 0.5 MG/DOSE) 2MG/3ML SC SOPN","OZEMPIC"],
    [7285,"7285","Carrier M","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","625","0.3536",null,"10.25","4.7","0","89","536","0","Wegovy (semaglutide injection)","WEGOVY"],
    [7286,"7286","Carrier M","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","493","0.3306",null,"8.4","2.33","0","60","433","0","Zepbound Injection (tirzepatide)","ZEPBOUND"],
    [7287,"7287","Carrier M","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","417","0.5635",null,"7.2","3.2","0","80","337","0","Mounjaro (tirzepatide)","MOUNJARO"],
    [7288,"7288","Carrier M","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","336","0.75",null,"0.8","3.91","0","60","276","0","Testosterone Cypionate 200MG/ML IM SOLN","TESTOSTERONE"],
    [7289,"7289","Carrier M","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","236","0.8898",null,null,"2.76","0","36","200","0","Omeprazole 20MG OR CPDR","OMEPRAZOLE"],
    [7290,"7290","Carrier M","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","219","0.7489",null,null,"5.64","0","19","200","0","Tacrolimus 0.1% Ointment","TACROLIMUS"],
    [7291,"7291","Carrier M","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","214","0.7897",null,"12.75","19.91","0","32","182","0","Dupixent Syn 300","DUPIXENT"],
    [7292,"7292","Carrier M","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","189","0.8942",null,"0.52","4.2","0","46","143","0","Jardiance 25MG OR TABS","JARDIANCE"],
    [7293,"7293","Carrier M","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","172","0.7035",null,"9.41","8.13","0","51","121","0","Amphetamine-Dextroamphetamine 30mg","AMPHETAMINE-DEXTROAMPHETAMINE"],
    [7294,"7294","Carrier M","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","13","1",null,"6",null,"0","8","5","0","Buprenorphine 7.5MCG/HR TD PTWK","BUPRENORPHINE"],
    [7295,"7295","Carrier M","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","11","1",null,null,null,"0","4","7","0","Synjardy XR 25-1000MG OR TB24","SYNJARDY"],
    [7296,"7296","Carrier M","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","10","1",null,null,"24","0","8","2","0","Spravato","SPRAVATO"],
    [7297,"7297","Carrier M","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","10","1",null,null,null,"0","2","8","0","Kesimpta","KESIMPTA"],
    [7298,"7298","Carrier M","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","10","1",null,null,null,"0","5","5","0","Acetaminophen-Codeine 300-30MG OR TABS","ACETAMINOPHEN-CODEINE"],
    [7299,"7299","Carrier M","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","10","1",null,null,null,"0",null,"10","0","Tazarotene 0.1% EX CREA","TAZAROTENE"],
    [7300,"7300","Carrier M","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","9","1",null,"48","9","0","1","8","0","RABEprazole Sodium 20MG OR TBEC","RABEPRAZOLE"],
    [7301,"7301","Carrier M","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","9","1",null,null,null,"0","3","6","0","Revlimid","REVLIMID"],
    [7302,"7302","Carrier M","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,null,"3","0",null,"8","0","Aklief 0.005% EX CREA","AKLIEF"],
    [7303,"7303","Carrier M","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,null,"24","0","1","6","0","Hizentra","HIZENTRA"],
    [7304,"7304","Carrier M","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","101",null,"1","25","24.62","0","24","77","0","Budesonide-Formoterol 160-4.5mcg/act Inhaler","BUDESONIDE-FORMOTEROL"],
    [7305,"7305","Carrier M","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","41",null,"1","13.09","13.6","0","11","30","0","Epinephrine","EPINEPHRINE"],
    [7306,"7306","Carrier M","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","39",null,"1",null,"15.48","0","8","31","0","Stelara SQ 90mg","STELARA"],
    [7307,"7307","Carrier M","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","61",null,"1","14","5.84","0","24","37","0","Fluticasone Propionate HFA","FLUTICASONE"],
    [7308,"7308","Carrier M","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","42",null,"1","11.29","10.56","0","17","25","0","Vilazodone","VILAZODONE"],
    [7309,"7309","Carrier M","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","9",null,"1",null,null,"0","3","6","0","Methylphenidate Patch","METHYLPHENIDATE"],
    [7310,"7310","Carrier M","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","139",null,"1","5.33","2.36","0","27","112","0","Nurtec ODT 75mg (rimegepant)","NURTEC"],
    [7311,"7311","Carrier M","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","17",null,"1",null,null,"0","2","15","0","Triamcinolone 0.1% Ointment","TRIAMCINOLONE"],
    [7312,"7312","Carrier M","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"1","48",null,"0","1","1","0","Methotrexate 25mg/mL Injection","METHOTREXATE"],
    [7313,"7313","Carrier M","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","7",null,"1",null,"8","0","1","6","0","Bydureon BCise (exenatide)","BYETTA"],
    [7314,"7314","Carrier A","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","10","0.8",null,null,"42.40066667",null,null,"10",null,"NA","NA"],
    [7315,"7315","Carrier A","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22612","Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)","9","0.7778",null,null,"39.85145062",null,null,"9",null,"NA","NA"],
    [7316,"7316","Carrier A","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","9","0.7778",null,null,"39.85145062",null,null,"9",null,"NA","NA"],
    [7317,"7317","Carrier A","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","5","0.6",null,null,"67.11994444",null,null,"5",null,"NA","NA"],
    [7318,"7318","Carrier A","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","61783","Stereotactic computer-assisted (navigational) procedure; spinal (List separately in addition to code for primary procedure)","5","0",null,null,"0.729",null,null,"5",null,"NA","NA"],
    [7319,"7319","Carrier A","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20930","Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for primary procedure)","5","0",null,null,"1.401",null,null,"5",null,"NA","NA"],
    [7320,"7320","Carrier A","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22585","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace (List separately in addition to code for primary procedure)","4","1",null,null,"5.765833333",null,null,"4",null,"NA","NA"],
    [7321,"7321","Carrier A","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22614","Arthrodesis, posterior or posterolateral technique, single level; each additional vertebral segment (List separately in addition to code for primary procedure)","4","1",null,null,"22.02895833","417.9693431",null,"4","2","NA","NA"],
    [7322,"7322","Carrier A","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22842","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)","3","1",null,null,"21.93685185",null,null,"3",null,"NA","NA"],
    [7323,"7323","Carrier A","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","50360","Renal allotransplantation, implantation of graft; without recipient nephrectomy","3","0",null,null,"0.010092593",null,null,"3",null,"NA","NA"],
    [7324,"7324","Carrier A","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22830","Exploration of spinal fusion","3","1",null,null,"21.96731481",null,null,"3",null,"NA","NA"],
    [7325,"7325","Carrier A","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63047","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","3","1",null,null,"36.49601852",null,null,"3",null,"NA","NA"],
    [7326,"7326","Carrier A","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22585","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace (List separately in addition to code for primary procedure)","4","1",null,null,"5.765833333",null,null,"4",null,"NA","NA"],
    [7327,"7327","Carrier A","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22614","Arthrodesis, posterior or posterolateral technique, single level; each additional vertebral segment (List separately in addition to code for primary procedure)","4","1",null,null,"22.02895833","417.9693431",null,"4","2","NA","NA"],
    [7328,"7328","Carrier A","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22842","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)","3","1",null,null,"21.93685185",null,null,"3",null,"NA","NA"],
    [7329,"7329","Carrier A","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22830","Exploration of spinal fusion","3","1",null,null,"21.96731481",null,null,"3",null,"NA","NA"],
    [7330,"7330","Carrier A","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63047","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","3","1",null,null,"36.49601852",null,null,"3",null,"NA","NA"],
    [7331,"7331","Carrier A","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22848","Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures) other than sacrum (List separately in addition to code for primary procedure)","2","1",null,null,"11.29819444",null,null,"2",null,"NA","NA"],
    [7332,"7332","Carrier A","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22843","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in addition to code for primary procedure)","2","1",null,null,"20.51763889","417.9693431",null,"2","2","NA","NA"],
    [7333,"7333","Carrier A","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27487","Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component","2","1",null,null,"0.082361111",null,null,"2",null,"NA","NA"],
    [7334,"7334","Carrier A","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22212","Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; thoracic","1","1",null,null,"18.73",null,null,"1",null,"NA","NA"],
    [7335,"7335","Carrier A","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63051","Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and non-segmental fixation devices [eg, wire, suture, mini-plates], when performed)","1","1",null,null,"31.18305556","319.6081722",null,"1","1","NA","NA"],
    [7336,"7336","Carrier A","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27280","Arthrodesis, sacroiliac joint, open, includes obtaining bone graft, including instrumentation, when performed","1","1",null,null,"22.30527778",null,null,"1",null,"NA","NA"],
    [7337,"7337","Carrier A","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22600","Arthrodesis, posterior or posterolateral technique, single level; cervical below C2 segment","1","1",null,null,"65.34361111","417.9693431",null,"1","2","NA","NA"],
    [7338,"7338","Carrier A","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63001","Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; cervical","1","1",null,null,"31.18305556","319.6081722",null,"1","1","NA","NA"],
    [7339,"7339","Carrier A","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22216","Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; each additional vertebral segment (List separately in addition to primary procedure)","1","1",null,null,"18.73",null,null,"1",null,"NA","NA"],
    [7340,"7340","Carrier A","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22802","Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 vertebral segments","1","1",null,null,"18.73",null,null,"1",null,"NA","NA"],
    [7341,"7341","Carrier A","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22551","Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2","1","1",null,null,"65.34361111",null,null,"1",null,"NA","NA"],
    [7342,"7342","Carrier A","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","47379","Unlisted laparoscopic procedure, liver","1","1",null,null,"4.545555556",null,null,"1",null,"NA","NA"],
    [7343,"7343","Carrier A","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27486","Revision of total knee arthroplasty, with or without allograft; 1 component","1","1",null,null,"0.106388889",null,null,"1",null,"NA","NA"],
    [7344,"7344","Carrier A","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45378","Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","355","0.969",null,"0.313541667","5.408888889","311.6373792","12","343","4","NA","NA"],
    [7345,"7345","Carrier A","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography","341","0.9384",null,null,"5.597543988","466.0545231",null,"341","1","NA","NA"],
    [7346,"7346","Carrier A","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","Colonoscopy, flexible; with biopsy, single or multiple","339","0.9705",null,"0.313634259","5.753335882","515.4680647","12","327","5","NA","NA"],
    [7347,"7347","Carrier A","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","250","0.876",null,null,"6.649204444","248.3317229",null,"250","15","NA","NA"],
    [7348,"7348","Carrier A","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45385","Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","248","0.9758",null,"0.413209877","28.78424802","423.6442907","9","239","5","NA","NA"],
    [7349,"7349","Carrier A","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97140","Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes","228","0.8684",null,null,"6.782820419","172.3699232",null,"228","5","NA","NA"],
    [7350,"7350","Carrier A","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material","213","0.8545",null,"2.693055556","7.836269654",null,"1","212",null,"NA","NA"],
    [7351,"7351","Carrier A","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97530","Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","211","0.8626",null,null,"6.724981569","163.5556299",null,"211","8","NA","NA"],
    [7352,"7352","Carrier A","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74177","Computed tomography, abdomen and pelvis; with contrast material(s)","179","0.933",null,null,"2.652892613","336.0130556",null,"179","2","NA","NA"],
    [7353,"7353","Carrier A","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72148","Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material","176","0.7216",null,null,"21.30910827",null,null,"176",null,"NA","NA"],
    [7354,"7354","Carrier A","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","78264","Gastric emptying imaging study (eg, solid, liquid, or both);","22","1",null,null,"1.02540404",null,null,"22",null,"NA","NA"],
    [7355,"7355","Carrier A","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","45390","Colonoscopy, flexible; with endoscopic mucosal resection","19","1",null,null,"3.879517544","292.0376564",null,"19","1","NA","NA"],
    [7356,"7356","Carrier A","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27130","Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft","16","1",null,null,"6.2371875",null,null,"16",null,"NA","NA"],
    [7357,"7357","Carrier A","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93308","Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study","10","1",null,"0.113611111","0.000648148","658.0841758","1","9","1","NA","NA"],
    [7358,"7358","Carrier A","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70552","Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","10","1",null,null,"0.117611111",null,null,"10",null,"NA","NA"],
    [7359,"7359","Carrier A","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","74174","Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","10","1",null,null,"0.012722222",null,null,"10",null,"NA","NA"],
    [7360,"7360","Carrier A","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","78306","Bone and/or joint imaging; whole body","10","1",null,null,"0.000472222",null,null,"10",null,"NA","NA"],
    [7361,"7361","Carrier A","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","9","1",null,null,"33.32033951",null,null,"9",null,"NA","NA"],
    [7362,"7362","Carrier A","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43248","Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire","9","1",null,null,"0.01537037",null,null,"9",null,"NA","NA"],
    [7363,"7363","Carrier A","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","29828","Arthroscopy, shoulder, surgical; biceps tenodesis","9","1",null,null,"47.03518519","437.4669158",null,"9","1","NA","NA"],
    [7364,"7364","Carrier A","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64628","Thermal destruction of intraosseous basivertebral nerve, first 2 vertebral bodies","1",null,"1",null,"825.6608333",null,null,"1",null,"NA","NA"],
    [7365,"7365","Carrier A","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64629","Thermal destruction of intraosseous basivertebral nerve, each additional vertebral body","1",null,"1",null,"825.6608333",null,null,"1",null,"NA","NA"],
    [7366,"7366","Carrier A","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27446","Arthroplasty, knee, condyle and plateau; medial OR lateral compartment","4",null,"0.25",null,"72.39763889",null,null,"4",null,"NA","NA"],
    [7367,"7367","Carrier A","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","29822","Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of","8",null,"0.125",null,"36.13864583","370.2510453",null,"8","1","NA","NA"],
    [7368,"7368","Carrier A","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64636","Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional facet joint (List separately in addition to code for primary procedure)","25",null,"0.04",null,"28.6053",null,null,"25",null,"NA","NA"],
    [7369,"7369","Carrier A","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64635","Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint","32",null,"0.0313",null,"23.03748264",null,null,"32",null,"NA","NA"],
    [7370,"7370","Carrier A","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","95811","Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist","34",null,"0.0294",null,"17.2117402",null,null,"34",null,"NA","NA"],
    [7371,"7371","Carrier A","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","29826","Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (ie, arch) release, when performed (List separately in addition to code for primary procedure)","36",null,"0.0278","1.000833333","65.06072222","502.1930412","1","31","2","NA","NA"],
    [7372,"7372","Carrier A","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","73221","Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)","157",null,"0.0064","0.196944445","22.63581909",null,"1","155",null,"NA","NA"],
    [7373,"7373","Carrier A","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1001","Residential treatment, Psychiatric","3","0.6667",null,null,"62.94564815",null,null,"3",null,"NA","NA"],
    [7374,"7374","Carrier A","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","54520","Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach","1","1",null,null,"42.96861111",null,null,"1",null,"NA","NA"],
    [7375,"7375","Carrier A","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","56805","Clitoroplasty for intersex state","1","1",null,null,"42.96861111",null,null,"1",null,"NA","NA"],
    [7376,"7376","Carrier A","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","55175","Scrotoplasty; simple","1","1",null,null,"42.96861111",null,null,"1",null,"NA","NA"],
    [7377,"7377","Carrier A","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","53430","Urethroplasty, reconstruction of female urethra","1","1",null,null,"42.96861111",null,null,"1",null,"NA","NA"],
    [7378,"7378","Carrier A","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1002","Residential treatment, Substance Use Disorder","1","1",null,null,"48.80472222",null,null,"1",null,"NA","NA"],
    [7379,"7379","Carrier A","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","57335","Vaginoplasty for intersex state","1","1",null,null,"42.96861111",null,null,"1",null,"NA","NA"],
    [7380,"7380","Carrier A","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","54125","Amputation of penis; complete","1","1",null,null,"42.96861111",null,null,"1",null,"NA","NA"],
    [7381,"7381","Carrier A","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","54520","Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach","1","1",null,null,"42.96861111",null,null,"1",null,"NA","NA"],
    [7382,"7382","Carrier A","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","56805","Clitoroplasty for intersex state","1","1",null,null,"42.96861111",null,null,"1",null,"NA","NA"],
    [7383,"7383","Carrier A","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","55175","Scrotoplasty; simple","1","1",null,null,"42.96861111",null,null,"1",null,"NA","NA"],
    [7384,"7384","Carrier A","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","53430","Urethroplasty, reconstruction of female urethra","1","1",null,null,"42.96861111",null,null,"1",null,"NA","NA"],
    [7385,"7385","Carrier A","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1002","Residential treatment, Substance Use Disorder","1","1",null,null,"48.80472222",null,null,"1",null,"NA","NA"],
    [7386,"7386","Carrier A","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","57335","Vaginoplasty for intersex state","1","1",null,null,"42.96861111",null,null,"1",null,"NA","NA"],
    [7387,"7387","Carrier A","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","54125","Amputation of penis; complete","1","1",null,null,"42.96861111",null,null,"1",null,"NA","NA"],
    [7388,"7388","Carrier A","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1001","Residential treatment, Psychiatric","3","0.6667",null,null,"62.94564815",null,null,"3",null,"NA","NA"],
    [7389,"7389","Carrier A","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71271","Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)","31","0.871",null,null,"3.61561828",null,null,"31",null,"NA","NA"],
    [7390,"7390","Carrier A","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","92507","Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual","16","0.5625",null,null,"38.65857639",null,null,"16",null,"NA","NA"],
    [7391,"7391","Carrier A","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","12","0.9167",null,null,"19.79671717",null,null,"12",null,"NA","NA"],
    [7392,"7392","Carrier A","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","12","0.9167",null,null,"19.79676768",null,null,"12",null,"NA","NA"],
    [7393,"7393","Carrier A","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","11","0.9091",null,null,"21.77511111",null,null,"11",null,"NA","NA"],
    [7394,"7394","Carrier A","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","7","1",null,null,"25.1915873",null,null,"7",null,"NA","NA"],
    [7395,"7395","Carrier A","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours","5","0.6",null,null,"40.62916667",null,null,"5",null,"NA","NA"],
    [7396,"7396","Carrier A","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","17380","Electrolysis epilation, each 30 minutes","2","1",null,null,"47.53888889",null,null,"2",null,"NA","NA"],
    [7397,"7397","Carrier A","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","17999","Unlisted procedure, skin, mucous membrane and subcutaneous tissue","2","1",null,null,"47.53888889",null,null,"2",null,"NA","NA"],
    [7398,"7398","Carrier A","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64999","Unlisted procedure, nervous system","2","1",null,null,"47.53888889",null,null,"2",null,"NA","NA"],
    [7399,"7399","Carrier A","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15877","Suction assisted lipectomy; trunk","2","1",null,null,"22.12902778",null,null,"2",null,"NA","NA"],
    [7400,"7400","Carrier A","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97530","Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","2","1",null,null,"0.104722222","522",null,"2","1","NA","NA"],
    [7401,"7401","Carrier A","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19303","Mastectomy, simple, complete","2","1",null,null,"19.79194444",null,null,"2",null,"NA","NA"],
    [7402,"7402","Carrier A","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19350","Nipple/areola reconstruction","2","1",null,null,"19.79194444",null,null,"2",null,"NA","NA"],
    [7403,"7403","Carrier A","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H2036","Alcohol and/or other drug treatment program, per diem","2","0.5",null,null,"15.26625",null,null,"2",null,"NA","NA"],
    [7404,"7404","Carrier A","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","7","1",null,null,"25.1915873",null,null,"7",null,"NA","NA"],
    [7405,"7405","Carrier A","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","17380","Electrolysis epilation, each 30 minutes","2","1",null,null,"47.53888889",null,null,"2",null,"NA","NA"],
    [7406,"7406","Carrier A","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","17999","Unlisted procedure, skin, mucous membrane and subcutaneous tissue","2","1",null,null,"47.53888889",null,null,"2",null,"NA","NA"],
    [7407,"7407","Carrier A","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64999","Unlisted procedure, nervous system","2","1",null,null,"47.53888889",null,null,"2",null,"NA","NA"],
    [7408,"7408","Carrier A","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15877","Suction assisted lipectomy; trunk","2","1",null,null,"22.12902778",null,null,"2",null,"NA","NA"],
    [7409,"7409","Carrier A","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97530","Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","2","1",null,null,"0.104722222","522",null,"2","1","NA","NA"],
    [7410,"7410","Carrier A","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19303","Mastectomy, simple, complete","2","1",null,null,"19.79194444",null,null,"2",null,"NA","NA"],
    [7411,"7411","Carrier A","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19350","Nipple/areola reconstruction","2","1",null,null,"19.79194444",null,null,"2",null,"NA","NA"],
    [7412,"7412","Carrier A","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","92610","Evaluation of oral and pharyngeal swallowing function","1","1",null,null,"16.84",null,null,"1",null,"NA","NA"],
    [7413,"7413","Carrier A","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","92523","Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language)","1","1",null,null,"16.84",null,null,"1",null,"NA","NA"],
    [7414,"7414","Carrier A","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","78608","Brain imaging, positron emission tomography (PET); metabolic evaluation","1","1",null,null,"0.000277778",null,null,"1",null,"NA","NA"],
    [7415,"7415","Carrier A","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","30400","Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tip","1","1",null,null,"165.5327778",null,null,"1",null,"NA","NA"],
    [7416,"7416","Carrier A","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","92526","Treatment of swallowing dysfunction and/or oral function for feeding","1","1",null,null,"28.90222222",null,null,"1",null,"NA","NA"],
    [7417,"7417","Carrier A","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","47000","Biopsy of liver, needle; percutaneous","1","1",null,null,"0.014722222",null,null,"1",null,"NA","NA"],
    [7418,"7418","Carrier A","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","67900","Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)","1","1",null,null,"165.5327778",null,null,"1",null,"NA","NA"],
    [7419,"7419","Carrier A","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0004","Alcohol And/Or Drug Services","1","1",null,null,"45.68138889",null,null,"1",null,"NA","NA"],
    [7420,"7420","Carrier A","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","21209","Osteoplasty, facial bones; reduction","1","1",null,null,"165.5327778",null,null,"1",null,"NA","NA"],
    [7421,"7421","Carrier A","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","Cont Airway Pressure Device","282","0.9504",null,null,"1.814744878",null,null,"282",null,"NA","NA"],
    [7422,"7422","Carrier A","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without backup rate","21","0.9524",null,null,"0.119510582",null,null,"21",null,"NA","NA"],
    [7423,"7423","Carrier A","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2402","Negative pressure wound therapy electrical pump, stationary or portable","7","0.4286",null,null,"93.47083333",null,null,"7",null,"NA","NA"],
    [7424,"7424","Carrier A","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate","7","1",null,null,"0.029087302",null,null,"7",null,"NA","NA"],
    [7425,"7425","Carrier A","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0748","Elec Osteogen Stim Spinal","6","0.5",null,null,"78.90444444",null,null,"6",null,"NA","NA"],
    [7426,"7426","Carrier A","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1399","Durable Medical Equipment Mi","2","0",null,null,"4.404722222",null,null,"2",null,"NA","NA"],
    [7427,"7427","Carrier A","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1012","Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","2","0",null,null,"4.861666667",null,null,"2",null,"NA","NA"],
    [7428,"7428","Carrier A","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1007","Wheelchair accessory, power seating system, combination tilt and recline, with manual shear reduction","2","0",null,null,"4.862222222",null,null,"2",null,"NA","NA"],
    [7429,"7429","Carrier A","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2298","Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","2","0",null,null,"4.861944444",null,null,"2",null,"NA","NA"],
    [7430,"7430","Carrier A","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1028","Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","2","0",null,null,"4.862083333",null,null,"2",null,"NA","NA"],
    [7431,"7431","Carrier A","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2313","PWC harness, expand control","2","0",null,null,"4.862222222",null,null,"2",null,"NA","NA"],
    [7432,"7432","Carrier A","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0486","Oral device/appliance cusfab","2","0",null,null,"7.760833333",null,null,"2",null,"NA","NA"],
    [7433,"7433","Carrier A","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2311","Power wheelchair accessory, electronic connection between wheelchair controller","2","0",null,null,"4.862361111",null,null,"2",null,"NA","NA"],
    [7434,"7434","Carrier A","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0760","Osteogen Ultrasound Stimltor","2","0.5",null,null,"3.808055556",null,null,"2",null,"NA","NA"],
    [7435,"7435","Carrier A","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2377","Expandable controller, initl","2","0",null,null,"4.862083333",null,null,"2",null,"NA","NA"],
    [7436,"7436","Carrier A","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0953","Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","2","0",null,null,"4.861805556",null,null,"2",null,"NA","NA"],
    [7437,"7437","Carrier A","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2624","Adj skin pro/pos cus<22in","2","0",null,null,"4.861805556",null,null,"2",null,"NA","NA"],
    [7438,"7438","Carrier A","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0955","Wheelchair accessory, headrest, cushioned, prefabricated, including fixed mounting hardware, each","2","0",null,null,"4.861666667",null,null,"2",null,"NA","NA"],
    [7439,"7439","Carrier A","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate","7","1",null,null,"0.029087302",null,null,"7",null,"NA","NA"],
    [7440,"7440","Carrier A","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without backup rate","21","0.9524",null,null,"0.119510582",null,null,"21",null,"NA","NA"],
    [7441,"7441","Carrier A","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0601","Cont Airway Pressure Device","282","0.9504",null,null,"1.814744878",null,null,"282",null,"NA","NA"],
    [7442,"7442","Carrier A","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0748","Elec Osteogen Stim Spinal","6","0.5",null,null,"78.90444444",null,null,"6",null,"NA","NA"],
    [7443,"7443","Carrier A","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0760","Osteogen Ultrasound Stimltor","2","0.5",null,null,"3.808055556",null,null,"2",null,"NA","NA"],
    [7444,"7444","Carrier A","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2402","Negative pressure wound therapy electrical pump, stationary or portable","7","0.4286",null,null,"93.47083333",null,null,"7",null,"NA","NA"],
    [7445,"7445","Carrier A","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4216","Sterile water/saline, 10 ml","1","0",null,null,"0.008611111",null,null,"1",null,"NA","NA"],
    [7446,"7446","Carrier A","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","1","0",null,null,"2.729444444",null,null,"1",null,"NA","NA"],
    [7447,"7447","Carrier A","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9276","Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply","1","0",null,"1.589722222",null,null,"1",null,null,"NA","NA"],
    [7448,"7448","Carrier A","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4216","Sterile water/saline, 10 ml","1","0",null,null,"0.008611111",null,null,"1",null,"NA","NA"],
    [7449,"7449","Carrier A","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","1","0",null,null,"2.729444444",null,null,"1",null,"NA","NA"],
    [7450,"7450","Carrier A","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9276","Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply","1","0",null,"1.589722222",null,null,"1",null,null,"NA","NA"],
    [7451,"7451","Carrier A","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","174","0.7586",null,"8.73","43.14",null,"76","98",null,"HYDROCODONE-ACETAMINOPHEN","HYDROCODONE-ACETAMINOPHEN"],
    [7452,"7452","Carrier A","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","138","0.0362",null,"10.84","15.17",null,"17","121",null,"SEMAGLUTIDE (WEIGHT MANAGEMENT)","WEGOVY"],
    [7453,"7453","Carrier A","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","86","0.6512",null,"7.01","3.89",null,"22","64",null,"SEMAGLUTIDE","OZEMPIC (0.25 OR 0.5 MG/DOSE), OZEMPIC (1 MG/DOSE), OZEMPIC (2 MG/DOSE), RYBELSUS"],
    [7454,"7454","Carrier A","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","81","0.0123",null,"1.89","4.73",null,"7","74",null,"TIRZEPATIDE (WEIGHT MANAGEMENT)","ZEPBOUND"],
    [7455,"7455","Carrier A","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","74","0.8108",null,"7.93","8.41",null,"33","41",null,"OXYCODONE HCL","OXYCODONE HCL, OXYCODONE HCL ER, OXYCONTIN"],
    [7456,"7456","Carrier A","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","73","0.8219",null,"3.02","7.85",null,"4","69",null,"CYCLOSPORINE (OPHTH)","CEQUA, CYCLOSPORINE, RESTASIS"],
    [7457,"7457","Carrier A","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","73","0.9041",null,"6.34","23.38",null,"21","52",null,"ADALIMUMAB","HUMIRA (2 PEN), HUMIRA (2 SYRINGE), HUMIRA-CD/UC/HS STARTER, HUMIRA-PSORIASIS/UVEIT STARTER"],
    [7458,"7458","Carrier A","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","72","0.5694",null,"4.83","5.28",null,"13","59",null,"TIRZEPATIDE","MOUNJARO"],
    [7459,"7459","Carrier A","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","65","0.7846",null,"7.78","8.66",null,"47","18",null,"OXYCODONE W/ ACETAMINOPHEN","OXYCODONE-ACETAMINOPHEN"],
    [7460,"7460","Carrier A","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","43","0.8372",null,"9.17","12.54",null,"8","35",null,"DUPILUMAB","DUPIXENT"],
    [7461,"7461","Carrier A","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","28","1",null,"6.34","86.82",null,"7","21",null,"SECUKINUMAB","COSENTYX, COSENTYX SENSOREADY (300 MG), COSENTYX SENSOREADY PEN, COSENTYX UNOREADY"],
    [7462,"7462","Carrier A","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","17","1",null,"5.15","4.53",null,"5","12",null,"GALCANEZUMAB-GNLM","EMGALITY"],
    [7463,"7463","Carrier A","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","15","1",null,"8.38","7.52",null,"9","6",null,"ETANERCEPT","ENBREL SURECLICK"],
    [7464,"7464","Carrier A","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","10","1",null,"4.95","283.87",null,"4","6",null,"BUPRENORPHINE HCL","BELBUCA"],
    [7465,"7465","Carrier A","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,"13.84","4.71",null,"3","5",null,"CERTOLIZUMAB PEGOL","CIMZIA, CIMZIA (2 SYRINGE)"],
    [7466,"7466","Carrier A","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,"7.75","6.58",null,"5","3",null,"FENTANYL","FENTANYL"],
    [7467,"7467","Carrier A","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,"2.02","7.14",null,"2","6",null,"TOFACITINIB CITRATE","XELJANZ, XELJANZ XR"],
    [7468,"7468","Carrier A","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","5","1",null,"15.48","3.87",null,"1","4",null,"LIFITEGRAST","XIIDRA"],
    [7469,"7469","Carrier A","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","4","1",null,null,"6.07",null,"0","4",null,"NETARSUDIL DIMESYLATE-LATANOPROST","ROCKLATAN"],
    [7470,"7470","Carrier A","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","4","1",null,null,"7.74",null,"0","4",null,"DIROXIMEL FUMARATE","VUMERITY"],
    [7471,"7471","Carrier A","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","4",null,"1","24.78","29.18",null,"3","1",null,"EVOLOCUMAB","REPATHA SURECLICK"],
    [7472,"7472","Carrier A","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"1","12.24",null,null,"2","0",null,"ADALIMUMAB","HUMIRA (2 PEN)"],
    [7473,"7473","Carrier A","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"1",null,"25.65",null,"0","2",null,"PENTOSAN POLYSULFATE SODIUM","ELMIRON"],
    [7474,"7474","Carrier A","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"1","16.54","46.99",null,"1","1",null,"OXYCODONE W/ ACETAMINOPHEN","OXYCODONE-ACETAMINOPHEN"],
    [7475,"7475","Carrier A","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"1","4.51",null,null,"2","0",null,"IVABRADINE HCL","CORLANOR"],
    [7476,"7476","Carrier A","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"1",null,"47.28",null,"0","2",null,"ERENUMAB-AOOE","AIMOVIG"],
    [7477,"7477","Carrier A","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1",null,"21.81",null,"0","1",null,"RIBOCICLIB SUCCINATE","KISQALI (600 MG DOSE)"],
    [7478,"7478","Carrier A","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1","15.7",null,null,"1","0",null,"SEMAGLUTIDE","OZEMPIC (0.25 OR 0.5 MG/DOSE)"],
    [7479,"7479","Carrier A","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1",null,"23.08",null,"0","1",null,"BUTORPHANOL TARTRATE","BUTORPHANOL TARTRATE"],
    [7480,"7480","Carrier A","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1","5.42",null,null,"1","0",null,"BUPRENORPHINE","BUPRENORPHINE"],
    [7481,"7481","Carrier B","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99231","SUBSEQUENT HOSPITAL CARE","16","0.875",null,"35.84","106.82","0","3","13","0","NA","NA"],
    [7482,"7482","Carrier B","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","TOTAL ABDOMINAL HYSTERECOMY WITH TUBES AND OVARIES","14","1",null,"24.73","107.44","0","2","12","0","NA","NA"],
    [7483,"7483","Carrier B","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44207","LAP; COLECT PART W/COLOPROCTOST","10","1",null,"38.72","68.74","0","5","5","0","NA","NA"],
    [7484,"7484","Carrier B","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","38724","CERV LYMPHADENECTOMY (MODIFIED RAD NECK DISECT)","10","0.9",null,"41.84","70.7","0","5","5","0","NA","NA"],
    [7485,"7485","Carrier B","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22612","LUMBAR SPINE FUSION","9","1",null,null,"18.78","0","0","9","0","NA","NA"],
    [7486,"7486","Carrier B","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","32663","SCOPE OF LUNGS WITH REMOVAL OF LOBE","8","1",null,"28.45","72.52","0","4","4","0","NA","NA"],
    [7487,"7487","Carrier B","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","31622","BRANCHOSCOPY W/WOUT FLUOROSCOPIC GUIDANCE","7","0.8571",null,"20.1","71.19","0","1","6","0","NA","NA"],
    [7488,"7488","Carrier B","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","69990","USE OPER MICROSCOPE","7","1",null,"36.02","54.48","0","2","5","0","NA","NA"],
    [7489,"7489","Carrier B","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","33405","REPLACEMENT AORTIC VALVE OPN","7","1",null,"39.71","59.82","0","3","4","0","NA","NA"],
    [7490,"7490","Carrier B","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","61781","SCAN PROC CRANIAL INTRA","6","1",null,"35.67","65.02","0","2","4","0","NA","NA"],
    [7491,"7491","Carrier B","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","49255","OMENTECTOMY/EPIPLOECTOMY-RESEC OMENTUM (SEP PRO)","1","1",null,null,"99.27","0","0","1","0","NA","NA"],
    [7492,"7492","Carrier B","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43621","GASTRECTOMY TOT; W/ROUX-EN-Y RECON","1","1",null,null,"290.12","0","0","1","0","NA","NA"],
    [7493,"7493","Carrier B","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","61867","TWST DRL BURR CRANIOT W/REC 1 ARRAY","1","1",null,null,"118.32","0","0","1","0","NA","NA"],
    [7494,"7494","Carrier B","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15769","HARVESTING OF SKIN WITH AUTOLOGOUS SOFT TISSUE","4","1",null,null,"87.71","0","0","4","0","NA","NA"],
    [7495,"7495","Carrier B","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","61863","TWST DRL BURR CRANIOT NO REC 1 ARAY","2","1",null,null,"42.26","0","0","2","0","NA","NA"],
    [7496,"7496","Carrier B","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15777","ACELLULAR DERM MATRIX IMPLT","2","1",null,"117.18","163.35","0","1","1","0","NA","NA"],
    [7497,"7497","Carrier B","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","61700","SURGERICAL TREATMENT OF SIMPLE ANEURYSM THRU THE INTRACRANIAL CAROTID ARTERY","1","1",null,"19.03",null,"0","1","0","0","NA","NA"],
    [7498,"7498","Carrier B","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19370","OPEN PERIPROSTHETIC CAPSULOTOMY BREAST","2","1",null,"118.3","163.35","0","1","1","0","NA","NA"],
    [7499,"7499","Carrier B","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33361","REPLACE AORTIC VALVE PERQ","3","1",null,"140.28","119.21","0","1","2","0","NA","NA"],
    [7500,"7500","Carrier B","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19371","PERI-IMPLANT CAPSULECTOMY BREAST COMPLETE","2","1",null,"118.28","163.35","0","1","1","0","NA","NA"],
    [7501,"7501","Carrier B","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0480","DEFINITIVE DRUG TEST OF CLASSES 1-7","216","0.6218",null,null,"79.41","0","0","216","0","NA","NA"],
    [7502,"7502","Carrier B","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0481","DEFINITIVE DRUG TEST OF CLASSES 8-14","179","0.3519",null,null,"88.25","0","0","179","0","NA","NA"],
    [7503,"7503","Carrier B","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0482","DEFINITIVE DRUG TEST OF CLASSES 15-22","176","0.0684",null,null,"85.91","0","0","176","0","NA","NA"],
    [7504,"7504","Carrier B","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0483","DEFINITIVE DRUG TEST OF CLASSES 22+","175","0.069",null,null,"89.88","0","0","175","0","NA","NA"],
    [7505,"7505","Carrier B","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95810","SLEEP STUDY GREATER THAN 6 YRS OLD","243","0.4774",null,"67.32","88.23","0","11","232","0","NA","NA"],
    [7506,"7506","Carrier B","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95811","SLEEP STUDY GREATER THAN 6 YRS OLD WITH CPAP MACHINE","183","0.5301",null,"62.73","83.99","0","11","172","0","NA","NA"],
    [7507,"7507","Carrier B","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J2469","INJECTION, PALONOSETRON HCL, 25 MCG","143","1",null,null,"1",null,"12","131",null,"NA","NA"],
    [7508,"7508","Carrier B","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0299","DIRECT SKILLED NURSING SERVICES OF A REGISTERED NURSE IN HOME OR HOSPICE SETTING","102","0.9855",null,"43.75","78.82","0","1","101","0","NA","NA"],
    [7509,"7509","Carrier B","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99212","OFFICE/OUTPATIENT ESTABLISHED MEMBER LASTING 10-19 MIN","127","0.5227",null,"50.22","105.89","0","23","104","0","NA","NA"],
    [7510,"7510","Carrier B","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","30520","SEPTOPLASTY/SMR W/WO CARTIL SCORING/REPLAC W/GFT","106","0.9907",null,"24.93","102.09","0","1","105","0","NA","NA"],
    [7511,"7511","Carrier B","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J2469","INJECTION, PALONOSETRON HCL, 25 MCG","143","1",null,null,"1",null,"12","131","0","NA","NA"],
    [7512,"7512","Carrier B","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J1453","INJECTION, FOSAPREPITANT, 1 MG","97","1",null,null,null,null,"10","87","0","NA","NA"],
    [7513,"7513","Carrier B","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J1100","INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1MG","56","1",null,null,"4",null,"5","51","0","NA","NA"],
    [7514,"7514","Carrier B","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J9217","LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG","38","1",null,null,null,null,"2","36","0","NA","NA"],
    [7515,"7515","Carrier B","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J3489","ZOLEDRONIC ACID 1MG (ZOMETA)","36","1",null,null,null,null,"1","35","0","NA","NA"],
    [7516,"7516","Carrier B","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","Q5118","INJECTION BEVACIZUMAB-BVZR BIOSIMILAR 10 MG","29","1",null,null,"5",null,"2","27","0","NA","NA"],
    [7517,"7517","Carrier B","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J9171","INJECTION, DOCETAXEL, 1 MG","29","1",null,"3","2",null,"5","24","0","NA","NA"],
    [7518,"7518","Carrier B","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J9306","INJECTION, PERTUZUMAB, 1 MG","29","1",null,null,"3",null,"3","26","0","NA","NA"],
    [7519,"7519","Carrier B","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J2405","INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG","26","1",null,null,"7",null,"4","22","0","NA","NA"],
    [7520,"7520","Carrier B","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J9060","INJECTION, CISPLATIN, POWDER OR SOLUTION, 10 MG","24","1",null,null,null,null,"0","24","0","NA","NA"],
    [7521,"7521","Carrier B","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21146","RECON MIDFACE LEFORT I; 2 PIECES REQ BONE GFT","1",null,"1",null,"75.48","0","0","1","0","NA","NA"],
    [7522,"7522","Carrier B","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","51999","UNLIS LAPS PX BLDR","1",null,"1","501.75",null,"0","1","0","0","NA","NA"],
    [7523,"7523","Carrier B","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21147","RECON MIDFACE LEFORT I; 3/MORE PIECES REQ GFT","2",null,"1",null,"76.5","0","0","2","0","NA","NA"],
    [7524,"7524","Carrier B","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","88323","CONS & REPORT REF MAT REQUIRING PREP SLIDES","1",null,"1",null,"88.12","0","0","1","0","NA","NA"],
    [7525,"7525","Carrier B","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","88321","CONS & REPORT REF SLIDES PREP ELSEWHERE","1",null,"1",null,"44.5","0","0","1","0","NA","NA"],
    [7526,"7526","Carrier B","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","29916","HIP ARTHRO W/LABRAL REPAIR","1",null,"1",null,"44.03","0","0","1","0","NA","NA"],
    [7527,"7527","Carrier B","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21196","RECONST LWR JAW W/ FIXATION","3",null,"0.6667",null,"91.45","0","0","3","0","NA","NA"],
    [7528,"7528","Carrier B","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21085","IMPRESS & CUST PREP; ORAL SURG SPLINT","4",null,"0.5",null,"77.94","0","0","4","0","NA","NA"],
    [7529,"7529","Carrier B","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27702","ARTHROPLASTY ANK; W/IMPLNT (TOT ANK)","2",null,"0.5",null,"48.63","0","0","2","0","NA","NA"],
    [7530,"7530","Carrier B","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43497","TRANSORAL LOWER ESOPHAGEAL MYOTOMY","2",null,"0.5",null,"158.39","0","0","2","0","NA","NA"],
    [7531,"7531","Carrier B","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","SEMI-PRIVATE PYSCHIATRIC INPATIENT STAY","189","0.9701",null,"22.72","49.34","0","1","188","0","NA","NA"],
    [7532,"7532","Carrier B","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","126","DETOXIFICATION BED","55","0.9818",null,null,"41.69","0","0","55","0","NA","NA"],
    [7533,"7533","Carrier B","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1002","BEHAVIORAL HEALTH ACCOMODATIONS-RELATED TO CHEMICAL DEPENDANCY","34","1",null,"66.96","107.39","0","2","32","0","NA","NA"],
    [7534,"7534","Carrier B","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1001","BEHAVIORAL HEALTH ACCOMODATIONS-RESIDENTIAL TREATMENT  PSYCHIATRIC","11","1",null,null,"94.91","0","0","11","0","NA","NA"],
    [7535,"7535","Carrier B","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1001","BEHAVIORAL HEALTH ACCOMODATIONS-RESIDENTIAL TREATMENT  PSYCHIATRIC","11","1",null,null,"94.91","0","0","11","0","NA","NA"],
    [7536,"7536","Carrier B","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1002","BEHAVIORAL HEALTH ACCOMODATIONS-RELATED TO CHEMICAL DEPENDANCY","34","1",null,"66.96","107.39","0","2","32","0","NA","NA"],
    [7537,"7537","Carrier B","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","126","DETOXIFICATION BED","55","0.9818",null,null,"41.69","0","0","55","0","NA","NA"],
    [7538,"7538","Carrier B","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","SEMI-PRIVATE PYSCHIATRIC INPATIENT STAY","189","0.9701",null,"22.72","49.34","0","1","188","0","NA","NA"],
    [7539,"7539","Carrier B","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S9480","INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES PER DIEM","55","0.9636",null,null,"69.17","0","0","55","0","NA","NA"],
    [7540,"7540","Carrier B","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","906","PROFESSIONAL FEE FOR PSYCHOLOGY","37","0.9211",null,"23.4","73.62","0","1","36","0","NA","NA"],
    [7541,"7541","Carrier B","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","905","INTENSIVE BEHAVIORAL HEALTH TREATMENT SERVICES","25","0.96",null,null,"44.45","0","0","25","0","NA","NA"],
    [7542,"7542","Carrier B","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0015","IOP AL &/OR DRG SRV->=3HRS DA/3DAWK","22","0.7826",null,"22.71","50.18","0","4","18","0","NA","NA"],
    [7543,"7543","Carrier B","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","912","PARTIAL HOSPITALIZATION PSYCHIATRIC  PROGRAM","22","0.9545",null,null,"181.07","0","0","22","0","NA","NA"],
    [7544,"7544","Carrier B","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96132","NEUROPSYCHOLOGICAL TEST EVALUATION BY A PHYSICIAN/QUALIFIED HEALTH PROFESSIONAL UP TO 1 HOUR.","16","1",null,null,"70.89","0","0","16","0","NA","NA"],
    [7545,"7545","Carrier B","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","TCRANIAL MAGN STIM TX DELI","13","0.6154",null,"96.83","178.19","0","1","12","0","NA","NA"],
    [7546,"7546","Carrier B","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","TRANSCRANIAL MAGNETIC STIMULATION USED TO IMPROVE DEPRESSION","12","0.5833",null,"96.83","139.83","0","1","11","0","NA","NA"],
    [7547,"7547","Carrier B","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","TCRAN MAGN STIM REDETEMINE","12","0.5833",null,"96.83","179.43","0","1","11","0","NA","NA"],
    [7548,"7548","Carrier B","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96130","PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR","10","1",null,null,"46.47","0","0","10","0","NA","NA"],
    [7549,"7549","Carrier B","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96133","NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR","1","1",null,null,"0.03","0","0","1","0","NA","NA"],
    [7550,"7550","Carrier B","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H2012","BEHAVIORAL HEALTH DAY TREATMENT, PER HOUR","2","1",null,null,"96.28","0","0","2","0","NA","NA"],
    [7551,"7551","Carrier B","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99366","TEAM CONF W/PAT BY HC PRO","1","1",null,null,"42.38","0","0","1","0","NA","NA"],
    [7552,"7552","Carrier B","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90837","PSYTX PT&/FAMILY 60 MINUTES","1","1",null,null,"0.1","0","0","1","0","NA","NA"],
    [7553,"7553","Carrier B","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","901","BEHAVIORAL HEALTH TREATMENT SERVICES, ELECTROSHOCK","1","1",null,null,"92.6","0","0","1","0","NA","NA"],
    [7554,"7554","Carrier B","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90870","ELECTRIC CONVULSIVE THERAPY","3","1",null,null,"107.03","0","0","3","0","NA","NA"],
    [7555,"7555","Carrier B","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96139","PSYCL/NRPSYCL TST TECH 2+ TST EA ADDL 30 MIN","1","1",null,null,"0.03","0","0","1","0","NA","NA"],
    [7556,"7556","Carrier B","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96101","PSYCHOLOGICAL TESTING PER HOUR FACE TO FACE TIME WITH PATIENT","1","1",null,null,null,"0","0","1","0","NA","NA"],
    [7557,"7557","Carrier B","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S0201","PART HOSPITALZTION SRVC <24 HR-DIEM","4","1",null,null,"79.97","0","0","4","0","NA","NA"],
    [7558,"7558","Carrier B","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96116","NUBHVL STATUS XM PR HR F2F W/PT INTERPJ&PREPJ","1","1",null,null,"0.17","0","0","1","0","NA","NA"],
    [7559,"7559","Carrier B","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","CONTINUOUS AIRWAY PRESSURE (CPAP) DEVICE","913","0.949",null,"40.96","103.95","0","26","887","0","NA","NA"],
    [7560,"7560","Carrier B","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1390","PORTABLE OXYGEN CONCENTRATOR","98","0.9636",null,"23.99","113.36","0","10","88","0","NA","NA"],
    [7561,"7561","Carrier B","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4239","CONTINUOUS GLUCOSE MONITORING SUPPLIES BY MONTH","70","0.9718",null,"35.95","112.15","0","2","68","0","NA","NA"],
    [7562,"7562","Carrier B","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0470","BI-PAP RESPIRATORY ASSIST DEVICE WITH OUT BACKUP","49","0.9388",null,"58.21","124.15","0","3","46","0","NA","NA"],
    [7563,"7563","Carrier B","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2402","NEGATIVE PRESSURE WOUND PUMP","33","1",null,"2.23","98.71","0","2","31","0","NA","NA"],
    [7564,"7564","Carrier B","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0471","BI-PAP RESPIRATORY ASSIST DEVICE WITH BACKUP","18","0.75",null,"24.19","164.14","0","2","16","0","NA","NA"],
    [7565,"7565","Carrier B","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2103","NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER","16","0.875",null,null,"140.48","0","0","16","0","NA","NA"],
    [7566,"7566","Carrier B","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0935","PASSIVE MOTION EXERCISE DEVICE","12","0.5",null,"25.86","101.77","0","2","10","0","NA","NA"],
    [7567,"7567","Carrier B","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0466","HOME VENTILATOR, USED WITH NON-INVASIVE INTERFACE (MASK, CHEST SHELL)","10","1",null,"27.65","123.54","0","4","6","0","NA","NA"],
    [7568,"7568","Carrier B","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0483","HF CW OS SYS FULL THOR REG RECV SIM EXT OS EA","10","0.6",null,null,"158.54","0","0","10","0","NA","NA"],
    [7569,"7569","Carrier B","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9273","COLD/HOT FL BTL ICE CAP/C HEAT AND/ COLD WRAP ANY","1","1",null,"0","53.65","0","0","1","0","NA","NA"],
    [7570,"7570","Carrier B","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2300","POWER WHEELCHAIR ACCESSORY, POWER SEAT ELEVATION SYSTEM","1","1",null,"0","119.35","0","0","1","0","NA","NA"],
    [7571,"7571","Carrier B","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1392","PORTABLE OXYGEN CONCENTRATOR","1","1",null,"0","96.63333333","0","0","1","0","NA","NA"],
    [7572,"7572","Carrier B","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","B9002","ENTERAL NUTRITION INFUSION PUMP WITH ALARM","1","1",null,"0","0.002777778","0","0","1","0","NA","NA"],
    [7573,"7573","Carrier B","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2609","CUSTOM FABRICATED WHEELCHAIR SEAT CUSHION SIZE","1","1",null,"0","74.45","0","0","1","0","NA","NA"],
    [7574,"7574","Carrier B","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","B9004","PARENTERAL NUTRITION INFUSION PUMP PORTABLE","1","1",null,"0","53.96666667","0","0","1","0","NA","NA"],
    [7575,"7575","Carrier B","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2343","PWER WHEELCHAIR ACC NONSTANDARD SEAT FRAME DEPTH, 20-25 INCHES","1","1",null,"0","149.4666667","0","0","1","0","NA","NA"],
    [7576,"7576","Carrier B","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0261","HOSPITAL  BED SEMI-ELECTRIC WITH  ANY RAILS AND WITHOUT MATTRESS","1","1",null,"0","46.55","0","0","1","0","NA","NA"],
    [7577,"7577","Carrier B","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0766","ELEC STIM CANCER TREATMENT","1","1",null,"55.63333333","0","0","1","0","0","NA","NA"],
    [7578,"7578","Carrier B","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0277","POWERED PRESS-REDUCING AIR MATRESS","1","1",null,"0","67.58333333","0","0","1","0","NA","NA"],
    [7579,"7579","Carrier B","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","K0606","AUTOMATIC EXTRNL DFBRLLTR, W INTGRTD ELECRDGRM ANALYSIS","3",null,"0.3333","69.11666667","96.175","0","1","2","0","NA","NA"],
    [7580,"7580","Carrier B","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E2103","NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER","16",null,"0.125","0","140.4791667","0","0","16","0","NA","NA"],
    [7581,"7581","Carrier B","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E2402","NEGATIVE PRESSURE WOUND PUMP","33",null,"0.0294","2.229861111","98.70549283","0","2","31","0","NA","NA"],
    [7582,"7582","Carrier B","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","A4239","CONTINUOUS GLUCOSE MONITORING SUPPLIES BY MONTH","70",null,"0.0282","35.95","112.1450449","0","2","68","0","NA","NA"],
    [7583,"7583","Carrier B","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0470","BI-PAP RESPIRATORY ASSIST DEVICE WITH OUT BACKUP","49",null,"0.0204","58.21111111","124.1508394","0","3","46","0","NA","NA"],
    [7584,"7584","Carrier B","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0601","CONTINUOUS AIRWAY PRESSURE (CPAP) DEVICE","913",null,"0.017","40.96410256","103.9486343","0","26","887","0","NA","NA"],
    [7585,"7585","Carrier B","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E1390","PORTABLE OXYGEN CONCENTRATOR","98",null,"0.0091","23.98666667","113.357178","0","10","88","0","NA","NA"],
    [7586,"7586","Carrier B","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","EXTERNAL AMBULATORY INFUSION PUMP, INSULIN","30","0.9667",null,"0","111.81","0","0","30","0","NA","NA"],
    [7587,"7587","Carrier B","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9277","EXTERNAL TRANSMITTER CONTINOUS GLUCOSE MONITOR DAILY","28","1",null,"0","120.48","0","0","28","0","NA","NA"],
    [7588,"7588","Carrier B","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9278","EXTERNAL RECEIVER  FOR CONTINOUS GLUCOSE MONITORING","10","0.8333",null,"0","101.92","0","0","10","0","NA","NA"],
    [7589,"7589","Carrier B","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9276","DISPOSABLE SENSOR  FOR CONTINOUS GLUCOSE MONITORING SYSTEM DAILY","1","1",null,"0","4.5","0","0","1","0","NA","NA"],
    [7590,"7590","Carrier B","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9276","DISPOSABLE SENSOR  FOR CONTINOUS GLUCOSE MONITORING SYSTEM DAILY","1","1",null,"0","4.5","0","0","1","0","NA","NA"],
    [7591,"7591","Carrier B","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9277","EXTERNAL TRANSMITTER CONTINOUS GLUCOSE MONITOR DAILY","28","1",null,"0","120.48","0","0","28","0","NA","NA"],
    [7592,"7592","Carrier B","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","EXTERNAL AMBULATORY INFUSION PUMP, INSULIN","30","0.9667",null,"0","111.81","0","0","30","0","NA","NA"],
    [7593,"7593","Carrier B","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9278","EXTERNAL RECEIVER  FOR CONTINOUS GLUCOSE MONITORING","10","0.8333",null,"0","101.92","0","0","10","0","NA","NA"],
    [7594,"7594","Carrier B","2024","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0784","EXTERNAL AMBULATORY INFUSION PUMP, INSULIN","30",null,"0.0333","0","111.81","0","0","30","0","NA","NA"],
    [7595,"7595","Carrier B","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","2242","0.839",null,"0","0",null,"362","1880",null,"Semaglutide","Ozempic"],
    [7596,"7596","Carrier B","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","818","0.302",null,"0","1",null,"98","720",null,"Clobetasol Propionate","Clobetasol"],
    [7597,"7597","Carrier B","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","560","0.7107",null,"0","1",null,"131","429",null,"Lisdexamfetamine Dimesylate","Lisdexamfeta"],
    [7598,"7598","Carrier B","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","488","0.3238",null,"0","1",null,"123","365",null,"Pregabalin","Pregabalin"],
    [7599,"7599","Carrier B","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","478","0.9372",null,"0","0",null,"105","373",null,"Dulaglutide","Trulicity"],
    [7600,"7600","Carrier B","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","467","0.6938",null,"0","0",null,"90","377",null,"Liraglutide","Victoza"],
    [7601,"7601","Carrier B","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","451","0.4812",null,"0","1",null,"32","419",null,"Tretinoin","Tretinoin"],
    [7602,"7602","Carrier B","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","415","0.9301",null,"0","1",null,"132","283",null,"Hydrocodone-Acetaminophen","Hydroco/apap"],
    [7603,"7603","Carrier B","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","412","0.6626",null,"0","3",null,"70","342",null,"Continuous Glucose System Sensor","Freesty Libr"],
    [7604,"7604","Carrier B","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","323","0.774",null,"0","1",null,"107","216",null,"Adalimumab","Humira Pen"],
    [7605,"7605","Carrier B","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","36","1",null,"0","1",null,"15","21",null,"Insulin Degludec","Ins Degl Flx"],
    [7606,"7606","Carrier B","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","29","1",null,"3","0",null,"25","4",null,"Abemaciclib","Verzenio"],
    [7607,"7607","Carrier B","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","27","1",null,"0","0",null,"8","19",null,"Sodium Zirconium Cyclosilicate","Lokelma"],
    [7608,"7608","Carrier B","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","25","1",null,"0","1",null,"9","16",null,"Insulin Aspart","Insulin Aspa"],
    [7609,"7609","Carrier B","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","16","1",null,"2","0",null,"13","3",null,"Lenvatinib Mesylate","Lenvima"],
    [7610,"7610","Carrier B","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","16","1",null,"1","2",null,"8","8",null,"Olaparib","Lynparza"],
    [7611,"7611","Carrier B","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","16","1",null,"0","2",null,"5","11",null,"Dextromethorphan Hydrobromide-Bupropion Hydrochloride","Auvelity"],
    [7612,"7612","Carrier B","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","11","1",null,"0","1",null,"1","10",null,"Segesterone Acetate-Ethinyl Estradiol","Annovera"],
    [7613,"7613","Carrier B","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","10","1",null,"1","1",null,"8","2",null,"Lenalidomide","Revlimid"],
    [7614,"7614","Carrier B","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","10","1",null,"1","0",null,"6","4",null,"Metronidazole","Metronidazol"],
    [7615,"7615","Carrier O","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","12","1",null,"24.31","49.63",null,"1","11",null,"NA","NA"],
    [7616,"7616","Carrier O","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22633","Filter, disposable, used with positive airway pressure device","9","1",null,"24.31","68",null,"1","8",null,"NA","NA"],
    [7617,"7617","Carrier O","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44207","LAPAROSCOPY, SURGICAL; COLECTOMY, PARTIAL, WITH ANASTOMOSIS, WITH COLOPROCTOSTOMY (LOW PELVIC ANASTOMOSIS)","8","0.875",null,"10.23","60.04",null,"4","4",null,"NA","NA"],
    [7618,"7618","Carrier O","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22840","Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","7","1",null,null,"39.23",null,null,"7",null,"NA","NA"],
    [7619,"7619","Carrier O","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63052","LAMINECTOMY, FACETECTOMY, OR FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA AND/OR NERVE ROOT[S] [EG, SPINAL OR LATERAL RECESS STENOSIS]), DURING POSTERIOR INTERBODY ARTHRODESIS, LUMBAR; SINGLE VERTEBRAL SEGMENT","7","1",null,"24.31","57.65",null,"1","6",null,"NA","NA"],
    [7620,"7620","Carrier O","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44213","Filter, disposable, used with positive airway pressure device","7","0.8571",null,"7.87","46.08",null,"5","2",null,"NA","NA"],
    [7621,"7621","Carrier O","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63048","Room & Board Semiprivate (Two Beds)-Psychiatric","6","1",null,"24.3","63.25",null,"1","5",null,"NA","NA"],
    [7622,"7622","Carrier O","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","38724","CERVICAL LYMPHADENECTOMY (MODIFIED RADICAL NECK DISSECTION)","6","0.6667",null,"2.03","52.67",null,"3","3",null,"NA","NA"],
    [7623,"7623","Carrier O","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22614","Room & Board Semiprivate (Two Beds)-Detoxification","6","1",null,"24.31","62.94",null,"1","5",null,"NA","NA"],
    [7624,"7624","Carrier O","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45330","SIGMOIDOSCOPY, FLEXIBLE; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE)","6","0.8333",null,"16.75","28.04",null,"1","5",null,"NA","NA"],
    [7625,"7625","Carrier O","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22853","Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","12","1",null,"24.31","49.63",null,"1","11",null,"NA","NA"],
    [7626,"7626","Carrier O","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22633","Filter, disposable, used with positive airway pressure device","9","1",null,"24.31","68",null,"1","8",null,"NA","NA"],
    [7627,"7627","Carrier O","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63052","LAMINECTOMY, FACETECTOMY, OR FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA AND/OR NERVE ROOT[S] [EG, SPINAL OR LATERAL RECESS STENOSIS]), DURING POSTERIOR INTERBODY ARTHRODESIS, LUMBAR; SINGLE VERTEBRAL SEGMENT","7","1",null,"24.31","57.65",null,"1","6",null,"NA","NA"],
    [7628,"7628","Carrier O","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22840","Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","7","1",null,null,"39.23",null,null,"7",null,"NA","NA"],
    [7629,"7629","Carrier O","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63048","Room & Board Semiprivate (Two Beds)-Psychiatric","6","1",null,"24.3","63.25",null,"1","5",null,"NA","NA"],
    [7630,"7630","Carrier O","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22614","Room & Board Semiprivate (Two Beds)-Detoxification","6","1",null,"24.31","62.94",null,"1","5",null,"NA","NA"],
    [7631,"7631","Carrier O","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","61783","STEREOTACTIC COMPUTER-ASSISTED (NAVIGATIONAL) PROCEDURE; SPINAL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)","4","1",null,"24.31","46.64",null,"1","3",null,"NA","NA"],
    [7632,"7632","Carrier O","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63047","Room & Board Private (One Bed)-Psychiatric","4","1",null,null,"68.27",null,null,"4",null,"NA","NA"],
    [7633,"7633","Carrier O","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","20936","Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar fragments) obtained from same incision (List separately in addition to code for primary procedure)","4","1",null,"24.31","46.99",null,"1","3",null,"NA","NA"],
    [7634,"7634","Carrier O","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44620","CLOSURE OF ENTEROSTOMY, LARGE OR SMALL INTESTINE;","4","1",null,"1.87","17.92",null,"1","3",null,"NA","NA"],
    [7635,"7635","Carrier O","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","32100","THORACOTOMY, MAJOR; WITH EXPLORATION AND BIOPSY","1",null,"1",null,"91.71",null,null,"1",null,"NA","NA"],
    [7636,"7636","Carrier O","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","534","0.676",null,"1.37","8.71",null,"54","480",null,"NA","NA"],
    [7637,"7637","Carrier O","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99213","Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","506","0.6917",null,"1.4","8.57",null,"53","453",null,"NA","NA"],
    [7638,"7638","Carrier O","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99203","Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","506","0.6976",null,"1.43","8.75",null,"50","456",null,"NA","NA"],
    [7639,"7639","Carrier O","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99205","Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","501","0.6886",null,"1.41","8.63",null,"52","449",null,"NA","NA"],
    [7640,"7640","Carrier O","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99204","Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","501","0.6926",null,"1.43","8.81",null,"50","451",null,"NA","NA"],
    [7641,"7641","Carrier O","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99215","Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","499","0.6994",null,"1.41","8.89",null,"51","448",null,"NA","NA"],
    [7642,"7642","Carrier O","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99202","Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","497","0.6942",null,"1.47","8.93",null,"52","445",null,"NA","NA"],
    [7643,"7643","Carrier O","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99212","Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 10 minutes must be met or exceeded.","491","0.6945",null,"1.56","8.75",null,"51","440",null,"NA","NA"],
    [7644,"7644","Carrier O","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99211","Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional","490","0.6959",null,"1.45","9.02",null,"49","441",null,"NA","NA"],
    [7645,"7645","Carrier O","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S)","399","0.9398",null,"7.96","25.7",null,"48","351",null,"NA","NA"],
    [7646,"7646","Carrier O","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","78815","Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh","33","1",null,"0.86","2.89",null,"18","15",null,"NA","NA"],
    [7647,"7647","Carrier O","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","78816","Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body","33","1",null,"0.89","2.81",null,"17","16",null,"NA","NA"],
    [7648,"7648","Carrier O","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","78813","POSITRON EMISSION TOMOGRAPHY (PET) IMAGING; WHOLE BODY","32","1",null,"0.89","2.89",null,"17","15",null,"NA","NA"],
    [7649,"7649","Carrier O","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","78812","POSITRON EMISSION TOMOGRAPHY (PET) IMAGING; SKULL BASE TO MID-THIGH","32","1",null,"0.89","2.89",null,"17","15",null,"NA","NA"],
    [7650,"7650","Carrier O","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","78811","POSITRON EMISSION TOMOGRAPHY (PET) IMAGING; LIMITED AREA (EG, CHEST, HEAD/NECK)","32","1",null,"0.89","2.89",null,"17","15",null,"NA","NA"],
    [7651,"7651","Carrier O","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77067","Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed","29","1",null,"0.94","2.65",null,"3","26",null,"NA","NA"],
    [7652,"7652","Carrier O","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77065","DIAGNOSTIC MAMMOGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED; UNILATERAL","25","1",null,"0.84","2.25",null,"4","21",null,"NA","NA"],
    [7653,"7653","Carrier O","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70460","COMPUTED TOMOGRAPHY, HEAD OR BRAIN; WITH CONTRAST MATERIAL(S)","25","1",null,"1.43","3.05",null,"5","20",null,"NA","NA"],
    [7654,"7654","Carrier O","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70470","COMPUTED TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS","25","1",null,"1.43","3.05",null,"5","20",null,"NA","NA"],
    [7655,"7655","Carrier O","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70450","COMPUTED TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL","25","1",null,"1.43","3.04",null,"5","20",null,"NA","NA"],
    [7656,"7656","Carrier O","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27130","Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft","4",null,"0.16",null,"145.62",null,null,"4",null,"NA","NA"],
    [7657,"7657","Carrier O","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97530","Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","2",null,"0.0065",null,"128.13",null,null,"2",null,"NA","NA"],
    [7658,"7658","Carrier O","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97110","Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","2",null,"0.0059",null,"128.13",null,null,"2",null,"NA","NA"],
    [7659,"7659","Carrier O","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","73720","Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences","2",null,"0.008",null,"102.66",null,null,"2",null,"NA","NA"],
    [7660,"7660","Carrier O","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","73722","MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY; WITH CONTRAST MATERIAL(S)","2",null,"0.008",null,"102.66",null,null,"2",null,"NA","NA"],
    [7661,"7661","Carrier O","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","62323","Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (ie, fluoroscopy or CT)","2",null,"0.0645",null,"81.42",null,null,"2",null,"NA","NA"],
    [7662,"7662","Carrier O","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97116","THERAPEUTIC PROCEDURE, 1 OR MORE AREAS, EACH 15 MINUTES; GAIT TRAINING (INCLUDES STAIR CLIMBING)","2",null,"0.0093",null,"128.13",null,null,"2",null,"NA","NA"],
    [7663,"7663","Carrier O","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64483","INJECTION, ANESTHETIC AGENT AND/OR STEROID, TRANSFORAMINAL EPIDURAL; LUMBAR OR SACRAL, SINGLE LEVEL","2",null,"0.0345",null,"71.96",null,null,"2",null,"NA","NA"],
    [7664,"7664","Carrier O","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","73719","MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY OTHER THAN JOINT; WITH CONTRAST MATERIAL(S)","2",null,"0.008",null,"102.66",null,null,"2",null,"NA","NA"],
    [7665,"7665","Carrier O","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64493","Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level","2",null,"0.0952",null,"52.95",null,null,"2",null,"NA","NA"],
    [7666,"7666","Carrier O","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0018","Behavioral health; short-term residential (nonhospital residential treatment program), without room and board, per diem","10","1",null,null,"72.81",null,null,"10",null,"NA","NA"],
    [7667,"7667","Carrier O","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","Room & Board in a psychiatric setting (semi-private/two-bed). Used for inpatient psychiatric services","8","1",null,null,"16.6",null,null,"8",null,"NA","NA"],
    [7668,"7668","Carrier O","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0011","ALCOHOL AND/OR DRUG SERVICES; ACUTE DETOXIFICATION (RESIDENTIAL ADDICTION PROGRAM INPATIENT)","6","0.1667",null,"19.83","24.69",null,"1","5",null,"NA","NA"],
    [7669,"7669","Carrier O","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0010","ALCOHOL AND/OR DRUG SERVICES; SUB-ACUTE DETOXIFICATION (RESIDENTIAL ADDICTION PROGRAM INPATIENT)","5","1",null,null,"19.44",null,null,"5",null,"NA","NA"],
    [7670,"7670","Carrier O","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99221","INITIAL HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A DETAILED","5","0.8",null,null,"37.79",null,null,"5",null,"NA","NA"],
    [7671,"7671","Carrier O","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","126","Semi-private, two-bed room for detoxification services in a hospital setting.","4","0.5",null,"22.85","11.22",null,"1","3",null,"NA","NA"],
    [7672,"7672","Carrier O","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","114","Private room & board for psychiatric services.","4","1",null,null,"18.09",null,null,"4",null,"NA","NA"],
    [7673,"7673","Carrier O","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S9485","CRISIS INTERVENTION MENTAL HEALTH SERVICES, PER DIEM","1","1",null,null,"17.8",null,null,"1",null,"NA","NA"],
    [7674,"7674","Carrier O","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H2013","PSYCHIATRIC HEALTH FACILITY SERVICE, PER DIEM","1","1",null,null,"3.44",null,null,"1",null,"NA","NA"],
    [7675,"7675","Carrier O","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0018","Behavioral health; short-term residential (nonhospital residential treatment program), without room and board, per diem","10","1",null,null,"72.81",null,null,"10",null,"NA","NA"],
    [7676,"7676","Carrier O","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","Room & Board in a psychiatric setting (semi-private/two-bed). Used for inpatient psychiatric services","8","1",null,null,"16.6",null,null,"8",null,"NA","NA"],
    [7677,"7677","Carrier O","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0010","ALCOHOL AND/OR DRUG SERVICES; SUB-ACUTE DETOXIFICATION (RESIDENTIAL ADDICTION PROGRAM INPATIENT)","5","1",null,null,"19.44",null,null,"5",null,"NA","NA"],
    [7678,"7678","Carrier O","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","114","Private room & board for psychiatric services.","4","1",null,null,"18.09",null,null,"4",null,"NA","NA"],
    [7679,"7679","Carrier O","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S9485","CRISIS INTERVENTION MENTAL HEALTH SERVICES, PER DIEM","1","1",null,null,"17.8",null,null,"1",null,"NA","NA"],
    [7680,"7680","Carrier O","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H2013","PSYCHIATRIC HEALTH FACILITY SERVICE, PER DIEM","1","1",null,null,"3.44",null,null,"1",null,"NA","NA"],
    [7681,"7681","Carrier O","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99221","INITIAL HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A DETAILED","4","0.8",null,null,"41.14",null,null,"4",null,"NA","NA"],
    [7682,"7682","Carrier O","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","126","Semi-private, two-bed room for detoxification services in a hospital setting.","2","0.5",null,null,"15.92",null,null,"2",null,"NA","NA"],
    [7683,"7683","Carrier O","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0011","ALCOHOL AND/OR DRUG SERVICES; ACUTE DETOXIFICATION (RESIDENTIAL ADDICTION PROGRAM INPATIENT)","1","0.1667",null,null,"42.22",null,null,"1",null,"NA","NA"],
    [7684,"7684","Carrier O","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY, 60 MINUTES WITH PATIENT","49","0.2857",null,"8.21","107.26",null,"9","40",null,"NA","NA"],
    [7685,"7685","Carrier O","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S9480","INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES, PER DIEM","25","0.48",null,"6.13","44.39",null,"3","22",null,"NA","NA"],
    [7686,"7686","Carrier O","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVALUATION","17","0.2941",null,"1.7","7.12",null,"2","15",null,"NA","NA"],
    [7687,"7687","Carrier O","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90834","PSYCHOTHERAPY, 45 MINUTES WITH PATIENT","13","0.3846",null,"1.36","8.82",null,"2","11",null,"NA","NA"],
    [7688,"7688","Carrier O","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","11","0.4545",null,"2.95","72.76",null,"1","10",null,"NA","NA"],
    [7689,"7689","Carrier O","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION TREATMENT; DELIVERY AND MANAGEMENT, PER SESSION","11","0.4545",null,"2.95","72.76",null,"1","10",null,"NA","NA"],
    [7690,"7690","Carrier O","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION TREATMENT; PLANNING","11","0.4545",null,"2.95","72.75",null,"1","10",null,"NA","NA"],
    [7691,"7691","Carrier O","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","10","0.2",null,null,"1.6",null,null,"10",null,"NA","NA"],
    [7692,"7692","Carrier O","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90832","PSYCHOTHERAPY, 30 MINUTES WITH PATIENT","7","0.2857",null,"2.43","15.3",null,"1","6",null,"NA","NA"],
    [7693,"7693","Carrier O","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99204","Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","6","0.6667",null,null,"3.1",null,null,"6",null,"NA","NA"],
    [7694,"7694","Carrier O","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99215","Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","2","1",null,null,"2.61",null,null,"2",null,"NA","NA"],
    [7695,"7695","Carrier O","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99203","Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","2","1",null,null,"0.56",null,null,"2",null,"NA","NA"],
    [7696,"7696","Carrier O","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99441","Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion","1","1",null,null,"0.43",null,null,"1",null,"NA","NA"],
    [7697,"7697","Carrier O","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96127","Brief emotional/behavioral assessment (eg, depression inventory, attention-deficit/hyperactivity disorder [ADHD] scale), with scoring and documentation, per standardized instrument","1","1",null,null,"4.77",null,null,"1",null,"NA","NA"],
    [7698,"7698","Carrier O","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96165","HEALTH BEHAVIOR INTERVENTION, GROUP (2 OR MORE PATIENTS), FACE-TO-FACE; EACH ADDITIONAL 15","1","1",null,null,"69.52",null,null,"1",null,"NA","NA"],
    [7699,"7699","Carrier O","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99442","Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion","1","1",null,null,"0.43",null,null,"1",null,"NA","NA"],
    [7700,"7700","Carrier O","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99211","Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional","1","1",null,null,"0.46",null,null,"1",null,"NA","NA"],
    [7701,"7701","Carrier O","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99212","Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 10 minutes must be met or exceeded.","1","1",null,null,"0.46",null,null,"1",null,"NA","NA"],
    [7702,"7702","Carrier O","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96164","HEALTH BEHAVIOR INTERVENTION, GROUP (2 OR MORE PATIENTS), FACE-TO-FACE; INITIAL 30 MINUTES","1","1",null,null,"69.51",null,null,"1",null,"NA","NA"],
    [7703,"7703","Carrier O","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99204","Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","4","0.6667",null,null,"0.58",null,null,"4",null,"NA","NA"],
    [7704,"7704","Carrier O","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) DEVICE","176","0.9659",null,"23.03","5817.52",null,"7","169",null,"NA","NA"],
    [7705,"7705","Carrier O","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0562","HUMIDIFIER, HEATED, USED WITH POSITIVE AIRWAY PRESSURE DEVICE","107","0.9626",null,"44.45","4355.19",null,"8","99",null,"NA","NA"],
    [7706,"7706","Carrier O","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","19","0.8947",null,"39.55","1284.95",null,"3","16",null,"NA","NA"],
    [7707,"7707","Carrier O","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4222","INFUSION SUPPLIES FOR EXTERNAL DRUG INFUSION PUMP, PER CASSETTE OR BAG (LIST DRUGS SEPARATELY)","15","1",null,"15.57","960.71",null,"1","14",null,"NA","NA"],
    [7708,"7708","Carrier O","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A7038","FILTER, DISPOSABLE, USED WITH POSITIVE AIRWAY PRESSURE DEVICE","14","1",null,"2.01","432.79",null,"1","13",null,"NA","NA"],
    [7709,"7709","Carrier O","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0781","Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","13","1",null,"15.57","1033.4",null,"1","12",null,"NA","NA"],
    [7710,"7710","Carrier O","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A7035","HEADGEAR USED WITH POSITIVE AIRWAY PRESSURE DEVICE","13","1",null,"2.12","415.51",null,"1","12",null,"NA","NA"],
    [7711,"7711","Carrier O","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A7034","NASAL INTERFACE (MASK OR CANNULA TYPE) USED WITH POSITIVE AIRWAY PRESSURE DEVICE, WITH OR WITHOUT HEAD STRAP","12","1",null,"2.12","294.43",null,"1","11",null,"NA","NA"],
    [7712,"7712","Carrier O","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L1852","Knee orthosis (KO), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","10","0.7",null,null,"30.83",null,null,"10",null,"NA","NA"],
    [7713,"7713","Carrier O","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L3000","FOOT, INSERT, REMOVABLE, MOLDED TO PATIENT MODEL, 'UCB' TYPE, BERKELEY SHELL, EACH","10","0.8",null,null,"71.31",null,null,"10",null,"NA","NA"],
    [7714,"7714","Carrier O","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4222","INFUSION SUPPLIES FOR EXTERNAL DRUG INFUSION PUMP, PER CASSETTE OR BAG (LIST DRUGS SEPARATELY)","14","1",null,"2.1","33.29",null,"1","13",null,"NA","NA"],
    [7715,"7715","Carrier O","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A7038","FILTER, DISPOSABLE, USED WITH POSITIVE AIRWAY PRESSURE DEVICE","14","1",null,"15.57","72.53",null,"1","13",null,"NA","NA"],
    [7716,"7716","Carrier O","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0781","Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","13","1",null,"15.57","86.12",null,"1","12",null,"NA","NA"],
    [7717,"7717","Carrier O","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A7035","HEADGEAR USED WITH POSITIVE AIRWAY PRESSURE DEVICE","13","1",null,"2.12","34.63",null,"1","12",null,"NA","NA"],
    [7718,"7718","Carrier O","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A7034","NASAL INTERFACE (MASK OR CANNULA TYPE) USED WITH POSITIVE AIRWAY PRESSURE DEVICE, WITH OR WITHOUT HEAD STRAP","12","1",null,"2.12","26.77",null,"1","11",null,"NA","NA"],
    [7719,"7719","Carrier O","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A7037","TUBING USED WITH POSITIVE AIRWAY PRESSURE DEVICE","10","1",null,null,"19.99",null,null,"10",null,"NA","NA"],
    [7720,"7720","Carrier O","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4604","TUBING WITH INTEGRATED HEATING ELEMENT FOR USE WITH POSITIVE AIRWAY PRESSURE DEVICE","10","1",null,"2.08","25.47",null,"1","9",null,"NA","NA"],
    [7721,"7721","Carrier O","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1390","Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","7","1",null,"1.77","25.46",null,"2","5",null,"NA","NA"],
    [7722,"7722","Carrier O","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A7036","CHINSTRAP USED WITH POSITIVE AIRWAY PRESSURE DEVICE","6","1",null,"2.13","20.78",null,"1","5",null,"NA","NA"],
    [7723,"7723","Carrier O","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A7039","FILTER, NON DISPOSABLE, USED WITH POSITIVE AIRWAY PRESSURE DEVICE","6","1",null,"2.08","17.83",null,"1","5",null,"NA","NA"],
    [7724,"7724","Carrier O","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L2820","ADDITION TO LOWER EXTREMITY ORTHOSIS, SOFT INTERFACE FOR MOLDED PLASTIC, BELOW KNEE SECTION","1",null,"0.1111",null,"193.29",null,null,"1",null,"NA","NA"],
    [7725,"7725","Carrier O","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L2750","ADDITION TO LOWER EXTREMITY ORTHOSIS, PLATING CHROME OR NICKEL, PER BAR","1",null,"0.5",null,"193.29",null,null,"1",null,"NA","NA"],
    [7726,"7726","Carrier O","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","A4222","INFUSION SUPPLIES FOR EXTERNAL DRUG INFUSION PUMP, PER CASSETTE OR BAG (LIST DRUGS SEPARATELY)","1",null,"0.0667",null,"17.83",null,null,"1",null,"NA","NA"],
    [7727,"7727","Carrier O","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","G0068","Professional services for the administration of anti-infective, pain management, chelation, pulmonary hypertension, inotropic, or other intravenous infusion drug or biological (excluding chemotherapy or other highly complex drug or biological) for each infusion drug administration calendar day in the individual's home, each 15 min","1",null,"1",null,"17.83",null,null,"1",null,"NA","NA"],
    [7728,"7728","Carrier O","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L2755","Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","1",null,"0.25",null,"193.29",null,null,"1",null,"NA","NA"],
    [7729,"7729","Carrier O","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L2036","Knee-ankle-foot orthosis (KAFO), full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","1",null,"0.5",null,"193.28",null,null,"1",null,"NA","NA"],
    [7730,"7730","Carrier O","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L2830","ADDITION TO LOWER EXTREMITY ORTHOSIS, SOFT INTERFACE FOR MOLDED PLASTIC, ABOVE KNEE SECTION","1",null,"0.5",null,"193.29",null,null,"1",null,"NA","NA"],
    [7731,"7731","Carrier O","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L2275","ADDITION TO LOWER EXTREMITY, VARUS/VALGUS CORRECTION, PLASTIC MODIFICATION, PADDED/LINED","1",null,"0.125",null,"193.29",null,null,"1",null,"NA","NA"],
    [7732,"7732","Carrier O","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L2415","ADDITION TO KNEE LOCK WITH INTEGRATED RELEASE MECHANISM ( BAIL, CABLE, OR EQUAL), ANY MATERIAL, EACH JOINT","1",null,"0.5",null,"193.29",null,null,"1",null,"NA","NA"],
    [7733,"7733","Carrier O","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","EXTERNAL AMBULATORY INFUSION PUMP, INSULIN","19","0.9474",null,"103","1155.1",null,"4","15",null,"NA","NA"],
    [7734,"7734","Carrier O","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9276","Sensor; invasive (e.g., subcutaneous), disposable, for use with nondurable medical equipment interstitial continuous glucose monitoring system (CGM), one unit = 1 day supply","14","1",null,"49.61","699.96",null,"3","11",null,"NA","NA"],
    [7735,"7735","Carrier O","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4239","Supply allowance for nonadjunctive, nonimplanted continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service","14","0.8571",null,null,"524.55",null,null,"14",null,"NA","NA"],
    [7736,"7736","Carrier O","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4221","SUPPLIES FOR MAINTENANCE OF NON-INSULIN DRUG INFUSION CATHETER, PER WEEK (LIST DRUGS  SEPARATELY)","12","0.9167",null,"15.57","419.13",null,"1","11",null,"NA","NA"],
    [7737,"7737","Carrier O","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9277","TRANSMITTER; EXTERNAL, FOR USE WITH INTERSTITIAL CONTINUOUS GLUCOSE MONITORING SYSTEM","11","1",null,"32.77","620.05",null,"2","9",null,"NA","NA"],
    [7738,"7738","Carrier O","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4224","SUPPLIES FOR MAINTENANCE OF INSULIN INFUSION CATHETER, PER WEEK","8","1",null,null,"529.58",null,null,"8",null,"NA","NA"],
    [7739,"7739","Carrier O","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4225","SUPPLIES FOR EXTERNAL INSULIN INFUSION PUMP, SYRINGE TYPE CARTRIDGE, STERILE, EACH","7","1",null,null,"410.96",null,null,"7",null,"NA","NA"],
    [7740,"7740","Carrier O","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2103","NON-ADJUNCTIVE, NON-IMPLANTED CONTINUOUS GLUCOSE MONITOR OR RECEIVER","6","0.8333",null,null,"179.17",null,null,"6",null,"NA","NA"],
    [7741,"7741","Carrier O","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4232","SYRINGE WITH NEEDLE FOR EXTERNAL INSULIN PUMP, STERILE, 3CC","6","1",null,null,"352.01",null,null,"6",null,"NA","NA"],
    [7742,"7742","Carrier O","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4230","INFUSION SET FOR EXTERNAL INSULIN PUMP, NON NEEDLE CANNULA TYPE","4","1",null,null,"222.61",null,null,"4",null,"NA","NA"],
    [7743,"7743","Carrier O","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9276","Sensor; invasive (e.g., subcutaneous), disposable, for use with nondurable medical equipment interstitial continuous glucose monitoring system (CGM), one unit = 1 day supply","14","1",null,"16.54","63.63",null,"3","11",null,"NA","NA"],
    [7744,"7744","Carrier O","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9277","TRANSMITTER; EXTERNAL, FOR USE WITH INTERSTITIAL CONTINUOUS GLUCOSE MONITORING SYSTEM","11","1",null,"16.39","68.89",null,"2","9",null,"NA","NA"],
    [7745,"7745","Carrier O","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4224","SUPPLIES FOR MAINTENANCE OF INSULIN INFUSION CATHETER, PER WEEK","7","1",null,null,"61.78",null,null,"7",null,"NA","NA"],
    [7746,"7746","Carrier O","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4225","SUPPLIES FOR EXTERNAL INSULIN INFUSION PUMP, SYRINGE TYPE CARTRIDGE, STERILE, EACH","6","1",null,null,"52.31",null,null,"6",null,"NA","NA"],
    [7747,"7747","Carrier O","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4232","SYRINGE WITH NEEDLE FOR EXTERNAL INSULIN PUMP, STERILE, 3CC","6","1",null,null,"58.67",null,null,"6",null,"NA","NA"],
    [7748,"7748","Carrier O","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4230","INFUSION SET FOR EXTERNAL INSULIN PUMP, NON NEEDLE CANNULA TYPE","4","1",null,null,"55.65",null,null,"4",null,"NA","NA"],
    [7749,"7749","Carrier O","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4238","Supply allowance for adjunctive, nonimplanted continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service","2","1",null,null,"21.34",null,null,"2",null,"NA","NA"],
    [7750,"7750","Carrier O","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2102","ADJUNCTIVE, NONIMPLANTED CONTINUOUS GLUCOSE MONITOR (CGM) OR RECEIVER","1","1",null,null,"21.06",null,null,"1",null,"NA","NA"],
    [7751,"7751","Carrier O","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","EXTERNAL AMBULATORY INFUSION PUMP, INSULIN","17","0.9474",null,"25.54","75.57",null,"3","14",null,"NA","NA"],
    [7752,"7752","Carrier O","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4221","SUPPLIES FOR MAINTENANCE OF NON-INSULIN DRUG INFUSION CATHETER, PER WEEK (LIST DRUGS  SEPARATELY)","11","0.9167",null,"15.57","41.81",null,"1","10",null,"NA","NA"],
    [7753,"7753","Carrier O","2024","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","A4224","SUPPLIES FOR MAINTENANCE OF INSULIN INFUSION CATHETER, PER WEEK","1",null,"1",null,"97.09",null,null,"1",null,"NA","NA"],
    [7754,"7754","Carrier O","2024","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0784","EXTERNAL AMBULATORY INFUSION PUMP, INSULIN","1",null,"1",null,"97.09",null,null,"1",null,"NA","NA"],
    [7755,"7755","Carrier O","2024","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","A4225","SUPPLIES FOR EXTERNAL INSULIN INFUSION PUMP, SYRINGE TYPE CARTRIDGE, STERILE, EACH","1",null,"1",null,"97.09",null,null,"1",null,"NA","NA"],
    [7756,"7756","Carrier O","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","146","0.9",null,"0","2.887096774",null,"22","124",null,"DULAGLUTIDE","NA"],
    [7757,"7757","Carrier O","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","143","0.94",null,"0","0.324675325",null,"66","77",null,"APIXABAN","NA"],
    [7758,"7758","Carrier O","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","95","0.96",null,"0","0.172839506",null,"14","81",null,"EMPAGLIFLOZIN","NA"],
    [7759,"7759","Carrier O","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","94","0.98",null,"0","1.308641975",null,"13","81",null,"EMPAGLIFLOZIN","NA"],
    [7760,"7760","Carrier O","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","91","0.96",null,"0.481481481","0.640625","0.22","27","64","1","ADALIMUMAB","NA"],
    [7761,"7761","Carrier O","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","73","0.68",null,"0","7.253968254",null,"10","63",null,"TIRZEPATIDE","NA"],
    [7762,"7762","Carrier O","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","67","0.57",null,"0","0.387096774",null,"5","62",null,"FLASH GLUCOSE SENSOR","NA"],
    [7763,"7763","Carrier O","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","57","0.93",null,"0","0.066666667",null,"12","45",null,"DULAGLUTIDE","NA"],
    [7764,"7764","Carrier O","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","54","0.94",null,"0","0.56",null,"4","50",null,"DUPILUMAB","NA"],
    [7765,"7765","Carrier O","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","52","0.94",null,"0","0.024390244",null,"11","41",null,"RIVAROXABAN","NA"],
    [7766,"7766","Carrier O","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","39","1",null,"0","0",null,"6","33",null,"DEXTROAMPHETAMINE/AMPHETAMINE","NA"],
    [7767,"7767","Carrier O","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","28","1",null,"0","0.063596491",null,"9","19",null,"ETANERCEPT","NA"],
    [7768,"7768","Carrier O","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","27","1",null,"0","0",null,"5","22",null,"DEXTROAMPHETAMINE/AMPHETAMINE","NA"],
    [7769,"7769","Carrier O","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","23","1",null,"0","0",null,"8","15",null,"DEXTROAMPHETAMINE/AMPHETAMINE","NA"],
    [7770,"7770","Carrier O","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","21","1",null,"0","0",null,"4","17",null,"DEXTROAMPHETAMINE/AMPHETAMINE","NA"],
    [7771,"7771","Carrier O","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","17","1",null,"0","0",null,"5","12",null,"DEXTROAMPHETAMINE/AMPHETAMINE","NA"],
    [7772,"7772","Carrier O","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","16","1",null,"0","0",null,"2","14",null,"DAPAGLIFLOZIN PROPANEDIOL","NA"],
    [7773,"7773","Carrier O","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","15","1",null,"0","0",null,"7","8",null,"RISANKIZUMAB-RZAA","NA"],
    [7774,"7774","Carrier O","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","15","1",null,"0","0.002777778",null,"5","10",null,"OFATUMUMAB","NA"],
    [7775,"7775","Carrier O","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","15","1",null,"0","0",null,"3","12",null,"METHYLPHENIDATE HCL","NA"],
    [7776,"7776","Carrier N","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96416","CHEMO PROLONG INFUSE W/PUMP","7","1",null,"24","40","0","1","6","0","NA","NA"],
    [7777,"7777","Carrier N","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22633","ARTHRD CMBN 1NTRSPC LUMBAR","3","0",null,"0","80","0","0","3","0","NA","NA"],
    [7778,"7778","Carrier N","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44626","REPAIR BOWEL OPENING","2","1",null,"0","12","0","0","2","0","NA","NA"],
    [7779,"7779","Carrier N","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","S2068","BREAST DIEP OR SIEA FLAP","2","1",null,"0","36","0","0","2","0","NA","NA"],
    [7780,"7780","Carrier N","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","55920","PLACE NEEDLES PELVIC FOR RT","2","1",null,"0","48","0","0","2","0","NA","NA"],
    [7781,"7781","Carrier N","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","42415","EXCISE PAROTID GLAND/LESION","2","0",null,"0","120","0","0","2","0","NA","NA"],
    [7782,"7782","Carrier N","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","50543","LAPARO PARTIAL NEPHRECTOMY","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [7783,"7783","Carrier N","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","32667","THORACOSCOPY W/W RESECT ADDL","1","1",null,"0","72","0","0","1","0","NA","NA"],
    [7784,"7784","Carrier N","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","48999","UNLISTED PROCEDURE PANCREAS","1","1",null,"0","24","0","0","1","0","NA","NA"],
    [7785,"7785","Carrier N","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22800","ARTHRD PST DFRM<6 VRT SGM","1","1",null,"0","96","0","0","1","0","NA","NA"],
    [7786,"7786","Carrier N","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96416","CHEMO PROLONG INFUSE W/PUMP","7","1",null,"24","40","0","1","6","0","NA","NA"],
    [7787,"7787","Carrier N","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44626","REPAIR BOWEL OPENING","2","1",null,"0","12","0","0","2","0","NA","NA"],
    [7788,"7788","Carrier N","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","S2068","BREAST DIEP OR SIEA FLAP","2","1",null,"0","36","0","0","2","0","NA","NA"],
    [7789,"7789","Carrier N","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","55920","PLACE NEEDLES PELVIC FOR RT","2","1",null,"0","48","0","0","2","0","NA","NA"],
    [7790,"7790","Carrier N","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","50543","LAPARO PARTIAL NEPHRECTOMY","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [7791,"7791","Carrier N","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","32667","THORACOSCOPY W/W RESECT ADDL","1","1",null,"0","72","0","0","1","0","NA","NA"],
    [7792,"7792","Carrier N","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","48999","UNLISTED PROCEDURE PANCREAS","1","1",null,"0","24","0","0","1","0","NA","NA"],
    [7793,"7793","Carrier N","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22800","ARTHRD PST DFRM<6 VRT SGM","1","1",null,"0","96","0","0","1","0","NA","NA"],
    [7794,"7794","Carrier N","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","32608","THORACOSCOPY W/BX NODULE","1","1",null,"0","24","0","0","1","0","NA","NA"],
    [7795,"7795","Carrier N","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","54125","REMOVAL OF PENIS","1","1",null,"0","48","0","0","1","0","NA","NA"],
    [7796,"7796","Carrier N","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95810","POLYSOM 6/> YRS 4/> PARAM","35","0.886",null,"0","80.9","0","0","35","0","NA","NA"],
    [7797,"7797","Carrier N","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J0585","INJECTION,ONABOTULINUMTOXINA","29","0.897",null,"24","26.8","0","3","26","0","NA","NA"],
    [7798,"7798","Carrier N","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE O/P EST MOD 30 MIN","22","0.727",null,"12","126","0","2","20","0","NA","NA"],
    [7799,"7799","Carrier N","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64615","CHEMODENERV MUSC MIGRAINE","18","0.889",null,"24","24","0","2","16","0","NA","NA"],
    [7800,"7800","Carrier N","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J7323","EUFLEXXA INJ PER DOSE","15","1",null,"0","8.6","0","1","14","0","NA","NA"],
    [7801,"7801","Carrier N","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95811","POLYSOM 6/>YRS CPAP 4/> PARM","13","0.846",null,"0","81.2","0","0","13","0","NA","NA"],
    [7802,"7802","Carrier N","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99213","OFFICE O/P EST LOW 20 MIN","13","0.692",null,"0","174","0","1","12","0","NA","NA"],
    [7803,"7803","Carrier N","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","Q5103","INJECTION, INFLECTRA","10","0.9",null,"144","130.7","0","1","9","0","NA","NA"],
    [7804,"7804","Carrier N","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","INSJ BIOMECHANICAL DEVICE","10","0.6",null,"0","74.4","0","0","10","0","NA","NA"],
    [7805,"7805","Carrier N","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22845","INSERT SPINE FIXATION DEVICE","9","0.778",null,"0","80","0","0","9","0","NA","NA"],
    [7806,"7806","Carrier N","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95810","POLYSOM 6/> YRS 4/> PARAM","31","0.886",null,"0","35.6","0","0","31","0","NA","NA"],
    [7807,"7807","Carrier N","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J0585","INJECTION,ONABOTULINUMTOXINA","26","0.897",null,"24","26.1","0","3","23","0","NA","NA"],
    [7808,"7808","Carrier N","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99214","OFFICE O/P EST MOD 30 MIN","16","0.727",null,"12","87.4","0","2","14","0","NA","NA"],
    [7809,"7809","Carrier N","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64615","CHEMODENERV MUSC MIGRAINE","16","0.889",null,"24","22.3","0","2","14","0","NA","NA"],
    [7810,"7810","Carrier N","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J7323","EUFLEXXA INJ PER DOSE","15","1",null,"0","8.6","0","1","14","0","NA","NA"],
    [7811,"7811","Carrier N","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95811","POLYSOM 6/>YRS CPAP 4/> PARM","11","0.846",null,"0","63.3","0","0","11","0","NA","NA"],
    [7812,"7812","Carrier N","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99213","OFFICE O/P EST LOW 20 MIN","9","0.692",null,"0","108","0","1","8","0","NA","NA"],
    [7813,"7813","Carrier N","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J0178","AFLIBERCEPT INJECTION","9","1",null,"0","24","0","2","7","0","NA","NA"],
    [7814,"7814","Carrier N","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","Q5103","INJECTION, INFLECTRA","9","0.9",null,"144","111","0","1","8","0","NA","NA"],
    [7815,"7815","Carrier N","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J9306","INJECTION, PERTUZUMAB, 1 MG","8","1",null,"0","68.6","0","1","7","0","NA","NA"],
    [7816,"7816","Carrier N","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","J0585","Injection, Botox","5",null,"1","0","2784","0","0","5","0","NA","NA"],
    [7817,"7817","Carrier N","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","99214","Established patient office or other outpatient visit, 30-39 minutes","1",null,"1","0","72","0","0","1","0","NA","NA"],
    [7818,"7818","Carrier N","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","93655","Intracardiac Electrophysiological Procedures/Studies","1",null,"1","0","48","0","0","1","0","NA","NA"],
    [7819,"7819","Carrier N","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","33249","Pacemaker or Implantable Defibrillator Procedure","1",null,"1","0","288","0","0","1","0","NA","NA"],
    [7820,"7820","Carrier N","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","J0741","Injection, Cabenuva","1",null,"1","0","0","0","0","1","0","NA","NA"],
    [7821,"7821","Carrier N","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","J1437","Injection, Monoferric","1",null,"1","0","24","0","0","1","0","NA","NA"],
    [7822,"7822","Carrier N","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1002","SUBSTANCE ABUSE RESIDENTIAL","2","1",null,null,"0","0","2","0","0","NA","NA"],
    [7823,"7823","Carrier N","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","126","DETOX","1","1",null,null,"0","0","1","0","0","NA","NA"],
    [7824,"7824","Carrier N","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1001","EATING DISORDER RESIDENTIAL","1","1",null,null,"0","0","1","0","0","NA","NA"],
    [7825,"7825","Carrier N","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1002","SUBSTANCE ABUSE RESIDENTIAL","2","1",null,null,"0","0","2","0","0","NA","NA"],
    [7826,"7826","Carrier N","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","126","DETOX","1","1",null,null,"0","0","1","0","0","NA","NA"],
    [7827,"7827","Carrier N","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1001","EATING DISORDER RESIDENTIAL","1","1",null,null,"0","0","1","0","0","NA","NA"],
    [7828,"7828","Carrier N","2024","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","1001","Eating Disorder Residential","1",null,"1","24","0","0","1","0","0","NA","NA"],
    [7829,"7829","Carrier N","2024","Inpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","Revenue","1002","Substance Abuse Residential","1",null,"1","48","0","0","1","0","0","NA","NA"],
    [7830,"7830","Carrier N","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","TRANSCRANIAL MAGNETIC STIMULATION (TMS)","3","1",null,"0",null,"0","0","3","0","NA","NA"],
    [7831,"7831","Carrier N","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","0362T","APPLIED BEHAVIORAL ANALYSIS","1","1",null,"0",null,"0","0","1","0","NA","NA"],
    [7832,"7832","Carrier N","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","PSYCHIATRIC TREATMENT PARTIAL HOSPITALIZATION","1","1",null,"0",null,"0","0","1","0","NA","NA"],
    [7833,"7833","Carrier N","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90867","TRANSCRANIAL MAGNETIC STIMULATION (TMS)","3","1",null,"0",null,"0","0","3","0","NA","NA"],
    [7834,"7834","Carrier N","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","0362T","APPLIED BEHAVIORAL ANALYSIS","1","1",null,"0",null,"0","0","1","0","NA","NA"],
    [7835,"7835","Carrier N","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0035","PSYCHIATRIC TREATMENT PARTIAL HOSPITALIZATION","1","1",null,"0",null,"0","0","1","0","NA","NA"],
    [7836,"7836","Carrier N","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L8680","IMPLT NEUROSTIM ELCTR EACH","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [7837,"7837","Carrier N","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L8614","COCHLEAR DEVICE","1","1",null,"0","24","0","0","1","0","NA","NA"],
    [7838,"7838","Carrier N","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0760","OSTEOGEN ULTRASOUND STIMLTOR","1","1",null,"0","24","0","0","1","0","NA","NA"],
    [7839,"7839","Carrier N","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L8688","IMPLT NROSTM PLS GEN DUA NON","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [7840,"7840","Carrier N","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0466","HOME VENT NON-INVASIVE INTER","1","1",null,"0","48","0","0","1","0","NA","NA"],
    [7841,"7841","Carrier N","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L1846","KO W ADJ FLEX/EXT ROTAT MOLD","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [7842,"7842","Carrier N","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L8680","IMPLT NEUROSTIM ELCTR EACH","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [7843,"7843","Carrier N","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L8614","COCHLEAR DEVICE","1","1",null,"0","24","0","0","1","0","NA","NA"],
    [7844,"7844","Carrier N","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0760","OSTEOGEN ULTRASOUND STIMLTOR","1","1",null,"0","24","0","0","1","0","NA","NA"],
    [7845,"7845","Carrier N","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L8688","IMPLT NROSTM PLS GEN DUA NON","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [7846,"7846","Carrier N","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0466","HOME VENT NON-INVASIVE INTER","1","1",null,"0","48","0","0","1","0","NA","NA"],
    [7847,"7847","Carrier N","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L1846","KO W ADJ FLEX/EXT ROTAT MOLD","1","1",null,"0","0","0","0","1","0","NA","NA"],
    [7848,"7848","Carrier N","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","DEXCOM G7 SENSOR","82","0.5366",null,"3.9","7","0","17","65","0","NA","NA"],
    [7849,"7849","Carrier N","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","DEXCOM G6 SENSOR","34","0.8824",null,"0.5","6.5","0","7","27","0","NA","NA"],
    [7850,"7850","Carrier N","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","FREESTYLE LIBRE 3 SENSOR","34","0.3824",null,"18.5","16","0","6","28","0","NA","NA"],
    [7851,"7851","Carrier N","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","DEXCOM G7 RECEIVER","22","0.3636",null,"9.3","7.1","0","3","19","0","NA","NA"],
    [7852,"7852","Carrier N","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","DEXCOM G6 TRANSMITTER","21","0.7619",null,"0.1","3.5","0","4","17","0","NA","NA"],
    [7853,"7853","Carrier N","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","FREESTYLE LIBRE 3 PLUS SENSOR","10","0.3",null,"1.6","27.3","0","4","6","0","NA","NA"],
    [7854,"7854","Carrier N","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","FREESTYLE LIBRE 2 SENSOR","9","0.2222",null,"61.1","10.7","0","1","8","0","NA","NA"],
    [7855,"7855","Carrier N","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","FREESTYLE LIBRE 14 DAY SENSOR","5","0",null,"5","19.3","0","1","4","0","NA","NA"],
    [7856,"7856","Carrier N","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","TRUE METRIX GLUCOSE TEST STRIP","3","0.3333",null,"0.1","0.4","0","2","1","0","NA","NA"],
    [7857,"7857","Carrier N","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","FREESTYLE LIBRE 3 READER","3","0.3333",null,"0","0.6","0","1","2","0","NA","NA"],
    [7858,"7858","Carrier N","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","CONTOUR NEXT TEST STRIP","2","1",null,"0","47","0","1","1","0","NA","NA"],
    [7859,"7859","Carrier N","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","FREESTYLE LIBRE 2 READER","1","1",null,"61.1","1.7","0","0","1","0","NA","NA"],
    [7860,"7860","Carrier N","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","FREESTYLE TEST STRIPS","1","1",null,"0","0","0","1","0","0","NA","NA"],
    [7861,"7861","Carrier N","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","ACCU-CHEK GUIDE TEST STRIP","1","1",null,"0","0.2","0","0","1","0","NA","NA"],
    [7862,"7862","Carrier N","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","DEXCOM G6 SENSOR","34","0.8824",null,"0.5","6.5","0","7","27","0","NA","NA"],
    [7863,"7863","Carrier N","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","DEXCOM G6 TRANSMITTER","21","0.7619",null,"0.1","3.5","0","4","17","0","NA","NA"],
    [7864,"7864","Carrier N","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","DEXCOM G7 SENSOR","44","0.5366",null,"3.9","7","0","17","65","0","NA","NA"],
    [7865,"7865","Carrier N","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","FREESTYLE LIBRE 3 SENSOR","34","0.3824",null,"18.5","16","0","6","28","0","NA","NA"],
    [7866,"7866","Carrier N","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","DEXCOM G7 RECEIVER","82","0.3636",null,"9.3","7.1","0","3","19","0","NA","NA"],
    [7867,"7867","Carrier N","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","FREESTYLE LIBRE 3 READER","3","0.3333",null,"0","0.6","0","1","2","0","NA","NA"],
    [7868,"7868","Carrier N","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","195","0.5385",null,"3.9","7","0","27","168","0","semaglutide","OZEMPIC .25 OR 0.5 PEN INJCTR"],
    [7869,"7869","Carrier N","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","161","0.7826",null,"0.1","6.2","0","21","140","0","tirzepatide","ZEPBOUND 2.5 MG/0.5 PEN INJCTR"],
    [7870,"7870","Carrier N","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","146","0.4521",null,"0.8","6.9","0","26","120","0","tirzepatide","MOUNJARO 2.5 MG/0.5 PEN INJCTR"],
    [7871,"7871","Carrier N","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","94","0.7766",null,"2.2","3.9","0","8","86","0","semaglutide","WEGOVY 0.25MG/0.5 PEN INJCTR"],
    [7872,"7872","Carrier N","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","82","0.5366",null,"0","6.2","0","17","65","0","Dexcom","DEXCOM G7 SENSOR  EACH"],
    [7873,"7873","Carrier N","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","69","0.8382",null,"0.2","8.5","0","18","51","0","semaglutide","OZEMPIC 1/0.75 (3) PEN INJCTR"],
    [7874,"7874","Carrier N","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","68","0.6957",null,"0","2.9","0","8","60","0","rimegepant","NURTEC ODT 75 MG TAB RAPDIS"],
    [7875,"7875","Carrier N","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","53","0.8491",null,"0.7","8.8","0","27","26","0","apixaban","ELIQUIS 5 MG TABLET"],
    [7876,"7876","Carrier N","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","49","0.8571",null,"2.7","3","0","8","41","0","dupillamab","DUPIXENT PEN 300 MG/2ML PEN INJCTR"],
    [7877,"7877","Carrier N","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","49","0.6939",null,"1.9","3.9","0","2","47","0","ruxolitinib","OPZELURA 1.5 % CREAM (G)"],
    [7878,"7878","Carrier N","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","34","1",null,"0.1","7.8","0","4","30","0","dextroamphetamine","DEXTROAMPHETAMINE-AMPH 20 MG CAP.SR 24H"],
    [7879,"7879","Carrier N","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","28","1",null,"1","0.9","0","15","13","0","rivaroxaban","XARELTO 20 MG TABLET"],
    [7880,"7880","Carrier N","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","22","1",null,"13.7","0","0","5","17","0","dextroamphetamine","DEXTROAMPHETAMINE-AMPH 10 MG TABLET"],
    [7881,"7881","Carrier N","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","20","1",null,"3.6","0.1","0","5","15","0","dextroamphetamine","DEXTROAMPHETAMINE-AMPHET ER 20 MG CAP.SR 24H"],
    [7882,"7882","Carrier N","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","16","1",null,"0","2.6","0","4","12","0","upadacitinib","RINVOQ 15 MG TAB ER 24H"],
    [7883,"7883","Carrier N","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","16","1",null,"0","0.1","0","5","11","0","dextroamphetamine","DEXTROAMPHETAMINE-AMPHET ER 10 MG CAP.SR 24H"],
    [7884,"7884","Carrier N","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","14","1",null,"5.3","3.3","0","5","9","0","methylphenidate","METHYLPHENIDATE HCL 10 MG TABLET"],
    [7885,"7885","Carrier N","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","13","1",null,"0","0","0","3","10","0","methylphenidate","METHYLPHENIDATE ER 36 MG TAB ER 24"],
    [7886,"7886","Carrier N","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","13","1",null,"0","0.1","0","4","9","0","atogepant","QULIPTA 60 MG TABLET"],
    [7887,"7887","Carrier N","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","13","1",null,"17.2","5.4","0","3","10","0","etanercept","ENBREL SURECLICK 50MG/ML(1) PEN INJCTR"],
    [7888,"7888","Carrier N","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","5",null,"1","0","768","0","0","5","0","Evolocumab","REPATHA"],
    [7889,"7889","Carrier N","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","2",null,"1","0","216","0","0","2","0","Fremanezumab","AJOVY"],
    [7890,"7890","Carrier N","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","2",null,"1","0","48","0","0","2","0","Dupilumab","DUPIXENT"],
    [7891,"7891","Carrier N","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","2",null,"1","0","984","0","0","2","0","Semaglutide","OZEMPIC"],
    [7892,"7892","Carrier N","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","2",null,"1","0","744","0","0","2","0","Semaglutide","WEGOVY"],
    [7893,"7893","Carrier N","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","2",null,"1","0","384","0","0","2","0","Tirzepatide","ZEPBOUND"],
    [7894,"7894","Carrier N","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","1",null,"1","0","168","0","0","1","0","Eerenumab","AIMOVIG"],
    [7895,"7895","Carrier N","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","1",null,"1","0","432","0","0","1","0","Eerenumab","AIMOVIG AUTOINJECTOR"],
    [7896,"7896","Carrier N","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","1",null,"1","0","48","0","0","1","0","Bupropion Hydrochloride","APLENZIN"],
    [7897,"7897","Carrier N","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","1",null,"1","0","192","0","0","1","0","Dextromethorphan/Bupropion","AUVELITY"],
    [7898,"7898","Carrier C","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","59400","FULL ROUT OBSTE CARE,VAGINAL DELIV","43","1",null,null,"0.51",null,"0","43","0","NA","NA"],
    [7899,"7899","Carrier C","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","59510","FULL ROUT OBSTE CARE,CESAREAN DELIV","35","1",null,"0.8","12.5",null,"1","34","0","NA","NA"],
    [7900,"7900","Carrier C","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44204","COLECTOMY LAP PARTIAL W/ ANAST","14","1",null,"1","4",null,"2","12","0","NA","NA"],
    [7901,"7901","Carrier C","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96416","CHEMO ADMIN IV INFUS >8 HRS W/PORT/IMPLANTED PUMP","13","1",null,"3","28.92",null,"1","12","0","NA","NA"],
    [7902,"7902","Carrier C","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU","8","0.75",null,"12","63.67",null,"2","6","0","NA","NA"],
    [7903,"7903","Carrier C","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","120.101","REF SKILLED NURSING FACILITY (SNF)","6","0.2587",null,"85","3",null,"5","1","0","NA","NA"],
    [7904,"7904","Carrier C","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","33361","REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH","6","1",null,null,"42.67",null,"0","6","0","NA","NA"],
    [7905,"7905","Carrier C","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27447","TOTAL KNEE ARTHROPLASTY","6","0",null,null,"59",null,"0","6","0","NA","NA"],
    [7906,"7906","Carrier C","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95720","EEG, CONT RECORD, EA INCRMNT >12 HRS, UP TO 26 HRS, INTERP & REP AFTER EA 24 HR; W/VIDEO","5","1",null,null,"0.12",null,"0","5","0","NA","NA"],
    [7907,"7907","Carrier C","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","G4033","SKILLED NURSING FACILITY SS","5","0.2",null,"459",null,null,"3","2","0","NA","NA"],
    [7908,"7908","Carrier C","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","59400","FULL ROUT OBSTE CARE,VAGINAL DELIV","43","1",null,null,"0.51",null,"0","43","0","NA","NA"],
    [7909,"7909","Carrier C","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","59510","FULL ROUT OBSTE CARE,CESAREAN DELIV","35","1",null,"0.8","12.5",null,"1","34","0","NA","NA"],
    [7910,"7910","Carrier C","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44204","COLECTOMY LAP PARTIAL W/ ANAST","14","1",null,"1","4",null,"2","12","0","NA","NA"],
    [7911,"7911","Carrier C","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96416","CHEMO ADMIN IV INFUS >8 HRS W/PORT/IMPLANTED PUMP","13","1",null,"3","28.92",null,"1","12","0","NA","NA"],
    [7912,"7912","Carrier C","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33361","REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH","6","1",null,null,"42.67",null,"0","6","0","NA","NA"],
    [7913,"7913","Carrier C","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95720","EEG, CONT RECORD, EA INCRMNT >12 HRS, UP TO 26 HRS, INTERP & REP AFTER EA 24 HR; W/VIDEO","5","1",null,null,"0.12",null,"0","5","0","NA","NA"],
    [7914,"7914","Carrier C","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","61624","TRANSCATH OCCLUSION/EMBOLIZAT PERCUT CNS","5","1",null,"16","32",null,"1","4","0","NA","NA"],
    [7915,"7915","Carrier C","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","36430","TRANSFUSION BLOOD/BLOOD COMPONENTS","5","1",null,null,"24.4",null,"0","5","0","NA","NA"],
    [7916,"7916","Carrier C","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","50360","TRANSPLANTATION OF KIDNEY","5","1",null,null,"30.6",null,"0","5","0","NA","NA"],
    [7917,"7917","Carrier C","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","59409","VAG DELIVERY ONLY (W/WO EPISIOTOMY &/OR FORCEPS)","4","1",null,null,"0.56",null,"0","4","0","NA","NA"],
    [7918,"7918","Carrier C","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","61512","CRANIECT TREPH BONE FLAP CRANIO EXC MENINGIO SUPR","3",null,"0.6667",null,"48.67",null,"0","3","0","NA","NA"],
    [7919,"7919","Carrier C","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN","57616","0.9853",null,"4.95","7.05",null,"4832","52784","0","NA","NA"],
    [7920,"7920","Carrier C","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES","9685","0.9922",null,"3.44","5.91",null,"326","9359","0","NA","NA"],
    [7921,"7921","Carrier C","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97124","THERA PROC 1+ AREAS EA 15 MIN MASSAGE","7060","0.9918",null,"1.54","2.51",null,"139","6921","0","NA","NA"],
    [7922,"7922","Carrier C","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","COLONOSCOPY W/ BX SINGLE/MULT","3305","0.9973",null,"1.34","5.5",null,"91","3214","0","NA","NA"],
    [7923,"7923","Carrier C","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","TTE (ECHO) WITH SPECTRAL & COLOR FLOW DOPPLER","1616","0.9963",null,"1.78","10.02",null,"176","1440","0","NA","NA"],
    [7924,"7924","Carrier C","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97530","THERA ACTVI DIRECT PAT CONTACT EA 15 MIN","1541","0.989",null,"2.59","8.95",null,"72","1469","0","NA","NA"],
    [7925,"7925","Carrier C","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99202","OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES","1482","0.973",null,"3.88","14.47",null,"176","1306","0","NA","NA"],
    [7926,"7926","Carrier C","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","MRI BRAIN W/ & W/O CONTRAST,","1365","0.8359",null,"7.75","32.84",null,"197","1168","0","NA","NA"],
    [7927,"7927","Carrier C","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99201.555","REF MISCELLANEOUS EXTERNAL","1306","0.9387",null,"15.4","28.94",null,"142","1164","0","NA","NA"],
    [7928,"7928","Carrier C","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","MRI ANY JOINT","1185","0.8034",null,"4.73","26.87",null,"97","1088","0","NA","NA"],
    [7929,"7929","Carrier C","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96040","GENETICS COUNSELING, EACH 30 MIN, W/ PT/FAMILY","996","1",null,"0.57","4.6",null,"347","649","0","NA","NA"],
    [7930,"7930","Carrier C","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95806","SLEEP STUDY, UNATTENDED","353","1",null,"1.68","5.94",null,"2","351","0","NA","NA"],
    [7931,"7931","Carrier C","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93015","ETT STRESS &/OR PHARMACOLOGICAL STRESS","344","1",null,"1.72","5.79",null,"18","326","0","NA","NA"],
    [7932,"7932","Carrier C","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","45389","COLONOSCOPY, FLEXIBLE; WITH ENDOSCOPIC STENT PLACEMENT","304","1",null,"1.15","5.84",null,"13","291","0","NA","NA"],
    [7933,"7933","Carrier C","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","52000","CYSTOURETHROSCOPY (SEP PROC)","235","1",null,"2.58","30.81",null,"12","223","0","NA","NA"],
    [7934,"7934","Carrier C","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","17000","DESTRUCT 1ST AK PREMALIG LESION","228","1",null,"1.33","2.5",null,"6","222","0","NA","NA"],
    [7935,"7935","Carrier C","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93922","NON-INVASIVE STUDY EXTREMITY ARTERY BILAT SINGLE","204","1",null,"0.28","6.51",null,"11","193","0","NA","NA"],
    [7936,"7936","Carrier C","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99024","POST OP FOLLOW-UP VISIT GLOBAL","197","1",null,"3.75","20.97",null,"28","169","0","NA","NA"],
    [7937,"7937","Carrier C","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93970","DUPLEX SCAN, VEINS, BILATERAL","178","1",null,"0.86","8.13",null,"14","164","0","NA","NA"],
    [7938,"7938","Carrier C","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99201.144","REF PODIATRY - INTERNAL","177","1",null,"39.81","147.77",null,"21","156","0","NA","NA"],
    [7939,"7939","Carrier C","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","0169U","NUDT15 & TPMT GENE ANALYSIS COMMON VARIANTS","2",null,"0.5",null,"28.5",null,"0","2","0","NA","NA"],
    [7940,"7940","Carrier C","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","36474","VENOUS ABLATION MECHANOCHEMICAL, EA ADDL VEIN","2",null,"0.5","1","75",null,"1","1","0","NA","NA"],
    [7941,"7941","Carrier C","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43497","TRANSORAL LOWER ESOPHAGEAL MYOTOMY","2",null,"0.5",null,"40",null,"0","2","0","NA","NA"],
    [7942,"7942","Carrier C","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","61736","LITT LES ICR SINGLE TRAJECTORY 1 SIMPLE LESION","2",null,"0.5",null,"40.5",null,"0","2","0","NA","NA"],
    [7943,"7943","Carrier C","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","S9341","HIT ENTERAL GRAV DIEM","2",null,"0.5",null,"58.5",null,"0","2","0","NA","NA"],
    [7944,"7944","Carrier C","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","0479T","FRACTIONAL ABL LASER FENESTRATION;  FIRST 100 SQCM","3",null,"0.3333","16","48",null,"1","2","0","NA","NA"],
    [7945,"7945","Carrier C","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64555","PERCUT IMPLANT NEUROSTIM ELECTRO","3",null,"0.3333",null,"57",null,"0","3","0","NA","NA"],
    [7946,"7946","Carrier C","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","81170","ABL1,GENE ANALYSIS, VARIANTS IN THE KINASE DOMAIN","3",null,"0.3333","26","45.5",null,"1","2","0","NA","NA"],
    [7947,"7947","Carrier C","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","81201","APC GENE ANALYSIS FULL GENE SEQUENCE","3",null,"0.3333",null,"40.67",null,"0","3","0","NA","NA"],
    [7948,"7948","Carrier C","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","81324","PMP22 GENE ANAL DUPLICATION/DELETION ANALYSIS","3",null,"0.3333",null,"40.67",null,"0","3","0","NA","NA"],
    [7949,"7949","Carrier C","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","128.102","REF IP CD RESIDENTIAL TREATMENT CENTER","3","1",null,"15",null,null,"3","0","0","NA","NA"],
    [7950,"7950","Carrier C","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","H2020","THER BEHAV SVC, PER DIEM","1","1",null,"70",null,null,"1","0","0","NA","NA"],
    [7951,"7951","Carrier C","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","128.102","REF IP CD RESIDENTIAL TREATMENT CENTER","3","1",null,"15",null,null,"3","0","0","NA","NA"],
    [7952,"7952","Carrier C","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H2020","THER BEHAV SVC, PER DIEM","1","1",null,"70",null,null,"1","0","0","NA","NA"],
    [7953,"7953","Carrier C","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY 60 MIN PATIENT","8544","0.9963",null,"0.92","2.72",null,"306","8238","0","NA","NA"],
    [7954,"7954","Carrier C","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90836","PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS","3219","0.9984",null,"0.55","4.13",null,"191","3028","0","NA","NA"],
    [7955,"7955","Carrier C","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES","678","0.9602",null,"6.92","11.29",null,"27","651","0","NA","NA"],
    [7956,"7956","Carrier C","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90853","GROUP PSYCHOTHERAPY","494","0.996",null,"5.4","7.29",null,"5","489","0","NA","NA"],
    [7957,"7957","Carrier C","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96130","PSYCHOLOGICAL TESTING EVAL BY PHYS OR QUAL PROF;  FIRST HOUR","320","0.9719",null,"20.5","8.38",null,"2","318","0","NA","NA"],
    [7958,"7958","Carrier C","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","TRANSCRANIAL MAG STIMJ TX DLVR & MGMT","235","0.8383",null,"35","56.62",null,"2","233","0","NA","NA"],
    [7959,"7959","Carrier C","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","BEHAV IDENTIFICATION ASSESSMNT, ADM BY PHYS OR QUAL PROF, EA 15 MINS","185","0.8541",null,"72","99.03",null,"1","184","0","NA","NA"],
    [7960,"7960","Carrier C","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96132","NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR","172","0.8721",null,"18.5","40.52",null,"2","170","0","NA","NA"],
    [7961,"7961","Carrier C","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90792","PSYCHIATRIC DIAGNOSTIC EVALUATION W/MEDICAL SERVICES","135","0.9778",null,"19.2","39.07",null,"5","130","0","NA","NA"],
    [7962,"7962","Carrier C","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","H0020","ALCOHOL AND/OR DRUG SERVICES","102","1",null,null,"2.57",null,"0","102","0","NA","NA"],
    [7963,"7963","Carrier C","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H0020","ALCOHOL AND/OR DRUG SERVICES","102","1",null,null,"2.57",null,"0","102","0","NA","NA"],
    [7964,"7964","Carrier C","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90833","PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS","88","1",null,"1.2","7.16",null,"5","83","0","NA","NA"],
    [7965,"7965","Carrier C","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90806.102","REF MENTAL HEALTH EXTERNAL","46","1",null,null,"26.98",null,"0","46","0","NA","NA"],
    [7966,"7966","Carrier C","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","S9480","PSYCH SVC INTENSIVE OUTPT","19","1",null,null,"12.95",null,"0","19","0","NA","NA"],
    [7967,"7967","Carrier C","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96156","HEALTH BEHAVIOR ASSESSMENT, OR RE-ASSESSMENT","7","1",null,null,"2.14",null,"0","7","0","NA","NA"],
    [7968,"7968","Carrier C","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96116","NEUROBEHAVIORAL STATUS EXAM, PHYS OR QUAL PROF, FIRST HOUR","6","1",null,null,"7",null,"0","6","0","NA","NA"],
    [7969,"7969","Carrier C","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90849","MULT-FAMILY GROUP PSYCHOTHERAPY","4","1",null,null,"2.5",null,"0","4","0","NA","NA"],
    [7970,"7970","Carrier C","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90870","ECT (W/ MONITORING) SINGLE SEIZURE","4","1",null,"339","52.33",null,"1","3","0","NA","NA"],
    [7971,"7971","Carrier C","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99214.103","REF SUBSTANCE USE DISORDER TREATMENT - EXTERNAL","3","1",null,null,"1.33",null,"0","3","0","NA","NA"],
    [7972,"7972","Carrier C","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96136","PSYCHOLOGICAL OR NEUROPSYCHOLOGICAL TEST BY PHYS,2 OR MORE;FIRST 30 MINS","2","1",null,null,"60.5",null,"0","2","0","NA","NA"],
    [7973,"7973","Carrier C","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90868","TRANSCRANIAL MAG STIMJ TX DLVR & MGMT","235",null,"0.0128","35","56.62",null,"2","233","0","NA","NA"],
    [7974,"7974","Carrier C","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97151","BEHAV IDENTIFICATION ASSESSMNT, ADM BY PHYS OR QUAL PROF, EA 15 MINS","185",null,"0.0054","72","99.03",null,"1","184","0","NA","NA"],
    [7975,"7975","Carrier C","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90837","PSYCHOTHERAPY 60 MIN PATIENT","8544",null,"0.0001","0.92","2.72",null,"306","8238","0","NA","NA"],
    [7976,"7976","Carrier C","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0601","CPAP DEVICE","2136","0.993",null,"0.72","5.31",null,"528","1608","0","NA","NA"],
    [7977,"7977","Carrier C","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0603","DME ELECTRIC BREAST PUMP KIT PURCHASE","1306","0.9985",null,"1.68","8.95",null,"752","554","0","NA","NA"],
    [7978,"7978","Carrier C","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0604","DME ELECTRIC BREAST PUMP KIT RENTAL","719","0.9972",null,"0.32","5.69",null,"525","194","0","NA","NA"],
    [7979,"7979","Carrier C","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0143","WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT","537","0.9981",null,"2.67","7.65",null,"261","276","0","NA","NA"],
    [7980,"7980","Carrier C","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0114","CRUTCHES METAL UNDERARM PAIR","511","0.998",null,"1.88","2",null,"24","487","0","NA","NA"],
    [7981,"7981","Carrier C","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L4361","PNEUMATIC, WALKING BOOT","493","1",null,"3.8","3.79",null,"5","488","0","NA","NA"],
    [7982,"7982","Carrier C","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A7027","COMB ORAL/NASAL MASK USED W/CPAP DEVICE EA","490","0.998",null,"1.11","3.83",null,"57","433","0","NA","NA"],
    [7983,"7983","Carrier C","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L3908","WRIST SPLINT W/WO COCK-UP","307","1",null,"2","3.71",null,"8","299","0","NA","NA"],
    [7984,"7984","Carrier C","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0118","CRUTCH SUBSTITUTE, LOWER LEG PLATFORM, WITH OR WITHOUT WHEELS, EACH","301","0.9867",null,"2.49","10.63",null,"134","167","0","NA","NA"],
    [7985,"7985","Carrier C","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E1390","OXYGEN CONCENTRATOR","288","0.9861",null,"1.8","4.89",null,"97","191","0","NA","NA"],
    [7986,"7986","Carrier C","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L4361","PNEUMATIC, WALKING BOOT","493","1",null,"3.8","3.79",null,"5","488","0","NA","NA"],
    [7987,"7987","Carrier C","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L3908","WRIST SPLINT W/WO COCK-UP","307","1",null,"2","3.71",null,"8","299","0","NA","NA"],
    [7988,"7988","Carrier C","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L3809","WRIST THUMB SPICA","261","1",null,"0.5","3.41",null,"6","255","0","NA","NA"],
    [7989,"7989","Carrier C","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","DME0003","DME ELECTRIC BREAST PUMP KIT PURCHASE (E0603)","260","1",null,"14.71","18.75",null,"209","51","0","NA","NA"],
    [7990,"7990","Carrier C","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L3670","SHLDER IMMOB W/ABDUCTION PILLOW","260","1",null,"0.5","3.4",null,"2","258","0","NA","NA"],
    [7991,"7991","Carrier C","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L3660","SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND","209","1",null,null,"1.31",null,"0","209","0","NA","NA"],
    [7992,"7992","Carrier C","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4670","AUTOMATIC BP MONITOR DIAL","184","1",null,"0.56","2.79",null,"39","145","0","NA","NA"],
    [7993,"7993","Carrier C","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4388","DRAINABLE PCH W EX WEAR BARR","173","1",null,"0.69","5.44",null,"77","96","0","NA","NA"],
    [7994,"7994","Carrier C","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L1852","KNEE ORTHOSIS, DOUBLE UPRIGHT, THIGH/CALF, PREFAB, OFF-THE-SHELF","153","1",null,"0.87","8.54",null,"23","130","0","NA","NA"],
    [7995,"7995","Carrier C","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0156","SEAT ATTACHMENT, WALKER","120","1",null,"2.24","2.33",null,"69","51","0","NA","NA"],
    [7996,"7996","Carrier C","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L5020","PARTIAL FOOT MOLDED SOCKET","2",null,"0.5",null,"44",null,"0","2","0","NA","NA"],
    [7997,"7997","Carrier C","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0483","HIGH FREQ CHEST WALL OCSILLATION SYSTEM, INCL ALL ACCESSORIES/SUPPLIES, EA","15",null,"0.0667","1","64.07",null,"1","14","0","NA","NA"],
    [7998,"7998","Carrier C","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","B4149","ENTERAL FORMULA, MANUFACT, ADM VIA ENTERAL FEED TUBE, 100 CALORIES=1UN","17",null,"0.0588","25","48.8",null,"2","15","0","NA","NA"],
    [7999,"7999","Carrier C","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","B4161","ENTERAL FORM,PEDS, HYDROLYZED/AMINO ACID/PEPTIDE CHAIN PROT,100 CAL=1 UN","25",null,"0.04",null,"39.84",null,"0","25","0","NA","NA"],
    [8000,"8000","Carrier C","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L1960","AFO POS SOLID ANK PLASTIC MO","28",null,"0.0357","0.07","20.93",null,"1","27","0","NA","NA"],
    [8001,"8001","Carrier C","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0760","OSTEOGEN U/S STIMLTOR","63",null,"0.0317","9.19","48.47",null,"16","47","0","NA","NA"],
    [8002,"8002","Carrier C","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L3010","FOOT INSERT REMOVABLE LONG ARCH SPPT","155",null,"0.0129","1","10.88",null,"1","154","0","NA","NA"],
    [8003,"8003","Carrier C","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L3030","FOOT INSERT REMOVABLE FORMED TO PT","86",null,"0.0116",null,"12.65",null,"0","86","0","NA","NA"],
    [8004,"8004","Carrier C","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E2103","NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER","1552","0.7899",null,"2.48","22.11",null,"99","1453","0","NA","NA"],
    [8005,"8005","Carrier C","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN","952","0.9895",null,"1.98","6.39",null,"51","901","0","NA","NA"],
    [8006,"8006","Carrier C","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4239","SPLY ALW NONADJUNC NONIMPL CGM 1 MO SPLY= 1 UOS","304","0.9605",null,"2.26","17.66",null,"57","247","0","NA","NA"],
    [8007,"8007","Carrier C","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4221","WEEKLY SUPPLIES DRUG INFUS CATH","274","0.9854",null,"4.99","17.72",null,"52","222","0","NA","NA"],
    [8008,"8008","Carrier C","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97802","MED NUTRIT THRPY INIT ASSESS 15 MIN","263","0.9962",null,"2.1","5.07",null,"10","253","0","NA","NA"],
    [8009,"8009","Carrier C","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A5500","DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE","165","0.9939",null,"1.33","13.62",null,"3","162","0","NA","NA"],
    [8010,"8010","Carrier C","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0784","EXTERN AMBUL INSULIN INFUS PUMP","130","0.9231",null,"4.5","24.62",null,"6","124","0","NA","NA"],
    [8011,"8011","Carrier C","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E2102","ADJUNCTIVE NONIMPLANTED CGM/RECEIVER","80","0.675",null,"10.5","30.73",null,"2","78","0","NA","NA"],
    [8012,"8012","Carrier C","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J0178","INJ AFLIBERCEPT (EYLEA) 1 MG","71","0.9859",null,"5.89","23.03",null,"9","62","0","NA","NA"],
    [8013,"8013","Carrier C","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","G0108","DIAB MGMT TRN PER INDIV","60","1",null,"2","15.53",null,"2","58","0","NA","NA"],
    [8014,"8014","Carrier C","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","G0108","DIAB MGMT TRN PER INDIV","60","1",null,"2","15.53",null,"2","58","0","NA","NA"],
    [8015,"8015","Carrier C","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A5501","DIABETIC CUSTOM MOLDED SHOE","58","1",null,"1","13.93",null,"4","54","0","NA","NA"],
    [8016,"8016","Carrier C","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J9035","INJ BEVACIZUMAB 10 MG","40","1",null,"2.33","18.78",null,"3","37","0","NA","NA"],
    [8017,"8017","Carrier C","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4224","SUPPLIES FOR MAINTENANCE OF INSULIN INFUSION CATH, PER WEEK","25","1",null,"0.4","14.05",null,"5","20","0","NA","NA"],
    [8018,"8018","Carrier C","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","92012","INTERMEDIATE EYE EXAM ESTABLISHED PATIENT","21","1",null,null,"8.24",null,"0","21","0","NA","NA"],
    [8019,"8019","Carrier C","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A5513","FOR DIAB ONLY MX DNSITY INSRT CSTM MOLD CSTM EA","19","1",null,null,"11.37",null,"0","19","0","NA","NA"],
    [8020,"8020","Carrier C","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95250","GLUCOSE MONITORING 72 HRS MD OR OTH QUAL, EQUIP PROV, REC/STORAGE GL","18","1",null,null,"11.17",null,"0","18","0","NA","NA"],
    [8021,"8021","Carrier C","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A9274","EXTERNAL AMB INSULIN DEL SYSTEM DISPOSABLE EA","18","1",null,"0.07","12",null,"2","16","0","NA","NA"],
    [8022,"8022","Carrier C","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","67028","GLUCOSE MONITORING 72 HRS MD OR OTH QUAL, EQUIP PROV, REC/STORAGE GL","15","1",null,"2","33.14",null,"1","14","0","NA","NA"],
    [8023,"8023","Carrier C","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99201.555","REF MISCELLANEOUS EXTERNAL","14","1",null,null,"28.79",null,"0","14","0","NA","NA"],
    [8024,"8024","Carrier C","2024","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","DME0063","REF DME CONTINUOUS GLUCOSE MONITOR AND SUPPLIES","53",null,"0.0189","14","32.42",null,"1","52","0","NA","NA"],
    [8025,"8025","Carrier C","2024","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E2102","ADJUNCTIVE NONIMPLANTED CGM/RECEIVER","80",null,"0.0125","10.5","30.73",null,"2","78","0","NA","NA"],
    [8026,"8026","Carrier C","2024","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A4221","WEEKLY SUPPLIES DRUG INFUS CATH","274",null,"0.0036","4.99","17.72",null,"52","222","0","NA","NA"],
    [8027,"8027","Carrier C","2024","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E2103","NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER","1552",null,"0.0013","2.48","22.11",null,"99","1453","0","NA","NA"],
    [8028,"8028","Carrier C","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","3370","0.4246",null,"0.19","57.99",null,"68","3302",null,"semaglutide","Ozempic, Rybelsus"],
    [8029,"8029","Carrier C","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","1305","0.4199",null,"0.39","55.61",null,"53","1252",null,"lisdexamfetamine","Vyvanse"],
    [8030,"8030","Carrier C","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","820","0.772",null,"0.1","38.6",null,"3","817",null,"cyclosporine","Cequa, Restasis, Verkazia, Vevye"],
    [8031,"8031","Carrier C","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","813","0.6064",null,"0.33","44.33",null,"25","788",null,"budesonide-formoterol","Symbicort, Breyna"],
    [8032,"8032","Carrier C","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","793","0.5032",null,"0.51","57.36",null,"24","769",null,"liraglutide","Victoza"],
    [8033,"8033","Carrier C","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","736","0.8628",null,"0.35","18.91",null,"105","631",null,"rivaroxaban","Xarelto"],
    [8034,"8034","Carrier C","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","655","0.5802",null,"1.2","42.88",null,"109","546",null,"apixaban","Eliquis"],
    [8035,"8035","Carrier C","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","654","0.0765",null,"0.29","79.42",null,"17","637",null,"tirzepatide","Mounjaro"],
    [8036,"8036","Carrier C","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","587","0.0835",null,"0.08","81.62",null,"4","583",null,"semaglutide","Wegovy"],
    [8037,"8037","Carrier C","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","553","0.9312",null,"0.76","31.81",null,"25","528",null,"adalimumab-atto","Amjevita"],
    [8038,"8038","Carrier C","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","20","1",null,"0","7",null,"4","16",null,"lenalidomide","Revlimid"],
    [8039,"8039","Carrier C","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","18","1",null,"0","22",null,"3","15",null,"lenvatinib","Lenvima"],
    [8040,"8040","Carrier C","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","18","1",null,"0","51",null,"3","15",null,"tocilizumab","Tyenne"],
    [8041,"8041","Carrier C","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","17","1",null,"2","22",null,"2","15",null,"eltrombopag","Alvaiz"],
    [8042,"8042","Carrier C","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","16","1",null,"0","26",null,"2","14",null,"osimertinib","Tagrisso"],
    [8043,"8043","Carrier C","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","12","1",null,"1","28",null,"1","11",null,"vedolizumab","Entyvio"],
    [8044,"8044","Carrier C","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","11","1",null,"0","2",null,"2","9",null,"dofetilide","Tikosyn"],
    [8045,"8045","Carrier C","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","11","1",null,"0","29",null,"1","10",null,"lasmiditan","Reyvow"],
    [8046,"8046","Carrier C","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","10","1",null,"4","22",null,"3","7",null,"pomalidomide","Pomalyst"],
    [8047,"8047","Carrier C","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,"0","28",null,"1","6",null,"voriconazole","Vfend"],
    [8048,"8048","Carrier C","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1",null,"121.25",null,null,"1",null,"belzutifan","Welireg"],
    [8049,"8049","Carrier C","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"0.5",null,"62.2",null,null,"2",null,"clobazam","Sympazan"],
    [8050,"8050","Carrier C","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"0.5",null,"63.86",null,null,"2",null,"interferon-beta 1a","Avonex"],
    [8051,"8051","Carrier C","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"0.5","26.27",null,null,"2",null,null,"fenfluramine","Fintepla"],
    [8052,"8052","Carrier C","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","5",null,"0.4",null,"82.99",null,null,"5",null,"cenegermin","Oxervate"],
    [8053,"8053","Carrier C","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","5",null,"0.4","3.22","58.72",null,"1","4",null,"esketamine","Spravato"],
    [8054,"8054","Carrier C","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","8",null,"0.375","0.29","38.24",null,"1","7",null,"mavacamten","Camzyos"],
    [8055,"8055","Carrier C","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","8",null,"0.375","0.18","54.9",null,"2","6",null,"nintedanib","Ofev"],
    [8056,"8056","Carrier C","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3",null,"0.3333",null,"37.71",null,null,"3",null,"cabozantinib","Cabometyx"],
    [8057,"8057","Carrier C","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3",null,"0.3333","22.29","17.77",null,"2","1",null,"ponatinib","Iclusig"],
    [8058,"8058","Carrier D","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96416","CHEMO ADMIN IV INFUS >8 HRS W/PORT/IMPLANTED PUMP","22","1",null,"8.71","29.73",null,"7","15","0","NA","NA"],
    [8059,"8059","Carrier D","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","59510","FULL ROUT OBSTE CARE,CESAREAN DELIV","19","1",null,null,"5",null,"0","19","0","NA","NA"],
    [8060,"8060","Carrier D","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","59400","FULL ROUT OBSTE CARE,VAGINAL DELIV","14","1",null,null,"1.14",null,"0","14","0","NA","NA"],
    [8061,"8061","Carrier D","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44204","COLECTOMY LAP PARTIAL W/ ANAST","8","1",null,null,"2",null,"0","8","0","NA","NA"],
    [8062,"8062","Carrier D","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU","6","0.6667",null,null,"34.33",null,"0","6","0","NA","NA"],
    [8063,"8063","Carrier D","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43644","LAP GASTRIC BYPASS/ROUX-EN-Y","6","0.8333",null,"8","108.6",null,"1","5","0","NA","NA"],
    [8064,"8064","Carrier D","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","MRI BRAIN W/ & W/O CONTRAST,","5","0.2",null,null,"39.8",null,"0","5","0","NA","NA"],
    [8065,"8065","Carrier D","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","61624","TRANSCATH OCCLUSION/EMBOLIZAT PERCUT CNS","4","1",null,null,"5.25",null,"0","4","0","NA","NA"],
    [8066,"8066","Carrier D","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22633","ARTHDSIS POST/POSTEROLATRL/POSTINTERBODY LUMBAR","3","0.3333",null,"4","84",null,"1","2","0","NA","NA"],
    [8067,"8067","Carrier D","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44620","CLOSE ENTEROSTOMY LARGE/SMALL INTESTINE","3","1",null,null,"1",null,"0","3","0","NA","NA"],
    [8068,"8068","Carrier D","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96416","CHEMO ADMIN IV INFUS >8 HRS W/PORT/IMPLANTED PUMP","22","1",null,"8.71","29.73",null,"7","15","0","NA","NA"],
    [8069,"8069","Carrier D","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","59510","FULL ROUT OBSTE CARE,CESAREAN DELIV","19","1",null,null,"5",null,"0","19","0","NA","NA"],
    [8070,"8070","Carrier D","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","59400","FULL ROUT OBSTE CARE,VAGINAL DELIV","14","1",null,null,"1.14",null,"0","14","0","NA","NA"],
    [8071,"8071","Carrier D","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44204","COLECTOMY LAP PARTIAL W/ ANAST","8","1",null,null,"2",null,"0","8","0","NA","NA"],
    [8072,"8072","Carrier D","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","61624","TRANSCATH OCCLUSION/EMBOLIZAT PERCUT CNS","4","1",null,null,"5.25",null,"0","4","0","NA","NA"],
    [8073,"8073","Carrier D","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44620","CLOSE ENTEROSTOMY LARGE/SMALL INTESTINE","3","1",null,null,"1",null,"0","3","0","NA","NA"],
    [8074,"8074","Carrier D","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","45378","COLONOSCOPY DX W/WO SPEC/COLON DECOMP (SEP PROC)","3","1",null,null,"17.33",null,"0","3","0","NA","NA"],
    [8075,"8075","Carrier D","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","61510","CRANIECT TREPH BONE FLAP CRANIO EXC TUMOR SUPRA","3","1",null,"0.1","35.5",null,"1","2","0","NA","NA"],
    [8076,"8076","Carrier D","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","51590","CYSTECTOMY W/ URETEROILEAL CONDUIT/SIGMOID BLADR","3","1",null,null,"22.33",null,"0","3","0","NA","NA"],
    [8077,"8077","Carrier D","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","78264","GASTRIC EMPTYING STUDY","3","1",null,null,"2.67",null,"0","3","0","NA","NA"],
    [8078,"8078","Carrier D","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27130","TOTAL HIP ARTHROPLASTY","2",null,"0.5",null,"23.5",null,"0","2","0","NA","NA"],
    [8079,"8079","Carrier D","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22558","ARTHRODESIS ANT INTERBODY W/ DISKECTOMY LU","6",null,"0.1667",null,"34.33",null,"0","6","0","NA","NA"],
    [8080,"8080","Carrier D","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43644","LAP GASTRIC BYPASS/ROUX-EN-Y","6",null,"0.1667","8","108.6",null,"1","5","0","NA","NA"],
    [8081,"8081","Carrier D","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN","20445","0.992",null,"3.1","5.09",null,"1386","19059","0","NA","NA"],
    [8082,"8082","Carrier D","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","THERA PROC 1+ AREAS EA 15 MIN THERA EXERCISES","3261","0.9957",null,"2.55","4.46",null,"92","3169","0","NA","NA"],
    [8083,"8083","Carrier D","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97124","THERA PROC 1+ AREAS EA 15 MIN MASSAGE","1686","0.9958",null,"0.55","3.27",null,"22","1664","0","NA","NA"],
    [8084,"8084","Carrier D","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","MRI ANY JOINT","1120","0.7411",null,"8.89","33.96",null,"151","969","0","NA","NA"],
    [8085,"8085","Carrier D","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","MRI BRAIN W/ & W/O CONTRAST,","918","0.7386",null,"9.25","36.77",null,"107","811","0","NA","NA"],
    [8086,"8086","Carrier D","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","COLONOSCOPY W/ BX SINGLE/MULT","913","0.988",null,"1.67","5.24",null,"48","865","0","NA","NA"],
    [8087,"8087","Carrier D","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","TTE (ECHO) WITH SPECTRAL & COLOR FLOW DOPPLER","762","1",null,"2.5","9.55",null,"80","682","0","NA","NA"],
    [8088,"8088","Carrier D","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72158","MRI LUMBAR W/WO CONTRST SPINE","612","0.4248",null,"12.06","32.3",null,"53","559","0","NA","NA"],
    [8089,"8089","Carrier D","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72148","MAGNETIC RESONANCE (EG, PROTON) LUMBAR","551","0.4029",null,"11.39","40.68",null,"71","480","0","NA","NA"],
    [8090,"8090","Carrier D","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99202","OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES","516","0.9942",null,"3","12.4",null,"35","481","0","NA","NA"],
    [8091,"8091","Carrier D","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93306","TTE (ECHO) WITH SPECTRAL & COLOR FLOW DOPPLER","762","1",null,"2.5","9.55",null,"80","682","0","NA","NA"],
    [8092,"8092","Carrier D","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77080","DXA BONE DENSITY STUDY 1+ SITS AXIAL SKE","298","1",null,"0.6","2.25",null,"15","283","0","NA","NA"],
    [8093,"8093","Carrier D","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96040","GENETICS COUNSELING, EACH 30 MIN, W/ PT/FAMILY","282","1",null,"0.72","3.81",null,"82","200","0","NA","NA"],
    [8094,"8094","Carrier D","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99203","OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES","279","1",null,"11.67","9.33",null,"36","243","0","NA","NA"],
    [8095,"8095","Carrier D","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99201.114","REF GASTROENTEROLOGY - INTERNAL","263","1",null,"22.11","52.53",null,"9","254","0","NA","NA"],
    [8096,"8096","Carrier D","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95806","SLEEP STUDY, UNATTENDED","201","1",null,"1","7.22",null,"1","200","0","NA","NA"],
    [8097,"8097","Carrier D","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","98941","CHIROPRACTIC MANIP TX (CMT) SPINAL 3-4 REGIONS","165","1",null,null,"3.89",null,"0","165","0","NA","NA"],
    [8098,"8098","Carrier D","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","11102","TANGENTIAL BIOPSY OF SKIN; FIRST LESION","163","1",null,"0.65","2.29",null,"1","162","0","NA","NA"],
    [8099,"8099","Carrier D","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","17311","MOHS HD, NCK, HND, FEET, GEN 1ST STGE UP TO 5 BLCK","160","1",null,"0.75","3.06",null,"16","144","0","NA","NA"],
    [8100,"8100","Carrier D","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97810","ACUPUNCTURE, 1ST 15 MIN, W/O ELECT STIM","156","1",null,"0.02","3.61",null,"1","155","0","NA","NA"],
    [8101,"8101","Carrier D","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21743","RECON REP PECTUS EXCAVATM/CARINATM; W/THORACSCPY","1",null,"1",null,"148",null,"0","1","0","NA","NA"],
    [8102,"8102","Carrier D","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","37761","SUBFASCIAL LIGATION PERFORATOR VEIN, OPEN, 1 LEG","2",null,"0.5",null,"56.5",null,"0","2","0","NA","NA"],
    [8103,"8103","Carrier D","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","42145","PALATOPHARYNGOPLASTY","2",null,"0.5",null,"74",null,"0","2","0","NA","NA"],
    [8104,"8104","Carrier D","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","81425","GENOME  SEQUENCE ANALYSIS","2",null,"0.5",null,"96",null,"0","2","0","NA","NA"],
    [8105,"8105","Carrier D","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","A9513","LUTETIUM LU 177, DOTATATE, THERAPEUTIC, 1 MCI","2",null,"0.5",null,"37",null,"0","2","0","NA","NA"],
    [8106,"8106","Carrier D","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","J9225","HISTRELIN IMPLANT","2",null,"0.5",null,"21.11",null,"0","2","0","NA","NA"],
    [8107,"8107","Carrier D","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L8693","AUDITORY OSSEOINTEGRATED DEVICE ABUTMENT, ANY LENGTH, REPLACEMENT ONLY","2",null,"0.5",null,"31.5",null,"0","2","0","NA","NA"],
    [8108,"8108","Carrier D","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","33285","INSERT SUBCUTANEOUS CARDIAC RHYTHM MONITOR, INCL PROGRAM","6",null,"0.3333",null,"41.5",null,"0","6","0","NA","NA"],
    [8109,"8109","Carrier D","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","81404","MOLECULAR PATHOLOGY PROCEDURE LEVEL 5","4",null,"0.25",null,"66.75",null,"0","4","0","NA","NA"],
    [8110,"8110","Carrier D","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","J3241","INJ, TEPROTUMUMAB-TRBW, 10 MG","4",null,"0.25",null,"17.53",null,"0","4","0","NA","NA"],
    [8111,"8111","Carrier D","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","H0045","RESPITE NOT-IN-HOME PER DIEM","1","0",null,null,"144",null,"0","1","0","NA","NA"],
    [8112,"8112","Carrier D","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","H2020","THER BEHAV SVC, PER DIEM","1","1",null,"4",null,null,"1","0","0","NA","NA"],
    [8113,"8113","Carrier D","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H0045","RESPITE NOT-IN-HOME PER DIEM","1","0",null,null,"144",null,"0","1","0","NA","NA"],
    [8114,"8114","Carrier D","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H2020","THER BEHAV SVC, PER DIEM","1","1",null,"4",null,null,"1","0","0","NA","NA"],
    [8115,"8115","Carrier D","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY 60 MIN PATIENT","700","0.9957",null,"1.1","2.22",null,"73","627","0","NA","NA"],
    [8116,"8116","Carrier D","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90836","PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS","381","1",null,"0.43","1.65",null,"56","325","0","NA","NA"],
    [8117,"8117","Carrier D","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES","251","0.9721",null,"6.2","15.24",null,"10","241","0","NA","NA"],
    [8118,"8118","Carrier D","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96132","NEUROPSYCHOLOGICAL TEST EVAL BY PHYS OR QUAL PROF; FIRST HOUR","94","0.9043",null,null,"30.02",null,"0","94","0","NA","NA"],
    [8119,"8119","Carrier D","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","TRANSCRANIAL MAG STIMJ TX DLVR & MGMT","93","0.828",null,"31.5","60.96",null,"2","91","0","NA","NA"],
    [8120,"8120","Carrier D","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96130","PSYCHOLOGICAL TESTING EVAL BY PHYS OR QUAL PROF;  FIRST HOUR","65","0.9846",null,null,"7.82",null,"0","65","0","NA","NA"],
    [8121,"8121","Carrier D","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","BEHAV IDENTIFICATION ASSESSMNT, ADM BY PHYS OR QUAL PROF, EA 15 MINS","64","0.7656",null,null,"101.88",null,"0","64","0","NA","NA"],
    [8122,"8122","Carrier D","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90792","PSYCHIATRIC DIAGNOSTIC EVALUATION W/MEDICAL SERVICES","31","0.9677",null,"15.46","35.12",null,"5","26","0","NA","NA"],
    [8123,"8123","Carrier D","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90853","GROUP PSYCHOTHERAPY","28","1",null,null,"2.29",null,"0","28","0","NA","NA"],
    [8124,"8124","Carrier D","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97153","ADAPTIVE BEHAV TX BY PROTOCOL, ADM BY TECH/SUP BY PHYS, EA 15 MINS","23","0.8696",null,null,"109.45",null,"0","23","0","NA","NA"],
    [8125,"8125","Carrier D","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90836","PSYCHOTHERAPY 45 MIN PATIENT WITH MEDICAL SVCS","381","1",null,"0.43","1.65",null,"56","325","0","NA","NA"],
    [8126,"8126","Carrier D","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90853","GROUP PSYCHOTHERAPY","28","1",null,null,"2.29",null,"0","28","0","NA","NA"],
    [8127,"8127","Carrier D","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99214","OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN","15","1",null,"4","21.43",null,"1","14","0","NA","NA"],
    [8128,"8128","Carrier D","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96136","PSYCHOLOGICAL OR NEUROPSYCHOLOGICAL TEST BY PHYS,2 OR MORE;FIRST 30 MINS","12","1",null,null,"10.08",null,"0","12","0","NA","NA"],
    [8129,"8129","Carrier D","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97155","ADAPTIVE BEHAV TX W/PROTOCOL MOD, ADM BY PHYS OR QUAL PROF, EA 15 MINS","3","1",null,null,"83",null,"0","3","0","NA","NA"],
    [8130,"8130","Carrier D","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","H0020","ALCOHOL AND/OR DRUG SERVICES","3","1",null,null,"1",null,"0","3","0","NA","NA"],
    [8131,"8131","Carrier D","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90834","PSYCHOTHERAPY 45 MIN PATIENT","2","1",null,null,"18",null,"0","2","0","NA","NA"],
    [8132,"8132","Carrier D","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90870","ECT (W/ MONITORING) SINGLE SEIZURE","2","1",null,"47","138",null,"1","1","0","NA","NA"],
    [8133,"8133","Carrier D","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96131","PSYCHOLOGICAL TESTING EVAL BY PHYS OR QUAL PROF; EA ADDL HOUR","2","1",null,null,"26",null,"0","2","0","NA","NA"],
    [8134,"8134","Carrier D","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90833","PSYCHOTHERAPY 30 MIN PATIENT WITH MEDICAL SVCS","2","1",null,null,"0",null,"0","2","0","NA","NA"],
    [8135,"8135","Carrier D","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90792","PSYCHIATRIC DIAGNOSTIC EVALUATION W/MEDICAL SERVICES","31",null,"0.0323","15.46","35.12",null,"5","26","0","NA","NA"],
    [8136,"8136","Carrier D","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90868","TRANSCRANIAL MAG STIMJ TX DLVR & MGMT","93",null,"0.0215","31.5","60.96",null,"2","91","0","NA","NA"],
    [8137,"8137","Carrier D","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0601","CPAP DEVICE","912","0.9912",null,"0.84","9.98",null,"159","753","0","NA","NA"],
    [8138,"8138","Carrier D","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L4361","PNEUMATIC, WALKING BOOT","303","1",null,"0.18","2.49",null,"1","302","0","NA","NA"],
    [8139,"8139","Carrier D","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0114","CRUTCHES METAL UNDERARM PAIR","297","1",null,"0.76","1.98",null,"2","295","0","NA","NA"],
    [8140,"8140","Carrier D","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0603","DME ELECTRIC BREAST PUMP KIT PURCHASE","288","1",null,"2.28","11.33",null,"255","33","0","NA","NA"],
    [8141,"8141","Carrier D","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A7027","COMB ORAL/NASAL MASK USED W/CPAP DEVICE EA","244","1",null,"7.45","4.56",null,"11","233","0","NA","NA"],
    [8142,"8142","Carrier D","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L3908","WRIST SPLINT W/WO COCK-UP","190","0.9947",null,"2.19","3.08",null,"3","187","0","NA","NA"],
    [8143,"8143","Carrier D","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0604","DME ELECTRIC BREAST PUMP KIT RENTAL","183","0.9945",null,"0.36","8.13",null,"137","46","0","NA","NA"],
    [8144,"8144","Carrier D","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0143","WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT","180","0.9889",null,"3.9","9.26",null,"60","120","0","NA","NA"],
    [8145,"8145","Carrier D","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L3809","WRIST THUMB SPICA","154","1",null,"2.33","2.69",null,"3","151","0","NA","NA"],
    [8146,"8146","Carrier D","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L3660","SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND","136","1",null,null,"1.42",null,"0","136","0","NA","NA"],
    [8147,"8147","Carrier D","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L4361","PNEUMATIC, WALKING BOOT","303","1",null,"0.18","2.49",null,"1","302","0","NA","NA"],
    [8148,"8148","Carrier D","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0114","CRUTCHES METAL UNDERARM PAIR","297","1",null,"0.76","1.98",null,"2","295","0","NA","NA"],
    [8149,"8149","Carrier D","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0603","DME ELECTRIC BREAST PUMP KIT PURCHASE","288","1",null,"2.28","11.33",null,"255","33","0","NA","NA"],
    [8150,"8150","Carrier D","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A7027","COMB ORAL/NASAL MASK USED W/CPAP DEVICE EA","244","1",null,"7.45","4.56",null,"11","233","0","NA","NA"],
    [8151,"8151","Carrier D","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L3809","WRIST THUMB SPICA","154","1",null,"2.33","2.69",null,"3","151","0","NA","NA"],
    [8152,"8152","Carrier D","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L3660","SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND","136","1",null,null,"1.42",null,"0","136","0","NA","NA"],
    [8153,"8153","Carrier D","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E1390","OXYGEN CONCENTRATOR","119","1",null,"4.29","9.92",null,"49","70","0","NA","NA"],
    [8154,"8154","Carrier D","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L3670","SHLDER IMMOB W/ABDUCTION PILLOW","115","1",null,"0.57","3.36",null,"2","113","0","NA","NA"],
    [8155,"8155","Carrier D","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L1902","ANKLE LACE UP BRACE","97","1",null,null,"3.74",null,"0","97","0","NA","NA"],
    [8156,"8156","Carrier D","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E0260","HOSPITAL BED, SEMI-ELECTRIC, W/ANY TYPE SIDE RAILS, W/MATTRESS","86","1",null,"1.21","4.3",null,"66","20","0","NA","NA"],
    [8157,"8157","Carrier D","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0986","MANUAL WHEELCHAIR ACCESS, PUSH-RIM ACTIVATED POWER ASSIST SYS","1",null,"1",null,"54",null,"0","1","0","NA","NA"],
    [8158,"8158","Carrier D","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E2224","PROPULSION WHL EXCLUDES TIRE","2",null,"0.5",null,"33",null,"0","2","0","NA","NA"],
    [8159,"8159","Carrier D","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L5700","REPLACE SOCKET BEL KNEE PT MODEL","4",null,"0.25",null,"83.5",null,"0","4","0","NA","NA"],
    [8160,"8160","Carrier D","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","K0005","ULTRALIGHTWEIGHT WHEELCHAIR","8",null,"0.125",null,"67.39",null,"0","8","0","NA","NA"],
    [8161,"8161","Carrier D","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","L8010","BREAST PROSTHESIS MASTECTOMY SLEEVE","8",null,"0.125","14","34.29",null,"1","7","0","NA","NA"],
    [8162,"8162","Carrier D","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0766","ELECT STIMULATION DEV USED FOR CANCER TX, INCL ALL ACCESS, ANY TYPE","8",null,"0.125","0","45.25",null,"0","8","0","NA","NA"],
    [8163,"8163","Carrier D","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0760","OSTEOGEN U/S STIMLTOR","27",null,"0.037","2.5","44.92",null,"2","25","0","NA","NA"],
    [8164,"8164","Carrier D","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E0601","CPAP DEVICE","912",null,"0.0011","0.84","9.98",null,"159","753","0","NA","NA"],
    [8165,"8165","Carrier D","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E2103","NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER","423","0.7565",null,"6","37.74",null,"24","399","0","NA","NA"],
    [8166,"8166","Carrier D","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN","352","0.9858",null,"4.06","4.19",null,"17","335","0","NA","NA"],
    [8167,"8167","Carrier D","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4239","SPLY ALW NONADJUNC NONIMPL CGM 1 MO SPLY= 1 UOS","124","0.9435",null,"1.11","15.97",null,"9","115","0","NA","NA"],
    [8168,"8168","Carrier D","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4221","WEEKLY SUPPLIES DRUG INFUS CATH","99","0.9798",null,"4.5","11.33",null,"18","81","0","NA","NA"],
    [8169,"8169","Carrier D","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97802","MED NUTRIT THRPY INIT ASSESS 15 MIN","93","1",null,"0","6.5",null,"1","92","0","NA","NA"],
    [8170,"8170","Carrier D","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E0784","EXTERN AMBUL INSULIN INFUS PUMP","59","0.9322",null,"11","26.61",null,"2","57","0","NA","NA"],
    [8171,"8171","Carrier D","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","G0108","DIAB MGMT TRN PER INDIV","47","1",null,"0","13.15",null,"1","46","0","NA","NA"],
    [8172,"8172","Carrier D","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J0178","INJ AFLIBERCEPT (EYLEA) 1 MG","46","0.9565",null,"35.5","21.58",null,"2","44","0","NA","NA"],
    [8173,"8173","Carrier D","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","J9035","INJ BEVACIZUMAB 10 MG","41","1",null,"2.25","16.03",null,"4","37","0","NA","NA"],
    [8174,"8174","Carrier D","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A5500","DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE","37","1",null,"0.32","11.25",null,"1","36","0","NA","NA"],
    [8175,"8175","Carrier D","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97802","MED NUTRIT THRPY INIT ASSESS 15 MIN","93","1",null,"0","6.5",null,"1","92","0","NA","NA"],
    [8176,"8176","Carrier D","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","G0108","DIAB MGMT TRN PER INDIV","47","1",null,"0","13.15",null,"1","46","0","NA","NA"],
    [8177,"8177","Carrier D","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","J9035","INJ BEVACIZUMAB 10 MG","41","1",null,"2.25","16.03",null,"4","37","0","NA","NA"],
    [8178,"8178","Carrier D","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A5500","DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE","37","1",null,"0.32","11.25",null,"1","36","0","NA","NA"],
    [8179,"8179","Carrier D","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","67228","DESTRUCT EXTENSIVE/PROG RETINOPATHY PHOTOCOAGULATN","12","1",null,"1","17.88",null,"4","8","0","NA","NA"],
    [8180,"8180","Carrier D","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A5501","DIABETIC CUSTOM MOLDED SHOE","9","1",null,"0.27","7.13",null,"1","8","0","NA","NA"],
    [8181,"8181","Carrier D","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99204","OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES","8","1",null,null,"9.13",null,"0","8","0","NA","NA"],
    [8182,"8182","Carrier D","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","0403T","PREV BEHAVIOR  CHANGE, INTENS DIAB PRGRM TO INDIVIDUAL IN A GRP SETTING, MINIMUM 60 MIN, PR DY","8","1",null,null,"13.25",null,"0","8","0","NA","NA"],
    [8183,"8183","Carrier D","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4238","SPL ALW ADJ NI CGM 1 MONTH SUPPLY = 1 UOS","8","1",null,"1.1","12.29",null,"1","7","0","NA","NA"],
    [8184,"8184","Carrier D","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95250","GLUCOSE MONITORING 72 HRS MD OR OTH QUAL, EQUIP PROV, REC/STORAGE GL","6","1",null,null,"7.33",null,"0","6","0","NA","NA"],
    [8185,"8185","Carrier D","2024","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","E2103","NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER","423",null,"0.0024","6","37.74",null,"24","399","0","NA","NA"],
    [8186,"8186","Carrier D","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","1804","0.3043",null,"0.77","54.7",null,"123","1681",null,"semaglutide","Ozempic, Rybelsus"],
    [8187,"8187","Carrier D","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","957","0.3406",null,"0.88","49.35",null,"92","865",null,"lisdexamfetamine","Vyvanse"],
    [8188,"8188","Carrier D","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","747","0.0884",null,"1.17","61.75",null,"54","693",null,"tirzepatide","Mounjaro"],
    [8189,"8189","Carrier D","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","378","0.4286",null,"1.23","47.88",null,"41","337",null,"budesonide-formoterol","Symbicort, Breyna"],
    [8190,"8190","Carrier D","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","307","0.3518",null,"0.17","59.85",null,"16","291",null,"liraglutide","Victoza"],
    [8191,"8191","Carrier D","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","281","0.089",null,"0.28","76.73",null,"5","276",null,"semaglutide","Wegovy"],
    [8192,"8192","Carrier D","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","254","0.5591",null,"0.41","44.22",null,"6","248",null,"cyclosporine","Cequa, Restasis, Verkazia, Vevye"],
    [8193,"8193","Carrier D","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","253","0.3083",null,"2.58","44.03",null,"64","189",null,"apixaban","Eliquis"],
    [8194,"8194","Carrier D","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","195","0.5078",null,"1.48","63.62",null,"23","172",null,"dupilumab","Dupixent"],
    [8195,"8195","Carrier D","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","192","0.7552",null,"1.39","15.74",null,"46","146",null,"adalimumab-atto","Amjevita"],
    [8196,"8196","Carrier D","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","12","1",null,"0","31",null,"3","9",null,"cannabidiol","Epidiolex"],
    [8197,"8197","Carrier D","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,"0","30",null,"2","5",null,"ribociclib","Kisqali"],
    [8198,"8198","Carrier D","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","6","1",null,"0","68",null,"0","6",null,"immune globulin","Hizentra"],
    [8199,"8199","Carrier D","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","6","1",null,"0","37",null,"0","6",null,"grass pollen allergen extract (timothy gras)","Grastek"],
    [8200,"8200","Carrier D","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","6","1",null,"4","39",null,"2","4",null,"enzalutamide","Xtandi"],
    [8201,"8201","Carrier D","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","5","1",null,"1","0",null,"5","0",null,"posaconzole","Noxafil"],
    [8202,"8202","Carrier D","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","5","1",null,"0","45",null,"0","5",null,"olaparib","Lynparza"],
    [8203,"8203","Carrier D","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","5","1",null,"0","11",null,"0","5",null,"tiotropium","Spiriva Respimat"],
    [8204,"8204","Carrier D","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","5","1",null,"3","9",null,"1","4",null,"salmeterol xinafoate","Serevent"],
    [8205,"8205","Carrier D","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","5","1",null,"1","28",null,"1","4",null,"vedolizumab","Entyvio"],
    [8206,"8206","Carrier D","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1",null,"68",null,"0","1",null,"cortrophin","Acthar"],
    [8207,"8207","Carrier D","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1",null,"70.93",null,"0","1",null,"ritlecitinib tosylate","Litfulo"],
    [8208,"8208","Carrier D","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"0.5",null,"72.33",null,"0","2",null,"umeclidinium","Incruse Ellipta"],
    [8209,"8209","Carrier D","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","5",null,"0.4","10.82","27.43",null,"3","2",null,"esketamine","Spravato"],
    [8210,"8210","Carrier D","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3",null,"0.3333",null,"119.15",null,"0","3",null,"albuterol","Proventil HFA"],
    [8211,"8211","Carrier D","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","12",null,"0.25","2.06","86.11",null,"1","11",null,"tezepelumab-ekko","Tezspire"],
    [8212,"8212","Carrier D","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","4",null,"0.25","0.07","55.87",null,"1","3",null,"nintedanib","Ofev"],
    [8213,"8213","Carrier D","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","4",null,"0.25","0.48","9.09",null,"2","2",null,"Golimumab","Simponi"],
    [8214,"8214","Carrier D","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","5",null,"0.2","0.54","27.94",null,"1","4",null,"netarsudil/latanoprost","Rocklatan"],
    [8215,"8215","Carrier D","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","7",null,"0.14",null,"22.09",null,"2","5",null,"valbenazine","Ingrezza"],
    [8216,"8216","Carrier E","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","150","ROOM & BOARD, WARD - GENERAL","27","1",null,null,"17.4",null,null,"27",null,"NA","NA"],
    [8217,"8217","Carrier E","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99223","1ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES","16","1",null,"16.1","22.7",null,"1","15",null,"NA","NA"],
    [8218,"8218","Carrier E","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","762","SPECIALTY SERVICES, OBSERVATION HOURS","11","1",null,null,"11.7",null,null,"11",null,"NA","NA"],
    [8219,"8219","Carrier E","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99291","CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN","9","1",null,null,"34.1",null,null,"9",null,"NA","NA"],
    [8220,"8220","Carrier E","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","158","ROOM & BOARD, WARD - REHABILITATION","5","1",null,null,"14.6",null,null,"5",null,"NA","NA"],
    [8221,"8221","Carrier E","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99222","1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES","4","1",null,null,"8.1",null,null,"4",null,"NA","NA"],
    [8222,"8222","Carrier E","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","80053","COMPREHENSIVE METABOLIC PANEL","3","1",null,null,"82.7",null,null,"3",null,"NA","NA"],
    [8223,"8223","Carrier E","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71045","RADIOLOGIC EXAM CHEST SINGLE VIEW","3","1",null,null,"34.1",null,null,"3",null,"NA","NA"],
    [8224,"8224","Carrier E","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27447","ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS","3","1",null,null,"8.2",null,null,"3",null,"NA","NA"],
    [8225,"8225","Carrier E","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","152","ROOM & BOARD, WARD - OB","3","1",null,null,"39",null,null,"3",null,"NA","NA"],
    [8226,"8226","Carrier E","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","150","ROOM & BOARD, WARD - GENERAL","27","1",null,null,"17.4",null,null,"27",null,"NA","NA"],
    [8227,"8227","Carrier E","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99223","1ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES","16","1",null,"16.1","22.7",null,"1","15",null,"NA","NA"],
    [8228,"8228","Carrier E","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","762","SPECIALTY SERVICES, OBSERVATION HOURS","11","1",null,null,"11.7",null,null,"11",null,"NA","NA"],
    [8229,"8229","Carrier E","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99291","CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN","9","1",null,null,"34.1",null,null,"9",null,"NA","NA"],
    [8230,"8230","Carrier E","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","158","ROOM & BOARD, WARD - REHABILITATION","5","1",null,null,"14.6",null,null,"5",null,"NA","NA"],
    [8231,"8231","Carrier E","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99222","1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES","4","1",null,null,"8.1",null,null,"4",null,"NA","NA"],
    [8232,"8232","Carrier E","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","80053","COMPREHENSIVE METABOLIC PANEL","3","1",null,null,"82.7",null,null,"3",null,"NA","NA"],
    [8233,"8233","Carrier E","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","71045","RADIOLOGIC EXAM CHEST SINGLE VIEW","3","1",null,null,"34.1",null,null,"3",null,"NA","NA"],
    [8234,"8234","Carrier E","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27447","ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS","3","1",null,null,"8.2",null,null,"3",null,"NA","NA"],
    [8235,"8235","Carrier E","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","152","ROOM & BOARD, WARD - OB","3","1",null,null,"39",null,null,"3",null,"NA","NA"],
    [8236,"8236","Carrier E","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97161","PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS","371","0.962",null,"5.6","51.8",null,"28","343",null,"NA","NA"],
    [8237,"8237","Carrier E","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99203","OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES","176","0.989",null,"3.5","59.3",null,"13","163",null,"NA","NA"],
    [8238,"8238","Carrier E","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99204","OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES","122","0.992",null,"6.5","62.2",null,"12","110",null,"NA","NA"],
    [8239,"8239","Carrier E","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72148","MRI LUMBAR SPINE NO CONTRAST","121","1",null,"11.9","29.6",null,"18","103",null,"NA","NA"],
    [8240,"8240","Carrier E","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","MRI BRAIN WO/W CONTRAST","90","1",null,"8.8","29.4",null,"21","69",null,"NA","NA"],
    [8241,"8241","Carrier E","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","MRI LEFT KNEE NO CONTRAST","85","1",null,"14.1","23.1",null,"25","60",null,"NA","NA"],
    [8242,"8242","Carrier E","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN","77","0.766",null,"25.3","139.6",null,"7","70",null,"NA","NA"],
    [8243,"8243","Carrier E","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97530","THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN","77","0.974",null,"9.1","71.6",null,"3","74",null,"NA","NA"],
    [8244,"8244","Carrier E","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","MRI RIGHT KNEE NO CONTRAST","68","1",null,"8.2","44",null,"24","44",null,"NA","NA"],
    [8245,"8245","Carrier E","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97162","PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS","62","0.984",null,"20.8","37.6","148.7","4","57","1","NA","NA"],
    [8246,"8246","Carrier E","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72148","MRI LUMBAR SPINE NO CONTRAST","121","1",null,"11.9","29.6",null,"18","103",null,"NA","NA"],
    [8247,"8247","Carrier E","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70553","MRI BRAIN WO/W CONTRAST","90","1",null,"8.8","29.4",null,"21","69",null,"NA","NA"],
    [8248,"8248","Carrier E","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","73721","MRI LEFT KNEE NO CONTRAST","85","1",null,"14.1","23.1",null,"25","60",null,"NA","NA"],
    [8249,"8249","Carrier E","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","73721","MRI RIGHT KNEE NO CONTRAST","68","1",null,"8.2","44",null,"24","44",null,"NA","NA"],
    [8250,"8250","Carrier E","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72141","MRI CERVICAL SPINE NO CONTRAST","58","1",null,"10.2","18.8",null,"18","40",null,"NA","NA"],
    [8251,"8251","Carrier E","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","73221","MRI RIGHT SHOULDER NO CONTRAST","53","1",null,"20.4","39.2",null,"8","45",null,"NA","NA"],
    [8252,"8252","Carrier E","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70551","MRI BRAIN NO CONTRAST","47","1",null,"12.3","32.3",null,"14","33",null,"NA","NA"],
    [8253,"8253","Carrier E","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","73221","MRI LEFT SHOULDER NO CONTRAST","33","1",null,"4.9","17.3",null,"8","25",null,"NA","NA"],
    [8254,"8254","Carrier E","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97112","THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA","27","1",null,"0.5","47.8",null,"3","24",null,"NA","NA"],
    [8255,"8255","Carrier E","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27130","ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT","27","1",null,null,"44.7",null,null,"27",null,"NA","NA"],
    [8256,"8256","Carrier E","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64635","DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL","1",null,"1",null,"321.3",null,null,"1",null,"NA","NA"],
    [8257,"8257","Carrier E","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","23413","EXT REFERRAL GYNECOLOGY","1",null,"1",null,"143.1",null,null,"1",null,"NA","NA"],
    [8258,"8258","Carrier E","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","A9593","GALLIUM GA-68 PSMA-11 DIAGNOSTIC UCSF 1 MCI","1",null,"1",null,"455.8",null,null,"1",null,"NA","NA"],
    [8259,"8259","Carrier E","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90837","PSYCHOTHERAPY W/PATIENT 60 MINUTES","8",null,"0.125","0.5","194.5",null,"2","6",null,"NA","NA"],
    [8260,"8260","Carrier E","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","26660","MEMBER REQUEST, PRE-SERVICE","22",null,"0.045","719.3","335.5",null,"4","18",null,"NA","NA"],
    [8261,"8261","Carrier E","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","21893","REFERRAL OCCUPATIONAL THERAPY PEDIATRICS","31",null,"0.032",null,"162.1",null,null,"31",null,"NA","NA"],
    [8262,"8262","Carrier E","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","92507","TX SPEECH LANG VOICE COMMJ &/AUDITORY PROC IND","45",null,"0.022","1","109",null,"2","43",null,"NA","NA"],
    [8263,"8263","Carrier E","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","97530","THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN","77",null,"0.013","9.1","71.6",null,"3","74",null,"NA","NA"],
    [8264,"8264","Carrier E","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","99203","OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES","176",null,"0.006","3.5","59.3",null,"13","163",null,"NA","NA"],
    [8265,"8265","Carrier E","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC","58","1",null,null,"17.5","31.8",null,"46","12","NA","NA"],
    [8266,"8266","Carrier E","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","126","ROOM & BOARD, SEMIPRIVATE TWO-BED - DETOXIFICATION","51","1",null,null,"35.9","48.3",null,"33","18","NA","NA"],
    [8267,"8267","Carrier E","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1002","BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP","36","1",null,null,"68.8","0.2",null,"35","1","NA","NA"],
    [8268,"8268","Carrier E","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1001","BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC","14","1",null,null,"23.4","47.8",null,"13","1","NA","NA"],
    [8269,"8269","Carrier E","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","194","SUBACUTE CARE, LEVEL IV","2","1",null,null,"19.7",null,null,"2",null,"NA","NA"],
    [8270,"8270","Carrier E","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","154","ROOM & BOARD, WARD - PSYCHIATRIC","2","1",null,null,"43.7",null,null,"2",null,"NA","NA"],
    [8271,"8271","Carrier E","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY W/PATIENT 60 MINUTES","1","1",null,null,null,"24",null,null,"1","NA","NA"],
    [8272,"8272","Carrier E","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","80321","DRUG SCREEN QUANT ALCOHOLS BIOMARKERS 1 OR 2","1","1",null,null,"7.1",null,null,"1",null,"NA","NA"],
    [8273,"8273","Carrier E","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","914","BEHAVIORAL HEALTH TREATMENTS/SVCS, INDIVIDUAL THERAPY","1","1",null,null,"169.7",null,null,"1",null,"NA","NA"],
    [8274,"8274","Carrier E","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","ROOM & BOARD, SEMIPRIVATE TWO-BED - PSYCHIATRIC","58","1",null,null,"17.5","31.8",null,"46","12","NA","NA"],
    [8275,"8275","Carrier E","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","126","ROOM & BOARD, SEMIPRIVATE TWO-BED - DETOXIFICATION","51","1",null,null,"35.9","48.3",null,"33","18","NA","NA"],
    [8276,"8276","Carrier E","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1002","BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, CHEM DEP","36","1",null,null,"68.8","0.2",null,"35","1","NA","NA"],
    [8277,"8277","Carrier E","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1001","BEHAVIORAL HEALTH ACCOMMODATIONS, RESIDENTIAL TREATMENT, PSYCHIATRIC","14","1",null,null,"23.4","47.8",null,"13","1","NA","NA"],
    [8278,"8278","Carrier E","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","194","SUBACUTE CARE, LEVEL IV","2","1",null,null,"19.7",null,null,"2",null,"NA","NA"],
    [8279,"8279","Carrier E","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","154","ROOM & BOARD, WARD - PSYCHIATRIC","2","1",null,null,"43.7",null,null,"2",null,"NA","NA"],
    [8280,"8280","Carrier E","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY W/PATIENT 60 MINUTES","1","1",null,null,null,"24",null,null,"1","NA","NA"],
    [8281,"8281","Carrier E","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","80321","DRUG SCREEN QUANT ALCOHOLS BIOMARKERS 1 OR 2","1","1",null,null,"7.1",null,null,"1",null,"NA","NA"],
    [8282,"8282","Carrier E","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","914","BEHAVIORAL HEALTH TREATMENTS/SVCS, INDIVIDUAL THERAPY","1","1",null,null,"169.7",null,null,"1",null,"NA","NA"],
    [8283,"8283","Carrier E","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97153","ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN","61","1",null,null,"50.1",null,null,"61",null,"NA","NA"],
    [8284,"8284","Carrier E","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVALUATION","57","0.877",null,null,"91.6",null,null,"57",null,"NA","NA"],
    [8285,"8285","Carrier E","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN","38","1",null,null,"26.7",null,null,"38",null,"NA","NA"],
    [8286,"8286","Carrier E","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN","23","1",null,null,"236.3",null,null,"23",null,"NA","NA"],
    [8287,"8287","Carrier E","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","912","BEHAVIORAL HEALTH TREATMENTS/SVCS, PARTIAL HOSPITAL - LESS INTENSIVE","21","1",null,null,"51.6",null,null,"21",null,"NA","NA"],
    [8288,"8288","Carrier E","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0001","ALCOHOL AND/OR DRUG ASSESS","19","1",null,null,"53.7","27.3",null,"18","1","NA","NA"],
    [8289,"8289","Carrier E","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90837","PSYCHOTHERAPY W/PATIENT 60 MINUTES","19","0.895",null,null,"102",null,null,"19",null,"NA","NA"],
    [8290,"8290","Carrier E","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S9480","INTENSIVE OUTPATIENT PSYCHIA","15","1",null,null,"69.4","69.9",null,"14","1","NA","NA"],
    [8291,"8291","Carrier E","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0410","GRP PSYCHOTX NOT MX FAM GP PART HSP/OP 45-50 MIN","14","1",null,"45.7","37",null,"1","13",null,"NA","NA"],
    [8292,"8292","Carrier E","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0020","ALCOHOL AND/OR DRUG SERVICES METHADONE ADMINISTRATION","11","1",null,null,"101.9","125.3",null,"10","1","NA","NA"],
    [8293,"8293","Carrier E","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97153","ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN","61","1",null,null,"50.1",null,null,"61",null,"NA","NA"],
    [8294,"8294","Carrier E","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97151","BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN","38","1",null,null,"26.7",null,null,"38",null,"NA","NA"],
    [8295,"8295","Carrier E","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99214","OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN","23","1",null,null,"236.3",null,null,"23",null,"NA","NA"],
    [8296,"8296","Carrier E","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","912","BEHAVIORAL HEALTH TREATMENTS/SVCS, PARTIAL HOSPITAL - LESS INTENSIVE","21","1",null,null,"51.6",null,null,"21",null,"NA","NA"],
    [8297,"8297","Carrier E","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0001","ALCOHOL AND/OR DRUG ASSESS","19","1",null,null,"53.7","27.3",null,"18","1","NA","NA"],
    [8298,"8298","Carrier E","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S9480","INTENSIVE OUTPATIENT PSYCHIA","15","1",null,null,"69.4","69.9",null,"14","1","NA","NA"],
    [8299,"8299","Carrier E","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","G0410","GRP PSYCHOTX NOT MX FAM GP PART HSP/OP 45-50 MIN","14","1",null,"45.7","37",null,"1","13",null,"NA","NA"],
    [8300,"8300","Carrier E","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0020","ALCOHOL AND/OR DRUG SERVICES METHADONE ADMINISTRATION","11","1",null,null,"101.9","125.3",null,"10","1","NA","NA"],
    [8301,"8301","Carrier E","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99204","OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES","9","1",null,null,"121.1",null,null,"9",null,"NA","NA"],
    [8302,"8302","Carrier E","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90792","PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES","9","1",null,null,"56.6","26.4",null,"8","1","NA","NA"],
    [8303,"8303","Carrier E","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90791","PSYCHIATRIC DIAGNOSTIC EVALUATION","57",null,"0.018",null,"91.6",null,null,"57",null,"NA","NA"],
    [8304,"8304","Carrier E","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0143","WALKER FOLDING WHEELED W/O S","157","0.994",null,"242.2","11.6",null,"1","156",null,"NA","NA"],
    [8305,"8305","Carrier E","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4239","SPLY ALW NONADJUNC NONIMPL CGM 1 MO SPLY= 1 UOS","105","0.981",null,null,"19.7",null,null,"105",null,"NA","NA"],
    [8306,"8306","Carrier E","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2103","NONADJUNCTIVE NONIMPLANTED CGM/RECEIVER","99","0.98",null,null,"8.5",null,null,"99",null,"NA","NA"],
    [8307,"8307","Carrier E","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0604","BREAST PUMP HEAVY DUTY HOSP GRADE PISTON OP","84","1",null,"0.3","16.4",null,"1","83",null,"NA","NA"],
    [8308,"8308","Carrier E","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0570","NEBULIZER WITH COMPRESSOR","76","0.987",null,"2.4","7.1",null,"7","69",null,"NA","NA"],
    [8309,"8309","Carrier E","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L1852","KNEE ORTHOSIS DOUBLE UPRIGHT THIGH AND CALF","62","1",null,null,"33.1",null,null,"62",null,"NA","NA"],
    [8310,"8310","Carrier E","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1390","OXYGEN CONCENTRATOR","62","1",null,"1","11.2",null,"4","58",null,"NA","NA"],
    [8311,"8311","Carrier E","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0730","TENS DEVICE 4/MORE LEADS MULTI NERVE STIMULATION","55","1",null,null,"22.2",null,null,"55",null,"NA","NA"],
    [8312,"8312","Carrier E","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A5500","DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE","50","1",null,null,"24.4",null,null,"50",null,"NA","NA"],
    [8313,"8313","Carrier E","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0001","STANDARD WHEELCHAIR","25","1",null,"1.3","20.4",null,"1","24",null,"NA","NA"],
    [8314,"8314","Carrier E","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0604","BREAST PUMP HEAVY DUTY HOSP GRADE PISTON OP","84","1",null,"0.3","16.4",null,"1","83",null,"NA","NA"],
    [8315,"8315","Carrier E","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L1852","KNEE ORTHOSIS DOUBLE UPRIGHT THIGH AND CALF","62","1",null,null,"33.1",null,null,"62",null,"NA","NA"],
    [8316,"8316","Carrier E","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1390","OXYGEN CONCENTRATOR","62","1",null,"1","11.2",null,"4","58",null,"NA","NA"],
    [8317,"8317","Carrier E","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0730","TENS DEVICE 4/MORE LEADS MULTI NERVE STIMULATION","55","1",null,null,"22.2",null,null,"55",null,"NA","NA"],
    [8318,"8318","Carrier E","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A5500","DIAB ONLY FIT CSTM PREP&SPL SHOE MX DNSITY INSRT PER SHOE","50","1",null,null,"24.4",null,null,"50",null,"NA","NA"],
    [8319,"8319","Carrier E","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0001","STANDARD WHEELCHAIR","25","1",null,"1.3","20.4",null,"1","24",null,"NA","NA"],
    [8320,"8320","Carrier E","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L0457","TLSO FLX SC JUNC TERM INF TO SCAP SPINE PREFAB","23","1",null,"2","21.1",null,"1","22",null,"NA","NA"],
    [8321,"8321","Carrier E","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9999","MISCELLANEOUS DME SUPPLY OR ACCESSORY NOS","23","1",null,null,"36.2",null,null,"23",null,"NA","NA"],
    [8322,"8322","Carrier E","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0202","PHOTOTHERAPY LIGHT W/ PHOTOM","22","1",null,"2.2","19.9",null,"6","16",null,"NA","NA"],
    [8323,"8323","Carrier E","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A6212","FOAM DRESS STERL PAD SZ 16 SQ/> W/ADHES BORDR EA","22","1",null,null,"18.2",null,null,"22",null,"NA","NA"],
    [8324,"8324","Carrier E","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95250","Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor f","115","0.704",null,null,"30",null,null,"115",null,"NA","NA"],
    [8325,"8325","Carrier E","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","EXT AMB INFUSN PUMP INSULIN","21","1",null,null,"27.6",null,null,"21",null,"NA","NA"],
    [8326,"8326","Carrier E","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4230","INFUS INSULIN PUMP NON NEEDL","15","1",null,null,"103.5",null,null,"15",null,"NA","NA"],
    [8327,"8327","Carrier E","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4232","SYRINGE W/NEEDLE INSULIN 3CC","7","1",null,null,"7.3",null,null,"7",null,"NA","NA"],
    [8328,"8328","Carrier E","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A6257","TRANSPARENT FILM STERL 16 SQ IN OR LESS EA DRESS","2","1",null,null,"24.7",null,null,"2",null,"NA","NA"],
    [8329,"8329","Carrier E","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A5120","SKIN BARRIER WIPES OR SWABS EACH","1","1",null,null,"3.1",null,null,"1",null,"NA","NA"],
    [8330,"8330","Carrier E","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","EXT AMB INFUSN PUMP INSULIN","21","1",null,null,"27.6",null,null,"21",null,"NA","NA"],
    [8331,"8331","Carrier E","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4230","INFUS INSULIN PUMP NON NEEDL","15","1",null,null,"103.5",null,null,"15",null,"NA","NA"],
    [8332,"8332","Carrier E","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4232","SYRINGE W/NEEDLE INSULIN 3CC","7","1",null,null,"7.3",null,null,"7",null,"NA","NA"],
    [8333,"8333","Carrier E","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A6257","TRANSPARENT FILM STERL 16 SQ IN OR LESS EA DRESS","2","1",null,null,"24.7",null,null,"2",null,"NA","NA"],
    [8334,"8334","Carrier E","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A5120","SKIN BARRIER WIPES OR SWABS EACH","1","1",null,null,"3.1",null,null,"1",null,"NA","NA"],
    [8335,"8335","Carrier E","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95250","Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor f","115","0.704",null,null,"30",null,null,"115",null,"NA","NA"],
    [8336,"8336","Carrier E","2024","Diabetes Supplies and Equip","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","95250","Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor f","115",null,"0.009",null,"30",null,null,"115",null,"NA","NA"],
    [8337,"8337","Carrier E","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","226","0.7522",null,null,"26.07653392",null,"0","226","0","EMPAGLIFLOZIN","JARDIANCE"],
    [8338,"8338","Carrier E","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","193","0.2798",null,null,"33.80955671",null,"0","193","0","SEMAGLUTIDE","OZEMPIC"],
    [8339,"8339","Carrier E","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","63","0.5079",null,null,"29.24854497",null,"0","63","0","LISDEXAMFETAMINE DIMESYLATE","VYVANSE"],
    [8340,"8340","Carrier E","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","53","1",null,null,"28.14422956",null,"0","53","0","ADALIMUMAB-ATTO","AMJEVITA"],
    [8341,"8341","Carrier E","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","53","0.9623",null,null,"23.051174",null,"0","53","0","FREMANEZUMAB-VFRM","AJOVY"],
    [8342,"8342","Carrier E","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","53","0.9245",null,null,"23.55567086",null,"0","53","0","UBROGEPANT","UBRELVY"],
    [8343,"8343","Carrier E","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","35","0.8857",null,null,"9.610103175",null,"0","35","0","RIVAROXABAN","XARELTO"],
    [8344,"8344","Carrier E","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","32","1",null,null,"25.31947917",null,"0","32","0","SECUKINUMAB","COSENTYX"],
    [8345,"8345","Carrier E","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","28","0.25",null,null,"40.00420635",null,"0","28","0","LIRAGLUTIDE","VICTOZA"],
    [8346,"8346","Carrier E","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","27","0.7778",null,null,"15.12006173",null,"0","27","0","TESTOSTERONE CYPIONATE","DEPO-TESTOST"],
    [8347,"8347","Carrier E","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","53","1",null,null,"28.14422956",null,"0","53","0","ADALIMUMAB-ATTO","AMJEVITA"],
    [8348,"8348","Carrier E","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","32","1",null,null,"25.31947917",null,"0","32","0","SECUKINUMAB","COSENTYX"],
    [8349,"8349","Carrier E","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","22","1",null,null,"52.01157828",null,"0","22","0","SACUBITRIL-VALSARTAN","ENTRESTO"],
    [8350,"8350","Carrier E","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","20","1",null,null,"32.34644444",null,"0","20","0","GALCANEZUMAB-GNLM","EMGALITY"],
    [8351,"8351","Carrier E","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","16","1",null,null,"79.31449653",null,"0","16","0","TICAGRELOR","BRILINTA"],
    [8352,"8352","Carrier E","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","12","1",null,null,"30.24680556",null,"0","12","0","CARIPRAZINE HCL","VRAYLAR"],
    [8353,"8353","Carrier E","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","10","1",null,null,"19.76813889",null,"0","10","0","ABATACEPT","ORENCIA"],
    [8354,"8354","Carrier E","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","10","1",null,null,"38.07980556",null,"0","10","0","GUSELKUMAB","TREMFYA"],
    [8355,"8355","Carrier E","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,null,"35.66954861",null,"0","8","0","OXYCODONE HCL","OXYCONTIN"],
    [8356,"8356","Carrier E","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,null,"31.79440476",null,"0","7","0","ERENUMAB-AOOE","AIMOVIG"],
    [8357,"8357","Carrier E","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1",null,"25.06333333",null,"0","1","0","PEGVISOMANT","SOMAVERT"],
    [8358,"8358","Carrier E","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"0.5",null,"49.05388889",null,"0","2","0","PAROXETINE HCL","PAXIL"],
    [8359,"8359","Carrier E","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"0.5",null,"3.415555556",null,"0","2","0","MESALAMINE","APRISO, LIALDA, PENTASA"],
    [8360,"8360","Carrier E","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","5",null,"0.2",null,"44.0995",null,"0","5","0","CLASCOTERONE","WINLEVI"],
    [8361,"8361","Carrier E","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","18",null,"0.0556",null,"44.67398148",null,"0","18","0","DUPILUMAB","DUPIXENT"],
    [8362,"8362","Carrier F","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","121","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Medical/Surgical/GYN","277","0.4043",null,"16","25",null,"79","198",null,"NA","NA"],
    [8363,"8363","Carrier F","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","13","0.6154",null,"19","52",null,"2","11",null,"NA","NA"],
    [8364,"8364","Carrier F","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27447","Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)","11","0.1818",null,"16","13",null,"1","10",null,"NA","NA"],
    [8365,"8365","Carrier F","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43235","Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","9","0",null,"18","6",null,"1","8",null,"NA","NA"],
    [8366,"8366","Carrier F","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44207","Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)","9","0.7778",null,"10","22",null,"3","6",null,"NA","NA"],
    [8367,"8367","Carrier F","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22614","Arthrodesis, posterior or posterolateral technique, single interspace; each additional interspace (List separately in addition to code for primary procedure)","8","0.5",null,"16","45",null,"1","7",null,"NA","NA"],
    [8368,"8368","Carrier F","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22842","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)","8","0.625",null,"15","51",null,"2","6",null,"NA","NA"],
    [8369,"8369","Carrier F","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","20930","Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for primary procedure)","7","0.5714",null,"14","72",null,"3","4",null,"NA","NA"],
    [8370,"8370","Carrier F","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","7","0.4286",null,null,"53",null,"0","7",null,"NA","NA"],
    [8371,"8371","Carrier F","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","7","0",null,null,"21",null,"0","7",null,"NA","NA"],
    [8372,"8372","Carrier F","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","44204","Laparoscopy, surgical; colectomy, partial, with anastomosis","6","1",null,"19","35",null,"1","5",null,"NA","NA"],
    [8373,"8373","Carrier F","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","49320","Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)","5","1",null,"22","55",null,"1","4",null,"NA","NA"],
    [8374,"8374","Carrier F","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","47120","Hepatectomy, resection of liver; partial lobectomy","4","1",null,"22","51",null,"1","3",null,"NA","NA"],
    [8375,"8375","Carrier F","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","20680","Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate)","3","1",null,"20","42",null,"1","2",null,"NA","NA"],
    [8376,"8376","Carrier F","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63052","Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment (List separately in addition to code for primary procedure)","3","1",null,"19","44",null,"2","1",null,"NA","NA"],
    [8377,"8377","Carrier F","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","32666","Thoracoscopy, surgical; with therapeutic wedge resection (eg, mass, nodule), initial unilateral","3","1",null,"3","19",null,"1","2",null,"NA","NA"],
    [8378,"8378","Carrier F","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","32674","Thoracoscopy, surgical; with mediastinal and regional lymphadenectomy (List separately in addition to code for primary procedure)","3","1",null,"3","19",null,"1","2",null,"NA","NA"],
    [8379,"8379","Carrier F","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33340","Percutaneous transcatheter closure of the left atrial appendage with endocardial implant, including fluoroscopy, transseptal puncture, catheter placement(s), left atrial angiography, left atrial appendage angiography, when performed, and radiological supervision and interpretation","3","1",null,null,"52",null,"0","3",null,"NA","NA"],
    [8380,"8380","Carrier F","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33430","Replacement, mitral valve, with cardiopulmonary bypass","3","1",null,"22","19",null,"2","1",null,"NA","NA"],
    [8381,"8381","Carrier F","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33508","Endoscopy, surgical, including video-assisted harvest of vein(s) for coronary artery bypass procedure (List separately in addition to code for primary procedure)","3","1",null,"29","18",null,"2","1",null,"NA","NA"],
    [8382,"8382","Carrier F","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43239","Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple","485","0.9526",null,"6","13",null,"52","433",null,"NA","NA"],
    [8383,"8383","Carrier F","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43235","Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","453","0.9558",null,"6","14",null,"50","403",null,"NA","NA"],
    [8384,"8384","Carrier F","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45378","Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","160","0.925",null,"9","15",null,"9","151",null,"NA","NA"],
    [8385,"8385","Carrier F","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","Colonoscopy, flexible; with biopsy, single or multiple","160","0.95",null,"9","15",null,"11","149",null,"NA","NA"],
    [8386,"8386","Carrier F","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64483","Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, single level","133","0.9248",null,"20","51",null,"13","120",null,"NA","NA"],
    [8387,"8387","Carrier F","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99214","Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","124","0.6532",null,"23","58",null,"35","89",null,"NA","NA"],
    [8388,"8388","Carrier F","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43249","Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter)","114","0.9474",null,"5","17",null,"11","103",null,"NA","NA"],
    [8389,"8389","Carrier F","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45385","Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","113","0.9381",null,"10","15",null,"9","104",null,"NA","NA"],
    [8390,"8390","Carrier F","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","731","Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified","96","0.9375",null,"13","19",null,"8","88",null,"NA","NA"],
    [8391,"8391","Carrier F","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27447","Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)","94","0.8298",null,"15","54",null,"3","91",null,"NA","NA"],
    [8392,"8392","Carrier F","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43242","Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examined distal to the anastomosis)","28","1",null,"15","37",null,"3","25",null,"NA","NA"],
    [8393,"8393","Carrier F","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","45390","Colonoscopy, flexible; with endoscopic mucosal resection","24","1",null,"15","7",null,"1","23",null,"NA","NA"],
    [8394,"8394","Carrier F","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64490","Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level","23","1",null,"11","43",null,"2","21",null,"NA","NA"],
    [8395,"8395","Carrier F","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","13152","Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm","20","1",null,"29","21",null,"3","17",null,"NA","NA"],
    [8396,"8396","Carrier F","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","14060","Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less","20","1",null,"12","4",null,"1","19",null,"NA","NA"],
    [8397,"8397","Carrier F","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","76942","Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation","20","1",null,"21","41",null,"4","16",null,"NA","NA"],
    [8398,"8398","Carrier F","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64479","Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or thoracic, single level","20","1",null,"3","58",null,"1","19",null,"NA","NA"],
    [8399,"8399","Carrier F","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","811","Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; not otherwise specified","18","1",null,"15","21",null,"1","17",null,"NA","NA"],
    [8400,"8400","Carrier F","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","66982","Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device, suture support for intraocular lens, or primary posterior capsulorrhexis) or performed on patients in the amblyogenic developmental stage; without endoscopic cyclophotocoagulation","18","1",null,null,"17",null,"0","18",null,"NA","NA"],
    [8401,"8401","Carrier F","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15260","Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; 20 sq cm or less","18","1",null,"28","25",null,"1","17",null,"NA","NA"],
    [8402,"8402","Carrier F","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","33228","Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; dual lead system","1",null,"1","22",null,null,"1","0",null,"NA","NA"],
    [8403,"8403","Carrier F","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","11621","Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm","1",null,"1",null,"25",null,"0","1",null,"NA","NA"],
    [8404,"8404","Carrier F","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","93312","Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report","1",null,"1",null,"116",null,"0","1",null,"NA","NA"],
    [8405,"8405","Carrier F","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","60210","Partial thyroid lobectomy, unilateral; with or without isthmusectomy","1",null,"1",null,"26",null,"0","1",null,"NA","NA"],
    [8406,"8406","Carrier F","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","74183","Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences","2",null,"0.5","22","96",null,"1","1",null,"NA","NA"],
    [8407,"8407","Carrier F","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","76376","3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not requiring image postprocessing on an independent workstation","2",null,"0.5","22","96",null,"1","1",null,"NA","NA"],
    [8408,"8408","Carrier F","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","81371","HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing)","2",null,"0.5",null,"59",null,"0","2",null,"NA","NA"],
    [8409,"8409","Carrier F","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","81376","HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each","2",null,"0.5",null,"59",null,"0","2",null,"NA","NA"],
    [8410,"8410","Carrier F","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","81378","HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1","2",null,"0.5",null,"59",null,"0","2",null,"NA","NA"],
    [8411,"8411","Carrier F","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","81379","HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C)","2",null,"0.5",null,"59",null,"0","2",null,"NA","NA"],
    [8412,"8412","Carrier F","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric","7","0",null,"12","11",null,"2","5",null,"NA","NA"],
    [8413,"8413","Carrier F","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","126","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Detoxification","4","0",null,"7","21",null,"2","2",null,"NA","NA"],
    [8414,"8414","Carrier F","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0010","Alcohol and/or drug services; subacute detoxification (residential addiction program inpatient)","3","1",null,null,"19",null,"0","3",null,"NA","NA"],
    [8415,"8415","Carrier F","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","128","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation","3","1",null,"44","98",null,"1","2",null,"NA","NA"],
    [8416,"8416","Carrier F","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0017","Behavioral health; residential (hospital residential treatment program), without room and board, per diem","3","0.3333",null,null,"33",null,"0","3",null,"NA","NA"],
    [8417,"8417","Carrier F","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0011","Alcohol and/or drug services; acute detoxification (residential addiction program inpatient)","1","0",null,null,"2",null,"0","1",null,"NA","NA"],
    [8418,"8418","Carrier F","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G2083","Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self administration, includes 2 hours post administration observation","1","0",null,"6",null,null,"1","0",null,"NA","NA"],
    [8419,"8419","Carrier F","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97530","Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","1","0",null,null,"11",null,"0","1",null,"NA","NA"],
    [8420,"8420","Carrier F","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","77412","Radiation treatment delivery, => 1 MeV; complex","1","0",null,"14",null,null,"1","0",null,"NA","NA"],
    [8421,"8421","Carrier F","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71250","Computed tomography, thorax, diagnostic; without contrast material","1","0",null,null,"12",null,"0","1",null,"NA","NA"],
    [8422,"8422","Carrier F","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0010","Alcohol and/or drug services; subacute detoxification (residential addiction program inpatient)","3","1",null,null,"19",null,"0","3",null,"NA","NA"],
    [8423,"8423","Carrier F","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","128","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation","3","1",null,"43.916666","98",null,"1","2",null,"NA","NA"],
    [8424,"8424","Carrier F","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0017","Behavioral health; residential (hospital residential treatment program), without room and board, per diem","3","0.3333",null,null,"33",null,"0","3",null,"NA","NA"],
    [8425,"8425","Carrier F","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric","7","0",null,"11.674999","11",null,"2","5",null,"NA","NA"],
    [8426,"8426","Carrier F","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","126","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Detoxification","4","0",null,"7.124999","21",null,"2","2",null,"NA","NA"],
    [8427,"8427","Carrier F","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0011","Alcohol and/or drug services; acute detoxification (residential addiction program inpatient)","1","0",null,null,"2",null,"0","1",null,"NA","NA"],
    [8428,"8428","Carrier F","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","G2083","Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self administration, includes 2 hours post administration observation","1","0",null,"6.083333",null,null,"1","0",null,"NA","NA"],
    [8429,"8429","Carrier F","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97530","Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","1","0",null,null,"11",null,"0","1",null,"NA","NA"],
    [8430,"8430","Carrier F","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77412","Radiation treatment delivery, => 1 MeV; complex","1","0",null,"13.683333",null,null,"1","0",null,"NA","NA"],
    [8431,"8431","Carrier F","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","71250","Computed tomography, thorax, diagnostic; without contrast material","1","0",null,null,"12",null,"0","1",null,"NA","NA"],
    [8432,"8432","Carrier F","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S9480","Intensive outpatient psychiatric services, per diem","97","0.6907",null,"9","61",null,"17","80",null,"NA","NA"],
    [8433,"8433","Carrier F","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","Mental health partial hospitalization, treatment, less than 24 hours","74","0.8514",null,"15","50",null,"6","68",null,"NA","NA"],
    [8434,"8434","Carrier F","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","65","0.8769",null,"27","89",null,"17","48",null,"NA","NA"],
    [8435,"8435","Carrier F","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","50","0.88",null,"24","93",null,"8","42",null,"NA","NA"],
    [8436,"8436","Carrier F","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","50","0.92",null,"26","92",null,"10","40",null,"NA","NA"],
    [8437,"8437","Carrier F","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0015","Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education","41","0.8537",null,null,"58",null,"0","41",null,"NA","NA"],
    [8438,"8438","Carrier F","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan","36","0.9167",null,"22","88",null,"2","34",null,"NA","NA"],
    [8439,"8439","Carrier F","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G2083","Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self administration, includes 2 hours post administration observation","33","0.7273",null,"31","77",null,"8","25",null,"NA","NA"],
    [8440,"8440","Carrier F","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97153","Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes","30","0.9333",null,"25","88",null,"2","28",null,"NA","NA"],
    [8441,"8441","Carrier F","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97156","Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes","27","0.9259",null,"24","83",null,"3","24",null,"NA","NA"],
    [8442,"8442","Carrier F","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0032","Mental health service plan development by nonphysician","14","1",null,"25","79",null,"2","12",null,"NA","NA"],
    [8443,"8443","Carrier F","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97152","Behavior identification-supporting assessment, administered by one technician under the direction of a physician or other qualified health care professional, face-to-face with the patient, each 15 minutes","5","1",null,null,"88",null,"0","5",null,"NA","NA"],
    [8444,"8444","Carrier F","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H2019","Therapeutic behavioral services, per 15 minutes","5","1",null,null,"110",null,"0","5",null,"NA","NA"],
    [8445,"8445","Carrier F","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97157","Multiple-family group adaptive behavior treatment guidance, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of guardians/caregivers, each 15 minutes","2","1",null,null,"65",null,"0","2",null,"NA","NA"],
    [8446,"8446","Carrier F","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96139","Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; each additional 30 minutes (List separately in addition to code for primary procedure)","1","1",null,null,"193",null,"0","1",null,"NA","NA"],
    [8447,"8447","Carrier F","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96138","Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; first 30 minutes","1","1",null,null,"193",null,"0","1",null,"NA","NA"],
    [8448,"8448","Carrier F","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0019","Behavioral health; long-term residential (nonmedical, nonacute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem","1","1",null,null,"111",null,"0","1",null,"NA","NA"],
    [8449,"8449","Carrier F","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0020","Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)","1","1",null,null,"1",null,"0","1",null,"NA","NA"],
    [8450,"8450","Carrier F","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0031","Mental health assessment, by nonphysician","1","1",null,null,"102",null,"0","1",null,"NA","NA"],
    [8451,"8451","Carrier F","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","96116","Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face-to-face time with the patient and time interpreting test results and preparing the report; first hour","1","1",null,null,"193",null,"0","1",null,"NA","NA"],
    [8452,"8452","Carrier F","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","J0578","Injection, buprenorphine extended-release (Brixadi), greater than 7 days and up to 28 days of therapy","3",null,"0.33","24",null,null,"3","0",null,"NA","NA"],
    [8453,"8453","Carrier F","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","S0013","Esketamine, nasal spray, 1 mg","7",null,"0.14","10","107",null,"3","4",null,"NA","NA"],
    [8454,"8454","Carrier F","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","50",null,"0.1","24","93",null,"8","42",null,"NA","NA"],
    [8455,"8455","Carrier F","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","50",null,"0.1","26","92",null,"10","40",null,"NA","NA"],
    [8456,"8456","Carrier F","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","65",null,"0.08","27","89",null,"17","48",null,"NA","NA"],
    [8457,"8457","Carrier F","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","G2083","Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self administration, includes 2 hours post administration observation","33",null,"0.06","31","77",null,"8","25",null,"NA","NA"],
    [8458,"8458","Carrier F","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","G2082","Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of up to 56 mg of esketamine nasal self administration, includes 2 hours post administration observation","18",null,"0.06","28","73",null,"4","14",null,"NA","NA"],
    [8459,"8459","Carrier F","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0486","Oral device/appliance used to reduce upper airway collapsibility, adjustable or nonadjustable, custom fabricated, includes fitting and adjustment","13","0.2308",null,"3","74",null,"1","12",null,"NA","NA"],
    [8460,"8460","Carrier F","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A6550","Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","12","0.8333",null,null,"117",null,"0","12",null,"NA","NA"],
    [8461,"8461","Carrier F","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A7000","Canister, disposable, used with suction pump, each","12","0.8333",null,null,"117",null,"0","12",null,"NA","NA"],
    [8462,"8462","Carrier F","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2402","Negative pressure wound therapy electrical pump, stationary or portable","12","0.8333",null,null,"117",null,"0","12",null,"NA","NA"],
    [8463,"8463","Carrier F","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4604","Tubing with integrated heating element for use with positive airway pressure device","11","0.2727",null,"27","51",null,"3","8",null,"NA","NA"],
    [8464,"8464","Carrier F","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0108","Wheelchair component or accessory, not otherwise specified","11","0.7273",null,"17","61",null,"1","10",null,"NA","NA"],
    [8465,"8465","Carrier F","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0562","Humidifier, heated, used with positive airway pressure device","10","0.3",null,"22.433333","41",null,"1","9",null,"NA","NA"],
    [8466,"8466","Carrier F","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A7030","Full face mask used with positive airway pressure device, each","9","0.3333",null,"22.433333","59",null,"1","8",null,"NA","NA"],
    [8467,"8467","Carrier F","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","Continuous positive airway pressure (CPAP) device","9","0.3333",null,"22.433333","41",null,"1","8",null,"NA","NA"],
    [8468,"8468","Carrier F","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","External ambulatory infusion pump, insulin","9","0.8889",null,null,"43",null,"0","9",null,"NA","NA"],
    [8469,"8469","Carrier F","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0955","Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","6","1",null,null,"59",null,"0","6",null,"NA","NA"],
    [8470,"8470","Carrier F","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0748","Osteogenesis stimulator, electrical, noninvasive, spinal applications","5","1",null,null,"60",null,"0","5",null,"NA","NA"],
    [8471,"8471","Carrier F","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1028","Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","5","1",null,null,"67",null,"0","5",null,"NA","NA"],
    [8472,"8472","Carrier F","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1390","Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","5","1",null,null,"45",null,"0","5",null,"NA","NA"],
    [8473,"8473","Carrier F","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S9342","Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem","5","1",null,null,"86",null,"0","5",null,"NA","NA"],
    [8474,"8474","Carrier F","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0466","Home ventilator, any type, used with noninvasive interface, (e.g., mask, chest shell)","4","1",null,"24.116666","62",null,"1","3",null,"NA","NA"],
    [8475,"8475","Carrier F","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2620","Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 in, any height, including any type mounting hardware","4","1",null,null,"79",null,"0","4",null,"NA","NA"],
    [8476,"8476","Carrier F","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","K0195","Elevating legrests, pair (for use with capped rental wheelchair base)","4","1",null,"20.988888","22",null,"3","1",null,"NA","NA"],
    [8477,"8477","Carrier F","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L2820","Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","4","1",null,null,"85",null,"0","4",null,"NA","NA"],
    [8478,"8478","Carrier F","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5673","Addition to lower extremity, below knee (BK)/above knee (AK), custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","4","1",null,null,"28",null,"0","4",null,"NA","NA"],
    [8479,"8479","Carrier F","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","S9342","Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem","5",null,"0.2",null,"86",null,"0","5",null,"NA","NA"],
    [8480,"8480","Carrier F","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","B4150","Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","6",null,"0.1667",null,"73",null,"0","6",null,"NA","NA"],
    [8481,"8481","Carrier F","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","Diabetes Supplies & Equip","15","0.8667",null,"0","47","0","0","15",null,"NA","NA"],
    [8482,"8482","Carrier F","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NA","NA","Diabetes Supplies & Equip","15","0.8667",null,"0","47","0","0","15",null,"NA","NA"],
    [8483,"8483","Carrier F","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","228","0.6009",null,"0.67","2.76",null,"27","201","0","Semaglutide","Ozempic"],
    [8484,"8484","Carrier F","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","98","0.5714",null,"0.03","2.84",null,"12","86","0","Tirzepatide","Mounjaro"],
    [8485,"8485","Carrier F","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","89","0.7303",null,"2.49","8.19",null,"11","78","0","Rimegepant","Nurtec"],
    [8486,"8486","Carrier F","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","61","0.8689",null,"6.02","10.19",null,"13","48","0","Dupilumab","Dupixent"],
    [8487,"8487","Carrier F","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","59","0.8644",null,"0.27","3.04",null,"14","45","0","Empagliflozin","Jardiance"],
    [8488,"8488","Carrier F","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","51","0.9804",null,"0.02","1.37",null,"6","45","0","Galcanezumab","Emgality"],
    [8489,"8489","Carrier F","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","49","0.8776",null,"2.73","7.21",null,"17","32","0","Evolocumab","Repatha"],
    [8490,"8490","Carrier F","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","48","0.875",null,"0.25","3.73",null,"6","42","0","Empagliflozin","Jardiance"],
    [8491,"8491","Carrier F","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","39","0.7692",null,"0.01","5.05",null,"3","36","0","Liraglutide","Victoza"],
    [8492,"8492","Carrier F","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","37","0.7027",null,"0.77","13.01",null,"7","30","0","Risankizumab","Skyrizi"],
    [8493,"8493","Carrier F","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","18","1",null,"7.08","10.1",null,"3","15","0","Etanercept","Enbrel"],
    [8494,"8494","Carrier F","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","10","1",null,"0.01","0.24",null,"1","9","0","Erenumab","Aimovig"],
    [8495,"8495","Carrier F","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","10","1",null,"2.1","10.19",null,"2","8","0","Ustekinumab","Stelara"],
    [8496,"8496","Carrier F","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","10","1",null,"0","0.01",null,"3","7","0","Cariprazine","Vraylar"],
    [8497,"8497","Carrier F","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","8","1",null,"0","6.28",null,"1","7","0","Dapagliflozin","Farxiga"],
    [8498,"8498","Carrier F","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","7","1",null,"0.45","6.31",null,"2","5","0","Ubrogepant","Ubrelvy"],
    [8499,"8499","Carrier F","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","7","1",null,"3.97","11.09",null,"1","6","0","Naltrexone","Vivitrol"],
    [8500,"8500","Carrier F","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","6","1",null,"0","9.74",null,"1","5","0","Sitagliptin","Januvia"],
    [8501,"8501","Carrier F","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","6","1",null,"5.9","16.95",null,"1","5","0","Adalimumab","Humira"],
    [8502,"8502","Carrier F","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","6","1",null,"0","5.39",null,"1","5","0","Denosumab","Prolia"],
    [8503,"8503","Carrier F","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","1",null,"0.3333",null,"3.17",null,"0","1","0","Leuprolide","Lupron"],
    [8504,"8504","Carrier F","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","1",null,"1",null,"0.13",null,"0","1","0","Testosterone","Testosterone"],
    [8505,"8505","Carrier F","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","1",null,"0.5",null,"0.08",null,"0","1","0","Buprenorphine-Naloxone","Suboxone"],
    [8506,"8506","Carrier F","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","1",null,"1","1.91",null,null,"1","0","0","Patiromer","Veltassa"],
    [8507,"8507","Carrier F","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","1",null,"1","0.93",null,null,"1","0","0","Filgrastim","Neupogen"],
    [8508,"8508","Carrier H","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","121","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Medical/Surgical/GYN","150","0.3667",null,"12.730952","29.746857",null,"28","122",null,"NA","NA"],
    [8509,"8509","Carrier H","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43644","Laparoscopy, Surg, Gastric Restrictive Procedure; W Gastric Bypass And Roux-En-Y Gastroent","44","0.8636",null,null,"17.454552",null,"0","44",null,"NA","NA"],
    [8510,"8510","Carrier H","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","43775","Laps Gstrc Rstrictiv Px Longitudinal Gastrectomy","41","0.9024",null,null,"16.2",null,"0","41",null,"NA","NA"],
    [8511,"8511","Carrier H","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22614","Arthrodesis, Posterior Or Posterolateral Technique, Single Interspace; Each Additional Int","31","1",null,"18","34.666656",null,"4","27",null,"NA","NA"],
    [8512,"8512","Carrier H","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","Total Abdominal Hysterectomy (Corpus And Cervix), With Or Without Removal Of Tube(S), With","31","0.9677",null,"0","12.444456",null,"2","29",null,"NA","NA"],
    [8513,"8513","Carrier H","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22585","Arthrodesis, Anterior/-Lateral,Ea Add.In","19","1",null,"12","39.529416",null,"2","17",null,"NA","NA"],
    [8514,"8514","Carrier H","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","63053","Laminectomy, Facetectomy, Or Foraminotomy During Posterior Interbody Arthrodesis, Lumbar;","16","0.6875",null,null,"46.5",null,"0","16",null,"NA","NA"],
    [8515,"8515","Carrier H","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22552","Arthrodesis, Anterior Interbody, Incl Disc Space Prep, Discectomy, Osteophytectomy & Decom","15","1",null,"24","60",null,"3","12",null,"NA","NA"],
    [8516,"8516","Carrier H","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22634","Arthrodesis, Combined Posterior Or Posterolateral Technique With Posterior Interbody Techn","14","0.6429",null,null,"39.428568",null,"0","14",null,"NA","NA"],
    [8517,"8517","Carrier H","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","27487","Revis.Totl Knee Arthroplas,W/Wo Allogft;","14","1",null,"0","5.538456",null,"1","13",null,"NA","NA"],
    [8518,"8518","Carrier H","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22614","Arthrodesis, Posterior Or Posterolateral Technique, Single Interspace; Each Additional Int","31","1",null,"18","34.666656",null,"4","27",null,"NA","NA"],
    [8519,"8519","Carrier H","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22585","Arthrodesis, Anterior/-Lateral,Ea Add.In","19","1",null,"12","39.529416",null,"2","17",null,"NA","NA"],
    [8520,"8520","Carrier H","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22552","Arthrodesis, Anterior Interbody, Incl Disc Space Prep, Discectomy, Osteophytectomy & Decom","15","1",null,"24","60",null,"3","12",null,"NA","NA"],
    [8521,"8521","Carrier H","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27487","Revis.Totl Knee Arthroplas,W/Wo Allogft;","14","1",null,"0","5.538456",null,"1","13",null,"NA","NA"],
    [8522,"8522","Carrier H","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19328","Removal Of Intact Breast Implant","11","1",null,"24","0",null,"1","10",null,"NA","NA"],
    [8523,"8523","Carrier H","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33340","Percutaneous Transcatheter Closure Of The Left Atrial Appendage With Endocardial Implant,","10","1",null,null,"21.6",null,"0","10",null,"NA","NA"],
    [8524,"8524","Carrier H","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33361","Transcatheter Aortic Valve Replacement (Tavr/Tavi) With Prosthetic Valve; Percutaneous Fem","9","1",null,null,"34.666656",null,"0","9",null,"NA","NA"],
    [8525,"8525","Carrier H","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","11971","Removal Of Tissue Expander Without Insertion Of Implant","9","1",null,null,"0",null,"0","9",null,"NA","NA"],
    [8526,"8526","Carrier H","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27137","Revision Total Hip-Acetabular Only","9","1",null,"12","24",null,"2","7",null,"NA","NA"],
    [8527,"8527","Carrier H","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27130","Replacement Hip Total Simple","7","1",null,null,"6.857136",null,"0","7",null,"NA","NA"],
    [8528,"8528","Carrier H","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43644","Laparoscopy, Surg, Gastric Restrictive Procedure; W Gastric Bypass And Roux-En-Y Gastroent","44",null,"1",null,"17.454552",null,"0","44",null,"NA","NA"],
    [8529,"8529","Carrier H","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22614","Arthrodesis, Posterior Or Posterolateral Technique, Single Interspace; Each Additional Int","31",null,"1","18","34.666656",null,"4","27",null,"NA","NA"],
    [8530,"8530","Carrier H","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22585","Arthrodesis, Anterior/-Lateral,Ea Add.In","19",null,"1","12","39.529416",null,"2","17",null,"NA","NA"],
    [8531,"8531","Carrier H","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22552","Arthrodesis, Anterior Interbody, Incl Disc Space Prep, Discectomy, Osteophytectomy & Decom","15",null,"1","24","60",null,"3","12",null,"NA","NA"],
    [8532,"8532","Carrier H","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","33361","Transcatheter Aortic Valve Replacement (Tavr/Tavi) With Prosthetic Valve; Percutaneous Fem","9",null,"1",null,"34.666656",null,"0","9",null,"NA","NA"],
    [8533,"8533","Carrier H","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","61863","Burr Hole Craniotomy With Implantation Of Subcortical Electrode Array, Wo Intraop Microele","6",null,"1",null,"16.000008",null,"0","6",null,"NA","NA"],
    [8534,"8534","Carrier H","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43659","Unlisted Laparoscopy Procedure, Stomach","5",null,"1",null,"30",null,"0","5",null,"NA","NA"],
    [8535,"8535","Carrier H","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","61864","Burr Hole Craniotomy W Implantation Of Subcortical Electrode Array, Wo Intraop Microelectr","4",null,"1",null,"24",null,"0","4",null,"NA","NA"],
    [8536,"8536","Carrier H","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","15879","Suction Assist Lipectomy Lower Extremity","1",null,"1",null,"24",null,"0","1",null,"NA","NA"],
    [8537,"8537","Carrier H","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","15878","Suction Assist Lipectomy Up Extrem","1",null,"1",null,"24",null,"0","1",null,"NA","NA"],
    [8538,"8538","Carrier H","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","Echo, Transthoracic W/Doppler, Complete","38758","0.9326",null,"1.371429","5.803063",null,"35","38723",null,"NA","NA"],
    [8539,"8539","Carrier H","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","Continuous Airway Pressure (Cpap) Device [May Be Used For Either Cpap Or Apap]","34534","0.9729",null,null,"1.665837",null,"0","34534",null,"NA","NA"],
    [8540,"8540","Carrier H","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","Mri, Lower Extremity Any Joint; Wo Contr","26541","0.8731",null,"1.690141","7.770306",null,"71","26470",null,"NA","NA"],
    [8541,"8541","Carrier H","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","MSMPT","Physical Therapy","21420","0.68",null,"13","9",null,null,null,null,"NA","NA"],
    [8542,"8542","Carrier H","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72148","Mri Of Lumbar Spine","19137","0.8792",null,"0.96","7.645851",null,"49","19088",null,"NA","NA"],
    [8543,"8543","Carrier H","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","Mri Of Brain And Further Sequences","18487","0.9382",null,"2.086957","5.063934",null,"46","18441",null,"NA","NA"],
    [8544,"8544","Carrier H","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74177","Ct Abd & Pelv W Contrast","17662","0.9321",null,"0.338028","8.115948",null,"71","17591",null,"NA","NA"],
    [8545,"8545","Carrier H","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73221","Mri, Any Joint Of Upper Extremity; Wo Co","13375","0.8552",null,"0.888889","8.691639",null,"27","13348",null,"NA","NA"],
    [8546,"8546","Carrier H","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72141","Mri Of Cervical Spine","11318","0.8771",null,"0.8","8.12118",null,"29","11289",null,"NA","NA"],
    [8547,"8547","Carrier H","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71260","Diagnostic Ct Thorax W/Contrast","10123","0.9429",null,"0","4.934602",null,"31","10092",null,"NA","NA"],
    [8548,"8548","Carrier H","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95800","Sleep Study, Unattended, Simultaneous Recording; Heart Rate, Oxygen Saturation, Respiratory Analysis (E.G., By Air Flow Or Peripheral Arterial Tone) And Sleep Time","112","1",null,null,"0",null,"0","112",null,"NA","NA"],
    [8549,"8549","Carrier H","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19380","Revision Of Reconstructed Breast (Eg, Significant Removal Of Tissue, Re-Advancement And/Or","61","1",null,"0","14.89656",null,"1","60",null,"NA","NA"],
    [8550,"8550","Carrier H","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19357","Tissue Expander Placement In Breast Reconstruction, Including Subsequent Expansion(S)","45","1",null,"0","9.081072",null,"7","38",null,"NA","NA"],
    [8551,"8551","Carrier H","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27446","Arthropls,Knee,Cond/Plat;Medor Lat","26","1",null,"0","19.999992",null,"2","24",null,"NA","NA"],
    [8552,"8552","Carrier H","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","11970","Replacement Of Tissue Expander With Permanent Implant","20","1",null,null,"21.6",null,"0","20",null,"NA","NA"],
    [8553,"8553","Carrier H","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","92250","Fundus photography with interpretation and report","33","1",null,"2.216666","2.804166",null,"1","32",null,"NA","NA"],
    [8554,"8554","Carrier H","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64493","Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level","27","1",null,"17.036666","23.829545",null,"5","22",null,"NA","NA"],
    [8555,"8555","Carrier H","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64635","Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint","19","1",null,"2.991666","32.22745",null,"2","17",null,"NA","NA"],
    [8556,"8556","Carrier H","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99204","Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","19","1",null,"0.008333","2.043137",null,"2","17",null,"NA","NA"],
    [8557,"8557","Carrier H","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93458","Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","17","1",null,"16.456249","70.998147",null,"8","9",null,"NA","NA"],
    [8558,"8558","Carrier H","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27447","Replacement Knee Total","325",null,"1","0","14.552376",null,"10","315",null,"NA","NA"],
    [8559,"8559","Carrier H","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","15771","Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk, Breasts, Scalp, Ar","89",null,"1",null,"26.157312",null,"0","89",null,"NA","NA"],
    [8560,"8560","Carrier H","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","36465","Injection Of Non-Compounded Foam Sclerosant W/ Ultrasound Compression Maneuvers To Guide D","79",null,"1","0","20.7",null,"4","75",null,"NA","NA"],
    [8561,"8561","Carrier H","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","15772","Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk, Breasts, Scalp, Ar","61",null,"1",null,"22.426224",null,"0","61",null,"NA","NA"],
    [8562,"8562","Carrier H","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","36482","Endovenous Ablation Therapy Of Incompetent Vein, Extremity, By Transcatheter Delivery Of A","56",null,"1",null,"19.525416",null,"0","56",null,"NA","NA"],
    [8563,"8563","Carrier H","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22552","Arthrodesis, Anterior Interbody, Incl Disc Space Prep, Discectomy, Osteophytectomy & Decom","42",null,"1","14.4","42.162168",null,"5","37",null,"NA","NA"],
    [8564,"8564","Carrier H","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","67904","Rep Blepharoptosis Levator External","40",null,"1",null,"21.142848",null,"0","40",null,"NA","NA"],
    [8565,"8565","Carrier H","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27446","Arthropls,Knee,Cond/Plat;Medor Lat","26",null,"1","0","19.999992",null,"2","24",null,"NA","NA"],
    [8566,"8566","Carrier H","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","36476","Endovenous Ablation Tx Of Incompetent Vein, Extremity, Inclusive Imaging Guidance & Monito","24",null,"1",null,"21.12",null,"0","24",null,"NA","NA"],
    [8567,"8567","Carrier H","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64582","Open Implantation Of Hypoglossal Nerve Neurostimulator Array, Pulse Generator, And Distal","22",null,"1",null,"25.09092",null,"0","22",null,"NA","NA"],
    [8568,"8568","Carrier H","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","128","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation","2","0",null,"22.433333","114.316666",null,"1","1",null,"NA","NA"],
    [8569,"8569","Carrier H","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric","2","0",null,"11.1","50.2",null,"1","1",null,"NA","NA"],
    [8570,"8570","Carrier H","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","126","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Detoxification","2","0",null,"3.958333",null,null,"2","0",null,"NA","NA"],
    [8571,"8571","Carrier H","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","1","0",null,"7.666666",null,null,"1","0",null,"NA","NA"],
    [8572,"8572","Carrier H","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","1","0",null,"7.666666",null,null,"1","0",null,"NA","NA"],
    [8573,"8573","Carrier H","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","1","0",null,"7.666666",null,null,"1","0",null,"NA","NA"],
    [8574,"8574","Carrier H","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97530","Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","1","0",null,null,"50.2",null,"0","1",null,"NA","NA"],
    [8575,"8575","Carrier H","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","Mental health partial hospitalization, treatment, less than 24 hours","1","0",null,"22.15",null,null,"1","0",null,"NA","NA"],
    [8576,"8576","Carrier H","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","J2777","Injection, faricimab-svoa, 0.1 mg","1","0",null,"11.1",null,null,"1","0",null,"NA","NA"],
    [8577,"8577","Carrier H","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64635","Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint","1","0",null,"0.25",null,null,"1","0",null,"NA","NA"],
    [8578,"8578","Carrier H","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","NA","Accommodation Codes - Room & Board-Semiprivate (Two-Beds)-Rehabilitation","2","0",null,"22.433333","114.316666",null,"1","1",null,"NA","NA"],
    [8579,"8579","Carrier H","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","128","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Psychiatric","2","0",null,"11.1","50.2",null,"1","1",null,"NA","NA"],
    [8580,"8580","Carrier H","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","Accommodation Codes - Room & Board Semiprivate (Two Beds)-Detoxification","2","0",null,"3.958333",null,null,"2","0",null,"NA","NA"],
    [8581,"8581","Carrier H","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","126","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","1","0",null,"7.666666",null,null,"1","0",null,"NA","NA"],
    [8582,"8582","Carrier H","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","1","0",null,"7.666666",null,null,"1","0",null,"NA","NA"],
    [8583,"8583","Carrier H","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","1","0",null,"7.666666",null,null,"1","0",null,"NA","NA"],
    [8584,"8584","Carrier H","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97530","Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","1","0",null,null,"50.2",null,"0","1",null,"NA","NA"],
    [8585,"8585","Carrier H","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0035","Mental health partial hospitalization, treatment, less than 24 hours","1","0",null,"22.15",null,null,"1","0",null,"NA","NA"],
    [8586,"8586","Carrier H","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J2777","Injection, faricimab-svoa, 0.1 mg","1","0",null,"11.1",null,null,"1","0",null,"NA","NA"],
    [8587,"8587","Carrier H","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64635","Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint","1","0",null,"0.25",null,null,"1","0",null,"NA","NA"],
    [8588,"8588","Carrier H","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Therapeutic Repetitive Transcranial Magnetic Simulation (Tms) Treatment; Initial, Includin","232","0.8147",null,"16.615392","36.428568",null,"13","219",null,"NA","NA"],
    [8589,"8589","Carrier H","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","Therapeutic Repetitive Transcranial Magnetic Simulation (Tms) Treatment; Including Cortica","200","0.845",null,"17.454552","37.20636",null,"11","189",null,"NA","NA"],
    [8590,"8590","Carrier H","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","Therapeutic Repetitive Transcranial Magnetic Stimulation (Tms) Treatment; Subsequent Motor","195","0.8513",null,"16.000008","35.805408",null,"12","183",null,"NA","NA"],
    [8591,"8591","Carrier H","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","Mental health partial hospitalization, treatment, less than 24 hours","149","0.7987",null,"19.707142","41.255868",null,"7","142",null,"NA","NA"],
    [8592,"8592","Carrier H","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan","110","0.7636",null,"18.074358","71.811855",null,"13","97",null,"NA","NA"],
    [8593,"8593","Carrier H","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97155","Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes","102","0.7745",null,"22.902083","70.11027",null,"16","86",null,"NA","NA"],
    [8594,"8594","Carrier H","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97153","Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes","96","0.7708",null,"21.224999","68.501422",null,"14","82",null,"NA","NA"],
    [8595,"8595","Carrier H","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97156","Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes","95","0.7684",null,"20.207142","70.574485",null,"14","81",null,"NA","NA"],
    [8596,"8596","Carrier H","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S9480","Intensive outpatient psychiatric services, per diem","69","0.6957",null,"21.399999","43.605472",null,"2","67",null,"NA","NA"],
    [8597,"8597","Carrier H","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0032","Mental health service plan development by nonphysician","52","0.7692",null,"18.054166","57.667707",null,"4","48",null,"NA","NA"],
    [8598,"8598","Carrier H","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S9480","Intensive Outpatient Psychiatric Services Per Diem","6","1",null,"24","57.6",null,"1","5",null,"NA","NA"],
    [8599,"8599","Carrier H","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90837","Psychotherapy, 60 Minutes With Patient","5","1",null,null,"38.4",null,"0","5",null,"NA","NA"],
    [8600,"8600","Carrier H","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90791","Psychiatric Diagnostic Evaluation","5","1",null,null,"52.8",null,"0","5",null,"NA","NA"],
    [8601,"8601","Carrier H","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0020","Alcohol And/Or Drug Services","2","1",null,null,"36",null,"0","2",null,"NA","NA"],
    [8602,"8602","Carrier H","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0035","Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours","2","1",null,"24","24",null,"1","1",null,"NA","NA"],
    [8603,"8603","Carrier H","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","G2067","Medication Assisted Treatment, Methadone; Weekly Bundle Including Dispensing And/Or Admini","2","1",null,null,"36",null,"0","2",null,"NA","NA"],
    [8604,"8604","Carrier H","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S0201","Partial hospitalization services, less than 24 hours, per diem","5","1",null,null,"67.789999",null,"0","5",null,"NA","NA"],
    [8605,"8605","Carrier H","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97155","Adptve Bhvr Trtmnt W/ Protocol Modifictn, Admnstrd By Phys Or Other Qualified Hlth Care Pr","1","1",null,null,"72",null,"0","1",null,"NA","NA"],
    [8606,"8606","Carrier H","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97151","Behavior Identification Assessment, Administered By A Physician Or Other Qualified Health","1","1",null,null,"72",null,"0","1",null,"NA","NA"],
    [8607,"8607","Carrier H","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90834","Psychotherapy; 45 Minutes With Patient","1","1",null,null,"72",null,"0","1",null,"NA","NA"],
    [8608,"8608","Carrier H","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","G2083","Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patie","42",null,"0.7143","13.333344","32.64",null,"18","24",null,"NA","NA"],
    [8609,"8609","Carrier H","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","S0013","Esketamine, Nasal Spray, 1 Mg","39",null,"0.6667","10.285704","35.555544",null,"14","25",null,"NA","NA"],
    [8610,"8610","Carrier H","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90868","Therapeutic Repetitive Transcranial Magnetic Simulation (Tms) Treatment; Initial, Includin","232",null,"0.5","16.615392","36.428568",null,"13","219",null,"NA","NA"],
    [8611,"8611","Carrier H","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","G2082","Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patie","17",null,"0.5","10.285704","31.2",null,"7","10",null,"NA","NA"],
    [8612,"8612","Carrier H","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90867","Therapeutic Repetitive Transcranial Magnetic Simulation (Tms) Treatment; Including Cortica","200",null,"0.4286","17.454552","37.20636",null,"11","189",null,"NA","NA"],
    [8613,"8613","Carrier H","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","90869","Therapeutic Repetitive Transcranial Magnetic Stimulation (Tms) Treatment; Subsequent Motor","195",null,"0.4","16.000008","35.805408",null,"12","183",null,"NA","NA"],
    [8614,"8614","Carrier H","2024","Outpatient MH-SUD","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","S9480","Intensive Outpatient Psychiatric Services Per Diem","6",null,"0","24","57.6",null,"1","5",null,"NA","NA"],
    [8615,"8615","Carrier H","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0486","Oral Device/Appliance Cusfab","226","0.9823",null,null,"3.128964",null,"0","1645",null,"NA","NA"],
    [8616,"8616","Carrier H","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0108","Wheelchair Component Or Accessory, Not Otherwise Specified","86","0.8023",null,null,"24.505272",null,"0","86",null,"NA","NA"],
    [8617,"8617","Carrier H","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S1040","Cranial Remolding Orthosis, Rigid, With Soft Interface Material, Custom Fabricated, Includ","70","0.9571",null,null,"16.457136",null,"0","70",null,"NA","NA"],
    [8618,"8618","Carrier H","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L8680","Implantable Neurostimulator Electrode Each","48","0.9167",null,"24","49.534872",null,"1","47",null,"NA","NA"],
    [8619,"8619","Carrier H","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0748","Osteogenic Stimulator, Noninvasive, Spinal Applications","33","0.6061",null,"0","99.096768",null,"1","32",null,"NA","NA"],
    [8620,"8620","Carrier H","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0760","Osteogenesis Stimulator Low Intensity Ultrasound Noninvasive","32","0",null,null,"36.75",null,"0","32",null,"NA","NA"],
    [8621,"8621","Carrier H","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2620","Positioning Wheelchair Back Cushion, Planar Back With Lateral Supports, Width","25","0.96",null,null,"24",null,"0","25",null,"NA","NA"],
    [8622,"8622","Carrier H","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0652","Pneumatic Compressor, Segmental Home Model With Calibrated Gradient Pr","25","0.72",null,null,"24.96",null,"0","25",null,"NA","NA"],
    [8623,"8623","Carrier H","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0747","Osteogenesis Stimulator (Non-Invasive)","24","0.4167",null,null,"30.26088",null,"0","24",null,"NA","NA"],
    [8624,"8624","Carrier H","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0005","Ultralightweight Wheelchair","24","1",null,null,"21",null,"0","24",null,"NA","NA"],
    [8625,"8625","Carrier H","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0005","Ultralightweight Wheelchair","24","1",null,null,"21",null,"0","24",null,"NA","NA"],
    [8626,"8626","Carrier H","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0260","Hospital Bed, Seimi-Electric (Head And Foot Adjustment), With Any Type","9","1",null,null,"21.333336",null,"0","9",null,"NA","NA"],
    [8627,"8627","Carrier H","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8690","Aud Osseo Dev, Int/Ext Comp","8","1",null,null,"30.857136",null,"0","8",null,"NA","NA"],
    [8628,"8628","Carrier H","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0766","Electrical Stimulation Device Used For Cancer Treatment, Includes All Accessories, Any Typ","8","1",null,null,"21",null,"0","8",null,"NA","NA"],
    [8629,"8629","Carrier H","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8687","Implt Nrostm Pls Gen Dua Rec","7","1",null,"24","19.999992",null,"1","6",null,"NA","NA"],
    [8630,"8630","Carrier H","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0465","Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","7","1",null,null,"72.707142",null,"0","7",null,"NA","NA"],
    [8631,"8631","Carrier H","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8686","Implt Nrostm Pls Gen Sng Non","6","1",null,null,"14.4",null,"0","6",null,"NA","NA"],
    [8632,"8632","Carrier H","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2609","Custom Fabricated Wheelchair Seat Cushion, Any Size","6","1",null,null,"24",null,"0","6",null,"NA","NA"],
    [8633,"8633","Carrier H","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2617","Custom Fabricated Wheelchair Back Cushion, Any Size, Including Any Type","5","1",null,null,"24",null,"0","5",null,"NA","NA"],
    [8634,"8634","Carrier H","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2607","Skin Protection And Positioning Wheelchair Seat Cushion, Width Less Than 22","4","1",null,null,"18",null,"0","4",null,"NA","NA"],
    [8635,"8635","Carrier H","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","K0606","Aed Garment With Electrocardiogram Analysis","11",null,"1","6.545448",null,null,"11","0",null,"NA","NA"],
    [8636,"8636","Carrier H","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L8614","Cochlear Device/System","10",null,"1",null,"18.666672",null,"0","10",null,"NA","NA"],
    [8637,"8637","Carrier H","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0483","High Frequency Chest Wall Oscillation System, With Full Anterior And/Or Posterior Thoracic","8",null,"1",null,"33",null,"0","8",null,"NA","NA"],
    [8638,"8638","Carrier H","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E0766","Electrical Stimulation Device Used For Cancer Treatment, Includes All Accessories, Any Typ","8",null,"1",null,"21",null,"0","8",null,"NA","NA"],
    [8639,"8639","Carrier H","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L8686","Implt Nrostm Pls Gen Sng Non","6",null,"1",null,"14.4",null,"0","6",null,"NA","NA"],
    [8640,"8640","Carrier H","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E2609","Custom Fabricated Wheelchair Seat Cushion, Any Size","6",null,"1",null,"24",null,"0","6",null,"NA","NA"],
    [8641,"8641","Carrier H","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E2617","Custom Fabricated Wheelchair Back Cushion, Any Size, Including Any Type","5",null,"1",null,"24",null,"0","5",null,"NA","NA"],
    [8642,"8642","Carrier H","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","L5856","Addition To Lower Extremity Prosthesis, Endoskeletal Knee-Shin System,","5",null,"1",null,"33.6",null,"0","5",null,"NA","NA"],
    [8643,"8643","Carrier H","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E2607","Skin Protection And Positioning Wheelchair Seat Cushion, Width Less Than 22","4",null,"1",null,"18",null,"0","4",null,"NA","NA"],
    [8644,"8644","Carrier H","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","Diabetes Supplies & Equip","52","0.5577",null,"2.017243577","9.671153808","0","9","43","0","NA","NA"],
    [8645,"8645","Carrier H","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","NA","NA","Diabetes Supplies & Equip","52","0.5577",null,"2.017243577","9.671153808","0","9","43","0","NA","NA"],
    [8646,"8646","Carrier H","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","2282","0.5513",null,"0.94","2.84",null,"270","2012","0","Semaglutide","Ozempic"],
    [8647,"8647","Carrier H","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","1229","0.5159",null,"0.5","2.34",null,"135","1094","0","Tirzepatide","Mounjaro"],
    [8648,"8648","Carrier H","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","915","0.7628",null,"2.63","8.44",null,"163","752","0","Rimegepant","Nurtec"],
    [8649,"8649","Carrier H","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","663","0.7677",null,"6.42","16.2",null,"147","516","0","Dupilumab","Dupixent"],
    [8650,"8650","Carrier H","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","551","0.8475",null,"0.89","2.93",null,"135","416","0","Empagliflozin","Jardiance"],
    [8651,"8651","Carrier H","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","494","0.8158",null,"1.63","5.76",null,"62","432","0","Tirzepatide","Zepbound"],
    [8652,"8652","Carrier H","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","415","0.8096",null,"1.4","7.99",null,"80","335","0","Ubrogepant","Ubrelvy"],
    [8653,"8653","Carrier H","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","397","0.9647",null,"0.42","2.06",null,"98","299","0","Galcanezumab","Emgality"],
    [8654,"8654","Carrier H","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","386","0.6736",null,"0.65","2.08",null,"47","339","0","Semaglutide","Ozempic"],
    [8655,"8655","Carrier H","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","366","0.8525",null,"1.1","7.51",null,"64","302","0","Evolocumab","Repatha"],
    [8656,"8656","Carrier H","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","NDC9","NA","NA","15","1",null,"11.83","1.83",null,"2","13","0","Linagliptin","Tradjenta"],
    [8657,"8657","Carrier H","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","14","1",null,"4.57","36.15",null,"9","5","0","Acalabrutinib","Calquence"],
    [8658,"8658","Carrier H","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","13","1",null,"11.86","8.36",null,"5","8","0","Glatiramer","Glatiramer"],
    [8659,"8659","Carrier H","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","12","1",null,"1.67","28.8",null,"4","8","0","Macitentan","Opsumit"],
    [8660,"8660","Carrier H","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","12","1",null,"5.37","7.23",null,"6","6","0","Dabrafenb","Tafinlar"],
    [8661,"8661","Carrier H","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","12","1",null,"0","0.1",null,"2","10","0","Sitagliptin","Januvia"],
    [8662,"8662","Carrier H","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","11","1",null,"0.01","0.01",null,"4","7","0","Cariprazine","Vraylar"],
    [8663,"8663","Carrier H","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","11","1",null,"3.4","2.84",null,"6","5","0","Abemaciclib","Verzenio"],
    [8664,"8664","Carrier H","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","10","1",null,"0","3.35",null,"3","7","0","Desvenlafaxine Er","Desvenlafaxine Er"],
    [8665,"8665","Carrier H","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","NDC9","NA","NA","10","1",null,"0.01","7.38",null,"2","8","0","Lemborexant","Dayvigo"],
    [8666,"8666","Carrier H","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","17",null,"0.1104","1.08","15.14",null,"5","12","0","Dupilumab","Dupixent"],
    [8667,"8667","Carrier H","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","11",null,"0.1294","1.88","18.69",null,"2","9","0","Risankizumab","Skyrizi"],
    [8668,"8668","Carrier H","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","8",null,"0.0516","0.58","33.49",null,"2","6","0","Ruxolitinib","Opzelura"],
    [8669,"8669","Carrier H","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","8",null,"0.036","1.89","28.27",null,"1","7","0","Rifaximin","Xifaxan"],
    [8670,"8670","Carrier H","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","5",null,"0.1563",null,"18.97",null,"0","5","0","Dupilumab","Dupixent"],
    [8671,"8671","Carrier H","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","5",null,"0.2","1.24","22.49",null,"2","3","0","Adalimumab","Humira"],
    [8672,"8672","Carrier H","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","4",null,"0.044",null,"35.02",null,"0","4","0","Tirzepatide","Zepbound"],
    [8673,"8673","Carrier H","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","4",null,"0.2857",null,"1.08",null,"0","4","0","Dupilumab","Dupixent"],
    [8674,"8674","Carrier H","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","4",null,"0.0039","0.61","0.93",null,"2","2","0","Semaglutide","Ozempic"],
    [8675,"8675","Carrier H","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","NDC9","NA","NA","4",null,"0.1026","18.21","18.53",null,"2","2","0","Guselkumab","Tremfya"],
    [8676,"8676","Carrier J","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","56","0.7143",null,"72.18194444","83.59531313","392.7473278","1","54","2","NA","NA"],
    [8677,"8677","Carrier J","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96416","Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours), requiring use of a portable or implantable pump","36","0",null,"1.822523148","1.473171296",null,"24","12",null,"NA","NA"],
    [8678,"8678","Carrier J","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","30","0.7667",null,"72.18194444","93.57715517",null,"1","29",null,"NA","NA"],
    [8679,"8679","Carrier J","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22558","Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","29","0.8276",null,null,"77.56280651","150.502625",null,"29","1","NA","NA"],
    [8680,"8680","Carrier J","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22842","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)","28","0.8214",null,"19.98180556","89.5417735","394.009833","2","26","9","NA","NA"],
    [8681,"8681","Carrier J","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44204","Laparoscopy, surgical; colectomy, partial, with anastomosis","27","0",null,"1.466666667","0.381068376",null,"1","26",null,"NA","NA"],
    [8682,"8682","Carrier J","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22612","Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)","27","0.7778",null,"13.39296296","85.30444444","291.9845494","3","24","3","NA","NA"],
    [8683,"8683","Carrier J","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22633","Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar","26","0.7692",null,"72.18194444","80.61262222","634.9920306","1","25","1","NA","NA"],
    [8684,"8684","Carrier J","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22614","Arthrodesis, posterior or posterolateral technique, single level; each additional vertebral segment (List separately in addition to code for primary procedure)","25","0.88",null,"19.98180556","90.31719807","441.1424498","2","23","9","NA","NA"],
    [8685,"8685","Carrier J","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44207","Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)","22","0",null,"0.222055556","19.85996732",null,"5","17",null,"NA","NA"],
    [8686,"8686","Carrier J","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22600","Arthrodesis, posterior or posterolateral technique, single level; cervical below C2 segment","9","1",null,null,"96.5891358","574.7819999",null,"9","4","NA","NA"],
    [8687,"8687","Carrier J","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63047","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","7","1",null,"39.75888889","114.7148148","613.1345389","1","6","1","NA","NA"],
    [8688,"8688","Carrier J","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63048","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure)","7","1",null,"39.75888889","73.30351852","377.0117495","1","6","4","NA","NA"],
    [8689,"8689","Carrier J","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22212","Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; thoracic","6","1",null,null,"69.37333333",null,null,"6",null,"NA","NA"],
    [8690,"8690","Carrier J","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22216","Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; each additional vertebral segment (List separately in addition to primary procedure)","5","1",null,null,"83.21033333","646.7831486",null,"5","2","NA","NA"],
    [8691,"8691","Carrier J","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63045","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; cervical","4","1",null,null,"48.64680556",null,null,"4",null,"NA","NA"],
    [8692,"8692","Carrier J","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27134","Revision of total hip arthroplasty; both components, with or without autograft or allograft","4","1",null,null,"29.90104167","278.5272397",null,"4","1","NA","NA"],
    [8693,"8693","Carrier J","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64999","Unlisted procedure, nervous system","3","1",null,null,"34.14657407",null,null,"3",null,"NA","NA"],
    [8694,"8694","Carrier J","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22610","Arthrodesis, posterior or posterolateral technique, single level; thoracic (with lateral transverse technique, when performed)","3","1",null,null,"117.9865741","413.5715076",null,"3","5","NA","NA"],
    [8695,"8695","Carrier J","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22802","Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 vertebral segments","3","1",null,null,"22.18925926","658.5742667",null,"3","1","NA","NA"],
    [8696,"8696","Carrier J","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","38241","Hematopoietic progenitor cell (HPC); autologous transplantation","3","1",null,null,"45.89935185",null,null,"3",null,"NA","NA"],
    [8697,"8697","Carrier J","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27130","Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft","4",null,"0.25",null,"129.3272222","270.8097551",null,"4","2","NA","NA"],
    [8698,"8698","Carrier J","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","30",null,"0.1","72.18194444","93.57715517",null,"1","29",null,"NA","NA"],
    [8699,"8699","Carrier J","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22633","Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar","26",null,"0.0769","72.18194444","80.61262222","634.9920306","1","25","1","NA","NA"],
    [8700,"8700","Carrier J","2024","Inpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","56",null,"0.0357","72.18194444","83.59531313","392.7473278","1","54","2","NA","NA"],
    [8701,"8701","Carrier J","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography","3791","0.9478",null,"1.028611111","3.940282249","503.8950169","1","3790","7","NA","NA"],
    [8702,"8702","Carrier J","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45378","Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","3520","0.9764",null,"0.66202381","2.429828867","336.0553379","84","3436","4","NA","NA"],
    [8703,"8703","Carrier J","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97530","Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","3343","0.8995",null,"0.155138889","11.93305797","437.7033611","4","3339","72","NA","NA"],
    [8704,"8704","Carrier J","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","Colonoscopy, flexible; with biopsy, single or multiple","3171","0.9754",null,"0.582642045","2.327970176","422.6796316","88","3083","16","NA","NA"],
    [8705,"8705","Carrier J","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","2861","0.9077",null,"14.76361111","11.6278291","433.4146059","3","2858","65","NA","NA"],
    [8706,"8706","Carrier J","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material","2818","0.8616",null,"1.118928571","7.650428059","513.5461227","14","2802","4","NA","NA"],
    [8707,"8707","Carrier J","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45385","Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","2764","0.9801",null,"0.600535475","2.302260586","325.3434495","83","2681","17","NA","NA"],
    [8708,"8708","Carrier J","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97112","Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities","2711","0.9004",null,"14.46574074","10.55316152","397.5885053","3","2708","54","NA","NA"],
    [8709,"8709","Carrier J","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74177","Computed tomography, abdomen and pelvis; with contrast material(s)","2556","0.9566",null,"2.269646465","3.571261842","509.7638371","11","2545","11","NA","NA"],
    [8710,"8710","Carrier J","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97140","Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes","2419","0.9078",null,"8.915722222","11.27250771","374.6192323","5","2414","36","NA","NA"],
    [8711,"8711","Carrier J","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","20680","Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate)","55","1",null,"0.080277778","6.366172839","421.2178901","1","54","8","NA","NA"],
    [8712,"8712","Carrier J","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43260","Endoscopic retrograde cholangiopancreatography (ERCP); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","36","1",null,"1.081111111","5.748404762","464.9407964","1","35","1","NA","NA"],
    [8713,"8713","Carrier J","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","43261","Endoscopic retrograde cholangiopancreatography (ERCP); with biopsy, single or multiple","26","1",null,"1.081111111","7.7606",null,"1","25",null,"NA","NA"],
    [8714,"8714","Carrier J","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","52224","Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of MINOR (less than 0.5 cm) lesion(s) with or without biopsy","25","1",null,"0.960833333","0.22625",null,"1","24",null,"NA","NA"],
    [8715,"8715","Carrier J","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","32408","Core needle biopsy, lung or mediastinum, percutaneous, including imaging guidance, when performed","25","1",null,"1.382962963","14.92536616",null,"3","22",null,"NA","NA"],
    [8716,"8716","Carrier J","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","21230","Graft; rib cartilage, autogenous, to face, chin, nose or ear (includes obtaining graft)","25","1",null,null,"30.31373333",null,null,"25",null,"NA","NA"],
    [8717,"8717","Carrier J","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","78472","Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative processing","23","1",null,null,"0.164951691",null,null,"23",null,"NA","NA"],
    [8718,"8718","Carrier J","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","52214","Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands","23","1",null,"0.960833333","0.066767677",null,"1","22",null,"NA","NA"],
    [8719,"8719","Carrier J","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27792","Open treatment of distal fibular fracture (lateral malleolus), includes internal fixation, when performed","23","1",null,"0.087962963","0.041944444","323.37173","9","14","2","NA","NA"],
    [8720,"8720","Carrier J","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","32555","Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance","22","1",null,"1.006481481","6.600102339","258.247309","3","19","3","NA","NA"],
    [8721,"8721","Carrier J","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","64555","Percutaneous implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve)","3",null,"0.6667",null,"6.655925926",null,null,"3",null,"NA","NA"],
    [8722,"8722","Carrier J","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","72295","Discography, lumbar, radiological supervision and interpretation","3",null,"0.3333",null,"136.3084259",null,null,"3",null,"NA","NA"],
    [8723,"8723","Carrier J","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","27420","Reconstruction of dislocating patella; (eg, Hauser type procedure)","3",null,"0.3333",null,"87.74425926",null,null,"3",null,"NA","NA"],
    [8724,"8724","Carrier J","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","43497","Lower esophageal myotomy, transoral","3",null,"0.3333","106.1877778","84.64652778",null,"1","2",null,"NA","NA"],
    [8725,"8725","Carrier J","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22634","Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; each additional interspace and segment (List separately in addition to code for primary procedure)","4",null,"0.25",null,"126.4635417","313.27",null,"4","1","NA","NA"],
    [8726,"8726","Carrier J","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22612","Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)","15",null,"0.2",null,"93.93064815",null,null,"15",null,"NA","NA"],
    [8727,"8727","Carrier J","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","29897","Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, limited","5",null,"0.2",null,"14.36666667",null,null,"5",null,"NA","NA"],
    [8728,"8728","Carrier J","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22514","Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar","5",null,"0.2",null,"116.2152778","347.1774393",null,"5","2","NA","NA"],
    [8729,"8729","Carrier J","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","62290","Injection procedure for discography, each level; lumbar","5",null,"0.2",null,"102.6071667",null,null,"5",null,"NA","NA"],
    [8730,"8730","Carrier J","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","22842","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)","9",null,"0.1111",null,"97.37151235","395.9205704",null,"9","3","NA","NA"],
    [8731,"8731","Carrier J","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1002","Residential treatment, Substance Use Disorder","67","0.9403",null,"47.14222222","36.960194","608.6548083","1","66","1","NA","NA"],
    [8732,"8732","Carrier J","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1001","Residential treatment, Psychiatric","33","0.6667",null,"24.8237963","43.85863027",null,"3","30",null,"NA","NA"],
    [8733,"8733","Carrier J","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","54520","Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach","17","0.7647",null,null,"49.41284314",null,null,"17",null,"NA","NA"],
    [8734,"8734","Carrier J","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","56805","Clitoroplasty for intersex state","17","0.8235",null,null,"57.57433007",null,null,"17",null,"NA","NA"],
    [8735,"8735","Carrier J","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","53430","Urethroplasty, reconstruction of female urethra","16","0.8125",null,null,"50.80682292",null,null,"16",null,"NA","NA"],
    [8736,"8736","Carrier J","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","54125","Amputation of penis; complete","15","0.8",null,null,"53.1567037",null,null,"15",null,"NA","NA"],
    [8737,"8737","Carrier J","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","57335","Vaginoplasty for intersex state","14","0.8571",null,null,"54.62190476",null,null,"14",null,"NA","NA"],
    [8738,"8738","Carrier J","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","55175","Scrotoplasty; simple","12","0.8333",null,null,"46.28229167",null,null,"12",null,"NA","NA"],
    [8739,"8739","Carrier J","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","14301","Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm","6","0.1667",null,null,"35.13125",null,null,"6",null,"NA","NA"],
    [8740,"8740","Carrier J","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","124","Room and board, Semi-Private, Psychiatric","6","1",null,null,"28.2925","619.9205375",null,"6","4","NA","NA"],
    [8741,"8741","Carrier J","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","124","Room and board, Semi-Private, Psychiatric","6","1",null,null,"28.2925","619.9205375",null,"6","4","NA","NA"],
    [8742,"8742","Carrier J","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","53410","Urethroplasty, 1-stage reconstruction of male anterior urethra","2","1",null,null,"90.70652778",null,null,"2",null,"NA","NA"],
    [8743,"8743","Carrier J","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","126","Room and board, Semi Private Detoxification","2","1",null,null,"82.41583333",null,null,"2",null,"NA","NA"],
    [8744,"8744","Carrier J","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","76857","Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","1","1",null,null,"162.1047222",null,null,"1",null,"NA","NA"],
    [8745,"8745","Carrier J","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","14040","Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less","1","1",null,null,"162.1047222",null,null,"1",null,"NA","NA"],
    [8746,"8746","Carrier J","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","57106","Vaginectomy, partial removal of vaginal wall;","1","1",null,null,"162.1047222",null,null,"1",null,"NA","NA"],
    [8747,"8747","Carrier J","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","56620","Vulvectomy simple; partial","1","1",null,null,"162.1047222",null,null,"1",null,"NA","NA"],
    [8748,"8748","Carrier J","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","51102","Aspiration of bladder; with insertion of suprapubic catheter","1","1",null,null,"162.1047222",null,null,"1",null,"NA","NA"],
    [8749,"8749","Carrier J","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","56800","Plastic repair of introitus","1","1",null,null,"15.55861111",null,null,"1",null,"NA","NA"],
    [8750,"8750","Carrier J","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","13131","Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 1.1 cm to 2.5 cm","1","1",null,null,"162.1047222",null,null,"1",null,"NA","NA"],
    [8751,"8751","Carrier J","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","55180","Scrotoplasty; complicated","1","1",null,null,"162.1047222",null,null,"1",null,"NA","NA"],
    [8752,"8752","Carrier J","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","56810","Perineoplasty, repair of perineum, nonobstetrical (separate procedure)","1","1",null,null,"162.1047222",null,null,"1",null,"NA","NA"],
    [8753,"8753","Carrier J","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","53450","Urethromeatoplasty, with mucosal advancement","1","1",null,null,"162.1047222",null,null,"1",null,"NA","NA"],
    [8754,"8754","Carrier J","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71271","Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)","316","0.9462",null,null,"2.147284634","653.5",null,"316","2","NA","NA"],
    [8755,"8755","Carrier J","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","185","0.8973",null,"5.665972222","21.19044884",null,"4","181",null,"NA","NA"],
    [8756,"8756","Carrier J","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","176","0.8977",null,"7.549722222","21.6486522",null,"3","173",null,"NA","NA"],
    [8757,"8757","Carrier J","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","92507","Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual","174","0.7989",null,"16.02101852","58.17794347","274.4116901","3","171","23","NA","NA"],
    [8758,"8758","Carrier J","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","157","0.8917",null,"7.549722222","19.75808889","545","3","154","1","NA","NA"],
    [8759,"8759","Carrier J","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","153","0.9739",null,"3.127166667","15.89239087",null,"11","142",null,"NA","NA"],
    [8760,"8760","Carrier J","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0035","Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours","87","0.8506",null,null,"36.79083333",null,null,"87",null,"NA","NA"],
    [8761,"8761","Carrier J","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan","47","0.4255",null,"2.1525","57.3347619",null,"2","45",null,"NA","NA"],
    [8762,"8762","Carrier J","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19303","Mastectomy, simple, complete","45","0.8889",null,"1.94","38.54463384",null,"1","44",null,"NA","NA"],
    [8763,"8763","Carrier J","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19350","Nipple/areola reconstruction","43","0.8837",null,"1.94","46.10008808",null,"1","42",null,"NA","NA"],
    [8764,"8764","Carrier J","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15773","Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; 25 cc or less injectate","13","1",null,null,"31.10899573",null,null,"13",null,"NA","NA"],
    [8765,"8765","Carrier J","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97110","Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","7","1",null,null,"29.09107143",null,null,"7",null,"NA","NA"],
    [8766,"8766","Carrier J","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15774","Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; each additional 25 cc injectate, or part thereof (List separately in addition to code for primary procedure)","7","1",null,null,"39.74900794",null,null,"7",null,"NA","NA"],
    [8767,"8767","Carrier J","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97112","Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities","7","1",null,null,"27.1334127","489.6389425",null,"7","1","NA","NA"],
    [8768,"8768","Carrier J","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","54520","Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach","6","1",null,null,"46.11106481",null,null,"6",null,"NA","NA"],
    [8769,"8769","Carrier J","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81416","Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure)","5","1",null,null,"10.54655556",null,null,"5",null,"NA","NA"],
    [8770,"8770","Carrier J","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15828","Rhytidectomy; cheek, chin, and neck","5","1",null,null,"15.99005556",null,null,"5",null,"NA","NA"],
    [8771,"8771","Carrier J","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","21122","Genioplasty; sliding osteotomies, 2 or more osteotomies (eg, wedge excision or bone wedge reversal for asymmetrical chin)","5","1",null,null,"24.33833333",null,null,"5",null,"NA","NA"],
    [8772,"8772","Carrier J","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81415","Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis","5","1",null,null,"10.54655556",null,null,"5",null,"NA","NA"],
    [8773,"8773","Carrier J","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70450","Computed tomography, head or brain; without contrast material","4","1",null,null,"0.000416667",null,null,"4",null,"NA","NA"],
    [8774,"8774","Carrier J","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","Cont Airway Pressure Device","4210","0.9629",null,null,"1.743706651","486.0150337",null,"4210","3","NA","NA"],
    [8775,"8775","Carrier J","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without backup rate","270","0.9667",null,null,"2.388569959",null,null,"270",null,"NA","NA"],
    [8776,"8776","Carrier J","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate","88","0.9773",null,null,"1.077493687",null,null,"88",null,"NA","NA"],
    [8777,"8777","Carrier J","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2402","Negative pressure wound therapy electrical pump, stationary or portable","41","0.3902",null,null,"61.60180912",null,null,"41",null,"NA","NA"],
    [8778,"8778","Carrier J","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1399","Durable Medical Equipment Mi","40","0",null,"0.145555556","16.40201754",null,"1","39",null,"NA","NA"],
    [8779,"8779","Carrier J","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1028","Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","20","0",null,null,"14.8895",null,null,"20",null,"NA","NA"],
    [8780,"8780","Carrier J","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0760","Osteogen Ultrasound Stimltor","17","0.2941",null,null,"29.64620915",null,null,"17",null,"NA","NA"],
    [8781,"8781","Carrier J","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0955","Wheelchair accessory, headrest, cushioned, prefabricated, including fixed mounting hardware, each","16","0",null,null,"18.33130208",null,null,"16",null,"NA","NA"],
    [8782,"8782","Carrier J","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0747","Elec Osteogen Stim Not Spine","14","0.1429",null,null,"35.72694444",null,null,"14",null,"NA","NA"],
    [8783,"8783","Carrier J","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0748","Elec Osteogen Stim Spinal","13","0.3077",null,null,"133.9647863",null,null,"13",null,"NA","NA"],
    [8784,"8784","Carrier J","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0766","ELEC STIM CANCER TREATMENT","5","1",null,"3.21625","15.90138889",null,"2","3",null,"NA","NA"],
    [8785,"8785","Carrier J","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate","88","0.9773",null,null,"1.077493687",null,null,"88",null,"NA","NA"],
    [8786,"8786","Carrier J","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without backup rate","270","0.9667",null,null,"2.388569959",null,null,"270",null,"NA","NA"],
    [8787,"8787","Carrier J","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0601","Cont Airway Pressure Device","4210","0.9629",null,null,"1.743706651","486.0150337",null,"4210","3","NA","NA"],
    [8788,"8788","Carrier J","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0466","HOME VENT NON-INVASIVE INTER","6","0.5",null,"3.893333333","24.3785",null,"1","5",null,"NA","NA"],
    [8789,"8789","Carrier J","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2402","Negative pressure wound therapy electrical pump, stationary or portable","41","0.3902",null,null,"61.60180912",null,null,"41",null,"NA","NA"],
    [8790,"8790","Carrier J","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0748","Elec Osteogen Stim Spinal","13","0.3077",null,null,"133.9647863",null,null,"13",null,"NA","NA"],
    [8791,"8791","Carrier J","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0760","Osteogen Ultrasound Stimltor","17","0.2941",null,null,"29.64620915",null,null,"17",null,"NA","NA"],
    [8792,"8792","Carrier J","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0486","Oral device/appliance cusfab","6","0.1667",null,"1.264444444","6.195833333",null,"1","5",null,"NA","NA"],
    [8793,"8793","Carrier J","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0747","Elec Osteogen Stim Not Spine","14","0.1429",null,null,"35.72694444",null,null,"14",null,"NA","NA"],
    [8794,"8794","Carrier J","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4216","Sterile water/saline, 10 ml","19","0",null,"0.008611111","0.429135802",null,"1","18",null,"NA","NA"],
    [8795,"8795","Carrier J","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9276","Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply","6","0",null,null,"3.323722222",null,null,"6",null,"NA","NA"],
    [8796,"8796","Carrier J","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9277","Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system","4","0",null,null,"3.932777778",null,null,"4",null,"NA","NA"],
    [8797,"8797","Carrier J","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","3","0",null,null,"4.149444444",null,null,"3",null,"NA","NA"],
    [8798,"8798","Carrier J","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4211","Supp For Self-Adm Injections","2","0",null,"1.375555556",null,null,"2",null,null,"NA","NA"],
    [8799,"8799","Carrier J","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4239","Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","2","0",null,null,"20.75861111",null,null,"2",null,"NA","NA"],
    [8800,"8800","Carrier J","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4230","Infus Insulin Pump Non Needl","1","0",null,null,"1.721388889",null,null,"1",null,"NA","NA"],
    [8801,"8801","Carrier J","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A5500","Diab Shoe For Density Insert","1","0",null,"0.008888889",null,null,"1",null,null,"NA","NA"],
    [8802,"8802","Carrier J","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2103","Non-adjunctive, non-implanted continuous glucose monitor or receiver","1","0",null,null,"23.59222222",null,null,"1",null,"NA","NA"],
    [8803,"8803","Carrier J","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4232","Syringe W/Needle Insulin 3cc","1","0",null,null,"1.721388889",null,null,"1",null,"NA","NA"],
    [8804,"8804","Carrier J","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4238","Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","1","0",null,null,"17.925",null,null,"1",null,"NA","NA"],
    [8805,"8805","Carrier J","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4216","Sterile water/saline, 10 ml","19","0",null,"0.008611111","0.429135802",null,"1","18",null,"NA","NA"],
    [8806,"8806","Carrier J","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9276","Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply","6","0",null,null,"3.323722222",null,null,"6",null,"NA","NA"],
    [8807,"8807","Carrier J","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A9277","Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system","4","0",null,null,"3.932777778",null,null,"4",null,"NA","NA"],
    [8808,"8808","Carrier J","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","Ext Amb Infusn Pump Insulin","3","0",null,null,"4.149444444",null,null,"3",null,"NA","NA"],
    [8809,"8809","Carrier J","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4211","Supp For Self-Adm Injections","2","0",null,"1.375555556",null,null,"2",null,null,"NA","NA"],
    [8810,"8810","Carrier J","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4239","Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","2","0",null,null,"20.75861111",null,null,"2",null,"NA","NA"],
    [8811,"8811","Carrier J","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4230","Infus Insulin Pump Non Needl","1","0",null,null,"1.721388889",null,null,"1",null,"NA","NA"],
    [8812,"8812","Carrier J","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A5500","Diab Shoe For Density Insert","1","0",null,"0.008888889",null,null,"1",null,null,"NA","NA"],
    [8813,"8813","Carrier J","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2103","Non-adjunctive, non-implanted continuous glucose monitor or receiver","1","0",null,null,"23.59222222",null,null,"1",null,"NA","NA"],
    [8814,"8814","Carrier J","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4232","Syringe W/Needle Insulin 3cc","1","0",null,null,"1.721388889",null,null,"1",null,"NA","NA"],
    [8815,"8815","Carrier J","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4238","Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","1","0",null,null,"17.925",null,null,"1",null,"NA","NA"],
    [8816,"8816","Carrier J","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","1541","0.0324",null,"46.68","9.36",null,"150","1391",null,"SEMAGLUTIDE (WEIGHT MANAGEMENT)","WEGOVY"],
    [8817,"8817","Carrier J","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","1324","0.0038",null,"63.91","6.48",null,"120","1204",null,"TIRZEPATIDE (WEIGHT MANAGEMENT)","ZEPBOUND"],
    [8818,"8818","Carrier J","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","1113","0.7305",null,"10.66","26.14",null,"391","722",null,"HYDROCODONE-ACETAMINOPHEN","HYDROCODONE-ACETAMINOPHEN"],
    [8819,"8819","Carrier J","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","1100","0.6373",null,"6.84","7.03",null,"175","925",null,"SEMAGLUTIDE","OZEMPIC (0.25 OR 0.5 MG/DOSE), OZEMPIC (1 MG/DOSE), OZEMPIC (2 MG/DOSE), RYBELSUS"],
    [8820,"8820","Carrier J","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","1056","0.7699",null,"7.75","17.04",null,"395","661",null,"OXYCODONE HCL","OXYCODONE HCL, OXYCODONE HCL ER, OXYCONTIN, ROXICODONE"],
    [8821,"8821","Carrier J","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","859","0.5669",null,"8.93","6.33",null,"99","760",null,"TIRZEPATIDE","MOUNJARO, MOUNJARO SUBCUTANEOUS SOLUTION PEN-INJECTOR 2.5 MG/0.5ML"],
    [8822,"8822","Carrier J","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","756","0.7235",null,"7.32","13.18",null,"50","706",null,"CYCLOSPORINE (OPHTH)","CEQUA, CYCLOSPORINE, CYCLOSPORINE IN KLARITY, KLARITY-C DROPS, RESTASIS, RESTASIS MULTIDOSE, VEVYE"],
    [8823,"8823","Carrier J","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","675","0.9081",null,"18.38","16.89",null,"190","485",null,"ADALIMUMAB","HUMIRA (2 PEN), HUMIRA (2 PEN) SUBCUTANEOUS PEN-INJECTOR KIT 40 MG/0.4ML, HUMIRA (2 SYRINGE), HUMIRA-CD/UC/HS STARTER, HUMIRA-PED<40KG CROHNS STARTER, HUMIRA-PED>/=40KG UC STARTER, HUMIRA-PSORIASIS/UVEIT STARTER"],
    [8824,"8824","Carrier J","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","607","0.8913",null,"8.91","21.95",null,"147","460",null,"DUPILUMAB","DUPIXENT"],
    [8825,"8825","Carrier J","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","421","0.734",null,"20.77","24.89",null,"171","250",null,"OXYCODONE W/ ACETAMINOPHEN","ENDOCET, OXYCODONE-ACETAMINOPHEN, PERCOCET"],
    [8826,"8826","Carrier J","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","31","1",null,"6.91","7.74",null,"19","12",null,"LUMATEPERONE TOSYLATE","CAPLYTA"],
    [8827,"8827","Carrier J","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","27","1",null,"1.93","4.02",null,"2","25",null,"VARENICLINE TARTRATE","VARENICLINE TARTRATE, VARENICLINE TARTRATE (STARTER)"],
    [8828,"8828","Carrier J","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","21","1",null,"6.08","6.43",null,"4","17",null,"CARBIDOPA-LEVODOPA","CARBIDOPA-LEVODOPA, RYTARY, SINEMET"],
    [8829,"8829","Carrier J","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","17","1",null,"6.53","11.08",null,"13","4",null,"AMPHETAMINE","ADZENYS XR-ODT, DYANAVEL XR"],
    [8830,"8830","Carrier J","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","16","1",null,"4.43","3.42",null,"5","11",null,"CONTINUOUS GLUCOSE SYSTEM RECEIVER","DEXCOM G6 RECEIVER, DEXCOM G7 RECEIVER, FREESTYLE LIBRE 2 READER"],
    [8831,"8831","Carrier J","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","13","1",null,"7.01","2.12",null,"8","5",null,"TOLVAPTAN","JYNARQUE, TOLVAPTAN"],
    [8832,"8832","Carrier J","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","12","1",null,"4.65","2.15",null,"10","2",null,"RUXOLITINIB PHOSPHATE","JAKAFI"],
    [8833,"8833","Carrier J","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","12","1",null,null,"3.62",null,"0","12",null,"ACOLTREMON","TRYPTYR"],
    [8834,"8834","Carrier J","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","12","1",null,"2.44","9.9",null,"6","6",null,"ESCITALOPRAM OXALATE","ESCITALOPRAM OXALATE, LEXAPRO"],
    [8835,"8835","Carrier J","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","12","1",null,"5.5","6.69",null,"3","9",null,"PAROXETINE HCL","PAROXETINE HCL, PAROXETINE HCL ER"],
    [8836,"8836","Carrier J","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","8",null,"1","5.47","48.48",null,"1","7",null,"DEXTROMETHORPHAN HYDROBROMIDE-BUPROPION HYDROCHLORIDE","AUVELITY"],
    [8837,"8837","Carrier J","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","6",null,"1","4.74","60.83",null,"2","4",null,"PRUCALOPRIDE SUCCINATE","MOTEGRITY"],
    [8838,"8838","Carrier J","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","5",null,"1","10.81","99.03",null,"2","3",null,"BUPRENORPHINE","BUPRENORPHINE, BUTRANS"],
    [8839,"8839","Carrier J","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","4",null,"1","22.02","43.05",null,"1","3",null,"TOFACITINIB CITRATE","XELJANZ, XELJANZ XR"],
    [8840,"8840","Carrier J","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","4",null,"1","60.78","71.77",null,"3","1",null,"APREMILAST","OTEZLA"],
    [8841,"8841","Carrier J","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3",null,"1","11.64",null,null,"3","0",null,"SUVOREXANT","BELSOMRA"],
    [8842,"8842","Carrier J","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3",null,"1","22.97",null,null,"3","0",null,"TIVOZANIB HCL","FOTIVDA"],
    [8843,"8843","Carrier J","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3",null,"1","16.31","41.61",null,"2","1",null,"ERENUMAB-AOOE","AIMOVIG"],
    [8844,"8844","Carrier J","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3",null,"1",null,"68.62",null,"0","3",null,"MORPHINE SULFATE","MORPHINE SULFATE ER"],
    [8845,"8845","Carrier J","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"1","32.17",null,null,"2","0",null,"IVOSIDENIB","TIBSOVO"],
    [8846,"8846","Carrier I","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44205","Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomy","10","0",null,"1.281666667","0.804236111",null,"2","8",null,"NA","NA"],
    [8847,"8847","Carrier I","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44206","Laparoscopy, surgical; colectomy, partial, with end colostomy and closure of distal segment (Hartmann type procedure)","9","0",null,null,"0.621018519",null,null,"9",null,"NA","NA"],
    [8848,"8848","Carrier I","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44204","Laparoscopy, surgical; colectomy, partial, with anastomosis","9","0",null,null,"0.674382716",null,null,"9",null,"NA","NA"],
    [8849,"8849","Carrier I","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","44207","Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)","8","0",null,null,"0.697465278",null,null,"8",null,"NA","NA"],
    [8850,"8850","Carrier I","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22853","Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)","8","0.75",null,null,"50.68173611",null,null,"8",null,"NA","NA"],
    [8851,"8851","Carrier I","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64421","Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, each additional level (List separately in addition to code for primary procedure)","6","0",null,"0.663888889","90.59772222",null,"1","5",null,"NA","NA"],
    [8852,"8852","Carrier I","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","31622","Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)","6","0",null,"0.663888889","90.59761111",null,"1","5",null,"NA","NA"],
    [8853,"8853","Carrier I","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22842","Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)","5","0.6",null,null,"63.06127778","474.5755972",null,"5","1","NA","NA"],
    [8854,"8854","Carrier I","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","52005","Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","5","0.2",null,null,"4.340111111",null,null,"5",null,"NA","NA"],
    [8855,"8855","Carrier I","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45378","Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","4","0",null,null,"1.384861111",null,null,"4",null,"NA","NA"],
    [8856,"8856","Carrier I","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45330","Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","4","0",null,null,"0.841805556",null,null,"4",null,"NA","NA"],
    [8857,"8857","Carrier I","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22612","Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)","4","0.75",null,null,"43.75326389",null,null,"4",null,"NA","NA"],
    [8858,"8858","Carrier I","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","22614","Arthrodesis, posterior or posterolateral technique, single level; each additional vertebral segment (List separately in addition to code for primary procedure)","4","0.75",null,null,"43.75326389","474.5755972",null,"4","1","NA","NA"],
    [8859,"8859","Carrier I","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27130","Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft","3","1",null,null,"0.074259259","689.4079806",null,"3","1","NA","NA"],
    [8860,"8860","Carrier I","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22551","Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2","2","1",null,null,"83.50708333",null,null,"2",null,"NA","NA"],
    [8861,"8861","Carrier I","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63048","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure)","2","1",null,null,"81.26847222",null,null,"2",null,"NA","NA"],
    [8862,"8862","Carrier I","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63047","Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","2","1",null,null,"81.26847222",null,null,"2",null,"NA","NA"],
    [8863,"8863","Carrier I","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22552","Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2, each additional interspace (List separately in addition to code for separate procedure)","2","1",null,null,"83.50708333",null,null,"2",null,"NA","NA"],
    [8864,"8864","Carrier I","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22840","Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)","2","1",null,null,"23.0675","322.7895339",null,"2","2","NA","NA"],
    [8865,"8865","Carrier I","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","37241","Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, other than hemorrhage (eg, congenital or acquired venous malformations, venous and capillary hemangiomas, varices, varicoceles)","1","1",null,null,"26.06722222",null,null,"1",null,"NA","NA"],
    [8866,"8866","Carrier I","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","37246","Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery; initial artery","1","1",null,null,"118.1091667",null,null,"1",null,"NA","NA"],
    [8867,"8867","Carrier I","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","38205","Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic","1","1",null,null,"20.56138889",null,null,"1",null,"NA","NA"],
    [8868,"8868","Carrier I","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","38240","Hematopoietic progenitor cell (HPC); allogeneic transplantation per donor","1","1",null,null,"20.56138889",null,null,"1",null,"NA","NA"],
    [8869,"8869","Carrier I","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","61863","Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), without use of intraoperative microelectrode recording; first array","1","1",null,null,"25.62305556",null,null,"1",null,"NA","NA"],
    [8870,"8870","Carrier I","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","38724","Cervical lymphadenectomy (modified radical neck dissection)","1","1",null,"1.181666667",null,null,"1",null,null,"NA","NA"],
    [8871,"8871","Carrier I","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63005","Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; lumbar, except for spondylolisthesis","1","1",null,null,"123.0016667",null,null,"1",null,"NA","NA"],
    [8872,"8872","Carrier I","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","63277","Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar","1","1",null,null,"123.0016667",null,null,"1",null,"NA","NA"],
    [8873,"8873","Carrier I","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","39599","Unlisted procedure, diaphragm","1","1",null,null,"135.3305556",null,null,"1",null,"NA","NA"],
    [8874,"8874","Carrier I","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22846","Anterior instrumentation; 4 to 7 vertebral segments (List separately in addition to code for primary procedure)","1","1",null,null,"47.83388889",null,null,"1",null,"NA","NA"],
    [8875,"8875","Carrier I","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","61864","Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), without use of intraoperative microelectrode recording; each additional array (List separately in addition to primary procedure)","1","1",null,null,"25.62305556",null,null,"1",null,"NA","NA"],
    [8876,"8876","Carrier I","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22999","Unlisted procedure, abdomen, musculoskeletal system","1","1",null,null,"144.7780556",null,null,"1",null,"NA","NA"],
    [8877,"8877","Carrier I","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","27134","Revision of total hip arthroplasty; both components, with or without autograft or allograft","1","1",null,null,"51.21638889",null,null,"1",null,"NA","NA"],
    [8878,"8878","Carrier I","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22325","Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; lumbar","1","1",null,null,"123.0016667",null,null,"1",null,"NA","NA"],
    [8879,"8879","Carrier I","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","22634","Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; each additional interspace and segment (List separately in addition to code for primary procedure)","1","1",null,null,"111.1",null,null,"1",null,"NA","NA"],
    [8880,"8880","Carrier I","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","47135","Liver allotransplantation, orthotopic, partial or whole, from cadaver or living donor, any age","1","1",null,"26.2",null,null,"1",null,null,"NA","NA"],
    [8881,"8881","Carrier I","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography","379","0.9024",null,null,"7.120237467",null,null,"379",null,"NA","NA"],
    [8882,"8882","Carrier I","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","74177","Computed tomography, abdomen and pelvis; with contrast material(s)","285","0.9228",null,"18.37277778","7.452548905","551.8094797","1","284","2","NA","NA"],
    [8883,"8883","Carrier I","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","70553","Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences","267","0.9064",null,null,"9.777399084",null,null,"267",null,"NA","NA"],
    [8884,"8884","Carrier I","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","73721","Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material","184","0.7391",null,null,"9.766171498",null,null,"184",null,"NA","NA"],
    [8885,"8885","Carrier I","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","72148","Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material","176","0.7045",null,"2.756851852","25.61194284",null,"3","173",null,"NA","NA"],
    [8886,"8886","Carrier I","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71260","Computed tomography, thorax, diagnostic; with contrast material(s)","143","0.9161",null,null,"9.785207848","562.2420436",null,"143","1","NA","NA"],
    [8887,"8887","Carrier I","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45378","Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","141","0.922",null,"1.190555556","2.685642741",null,"4","137",null,"NA","NA"],
    [8888,"8888","Carrier I","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97110","Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","137","0.9197",null,null,"3.426849148","328.4210565",null,"137","4","NA","NA"],
    [8889,"8889","Carrier I","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","45380","Colonoscopy, flexible; with biopsy, single or multiple","126","0.9127",null,"1.190555556","2.792313297","340.2249947","4","122","3","NA","NA"],
    [8890,"8890","Carrier I","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71250","Computed tomography, thorax, diagnostic; without contrast material","123","0.8293",null,null,"13.90338753",null,null,"123",null,"NA","NA"],
    [8891,"8891","Carrier I","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","74170","Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections","24","1",null,null,"1.272164352",null,null,"24",null,"NA","NA"],
    [8892,"8892","Carrier I","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","70480","Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material","16","1",null,null,"5.184253472",null,null,"16",null,"NA","NA"],
    [8893,"8893","Carrier I","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64484","Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, each additional level (List separately in addition to code for primary procedure)","13","1",null,null,"1.913717949",null,null,"13",null,"NA","NA"],
    [8894,"8894","Carrier I","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58572","Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g;","12","1",null,"14.04861111","14.83073232",null,"1","11",null,"NA","NA"],
    [8895,"8895","Carrier I","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93312","Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report","11","1",null,null,"0.000454545",null,null,"11",null,"NA","NA"],
    [8896,"8896","Carrier I","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","78816","Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body","11","1",null,null,"31.01876263",null,null,"11",null,"NA","NA"],
    [8897,"8897","Carrier I","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72192","Computed tomography, pelvis; without contrast material","10","1",null,null,"24.22241667",null,null,"10",null,"NA","NA"],
    [8898,"8898","Carrier I","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","72193","Computed tomography, pelvis; with contrast material(s)","10","1",null,null,"4.623388889",null,null,"10",null,"NA","NA"],
    [8899,"8899","Carrier I","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","31624","Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial alveolar lavage","10","1",null,"0.866944444","1.130185185",null,"4","6",null,"NA","NA"],
    [8900,"8900","Carrier I","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58662","Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method","9","1",null,null,"14.93222222","288.2662813",null,"9","5","NA","NA"],
    [8901,"8901","Carrier I","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77078","Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine)","9","1",null,null,"2.363240741",null,null,"9",null,"NA","NA"],
    [8902,"8902","Carrier I","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","74174","Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","9","1",null,null,"5.304567901",null,null,"9",null,"NA","NA"],
    [8903,"8903","Carrier I","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","38222","Diagnostic bone marrow; biopsy(ies) and aspiration(s)","9","1",null,"0.297055556","0.215",null,"5","4",null,"NA","NA"],
    [8904,"8904","Carrier I","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","70470","Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections","5",null,"0.2",null,"4.202388889",null,null,"5",null,"NA","NA"],
    [8905,"8905","Carrier I","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","73222","Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s)","18",null,"0.0556",null,"12.99748457",null,null,"18",null,"NA","NA"],
    [8906,"8906","Carrier I","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","72148","Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material","176",null,"0.017","2.756851852","25.61194284",null,"3","173",null,"NA","NA"],
    [8907,"8907","Carrier I","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","72141","Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material","121",null,"0.0083",null,"19.36479109","517.6161111",null,"121","1","NA","NA"],
    [8908,"8908","Carrier I","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","70553","Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences","267",null,"0.0037",null,"9.777399084",null,null,"267",null,"NA","NA"],
    [8909,"8909","Carrier I","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1002","Residential treatment, Substance Use Disorder","8","1",null,null,"49.4796875",null,null,"8",null,"NA","NA"],
    [8910,"8910","Carrier I","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","Revenue","1001","Residential treatment, Psychiatric","4","0.75",null,null,"45.39465278",null,null,"4",null,"NA","NA"],
    [8911,"8911","Carrier I","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15240","Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less","2","0",null,null,"0.244027778",null,null,"2",null,"NA","NA"],
    [8912,"8912","Carrier I","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","56805","Clitoroplasty for intersex state","2","1",null,null,"53.59708333",null,null,"2",null,"NA","NA"],
    [8913,"8913","Carrier I","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","54520","Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach","2","1",null,null,"53.59708333",null,null,"2",null,"NA","NA"],
    [8914,"8914","Carrier I","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15241","Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)","2","0",null,null,"0.244027778",null,null,"2",null,"NA","NA"],
    [8915,"8915","Carrier I","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","53410","Urethroplasty, 1-stage reconstruction of male anterior urethra","2","1",null,null,"53.59708333",null,null,"2",null,"NA","NA"],
    [8916,"8916","Carrier I","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15876","Suction assisted lipectomy; head and neck","1","1",null,null,"47.32361111",null,null,"1",null,"NA","NA"],
    [8917,"8917","Carrier I","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","54550","Exploration for undescended testis (inguinal or scrotal area)","1","0",null,null,"0.017222222",null,null,"1",null,"NA","NA"],
    [8918,"8918","Carrier I","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","54530","Orchiectomy, radical, for tumor; inguinal approach","1","0",null,null,"0.017222222",null,null,"1",null,"NA","NA"],
    [8919,"8919","Carrier I","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","57335","Vaginoplasty for intersex state","1","1",null,null,"99.86166667",null,null,"1",null,"NA","NA"],
    [8920,"8920","Carrier I","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","55150","Resection of scrotum","1","0",null,null,"0.470833333",null,null,"1",null,"NA","NA"],
    [8921,"8921","Carrier I","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19325","Breast augmentation with implant","1","1",null,null,"99.86166667",null,null,"1",null,"NA","NA"],
    [8922,"8922","Carrier I","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","49329","Unlisted laparoscopy procedure, abdomen, peritoneum and omentum","1","1",null,null,"7.3325",null,null,"1",null,"NA","NA"],
    [8923,"8923","Carrier I","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","57425","Laparoscopy, surgical, colpopexy (suspension of vaginal apex)","1","0",null,null,"0.470833333",null,null,"1",null,"NA","NA"],
    [8924,"8924","Carrier I","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58999","Unlisted procedure, female genital system (nonobstetrical)","1","1",null,null,"7.3325",null,null,"1",null,"NA","NA"],
    [8925,"8925","Carrier I","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","54125","Amputation of penis; complete","1","1",null,null,"7.3325",null,null,"1",null,"NA","NA"],
    [8926,"8926","Carrier I","2024","Inpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","54120","Amputation of penis; partial","1","0",null,null,"0.017222222",null,null,"1",null,"NA","NA"],
    [8927,"8927","Carrier I","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","Revenue","1002","Residential treatment, Substance Use Disorder","8","1",null,null,"49.4796875",null,null,"8",null,"NA","NA"],
    [8928,"8928","Carrier I","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","56805","Clitoroplasty for intersex state","2","1",null,null,"53.59708333",null,null,"2",null,"NA","NA"],
    [8929,"8929","Carrier I","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","54520","Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach","2","1",null,null,"53.59708333",null,null,"2",null,"NA","NA"],
    [8930,"8930","Carrier I","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","53410","Urethroplasty, 1-stage reconstruction of male anterior urethra","2","1",null,null,"53.59708333",null,null,"2",null,"NA","NA"],
    [8931,"8931","Carrier I","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15876","Suction assisted lipectomy; head and neck","1","1",null,null,"47.32361111",null,null,"1",null,"NA","NA"],
    [8932,"8932","Carrier I","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","57335","Vaginoplasty for intersex state","1","1",null,null,"99.86166667",null,null,"1",null,"NA","NA"],
    [8933,"8933","Carrier I","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19325","Breast augmentation with implant","1","1",null,null,"99.86166667",null,null,"1",null,"NA","NA"],
    [8934,"8934","Carrier I","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","49329","Unlisted laparoscopy procedure, abdomen, peritoneum and omentum","1","1",null,null,"7.3325",null,null,"1",null,"NA","NA"],
    [8935,"8935","Carrier I","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58999","Unlisted procedure, female genital system (nonobstetrical)","1","1",null,null,"7.3325",null,null,"1",null,"NA","NA"],
    [8936,"8936","Carrier I","2024","Inpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","54125","Amputation of penis; complete","1","1",null,null,"7.3325",null,null,"1",null,"NA","NA"],
    [8937,"8937","Carrier I","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90868","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session","18","0.6667",null,"19.49333333","18.5529085",null,"1","17",null,"NA","NA"],
    [8938,"8938","Carrier I","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90867","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","18","0.6667",null,"19.49333333","18.5529085",null,"1","17",null,"NA","NA"],
    [8939,"8939","Carrier I","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90869","Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management","17","0.6471",null,"19.49333333","19.34711806",null,"1","16",null,"NA","NA"],
    [8940,"8940","Carrier I","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","10","0.9",null,"15.22194444","10.47753086",null,"1","9",null,"NA","NA"],
    [8941,"8941","Carrier I","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","71271","Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)","10","0.7",null,null,"11.52672222",null,null,"10",null,"NA","NA"],
    [8942,"8942","Carrier I","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","92507","Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual","6","0.6667",null,null,"51.50717593",null,null,"6",null,"NA","NA"],
    [8943,"8943","Carrier I","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","19318","Breast reduction","4","1",null,null,"3.064722222",null,null,"4",null,"NA","NA"],
    [8944,"8944","Carrier I","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97151","Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan","4","0.25",null,null,"24.15055556",null,null,"4",null,"NA","NA"],
    [8945,"8945","Carrier I","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","17380","Electrolysis epilation, each 30 minutes","4","0.75",null,null,"331.8572222",null,null,"4",null,"NA","NA"],
    [8946,"8946","Carrier I","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","H2036","Alcohol and/or other drug treatment program, per diem","3","1",null,null,"10.6525",null,null,"3",null,"NA","NA"],
    [8947,"8947","Carrier I","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","81415","Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis","3","0",null,null,"3.894814815",null,null,"3",null,"NA","NA"],
    [8948,"8948","Carrier I","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","92523","Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language)","3","0.6667",null,null,"73.42824074",null,null,"3",null,"NA","NA"],
    [8949,"8949","Carrier I","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19318","Breast reduction","4","1",null,null,"3.064722222",null,null,"4",null,"NA","NA"],
    [8950,"8950","Carrier I","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H2036","Alcohol and/or other drug treatment program, per diem","3","1",null,null,"10.6525",null,null,"3",null,"NA","NA"],
    [8951,"8951","Carrier I","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19350","Nipple/areola reconstruction","2","1",null,null,"4.001388889",null,null,"2",null,"NA","NA"],
    [8952,"8952","Carrier I","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19303","Mastectomy, simple, complete","2","1",null,null,"4.001388889",null,null,"2",null,"NA","NA"],
    [8953,"8953","Carrier I","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0035","Mental Health Partial Hospitalization, Treatment, Less Than 24 Hours","2","1",null,null,"16.08777778",null,null,"2",null,"NA","NA"],
    [8954,"8954","Carrier I","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97110","Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","1","1",null,null,"2.005555556",null,null,"1",null,"NA","NA"],
    [8955,"8955","Carrier I","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97535","Self-care/home management training (eg, activities of daily living (ADL) and compensatory training, meal preparation, safety procedures, and instructions in use of assistive technology devices/adaptive equipment) direct one-on-one contact, each 15 minutes","1","1",null,null,"2.005555556",null,null,"1",null,"NA","NA"],
    [8956,"8956","Carrier I","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97140","Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes","1","1",null,null,"2.005555556",null,null,"1",null,"NA","NA"],
    [8957,"8957","Carrier I","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","97152","Behavior identification-supporting assessment, administered by one technician under the direction of a physician or other qualified health care professional, face-to-face with the patient, each 15 minutes","1","1",null,null,"3.056944444",null,null,"1",null,"NA","NA"],
    [8958,"8958","Carrier I","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","H0015","Alcohol And/Or Drug Services","10","0.9",null,"15.22194444","10.47753086",null,"1","9",null,"NA","NA"],
    [8959,"8959","Carrier I","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0601","Cont Airway Pressure Device","372","0.9409",null,null,"2.449742384","440.4642564",null,"372","1","NA","NA"],
    [8960,"8960","Carrier I","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without backup rate","13","0.8462",null,null,"4.690235043",null,null,"13",null,"NA","NA"],
    [8961,"8961","Carrier I","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1399","Durable Medical Equipment Mi","5","0",null,"1.443333333","0.35875",null,"1","4",null,"NA","NA"],
    [8962,"8962","Carrier I","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0486","Oral device/appliance cusfab","2","0",null,null,"2.540138889",null,null,"2",null,"NA","NA"],
    [8963,"8963","Carrier I","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2402","Negative pressure wound therapy electrical pump, stationary or portable","2","0.5",null,null,"41.27930556",null,null,"2",null,"NA","NA"],
    [8964,"8964","Carrier I","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1236","Wheelchair, Pediatric Size, Folding, Adjustable, With Seating System","1","0",null,"2.2425",null,null,"1",null,null,"NA","NA"],
    [8965,"8965","Carrier I","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0973","Wheelchair Adjustabl Height","1","0",null,null,"1.442222222",null,null,"1",null,"NA","NA"],
    [8966,"8966","Carrier I","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0766","ELEC STIM CANCER TREATMENT","1","1",null,"27.06694444",null,null,"1",null,null,"NA","NA"],
    [8967,"8967","Carrier I","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate","1","1",null,null,"0.000277778",null,null,"1",null,"NA","NA"],
    [8968,"8968","Carrier I","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1028","Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","1","0",null,null,"1.442222222",null,null,"1",null,"NA","NA"],
    [8969,"8969","Carrier I","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2510","Speech generating device, synthesized speech, permitting multiple methods","1","0",null,null,"8.193333333",null,null,"1",null,"NA","NA"],
    [8970,"8970","Carrier I","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0691","Ultraviolet Light Therapy System Panel, Includes Bulbs/Lamps, Timer An","1","0",null,null,"23.18527778",null,null,"1",null,"NA","NA"],
    [8971,"8971","Carrier I","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2619","Replace cover w/c seat cush","1","0",null,null,"0.294444444",null,null,"1",null,"NA","NA"],
    [8972,"8972","Carrier I","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0747","Elec Osteogen Stim Not Spine","1","0",null,null,"51.39472222",null,null,"1",null,"NA","NA"],
    [8973,"8973","Carrier I","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2512","Accessory for speech generating device, mounting system","1","0",null,null,"8.193333333",null,null,"1",null,"NA","NA"],
    [8974,"8974","Carrier I","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0748","Elec Osteogen Stim Spinal","1","0",null,null,"0.0925",null,null,"1",null,"NA","NA"],
    [8975,"8975","Carrier I","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0260","Hosp Bed Semi-Electr W/ Matt","1","0",null,null,"21.63972222",null,null,"1",null,"NA","NA"],
    [8976,"8976","Carrier I","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0760","Osteogen Ultrasound Stimltor","1","0",null,null,"1.544722222",null,null,"1",null,"NA","NA"],
    [8977,"8977","Carrier I","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0766","ELEC STIM CANCER TREATMENT","1","1",null,"27.06694444",null,null,"1",null,null,"NA","NA"],
    [8978,"8978","Carrier I","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate","1","1",null,null,"0.000277778",null,null,"1",null,"NA","NA"],
    [8979,"8979","Carrier I","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0601","Cont Airway Pressure Device","372","0.9409",null,null,"2.449742384","440.4642564",null,"372","1","NA","NA"],
    [8980,"8980","Carrier I","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0470","Respiratory assist device, bi-level pressure capability, without backup rate","13","0.8462",null,null,"4.690235043",null,null,"13",null,"NA","NA"],
    [8981,"8981","Carrier I","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2402","Negative pressure wound therapy electrical pump, stationary or portable","2","0.5",null,null,"41.27930556",null,null,"2",null,"NA","NA"],
    [8982,"8982","Carrier I","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1399","Durable Medical Equipment Mi","5","0",null,"1.443333333","0.35875",null,"1","4",null,"NA","NA"],
    [8983,"8983","Carrier I","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0486","Oral device/appliance cusfab","2","0",null,null,"2.540138889",null,null,"2",null,"NA","NA"],
    [8984,"8984","Carrier I","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1236","Wheelchair, Pediatric Size, Folding, Adjustable, With Seating System","1","0",null,"2.2425",null,null,"1",null,null,"NA","NA"],
    [8985,"8985","Carrier I","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0973","Wheelchair Adjustabl Height","1","0",null,null,"1.442222222",null,null,"1",null,"NA","NA"],
    [8986,"8986","Carrier I","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1028","Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","1","0",null,null,"1.442222222",null,null,"1",null,"NA","NA"],
    [8987,"8987","Carrier I","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2510","Speech generating device, synthesized speech, permitting multiple methods","1","0",null,null,"8.193333333",null,null,"1",null,"NA","NA"],
    [8988,"8988","Carrier I","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0691","Ultraviolet Light Therapy System Panel, Includes Bulbs/Lamps, Timer An","1","0",null,null,"23.18527778",null,null,"1",null,"NA","NA"],
    [8989,"8989","Carrier I","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2619","Replace cover w/c seat cush","1","0",null,null,"0.294444444",null,null,"1",null,"NA","NA"],
    [8990,"8990","Carrier I","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0747","Elec Osteogen Stim Not Spine","1","0",null,null,"51.39472222",null,null,"1",null,"NA","NA"],
    [8991,"8991","Carrier I","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2512","Accessory for speech generating device, mounting system","1","0",null,null,"8.193333333",null,null,"1",null,"NA","NA"],
    [8992,"8992","Carrier I","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0748","Elec Osteogen Stim Spinal","1","0",null,null,"0.0925",null,null,"1",null,"NA","NA"],
    [8993,"8993","Carrier I","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0260","Hosp Bed Semi-Electr W/ Matt","1","0",null,null,"21.63972222",null,null,"1",null,"NA","NA"],
    [8994,"8994","Carrier I","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0760","Osteogen Ultrasound Stimltor","1","0",null,null,"1.544722222",null,null,"1",null,"NA","NA"],
    [8995,"8995","Carrier I","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2103","Non-adjunctive, non-implanted continuous glucose monitor or receiver","1","0",null,null,"5.203055556",null,null,"1",null,"NA","NA"],
    [8996,"8996","Carrier I","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4239","Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","1","0",null,null,"2.074722222",null,null,"1",null,"NA","NA"],
    [8997,"8997","Carrier I","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2103","Non-adjunctive, non-implanted continuous glucose monitor or receiver","1","0",null,null,"5.203055556",null,null,"1",null,"NA","NA"],
    [8998,"8998","Carrier I","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4239","Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","1","0",null,null,"2.074722222",null,null,"1",null,"NA","NA"],
    [8999,"8999","Carrier I","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","114","0.6754",null,"13.16","14.95",null,"31","83",null,"HYDROCODONE-ACETAMINOPHEN","HYDROCODONE-ACETAMINOPHEN"],
    [9000,"9000","Carrier I","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","107","0.0374",null,"5.1","7.11",null,"8","99",null,"SEMAGLUTIDE (WEIGHT MANAGEMENT)","WEGOVY"],
    [9001,"9001","Carrier I","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","107","0.6542",null,"8.55","20.01",null,"19","88",null,"SEMAGLUTIDE","OZEMPIC (0.25 OR 0.5 MG/DOSE), OZEMPIC (1 MG/DOSE), OZEMPIC (2 MG/DOSE), RYBELSUS"],
    [9002,"9002","Carrier I","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","103","0.7476",null,"5.96","27.27",null,"36","67",null,"OXYCODONE HCL","OXYCODONE HCL, OXYCODONE HCL ER, OXYCONTIN"],
    [9003,"9003","Carrier I","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","70","0.6429",null,"7.29","6.75",null,"3","67",null,"CYCLOSPORINE (OPHTH)","CEQUA, CYCLOSPORINE, RESTASIS, RESTASIS MULTIDOSE, VEVYE"],
    [9004,"9004","Carrier I","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","68","0",null,"5.39","7.39",null,"9","59",null,"TIRZEPATIDE (WEIGHT MANAGEMENT)","ZEPBOUND"],
    [9005,"9005","Carrier I","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","54","0.7407",null,"5.88","3.53",null,"8","46",null,"TIRZEPATIDE","MOUNJARO"],
    [9006,"9006","Carrier I","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","44","0.7955",null,"4.41","46.12",null,"5","39",null,"RIMEGEPANT SULFATE","NURTEC"],
    [9007,"9007","Carrier I","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","44","0.9773",null,"6.19","12.75",null,"11","33",null,"ADALIMUMAB","HUMIRA (2 PEN), HUMIRA (2 SYRINGE), HUMIRA-CD/UC/HS STARTER, HUMIRA-PED<40KG CROHNS STARTER"],
    [9008,"9008","Carrier I","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","36","0.4444",null,"20.26","9.22",null,"4","32",null,"LINACLOTIDE","LINZESS"],
    [9009,"9009","Carrier I","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","25","1",null,null,"8.08",null,"0","25",null,"RISANKIZUMAB-RZAA","SKYRIZI, SKYRIZI PEN"],
    [9010,"9010","Carrier I","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","18","1",null,"4.65","2.98",null,"4","14",null,"PLECANATIDE","TRULANCE"],
    [9011,"9011","Carrier I","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","13","1",null,"2.07","4.73",null,"2","11",null,"SECUKINUMAB","COSENTYX SENSOREADY (300 MG), COSENTYX SENSOREADY PEN, COSENTYX UNOREADY"],
    [9012,"9012","Carrier I","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","11","1",null,"2.27","6.43",null,"3","8",null,"ETANERCEPT","ENBREL MINI, ENBREL SURECLICK"],
    [9013,"9013","Carrier I","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","9","1",null,"1.93","6.58",null,"4","5",null,"ABEMACICLIB","VERZENIO"],
    [9014,"9014","Carrier I","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,"1.78","6.07",null,"2","6",null,"DULAGLUTIDE","TRULICITY"],
    [9015,"9015","Carrier I","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,"1.96","7.27",null,"3","4",null,"LUMATEPERONE TOSYLATE","CAPLYTA"],
    [9016,"9016","Carrier I","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,null,"7.29",null,"0","7",null,"LIFITEGRAST","XIIDRA"],
    [9017,"9017","Carrier I","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,"2.49","6.25",null,"3","4",null,"LAMOTRIGINE","LAMOTRIGINE, LAMOTRIGINE ER"],
    [9018,"9018","Carrier I","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","6","1",null,"2.53","3.06",null,"2","4",null,"ELTROMBOPAG OLAMINE","PROMACTA"],
    [9019,"9019","Carrier I","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","4",null,"1","24.78","29.18",null,"3","1",null,"EVOLOCUMAB","REPATHA SURECLICK"],
    [9020,"9020","Carrier I","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"1","12.24",null,null,"2","0",null,"ADALIMUMAB","HUMIRA (2 PEN)"],
    [9021,"9021","Carrier I","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"1",null,"25.65",null,"0","2",null,"PENTOSAN POLYSULFATE SODIUM","ELMIRON"],
    [9022,"9022","Carrier I","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"1","16.54","46.99",null,"1","1",null,"OXYCODONE W/ ACETAMINOPHEN","OXYCODONE-ACETAMINOPHEN"],
    [9023,"9023","Carrier I","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"1","4.51",null,null,"2","0",null,"IVABRADINE HCL","CORLANOR"],
    [9024,"9024","Carrier I","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"1",null,"47.28",null,"0","2",null,"ERENUMAB-AOOE","AIMOVIG"],
    [9025,"9025","Carrier I","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1",null,"21.81",null,"0","1",null,"RIBOCICLIB SUCCINATE","KISQALI (600 MG DOSE)"],
    [9026,"9026","Carrier I","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1","15.7",null,null,"1","0",null,"SEMAGLUTIDE","OZEMPIC (0.25 OR 0.5 MG/DOSE)"],
    [9027,"9027","Carrier I","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1",null,"23.08",null,"0","1",null,"BUTORPHANOL TARTRATE","BUTORPHANOL TARTRATE"],
    [9028,"9028","Carrier I","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"1","5.42",null,null,"1","0",null,"BUPRENORPHINE","BUPRENORPHINE"],
    [9029,"9029","Carrier G","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","32666","THORACOSCOPY W/THERA WEDGE RESEXN INITIAL UNILAT","3","1",null,null,null,null,"1","2",null,"NA","NA"],
    [9030,"9030","Carrier G","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","32674","THORCOSCPY W/MEDIASTINL  AND  REGIONL LYMPHDENECTOMY","3","0.3333",null,null,null,null,null,"3",null,"NA","NA"],
    [9031,"9031","Carrier G","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","33259","ATRIA ABLTJ  AND  RCNSTJ W/OTHER PX EXTEN W/BYPASS","3","1",null,null,null,null,"1","2",null,"NA","NA"],
    [9032,"9032","Carrier G","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","33405","RPLCMT PROST AORTIC VALVE OPEN XCP HOMOGRF/STENT","3","1",null,null,null,null,null,"3",null,"NA","NA"],
    [9033,"9033","Carrier G","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","33427","VLVP MITRAL VALVE W/BYPASS RAD RCNSTJ W/WO RING","3","1",null,null,null,null,"1","2",null,"NA","NA"],
    [9034,"9034","Carrier G","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","35371","TEAEC W/WO PATCH GRAFT COMMON FEMORAL","3","1",null,null,null,null,null,"3",null,"NA","NA"],
    [9035,"9035","Carrier G","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93355","ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN","3","1",null,null,null,null,null,"3",null,"NA","NA"],
    [9036,"9036","Carrier G","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","33340","PERQ CLSR TCAT L ATR APNDGE W/ENDOCARDIAL IMPLNT","2","1",null,null,null,null,null,"2",null,"NA","NA"],
    [9037,"9037","Carrier G","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","33361","REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH","2","1",null,null,null,null,"1","1",null,"NA","NA"],
    [9038,"9038","Carrier G","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","33413","REPLACEMENT AORTIC AND PULMON VALVES ROSS PROCEDUR","2","1",null,null,null,null,null,"2",null,"NA","NA"],
    [9039,"9039","Carrier G","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","32666","THORACOSCOPY W/THERA WEDGE RESEXN INITIAL UNILAT","3","1",null,null,null,null,"1","2",null,"NA","NA"],
    [9040,"9040","Carrier G","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33259","ATRIA ABLTJ  AND  RCNSTJ W/OTHER PX EXTEN W/BYPASS","3","1",null,null,null,null,"1","2",null,"NA","NA"],
    [9041,"9041","Carrier G","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33405","RPLCMT PROST AORTIC VALVE OPEN XCP HOMOGRF/STENT","3","1",null,null,null,null,null,"3",null,"NA","NA"],
    [9042,"9042","Carrier G","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33427","VLVP MITRAL VALVE W/BYPASS RAD RCNSTJ W/WO RING","3","1",null,null,null,null,"1","2",null,"NA","NA"],
    [9043,"9043","Carrier G","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","35371","TEAEC W/WO PATCH GRAFT COMMON FEMORAL","3","1",null,null,null,null,null,"3",null,"NA","NA"],
    [9044,"9044","Carrier G","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93355","ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN","3","1",null,null,null,null,null,"3",null,"NA","NA"],
    [9045,"9045","Carrier G","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33340","PERQ CLSR TCAT L ATR APNDGE W/ENDOCARDIAL IMPLNT","2","1",null,null,null,null,null,"2",null,"NA","NA"],
    [9046,"9046","Carrier G","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33361","REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH","2","1",null,null,null,null,"1","3",null,"NA","NA"],
    [9047,"9047","Carrier G","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33413","REPLACEMENT AORTIC AND PULMON VALVES ROSS PROCEDUR","2","1",null,null,null,null,null,"2",null,"NA","NA"],
    [9048,"9048","Carrier G","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","33416","VENTRICULOMYOTOMY-MYECTOMY","2","1",null,null,null,null,"1","1",null,"NA","NA"],
    [9049,"9049","Carrier G","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93306","ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC AND COLR D","1216","0.9622",null,null,null,null,"17","1199",null,"NA","NA"],
    [9050,"9050","Carrier G","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93971","DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY","208","0.9808",null,null,null,null,"12","196",null,"NA","NA"],
    [9051,"9051","Carrier G","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93015","CV STRS TST XERS AND /OR RX CONT ECG W/SI AND R","203","0.936",null,null,null,null,"2","201",null,"NA","NA"],
    [9052,"9052","Carrier G","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93248","EXTERNAL ECG REC GT 7D LT 15D REVIEW  AND  INTERPRETATION","201","0.9851",null,null,null,null,null,"201",null,"NA","NA"],
    [9053,"9053","Carrier G","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","78452","MYOCARDIAL SPECT MULTIPLE STUDIES","192","0.9271",null,null,null,null,"3","189",null,"NA","NA"],
    [9054,"9054","Carrier G","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93246","EXTERNAL ECG REC GT 7D LT 15D RECORDING","175","0.9829",null,null,null,null,null,"175",null,"NA","NA"],
    [9055,"9055","Carrier G","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93017","CV STRS TST XERS AND /OR RX CONT ECG TRCG ONLY","170","0.9471",null,null,null,null,null,"170",null,"NA","NA"],
    [9056,"9056","Carrier G","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","93970","DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY","156","0.9487",null,null,null,null,"4","152",null,"NA","NA"],
    [9057,"9057","Carrier G","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","77334","TX DEVICES DESIGN  AND  CONSTRUCTION COMPLEX","154","0.974",null,null,null,null,"14","140",null,"NA","NA"],
    [9058,"9058","Carrier G","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","77300","BASIC RADIATION DOSIMETRY CALCULATION","139","0.9784",null,null,null,null,"10","129",null,"NA","NA"],
    [9059,"9059","Carrier G","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77301","NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS","78","1",null,null,null,null,"6","72",null,"NA","NA"],
    [9060,"9060","Carrier G","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77338","MLC IMRT DESIGN  AND  CONSTRUCTION PER IMRT PLAN","75","1",null,null,null,null,"6","69",null,"NA","NA"],
    [9061,"9061","Carrier G","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77014","CT GUIDANCE RADIATION THERAPY FLDS PLACEMENT","73","1",null,null,null,null,"3","70",null,"NA","NA"],
    [9062,"9062","Carrier G","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93325","DOP ECHOCARD COLOR FLOW VELOCITY MAPPING","72","1",null,null,null,null,null,"72",null,"NA","NA"],
    [9063,"9063","Carrier G","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93308","ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD","63","1",null,null,null,null,null,"63",null,"NA","NA"],
    [9064,"9064","Carrier G","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93922","NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL","52","1",null,null,null,null,"3","49",null,"NA","NA"],
    [9065,"9065","Carrier G","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77332","TX DEVICES DESIGN  AND  CONSTRUCTION SIMPLE","35","1",null,null,null,null,"1","34",null,"NA","NA"],
    [9066,"9066","Carrier G","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","77386","INTENSITY MODULATED RADIATION TX DLVR COMPLEX","34","1",null,null,null,null,"2","32",null,"NA","NA"],
    [9067,"9067","Carrier G","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93290","INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON","31","1",null,null,null,null,null,"31",null,"NA","NA"],
    [9068,"9068","Carrier G","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","93280","PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER","27","1",null,null,null,null,null,"27",null,"NA","NA"],
    [9069,"9069","Carrier G","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","93970","DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY","1",null,"0.0048",null,null,null,"0","1",null,"NA","NA"],
    [9070,"9070","Carrier G","2024","Outpatient Med-Surg","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","CPT","93306","ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC AND COLR D","2",null,"0.0016",null,null,null,"0","2",null,"NA","NA"],
    [9071,"9071","Carrier G","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","90875","INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 30 MIN","1","1",null,null,null,null,null,"1",null,"NA","NA"],
    [9072,"9072","Carrier G","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96116","NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR","1","0",null,null,"11",null,null,"1",null,"NA","NA"],
    [9073,"9073","Carrier G","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96121","NEUROBEHAVIORAL STATUS XM PHYS/QHP EA ADDL HOUR","1","0",null,null,"11",null,null,"1",null,"NA","NA"],
    [9074,"9074","Carrier G","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96132","NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP 1ST HOUR","1","0",null,null,"11",null,null,"1",null,"NA","NA"],
    [9075,"9075","Carrier G","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96133","NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR","1","0",null,null,"11",null,null,"1",null,"NA","NA"],
    [9076,"9076","Carrier G","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96136","PSYL/NRPSYCL TST PHYS/QHP 2 PLUS  TST 1ST 30 MIN","1","0",null,null,"11",null,null,"1",null,"NA","NA"],
    [9077,"9077","Carrier G","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96137","PSYCL/NRPSYCL TST PHYS/QHP 2 PLUS  TST EA ADDL 30 MIN","1","0",null,null,"11",null,null,"1",null,"NA","NA"],
    [9078,"9078","Carrier G","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96138","PSYCL/NRPSYCL TST TECH 2 PLUS  TST 1ST 30 MIN","1","0",null,null,"11",null,null,"1",null,"NA","NA"],
    [9079,"9079","Carrier G","2024","Outpatient MH-SUD","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","96139","PSYCL/NRPSYCL TST TECH 2 PLUS  TST EA ADDL 30 MIN","1","0",null,null,"11",null,null,"1",null,"NA","NA"],
    [9080,"9080","Carrier G","2024","Outpatient MH-SUD","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","90875","INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 30 MIN","1","1",null,null,null,null,null,"1",null,"NA","NA"],
    [9081,"9081","Carrier G","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E1390","O2 CONC 1 DEL PORT 85 PCT  OR GT 02 CONC AT PRSC FLW RATE","6","1",null,null,null,null,null,"6",null,"NA","NA"],
    [9082,"9082","Carrier G","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","K0738","PORTABLE GASEOUS O2 SYS RENTAL; HOME COMPRESSOR","5","1",null,null,null,null,null,"5",null,"NA","NA"],
    [9083,"9083","Carrier G","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L0650","LSO SAGITTAL-CORONAL CONTRL RIGD ANT POST PANELS","1","1",null,null,null,null,null,"1",null,"NA","NA"],
    [9084,"9084","Carrier G","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","L3933","FINGER ORTHOSIS W/O JOINTS CUSTOM FABRICATED","1","1",null,null,null,null,null,"1",null,"NA","NA"],
    [9085,"9085","Carrier G","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","A4649","SURGICAL SUPPLY; MISCELLANEOUS","1","1",null,null,null,null,null,"1",null,"NA","NA"],
    [9086,"9086","Carrier G","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","E2298","COMPLEX REHAB PWR WC ACC PWR SEAT EL SYS ANY TYP","1","1",null,null,null,null,null,"1",null,"NA","NA"],
    [9087,"9087","Carrier G","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E1390","O2 CONC 1 DEL PORT 85 PCT  OR GT 02 CONC AT PRSC FLW RATE","6","1",null,null,null,null,null,"6",null,"NA","NA"],
    [9088,"9088","Carrier G","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","K0738","PORTABLE GASEOUS O2 SYS RENTAL; HOME COMPRESSOR","5","1",null,null,null,null,null,"5",null,"NA","NA"],
    [9089,"9089","Carrier G","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L0650","LSO SAGITTAL-CORONAL CONTRL RIGD ANT POST PANELS","1","1",null,null,null,null,null,"1",null,"NA","NA"],
    [9090,"9090","Carrier G","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","L3933","FINGER ORTHOSIS W/O JOINTS CUSTOM FABRICATED","1","1",null,null,null,null,null,"1",null,"NA","NA"],
    [9091,"9091","Carrier G","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","A4649","SURGICAL SUPPLY; MISCELLANEOUS","1","1",null,null,null,null,null,"1",null,"NA","NA"],
    [9092,"9092","Carrier G","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","E2298","COMPLEX REHAB PWR WC ACC PWR SEAT EL SYS ANY TYP","1","1",null,null,null,null,null,"1",null,"NA","NA"],
    [9093,"9093","Carrier G","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","1124","0.898",null,"11.1","20.9",null,"325","799",null,"AMPHETAMINE/DEXTROAMPHETAMINE","ADDERALL"],
    [9094,"9094","Carrier G","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","868","0.514",null,"22.6","65.4",null,"237","631",null,"DEXCOM Receiver/Sensor/Transmiter","DEXCOM Receiver/Sensor/Transmiter"],
    [9095,"9095","Carrier G","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","526","0.513",null,"18.7","38.8",null,"91","435",null,"SEMAGLUTIDE","OZEMPIC"],
    [9096,"9096","Carrier G","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","468","0.825",null,"14.3","24.2",null,"130","338",null,"METHYLPHENIDATE HCL","RITALIN"],
    [9097,"9097","Carrier G","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","381","0.52",null,"27.7","59.9",null,"100","281",null,"LISDEXAMFETAMINE DIMESYLATE","VYVANSE"],
    [9098,"9098","Carrier G","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","290","0.731",null,"13.4","30.6",null,"82","208",null,"ADALIMUMAB","HUMIRA"],
    [9099,"9099","Carrier G","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","211","0.464",null,"32.1","62.6",null,"10","201",null,"TRETINOIN","RETIN-A"],
    [9100,"9100","Carrier G","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","199","0.241",null,"40.6","61.7",null,"37","162",null,"TERZEPATIDE","MOUNJARO"],
    [9101,"9101","Carrier G","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","191","0.571",null,"28.7","42.7",null,"6","185",null,"TACROLIMUS","PROTOPIC"],
    [9102,"9102","Carrier G","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","189","0.794",null,"13.7","25.5",null,"44","145",null,"EMPAGLIFLOZIN","JARDIANCE"],
    [9103,"9103","Carrier G","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","22","1",null,"8.6","17.6",null,"6","16",null,"PANCRELIPASE","CREON"],
    [9104,"9104","Carrier G","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","21","1",null,"1.4","28",null,"2","19",null,"GUSELKUMAB","TREMFYA"],
    [9105,"9105","Carrier G","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","16","1",null,"4.3","1.2",null,"11","5",null,"CENOBAMATE","XCORPI"],
    [9106,"9106","Carrier G","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","10","1",null,"12.1","14.1",null,"3","7",null,"CARBIDOPA/LEVODOPA","RYTARY"],
    [9107,"9107","Carrier G","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","10","1",null,"11.6","17.2",null,"3","7",null,"AMBRISENTAN","LETAIRIS"],
    [9108,"9108","Carrier G","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","9","1",null,"9.8","7.3",null,"4","5",null,"PALIPERIDONE","INVEGA"],
    [9109,"9109","Carrier G","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","9","1",null,"11.5","28.4",null,"5","4",null,"LORAZEPAM","ATIVAN"],
    [9110,"9110","Carrier G","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,"3","21.1",null,"2","6",null,"VILOXAZINE","QELBREE"],
    [9111,"9111","Carrier G","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,"2.8","34.6",null,"6","2",null,"AZALABRUTINIB","CALQUENCE"],
    [9112,"9112","Carrier G","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,"12","6.7",null,"4","3",null,"LINEZOLID","ZYVOX"],
    [9113,"9113","Carrier G","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","6",null,"0.0069",null,null,null,"0","8",null,"DEXCOM Receiver/Sensor/Transmiter","DEXCOM Receiver/Sensor/Transmiter"],
    [9114,"9114","Carrier G","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","3",null,"0.0057",null,null,null,"0","5",null,"SEMAGLUTIDE","OZEMPIC"],
    [9115,"9115","Carrier G","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"0.0052",null,null,null,"0","3",null,"LISDEXAMFETAMINE DIMESYLATE","VYVANSE"],
    [9116,"9116","Carrier G","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","2",null,"0.0069",null,null,null,"0","3",null,"ADALIMUMAB","HUMIRA"],
    [9117,"9117","Carrier G","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"0.0047",null,null,null,"0","1",null,"TRETINOIN","RETIN-A"],
    [9118,"9118","Carrier G","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","1",null,"0.005",null,null,null,"0","3",null,"TERZEPATIDE","MOUNJARO"],
    [9119,"9119","Carrier K","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64405","Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve","5","0",null,null,"48.66",null,"0","5",null,"NA","NA"],
    [9120,"9120","Carrier K","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64483","Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, single level","5","0.8",null,null,"21.52",null,"0","5",null,"NA","NA"],
    [9121,"9121","Carrier K","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","67900","Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)","4","1",null,null,"54.55",null,"0","4",null,"NA","NA"],
    [9122,"9122","Carrier K","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2370","Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","3","0.6667",null,null,"95.23",null,"0","2",null,"NA","NA"],
    [9123,"9123","Carrier K","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","14301","Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm","2","1",null,null,"54.55",null,"0","2",null,"NA","NA"],
    [9124,"9124","Carrier K","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","14302","Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof","2","1",null,null,"54.55",null,"0","2",null,"NA","NA"],
    [9125,"9125","Carrier K","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15773","Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; 25 cc or less injectate","2","1",null,null,"54.55",null,"0","2",null,"NA","NA"],
    [9126,"9126","Carrier K","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","15774","Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; each additional 25 cc injectate, or part thereof","2","1",null,null,"54.55",null,"0","2",null,"NA","NA"],
    [9127,"9127","Carrier K","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","21089","Unlisted maxillofacial prosthetic procedure","2","0.5",null,null,"34.95",null,"0","2",null,"NA","NA"],
    [9128,"9128","Carrier K","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","21139","Reduction forehead; contouring and setback of anterior frontal sinus wall�","2","1",null,null,"54.55",null,"0","2",null,"NA","NA"],
    [9129,"9129","Carrier K","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","21175","Reconstruction, bifrontal, superior-lateral orbital rims and lower forehead, advancement or alteration (eg, plagiocephaly, trigonocephaly, brachycephaly), with or without grafts","2","1",null,null,"54.55",null,"0","2",null,"NA","NA"],
    [9130,"9130","Carrier K","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","30117","Excision or destruction (eg, laser), intranasal lesion; internal approach","2","1",null,null,"143.3",null,"0","2",null,"NA","NA"],
    [9131,"9131","Carrier K","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","30140","Submucous resection inferior turbinate, partial or complete, any method","2","1",null,null,"143.3",null,"0","2",null,"NA","NA"],
    [9132,"9132","Carrier K","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64484","Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, each additional level","2","1",null,null,"12.9",null,"0","2",null,"NA","NA"],
    [9133,"9133","Carrier K","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","J9039","Injection, blinatumomab, 1 microgram","2","1",null,null,"34.1",null,"1","1",null,"NA","NA"],
    [9134,"9134","Carrier K","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0108","Wheelchair component or accessory, not otherwise specified","2","0.5",null,null,"132.85",null,"0","2",null,"NA","NA"],
    [9135,"9135","Carrier K","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","K0739","Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","2","0.5",null,null,"132.85",null,"0","2",null,"NA","NA"],
    [9136,"9136","Carrier K","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","67900","Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)","4","1",null,null,"54.55",null,"0","4",null,"NA","NA"],
    [9137,"9137","Carrier K","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","14301","Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm","2","1",null,null,"54.55",null,"0","2",null,"NA","NA"],
    [9138,"9138","Carrier K","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","14302","Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof","2","1",null,null,"54.55",null,"0","2",null,"NA","NA"],
    [9139,"9139","Carrier K","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15773","Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; 25 cc or less injectate","2","1",null,null,"54.55",null,"0","2",null,"NA","NA"],
    [9140,"9140","Carrier K","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15774","Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; each additional 25 cc injectate, or part thereof","2","1",null,null,"54.55",null,"0","2",null,"NA","NA"],
    [9141,"9141","Carrier K","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","21139","Reduction forehead; contouring and setback of anterior frontal sinus wall�","2","1",null,null,"54.55",null,"0","2",null,"NA","NA"],
    [9142,"9142","Carrier K","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","21175","Reconstruction, bifrontal, superior-lateral orbital rims and lower forehead, advancement or alteration (eg, plagiocephaly, trigonocephaly, brachycephaly), with or without grafts","2","1",null,null,"54.55",null,"0","2",null,"NA","NA"],
    [9143,"9143","Carrier K","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","30117","Excision or destruction (eg, laser), intranasal lesion; internal approach","2","1",null,null,"143.3",null,"0","2",null,"NA","NA"],
    [9144,"9144","Carrier K","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","30140","Submucous resection inferior turbinate, partial or complete, any method","2","1",null,null,"143.3",null,"0","2",null,"NA","NA"],
    [9145,"9145","Carrier K","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64484","Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, each additional level","2","1",null,null,"12.9",null,"0","2",null,"NA","NA"],
    [9146,"9146","Carrier K","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","J9039","Injection, blinatumomab, 1 microgram","2","1",null,null,"34.1",null,"1","1",null,"NA","NA"],
    [9147,"9147","Carrier K","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","81420","Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21","39","0.5897",null,null,"32.96",null,"0","39",null,"NA","NA"],
    [9148,"9148","Carrier K","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","81479","Unlisted molecular pathology procedure","25","0.8",null,null,"17.18",null,"0","25",null,"NA","NA"],
    [9149,"9149","Carrier K","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95810","Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","23","0.6087",null,"24.5","20.71",null,"1","22",null,"NA","NA"],
    [9150,"9150","Carrier K","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64493","�Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level","19","0.8421",null,"0.5","12.76",null,"1","18",null,"NA","NA"],
    [9151,"9151","Carrier K","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","30140","Submucous resection inferior turbinate, partial or complete, any method","12","0.75",null,null,"43.6",null,"0","12",null,"NA","NA"],
    [9152,"9152","Carrier K","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","30520","Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft","12","0.75",null,null,"46.44",null,"0","12",null,"NA","NA"],
    [9153,"9153","Carrier K","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95811","Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist","12","0.5",null,null,"36.81",null,"0","12",null,"NA","NA"],
    [9154,"9154","Carrier K","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","17106","Destruction of cutaneous vascular proliferative lesions (eg, laser technique); less than 10 sq cm","11","1",null,null,"0.69",null,"0","11",null,"NA","NA"],
    [9155,"9155","Carrier K","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","30465","Repair of nasal vestibular stenosis (eg, spreader grafting, lateral nasal wall reconstruction)","10","0.4",null,null,"54.68",null,"0","10",null,"NA","NA"],
    [9156,"9156","Carrier K","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","36475","Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated","9","1",null,null,"7.1",null,"0","9",null,"NA","NA"],
    [9157,"9157","Carrier K","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64494","Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level","9","0.6667",null,null,"14.02",null,"0","9",null,"NA","NA"],
    [9158,"9158","Carrier K","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","17106","Destruction of cutaneous vascular proliferative lesions (eg, laser technique); less than 10 sq cm","11","1",null,null,"0.69",null,"0","11",null,"NA","NA"],
    [9159,"9159","Carrier K","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","36475","Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated","9","1",null,null,"7.1",null,"0","9",null,"NA","NA"],
    [9160,"9160","Carrier K","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","19318","Breast reduction","8","1",null,null,"7.45",null,"0","8",null,"NA","NA"],
    [9161,"9161","Carrier K","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","52000","Cystourethroscopy (separate procedure)","7","1",null,null,"0.71",null,"0","7",null,"NA","NA"],
    [9162,"9162","Carrier K","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","52356","Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent","7","1",null,null,"0.19",null,"0","7",null,"NA","NA"],
    [9163,"9163","Carrier K","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58558","Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D and C","7","1",null,null,"0.14",null,"0","7",null,"NA","NA"],
    [9164,"9164","Carrier K","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","31255","Nasal/sinus endoscopy, surgical with ethmoidectomy; total�","6","1",null,null,"12.65",null,"0","6",null,"NA","NA"],
    [9165,"9165","Carrier K","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","36471","Injection of sclerosant; multiple incompetent veins (other than telangiectasia), same leg","6","1",null,null,"10.52",null,"0","6",null,"NA","NA"],
    [9166,"9166","Carrier K","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","49650","Laparoscopy, surgical; repair initial inguinal hernia","6","1",null,"0.1","0.16",null,"1","5",null,"NA","NA"],
    [9167,"9167","Carrier K","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","50590","Lithotripsy, extracorporeal shock wave","6","1",null,null,"0.2",null,"0","6",null,"NA","NA"],
    [9168,"9168","Carrier K","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S1040","Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s)","6","0.5",null,null,"25.88",null,null,"6",null,"NA","NA"],
    [9169,"9169","Carrier K","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0760","Osteogenesis stimulator, low intensity ultrasound, non-invasive","2","1",null,null,"16",null,null,"2",null,"NA","NA"],
    [9170,"9170","Carrier K","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4239","Supply allowance for nonadjunctive, nonimplanted continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service","1","0",null,null,"38.5",null,null,"1",null,"NA","NA"],
    [9171,"9171","Carrier K","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0265","Hospital bed, total electric (head, foot, and height adjustments), with any type side rails, with mattress","1","0",null,"42.5",null,null,null,"0",null,"NA","NA"],
    [9172,"9172","Carrier K","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0486","Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","1","0",null,null,"61.1",null,null,"1",null,"NA","NA"],
    [9173,"9173","Carrier K","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2103","Nonadjunctive, nonimplanted continuous glucose monitor (CGM) or receiver","1","0",null,null,"38.5",null,null,"1",null,"NA","NA"],
    [9174,"9174","Carrier K","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2510","Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","1","1",null,null,"25.1",null,null,"1",null,"NA","NA"],
    [9175,"9175","Carrier K","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5301","Below knee, molded socket, shin, sach foot, endoskeletal system","1","1",null,null,"4.5",null,null,"1",null,"NA","NA"],
    [9176,"9176","Carrier K","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L5968","Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","1","1",null,null,"4.5",null,null,"1",null,"NA","NA"],
    [9177,"9177","Carrier K","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","L8619","Cochlear implant, external speech processor and controller, integrated system, replacement","1","1",null,null,"9.1",null,null,"1",null,"NA","NA"],
    [9178,"9178","Carrier K","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0760","Osteogenesis stimulator, low intensity ultrasound, non-invasive","2","1",null,null,"16",null,null,"2",null,"NA","NA"],
    [9179,"9179","Carrier K","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2510","Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","1","1",null,null,"25.1",null,null,"1",null,"NA","NA"],
    [9180,"9180","Carrier K","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5301","Below knee, molded socket, shin, sach foot, endoskeletal system","1","1",null,null,"4.5",null,null,"1",null,"NA","NA"],
    [9181,"9181","Carrier K","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L5968","Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","1","1",null,null,"4.5",null,null,"1",null,"NA","NA"],
    [9182,"9182","Carrier K","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","L8619","Cochlear implant, external speech processor and controller, integrated system, replacement","1","1",null,null,"9.1",null,null,"1",null,"NA","NA"],
    [9183,"9183","Carrier K","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S1040","Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s)","6","0.5",null,null,"25.88",null,null,"6",null,"NA","NA"],
    [9184,"9184","Carrier K","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4239","Supply allowance for nonadjunctive, nonimplanted continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service","1","0",null,null,"38.5",null,null,"1",null,"NA","NA"],
    [9185,"9185","Carrier K","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0265","Hospital bed, total electric (head, foot, and height adjustments), with any type side rails, with mattress","1","0",null,"42.5",null,null,null,"0",null,"NA","NA"],
    [9186,"9186","Carrier K","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0486","Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","1","0",null,null,"61.1",null,null,"1",null,"NA","NA"],
    [9187,"9187","Carrier K","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2103","Nonadjunctive, nonimplanted continuous glucose monitor (CGM) or receiver","1","0",null,null,"38.5",null,null,"1",null,"NA","NA"],
    [9188,"9188","Carrier K","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","A4239","Supply allowance for nonadjunctive, nonimplanted continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service","1",null,"0",null,"38.5",null,"0","1",null,"NA","NA"],
    [9189,"9189","Carrier K","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","E2103","Nonadjunctive, nonimplanted continuous glucose monitor (CGM) or receiver","1",null,"0",null,"38.5",null,"0","1",null,"NA","NA"],
    [9190,"9190","Carrier K","2024","DME","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","HCPC","S1040","Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s)","2",null,"0",null,"43.58",null,"0","2",null,"NA","NA"],
    [9191,"9191","Carrier K","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","External ambulatory infusion pump, insulin","3","1",null,null,"1.2",null,null,"3",null,"NA","NA"],
    [9192,"9192","Carrier K","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","External ambulatory infusion pump, insulin","3","1",null,null,"1.2",null,null,"3",null,"NA","NA"],
    [9193,"9193","Carrier L","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64483","Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, single level","19","0.8421",null,"12.03","27.71",null,"3","16",null,"NA","NA"],
    [9194,"9194","Carrier L","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64484","Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, each additional level (List separately in addition to code for primary procedure)","11","0.8182",null,null,"23.24",null,"0","11",null,"NA","NA"],
    [9195,"9195","Carrier L","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64405","Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve","5","0",null,null,"25.02",null,"0","5",null,"NA","NA"],
    [9196,"9196","Carrier L","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","38525","Biopsy or excision of lymph node(s); open, deep axillary node(s)","4","0.75",null,null,"0.33",null,"0","4",null,"NA","NA"],
    [9197,"9197","Carrier L","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58150","Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s)","4","1",null,null,"32.26",null,"0","4",null,"NA","NA"],
    [9198,"9198","Carrier L","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","62323","Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (ie, fluoroscopy or CT)","4","0.5",null,null,"40.15",null,"0","4",null,"NA","NA"],
    [9199,"9199","Carrier L","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","21089","Unlisted maxillofacial prosthetic procedure","3","0.6667",null,null,"17.3",null,"0","3",null,"NA","NA"],
    [9200,"9200","Carrier L","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","31622","Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)","3","1",null,null,"21.1",null,"0","3",null,"NA","NA"],
    [9201,"9201","Carrier L","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58571","Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)","3","0.3333",null,null,"13",null,"0","3",null,"NA","NA"],
    [9202,"9202","Carrier L","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64454","Injection(s), anesthetic agent(s) and/or steroid; genicular nerve branches, including imaging guidance, when performed","3","0",null,null,"23.23",null,"0","3",null,"NA","NA"],
    [9203,"9203","Carrier L","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","66991","Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drainage device, without extraocular reservoir, internal approach, one or more","3","1",null,null,"192.96",null,"0","3",null,"NA","NA"],
    [9204,"9204","Carrier L","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","97803","Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes","3","0.6667",null,null,"37.06",null,"0","3",null,"NA","NA"],
    [9205,"9205","Carrier L","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","99183","Physician or other qualified health care professional attendance and supervision of hyperbaric oxygen therapy, per session","3","1",null,null,"1.5",null,"0","3",null,"NA","NA"],
    [9206,"9206","Carrier L","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0277","Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval","3","1",null,null,"1.5",null,"0","3",null,"NA","NA"],
    [9207,"9207","Carrier L","2024","Inpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","G0299","Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes","3","0.6667",null,null,"84.5",null,"0","3",null,"NA","NA"],
    [9208,"9208","Carrier L","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58150","Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s)","4","1",null,null,"32.26",null,"0","4",null,"NA","NA"],
    [9209,"9209","Carrier L","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","31622","Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)","3","1",null,null,"21.1",null,"0","3",null,"NA","NA"],
    [9210,"9210","Carrier L","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","66991","Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drainage device, without extraocular reservoir, internal approach, one or more","3","1",null,null,"192.96",null,"0","3",null,"NA","NA"],
    [9211,"9211","Carrier L","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99183","Physician or other qualified health care professional attendance and supervision of hyperbaric oxygen therapy, per session","3","1",null,null,"1.5",null,"0","3",null,"NA","NA"],
    [9212,"9212","Carrier L","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","G0277","Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval","3","1",null,null,"1.5",null,"0","3",null,"NA","NA"],
    [9213,"9213","Carrier L","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","15004","Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; first 100 sq cm or 1% of body area of infants and children","2","1",null,null,"20.9",null,"0","2",null,"NA","NA"],
    [9214,"9214","Carrier L","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","30130","Excision inferior turbinate, partial or complete, any method","2","1",null,null,"22.55",null,"0","2",null,"NA","NA"],
    [9215,"9215","Carrier L","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","52235","Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; MEDIUM bladder tumor(s) (2.0 to 5.0 cm)","2","1",null,null,"0.9",null,"0","2",null,"NA","NA"],
    [9216,"9216","Carrier L","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","54520","Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach","2","1",null,null,"26.7",null,"0","2",null,"NA","NA"],
    [9217,"9217","Carrier L","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","67950","Canthoplasty (reconstruction of canthus)","2","1",null,null,"18",null,"0","2",null,"NA","NA"],
    [9218,"9218","Carrier L","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","76942","Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation","2","1",null,null,"43.9",null,"0","2",null,"NA","NA"],
    [9219,"9219","Carrier L","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95700","Electroencephalogram (EEG) continuous recording, with video when performed, setup, patient education, and takedown when performed, administered in person by EEG technologist, minimum of 8 channels","2","1",null,null,"13.2",null,"0","2",null,"NA","NA"],
    [9220,"9220","Carrier L","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","95716","Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; with continuous, real-time monitoring and maintenance","2","1",null,null,"13.2",null,"0","2",null,"NA","NA"],
    [9221,"9221","Carrier L","2024","Inpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","99152","Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intraservice time, patient age 5 years or older","2","1",null,null,"22.9",null,"0","2",null,"NA","NA"],
    [9222,"9222","Carrier L","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95810","Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","80","0.625",null,null,"21.1",null,null,"80",null,"NA","NA"],
    [9223,"9223","Carrier L","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","81479","Unlisted molecular pathology procedure","78","0.8846",null,null,"14.58",null,null,"78",null,"NA","NA"],
    [9224,"9224","Carrier L","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","81420","Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21","73","0.7808",null,null,"13.15",null,null,"73",null,"NA","NA"],
    [9225,"9225","Carrier L","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","95811","Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist","60","0.6167",null,null,"15.9",null,null,"60",null,"NA","NA"],
    [9226,"9226","Carrier L","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","30140","Submucous resection inferior turbinate, partial or complete, any method","34","0.9118",null,null,"40.24",null,null,"34",null,"NA","NA"],
    [9227,"9227","Carrier L","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","30520","Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft","31","0.9355",null,null,"42",null,null,"31",null,"NA","NA"],
    [9228,"9228","Carrier L","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","52356","Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, Gibbons or double-J type)","31","1",null,"0.15","1.15",null,"4","27",null,"NA","NA"],
    [9229,"9229","Carrier L","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58571","Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)","29","0.6897",null,"23.9","33.58",null,"4","25",null,"NA","NA"],
    [9230,"9230","Carrier L","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","64493","Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level","29","0.8966",null,null,"12.09",null,null,"29",null,"NA","NA"],
    [9231,"9231","Carrier L","2024","Outpatient Med-Surg","Codes with the highest total number of prior authorization requests during the previous plan year","CPT","58558","Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D and C","26","1",null,"0.2","2.48",null,"1","25",null,"NA","NA"],
    [9232,"9232","Carrier L","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","52356","Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, Gibbons or double-J type)","31","1",null,"0.15","1.15",null,"4","27",null,"NA","NA"],
    [9233,"9233","Carrier L","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","58558","Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D and C","26","1",null,"0.2","2.48",null,"1","25",null,"NA","NA"],
    [9234,"9234","Carrier L","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","49650","Laparoscopy, surgical; repair initial inguinal hernia","22","1",null,null,"1.46",null,null,"22",null,"NA","NA"],
    [9235,"9235","Carrier L","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","34675","Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated","20","1",null,null,"19.67",null,null,"20",null,"NA","NA"],
    [9236,"9236","Carrier L","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","52332","Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type)","16","1",null,"0.1","3.62",null,"2","14",null,"NA","NA"],
    [9237,"9237","Carrier L","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81229","Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic hybridization (CGH) microarray analysis","13","1",null,null,"4.95",null,null,"13",null,"NA","NA"],
    [9238,"9238","Carrier L","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","36471","Injection of sclerosant; multiple incompetent veins (other than telangiectasia), same leg","12","1",null,null,"19.18",null,null,"12",null,"NA","NA"],
    [9239,"9239","Carrier L","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81162","BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis","12","1",null,null,"10.02",null,null,"12",null,"NA","NA"],
    [9240,"9240","Carrier L","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","64721","Neuroplasty and/or transposition; median nerve at carpal tunnel","11","1",null,"2.4","0.16",null,"1","10",null,"NA","NA"],
    [9241,"9241","Carrier L","2024","Outpatient Med-Surg","Codes with the highest percentage of approved prior authorization requests during the previous plan year","CPT","81416","Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings)","11","1",null,null,"0.47",null,null,"11",null,"NA","NA"],
    [9242,"9242","Carrier L","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A4239","Supply allowance for nonadjunctive, nonimplanted continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service","17","0.5294",null,null,"22.82",null,"0","17",null,"NA","NA"],
    [9243,"9243","Carrier L","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2103","Nonadjunctive, nonimplanted continuous glucose monitor (CGM) or receiver","11","0.4545",null,null,"13.15",null,"0","11",null,"NA","NA"],
    [9244,"9244","Carrier L","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2402","Negative pressure wound therapy electrical pump, stationary or portable","6","0.6667",null,"20.2","22.12",null,"1","5",null,"NA","NA"],
    [9245,"9245","Carrier L","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","S1040","Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s)","5","1",null,null,"37.98",null,"0","5",null,"NA","NA"],
    [9246,"9246","Carrier L","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E1028","Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","4","0",null,null,"47.55",null,"0","4",null,"NA","NA"],
    [9247,"9247","Carrier L","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E2510","Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","4","1",null,null,"5.08",null,"0","4",null,"NA","NA"],
    [9248,"9248","Carrier L","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A6550","Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","3","1",null,null,"9.97",null,"0","3",null,"NA","NA"],
    [9249,"9249","Carrier L","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9276","Sensor; invasive (e.g., subcutaneous), disposable, for use with nondurable medical equipment interstitial continuous glucose monitoring system (CGM), one unit = 1 day supply","2","0",null,null,"62.85",null,"0","2",null,"NA","NA"],
    [9250,"9250","Carrier L","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","A9277","Transmitter; external, for use with nondurable medical equipment interstitial continuous glucose monitoring system (CGM)","2","0",null,null,"62.85",null,"0","2",null,"NA","NA"],
    [9251,"9251","Carrier L","2024","DME","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0486","Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","2","0.5",null,null,"20.4",null,"0","2",null,"NA","NA"],
    [9252,"9252","Carrier L","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","S1040","Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s)","5","1",null,null,"37.98",null,"0","5",null,"NA","NA"],
    [9253,"9253","Carrier L","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2510","Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","4","1",null,null,"5.08",null,"0","4",null,"NA","NA"],
    [9254,"9254","Carrier L","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A6550","Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","3","1",null,null,"9.97",null,"0","3",null,"NA","NA"],
    [9255,"9255","Carrier L","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0760","Osteogenesis stimulator, low intensity ultrasound, non-invasive","2","1",null,null,"14.85",null,"0","2",null,"NA","NA"],
    [9256,"9256","Carrier L","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E1399","Durable medical equipment, miscellaneous","2","1",null,null,"25.4",null,"0","2",null,"NA","NA"],
    [9257,"9257","Carrier L","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2512","Accessory for speech generating device, mounting system","2","1",null,null,"5.9",null,"0","2",null,"NA","NA"],
    [9258,"9258","Carrier L","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E2599","Accessory for speech generating device, not otherwise classified","2","1",null,null,"5.9",null,"0","2",null,"NA","NA"],
    [9259,"9259","Carrier L","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A4238","Supply allowance for adjunctive, nonimplanted continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service","1","1",null,null,"61",null,"0","1",null,"NA","NA"],
    [9260,"9260","Carrier L","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","A7000","Canister, disposable, used with suction pump, each","1","1",null,null,"7.3",null,"0","1",null,"NA","NA"],
    [9261,"9261","Carrier L","2024","DME","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0471","Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","1","1",null,null,"14.8",null,"0","1",null,"NA","NA"],
    [9262,"9262","Carrier L","2024","Diabetes Supplies and Equip","Codes with the highest total number of prior authorization requests during the previous plan year","HCPC","E0784","External ambulatory infusion pump, insulin","14","1",null,null,"12.16",null,"0","1",null,"NA","NA"],
    [9263,"9263","Carrier L","2024","Diabetes Supplies and Equip","Codes with the highest percentage of approved prior authorization requests during the previous plan year","HCPC","E0784","External ambulatory infusion pump, insulin","14","1",null,null,"12.16",null,"0","1",null,"NA","NA"],
    [9264,"9264","Carrier K","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","431","0.77",null,"13","45","0","53","378","0","SEMAGLUTIDE (WEIGHT MNGMT) SOLN AUTO-INJECTOR 0.25 MG/0.5ML","WEGOVY"],
    [9265,"9265","Carrier K","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","430","0.65",null,"19","39","0","50","380","0","TIRZEPATIDE (WEIGHT MNGMT) SOLN AUTO-INJECTOR 2.5 MG/0.5ML","ZEPBOUND"],
    [9266,"9266","Carrier K","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","172","0.44",null,"14","44","0","33","139","0","SEMAGLUTIDE SOLN PEN-INJ 0.25 OR 0.5 MG/DOSE (2 MG/3ML)","OZEMPIC"],
    [9267,"9267","Carrier K","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","153","0.59",null,"13","62","0","42","111","0","RIMEGEPANT SULFATE TAB DISINT 75 MG","NURTEC"],
    [9268,"9268","Carrier K","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","121","0.74",null,"32","59","0","19","102","0","SEMAGLUTIDE (WEIGHT MNGMT) SOLN AUTO-INJECTOR 0.5 MG/0.5ML","WEGOVY"],
    [9269,"9269","Carrier K","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","115","0.88",null,"0","39","0","9","106","0","SEMAGLUTIDE (WEIGHT MNGMT) SOLN AUTO-INJECTOR 2.4 MG/0.75ML","WEGOVY"],
    [9270,"9270","Carrier K","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","91","0.71",null,"11","42","0","12","79","0","SEMAGLUTIDE (WEIGHT MNGMT) SOLN AUTO-INJECTOR 1 MG/0.5ML","WEGOVY"],
    [9271,"9271","Carrier K","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","86","0.28",null,"12","56","0","16","70","0","TIRZEPATIDE SOLN PEN-INJECTOR 2.5 MG/0.5ML","MOUNJARO"],
    [9272,"9272","Carrier K","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","77","0.74",null,"1","20","0","17","60","0","*CONTINUOUS GLUCOSE SYSTEM SENSOR***","DEXCOM G7 SENSOR"],
    [9273,"9273","Carrier K","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","69","0.75",null,"15","21","0","9","60","0","RUXOLITINIB PHOSPHATE CREAM 1.5%","OPZELURA"],
    [9274,"9274","Carrier K","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","14","1",null,"1","2","0","9","5","0","OFATUMUMAB SOLN AUTO-INJECTOR 20 MG/0.4ML","KESIMPTA"],
    [9275,"9275","Carrier K","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","12","1",null,"0","11","0","0","12","0","*INSULIN INFUSION DISPOSABLE PUMP RESERVOIR***","OMNIPOD 5 DEXCOM G7G6 PODS (GEN 5)"],
    [9276,"9276","Carrier K","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,"2","10","0","3","5","0","OMALIZUMAB SUBCUTANEOUS SOLN PREFILLED SYRINGE 150 MG/ML","XOLAIR"],
    [9277,"9277","Carrier K","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,"0","0","0","4","4","0","BELIMUMAB SUBCUTANEOUS SOLUTION AUTO-INJECTOR 200 MG/ML","BENLYSTA"],
    [9278,"9278","Carrier K","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,"0","18","0","3","5","0","RELUGOLIX-ESTRADIOL-NORETHINDRONE ACETATE TAB 40-1-0.5 MG","MYFEMBREE"],
    [9279,"9279","Carrier K","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,"0","13","0","0","8","0","DROSPIRENONE TAB 4 MG","SLYND"],
    [9280,"9280","Carrier K","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,"0","1","0","2","5","0","METHYLPHENIDATE HCL CAP DELAYED ER 24HR 40 MG (PM)","JORNAY PM"],
    [9281,"9281","Carrier K","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,"0","0","0","2","5","0","METHYLPHENIDATE HCL CAP DELAYED ER 24HR 20 MG (PM)","JORNAY PM"],
    [9282,"9282","Carrier K","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,"0","0","0","3","4","0","TOFACITINIB CITRATE TAB ER 24HR 11 MG (BASE EQUIVALENT)","XELJANZ XR"],
    [9283,"9283","Carrier K","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","7","1",null,"1","0","0","7","0","0","LEUPROLIDE ACETATE INJ KIT 1 MG/0.2ML (5 MG/ML)","LEUPROLIDE ACETATE"],
    [9284,"9284","Carrier K","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","51",null,"0.16","43.44","67.68",null,"8","43",null,"n/a","WEGOVY"],
    [9285,"9285","Carrier K","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","20",null,"0.06","21.84","82.56",null,"1","19",null,"n/a","ZEPBOUND"],
    [9286,"9286","Carrier K","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","13",null,"0.12","45.6","107.9",null,"3","10",null,"n/a","DUPIXENT"],
    [9287,"9287","Carrier K","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","15",null,"0.07","0","134.64",null,"0","15",null,"n/a","OZEMPIC"],
    [9288,"9288","Carrier K","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","12",null,"0.1","27.36","136.8",null,"3","9",null,"n/a","SKYRIZI PEN"],
    [9289,"9289","Carrier K","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","12",null,"0.11","44.4","38.16",null,"11","1",null,"n/a","STELARA"],
    [9290,"9290","Carrier K","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","10",null,"0.11","36.48","182.88",null,"5","5",null,"n/a","HUMIRA PEN"],
    [9291,"9291","Carrier K","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","9",null,"0.04","0","137.52",null,"0","9",null,"n/a","MOUNJARO"],
    [9292,"9292","Carrier K","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","8",null,"0.07","82.56","96.96",null,"1","7",null,"n/a","NURTEC"],
    [9293,"9293","Carrier K","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","7",null,"0.03","40.56","268.8",null,"4","3",null,"n/a","REPATHA SURECLICK"],
    [9294,"9294","Carrier L","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","406","0.12",null,"36","62","0","15","391","0","SEMAGLUTIDE (WEIGHT MNGMT) SOLN AUTO-INJECTOR 0.25 MG/0.5ML","WEGOVY"],
    [9295,"9295","Carrier L","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","351","0.49",null,"14","64","0","52","299","0","SEMAGLUTIDE SOLN PEN-INJ 0.25 OR 0.5 MG/DOSE (2 MG/3ML)","OZEMPIC"],
    [9296,"9296","Carrier L","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","266","0.1",null,"6","41","0","6","260","0","TIRZEPATIDE (WEIGHT MNGMT) SOLN AUTO-INJECTOR 2.5 MG/0.5ML","ZEPBOUND"],
    [9297,"9297","Carrier L","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","168","0.32",null,"23","50","0","16","152","0","TIRZEPATIDE SOLN PEN-INJECTOR 2.5 MG/0.5ML","MOUNJARO"],
    [9298,"9298","Carrier L","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","128","0.64",null,"7","68","0","30","98","0","RIMEGEPANT SULFATE TAB DISINT 75 MG","NURTEC"],
    [9299,"9299","Carrier L","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","115","0.76",null,"16","53","0","34","81","0","SEMAGLUTIDE SOLN PEN-INJ 1 MG/DOSE (4 MG/3ML)","OZEMPIC"],
    [9300,"9300","Carrier L","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","100","0.58",null,"3","44","0","24","76","0","*CONTINUOUS GLUCOSE SYSTEM SENSOR***","DEXCOM G7 SENSOR"],
    [9301,"9301","Carrier L","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","77","0.75",null,"5","56","0","12","65","0","SEMAGLUTIDE SOLN PEN-INJ 2 MG/DOSE (8 MG/3ML)","OZEMPIC"],
    [9302,"9302","Carrier L","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","76","0.86",null,"24","21","0","17","59","0","ADALIMUMAB PEN-INJECTOR KIT 40 MG/0.4ML","HUMIRA PEN"],
    [9303,"9303","Carrier L","2024","Prescription Drugs","Codes with the highest total number of prior authorization requests during the previous plan year","GPI10","NA","NA","76","0.72",null,"7","28","0","9","67","0","RISANKIZUMAB-RZAA SOLN AUTO-INJECTOR 150 MG/ML","SKYRIZI PEN"],
    [9304,"9304","Carrier L","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","36","1",null,"1","5","0","12","24","0","ADALIMUMAB AUTO-INJECTOR KIT 40 MG/0.4ML","HUMIRA PEN"],
    [9305,"9305","Carrier L","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","16","1",null,"0","0","0","1","15","0","LUBIPROSTONE CAP 24 MCG","LUBIPROSTONE"],
    [9306,"9306","Carrier L","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","13","1",null,"0","1","0","6","7","0","DEXTROMETHORPHAN HBR-BUPROPION HCL TAB ER 45-105 MG","AUVELITY"],
    [9307,"9307","Carrier L","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","10","1",null,"0","1","0","2","8","0","TOFACITINIB CITRATE TAB ER 24HR 11 MG (BASE EQUIVALENT)","XELJANZ XR"],
    [9308,"9308","Carrier L","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,"0","0","0","2","6","0","CALCIUM, MAG, POTASSIUM, & SOD OXYBATES ORAL SOLN 500 MG/ML","XYWAV"],
    [9309,"9309","Carrier L","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,"6","13","0","5","3","0","MORPHINE SULFATE TAB ER 15 MG","MORPHINE SULFATE ER"],
    [9310,"9310","Carrier L","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,"0","1","0","1","7","0","DULAGLUTIDE SOLN PEN-INJECTOR 4.5 MG/0.5ML","TRULICITY"],
    [9311,"9311","Carrier L","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","8","1",null,"1","0","0","4","4","0","SUVOREXANT TAB 10 MG","BELSOMRA"],
    [9312,"9312","Carrier L","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","6","1",null,"1","1","0","1","5","0","DULAGLUTIDE SOLN PEN-INJECTOR 3 MG/0.5ML","TRULICITY"],
    [9313,"9313","Carrier L","2024","Prescription Drugs","Codes with the highest percentage of approved prior authorization requests during the previous plan year","GPI10","NA","NA","6","1",null,"0","0","0","0","6","0","UPADACITINIB TAB ER 24HR 30 MG","RINVOQ"],
    [9314,"9314","Carrier L","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","69",null,"0.02","29.76","64.8",null,"5","64",null,"n/a","WEGOVY"],
    [9315,"9315","Carrier L","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","17",null,"0.1","47.04","125.28",null,"3","14",null,"n/a","OZEMPIC"],
    [9316,"9316","Carrier L","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","16",null,"0.11","42.96","97.44",null,"6","10",null,"n/a","SKYRIZI PEN"],
    [9317,"9317","Carrier L","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","15",null,"0","29.76","62.4",null,"2","13",null,"n/a","ZEPBOUND"],
    [9318,"9318","Carrier L","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","13",null,"0.05","37.92","179.28",null,"1","12",null,"n/a","MOUNJARO"],
    [9319,"9319","Carrier L","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","13",null,"0.12","43.92","167.76",null,"7","6",null,"n/a","STELARA"],
    [9320,"9320","Carrier L","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","9",null,"0.08","29.28","143.76",null,"3","6",null,"n/a","DUPIXENT"],
    [9321,"9321","Carrier L","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","4",null,"0.04","37.2","131.28",null,"1","3",null,"n/a","Entresto"],
    [9322,"9322","Carrier L","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","4",null,"0.02","38.4","57.36",null,"2","2",null,"n/a","Taltz"],
    [9323,"9323","Carrier L","2024","Prescription Drugs","Codes with the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal","GPI10","NA","NA","4",null,"0.02","48.24","18.24",null,"3","1",null,"n/a","Xolair"]
]}