Interactive · 2021-2025 · California
Explore the dataset
Pick a condition and a treatment. Where the dataset holds at least 30 decisions in the most recent five complete years you get a rate; below that you get the count and a plain statement that no rate is claimed. Of the 154 broad pairs the dataset has seen at all, 54 clear the threshold.
Condition
24Treatment
28Pick one from each column. Most pairs people ask about are below the 30-decision threshold at which this dataset will claim a rate — that is the answer, not a gap in the tool.
The threshold is the product, not a limitation of it
why the answer is often 'no rate'External review is the end of a long funnel: fewer than 1% of denials are appealed internally at all, and only a fraction of those go external. So the dataset is thick where a lot of people fought the same fight and thin everywhere else. A rate computed on eight decisions would move by twelve points if one had gone the other way — which is why this publishes a precedent count instead, and says so.
Classes with enough decisions to be reliable
the thick endTreatments
- Weight Control87.0%n=1,434
- RTC79.4%n=1,153
- Viscosupp Injection97.7%n=529
- Biologics81.4%n=392
- Genetic/Genomic Test53.0%n=313
- MRI52.2%n=291
Conditions
- Obesity87.6%n=1,287
- Osteoarthritis83.5%n=503
- Depression74.6%n=492
- Back Pain40.6%n=443
- Diabetes74.2%n=407
- Substance Use Disorder82.4%n=369
Every figure here is conditional on a denial having reached external review, and describes California only. Who this does not cover. Free help, first: the DMHC Help Center files your Independent Medical Review at no cost — 1-888-466-2219.