Independent Medical Review (IMR) Determinations, Trend
- catalog.data.gov
- data.ca.gov
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Updated Oct 23, 2025
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EmailClick to copy linkLink copiedCiteCalifornia Department of Managed Health Care (2025). Independent Medical Review (IMR) Determinations, Trend [Dataset]. https://catalog.data.gov/dataset/independent-medical-review-imr-determinations-trend-a56a0Dataset updatedOct 23, 2025Dataset provided byCalifornia Department of Managed Health CareDescriptionThis data is from the California Department of Managed Health Care (DMHC). It contains all decisions from Independent Medical Reviews (IMR) administered by the DMHC since January 1, 2001. An IMR is an independent review of a denied, delayed, or modified health care service that the health plan has determined to be not medically necessary, experimental/investigational or non-emergent/urgent. If the IMR is decided in an enrollees favor, the health plan must authorize the service or treatment requested.
California Independent Medical Review Dataset
- kaggle.com
zipUpdated Nov 20, 2023ShareFacebookTwitterEmailClick to copy linkLink copiedCitePrasad Patil (2023). California Independent Medical Review Dataset [Dataset]. https://www.kaggle.com/datasets/prasad22/ca-independent-medical-review/codezip(6200045 bytes)Available download formatsDataset updatedNov 20, 2023AuthorsPrasad PatilLicensehttps://creativecommons.org/publicdomain/zero/1.0/https://creativecommons.org/publicdomain/zero/1.0/
Area coveredCaliforniaDescriptionThis data is from the California Department of Managed Health Care (DMHC). It contains all decisions from Independent Medical Reviews (IMR) administered by the DMHC since January 1, 2001. An IMR is an independent review of a denied, delayed, or modified health care service that the health plan has determined to be not medically necessary, experimental/investigational or non-emergent/urgent. If the IMR is decided in an enrollee's favor, the health plan must authorize the service or treatment requested.
Data Description
Field Name Description Data type Reference ID Unique identifier for the case Plain Text Report Year Year the case was reported Number Diagnosis Category The main diagnosis category Plain Text Diagnosis Sub Category The secondary diagnosis category Plain Text Treatment Category The main treatment category Plain Text Treatment Sub Category The secondary treatment category Plain Text Determination Indicates if the determination was upheld or overturned Plain Text Type Indicates the type of case (Experimental/Investigational, Urgent Care, Medical Necessity) Plain Text Age Range The age of the patient Number Patient Gender The gender of the patient Plain Text Findings A summary of the case findings Plain Text 
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FacebookTwitterEmailThis data is from the California Department of Managed Health Care (DMHC). It contains all decisions from Independent Medical Reviews (IMR) administered by the DMHC since January 1, 2001. An IMR is an independent review of a denied, delayed, or modified health care service that the health plan has determined to be not medically necessary, experimental/investigational or non-emergent/urgent. If the IMR is decided in an enrollees favor, the health plan must authorize the service or treatment requested.