| Medical authorizations | 255 |
| Behavioral health authorizations | 1 |
| Total denied | 34 |
| Total approved | 222 |
| Approval rate | 87% |
| Reason for denial | Number of authorizations |
| Benefit Exclusion | 9 |
| Failure to obtain prior authorization | 2 |
| Not medically necessary to use out-of-network | 4 |
| Not medically necessary | 17 |
| Inpatient level of care not necessary | 2 |
| Total denied | 34 |
| Pharmacy authorizations | |
| Approved | 58 |
| Denied | 53 |
| Approval rate | 53% |
| Pharmacy reason for denial | |
| Criteria not met | 14 |
| Formulary alternatives available | 5 |
| Not covered | 22 |
| Plan exclusion | 11 |
| Total denied | 53 |
| Appeals | Total | Overturned |
| Medical | 0 | 0 |
| Pharmacy | 1 | 0 |
| Total | 1 | 0 |
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