
Case Studies
PRIUM's focus is to ensure only medically appropriate drugs are being used for the injured worker's care. Our case studies illustrate the type of savings that can be realized for our clients through PRIUM's Physican Pharmaceutical Review (PPR) Program.
Florida Claim with Over $32k in Actual Savings
The patient is a 64-year-old female who has a long history of chronic low back pain with a date of industrial injury on 08/15/92. According to her treating physician there are multiple nonrelated medical issues for which he is treating her. As late as 2009 her pain rating remained at 8-9 out of 10... Download
Texas Claim with Over $23k in Actual Savings
The patient is a 74-year-old female who has a long history of chronic pain in the neck and low
back with a date of industrial injury on 03/29/94. As of May 2005 the patient had three
previous lumbar surgeries and three previous spine surgeries including lumbar fusion. There
have been longstanding questions about compensability due to generalized upper and lower
back pain and the diagnosis of fibromyalgia...
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New York Claim with Over $12K in Actual Savings
The patient is a 37-year-old female who has a long history of chronic low back pain with a date of industrial injury on 05/09/05. According to an MRI study, there was mention that the patient had a previous microdiscectomy surgery and that the patient had persistent low back pain from an old lifting injury... Download
California Claim with Over $39K in Actual Savings
The patient is a 46-year-old male who suffered an injury on 09/30/98. He has had six surgeries (ventral hernia surgery in October 1998, right shoulder surgery in 2000, right hand carpal tunnel surgery in 2001, right elbow ulnar release in 2001, left hand carpal tunnel surgery in 2003, left shoulder surgery in 2004, and left forearm radial nerve release) with additional surgeries possible... Download
Florida Claim with Over $2,300 in Actual Monthly Savings
The patient is a 45-year-old female who has a long history of chronic neck and low back pain
with a date of industrial injury on 10/20/00. In November 2008 her listed diagnoses included
lumbar laminectomy on 05/01/01, cervicalgia with C5-6 radiculopathy with multilevel cervical
herniated nucleus pulpous, right median neuropathy, right lower extremity paresthesia, and
depression that was stable...
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Texas Claim with Over $31k in Actual Savings
The patient is a 54-year-old male who has a long history of chronic low back pain with a date
of industrial injury on 06/08/01. In progress notes the patient’s treating physician has noted
failed back surgery syndrome but no detailed objective physical exam findings or functional
improvement from the long-term prescription medication management. Office visits, where
refills were provided, have been regularly scheduled every four weeks...
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New York Claim with Over $11K in Actual Savings
The patient is a 56-year-old male who has a long history of chronic neck pain with a date of industrial injury on 02/19/02. The patient developed neck and right shoulder pain with radiation to the right thumb. The patient’s symptoms were initially thought to be from the rotator cuff tear and he underwent surgery in October 2003 which involved an open repair that did help to decrease his shoulder pain, but did not help improve the neck pain or the arm pain/hand numbness... Download
California Claim with Over $17K in Actual Savings
The patient is a 37-year-old male who suffered an injury on 07/18/00, suffering from low back pain with sciatica to the bilateral lower extremities. The patient has continually declined the implantation of intrathecal pain pump and spinal cord stimulator. Within the past couple of years the treating physician had increased the dosage of Oxycontin without any corresponding increase in pain control... Download