Breakdown of Specific Medications Within Each Category
| Category | Data for Each Category |
|---|---|
| Acetaminophen | Acetaminophen |
| Acetaminophen | Tylenol |
| Antidepressants | Amitriptyline |
| Antidepressants | Buproprion HCL |
| Antidepressants | Celexa |
| Antidepressants | Citalopram |
| Antidepressants | Clomipramine |
| Antidepressants | Doxepin |
| Antidepressants | Duloxetine |
| Antidepressants | Escitalopram |
| Antidepressants | Fluoxetin |
| Antidepressants | Fluvoxamine |
| Antidepressants | Mirtazapine |
| Antidepressants | Nortriptyline |
| Antidepressants | Olanzapine |
| Antidepressants | Paroxetine |
| Antidepressants | Perphenazine-amitriptyline |
| Antidepressants | Prozac |
| Antidepressants | Quetiapine |
| Antidepressants | Remeron |
| Antidepressants | Trazodone |
| Antidepressants | Venlafaxine |
| Antidepressants | Zoloft |
| Behavioral Health | Consult/Referral to Behavioral Health Program |
| Behavioral Health | Consult/Referral to Neuropsychology |
| Behavioral Health | Consult/Referral to Psychiatry |
| Behavioral Health | Consult/Referral to Psychology |
| Behavioral Health | Consult/Referral to Psychology Evaluation |
| BENZOS | Alprazolam |
| BENZOS | Clonazepam |
| BENZOS | Diazepam |
| BENZOS | Klonopin |
| BENZOS | lorazepam |
| BENZOS | Oxazepam |
| BENZOS | Temazepam |
| BENZOS | Triazolam |
| BENZOS | Valium |
| Chiropractic/Osteopathic Manipulation | Consult/Referral to Chiropractic Therapy |
| Chiropractic/Osteopathic Manipulation | Consult/Referral to Osteopathic Manipulative Therapy |
| Chiropractic/Osteopathic Manipulation | Osteopathic Manipulative Tx 1 to 2 Body Regions |
| Chiropractic/Osteopathic Manipulation | Osteopathic Manipulative Tx 3 to 4 Body Regions |
| Chiropractic/Osteopathic Manipulation | Osteopathic Manipulative Tx 5 to 6 Body Regions |
| Chiropractic/Osteopathic Manipulation | Osteopathic Manipulative Tx 7 to 8 Body Regions |
| Coaching/Wellness/Lifestyle | Consult/Referral for Wellness Education |
| Coaching/Wellness/Lifestyle | Consult/Referral to Prescription for Wellness Health Coach |
| Diagnostic Imaging - MR/CT | CT Lumbar spine |
| Diagnostic Imaging - MR/CT | CT Lumbar spine |
| Diagnostic Imaging - MR/CT | MR Lumbar and Thoracic spine |
| Diagnostic Imaging - MR/CT | MR Lumbar spine |
| Diagnostic Imaging - MR/CT | MR Lumbo-sacral spine |
| Diagnostic Imaging - XRAY | Xray Lumbar Spine 2 or 3 views |
| Diagnostic Imaging - XRAY | Xray Lumbar Spine Minimum 4 views |
| Diagnostic Imaging - XRAY | XRay Lumbar Spine Minimum 4 views with Oblique |
| Diagnostic Imaging - XRAY | Xray Lumbar Spine with Flex and Ext. |
| Diagnostic Imaging - XRAY | XRay pelvic complete minimum 3 views |
| Diagnostic Imaging - XRAY | XRay Sacroiliac Joints (G) |
| Diagnostic Imaging - XRAY | XRay Sacroiliac Joints 1 or 2 Views |
| Diagnostic Imaging - XRAY | XRay Sacroiliac Joints 3+ Views |
| Diagnostic Imaging - XRAY | XRay Sacroiliac Joints less than 3 Views |
| Diagnostic Imaging - XRAY | XRay Sacroiliac Joints Minimum 3 Views |
| Diagnostic Imaging - XRAY | XRay Sacrum/Coccyx 2 Views |
| Diagnostic Imaging - XRAY | XRay Sacrum/Coccyx 2+ Views |
| Diagnostic Imaging - XRAY | XRay Sacrum/Coccyx Minimum 2 Views |
| Diagnostic Imaging - XRAY | XRay Spine Lumbar (G) |
| Diagnostic Imaging - XRAY | XRay Spine Lumbar 1 View |
| Diagnostic Imaging - XRAY | XRay Spine Lumbosacral 2 or 3 Views |
| Diagnostic Imaging - XRAY | XRay Spine Lumbosacral 4+ Views |
| Diagnostic Imaging - XRAY | XRay Spine Lumbosacral w/ Bending 6+ Views |
| Diagnostic Imaging - XRAY | XRay Spine Scoliosis Study (G) |
| Diagnostic Imaging - XRAY | XRay Spine Thoracolumbar 2 Views |
| Diagnostic Imaging - XRAY | XRay Spine Thoracolumbar 2+ Views |
| Mind and Body Therapies | Consult/Referral for Acupuncture |
| Mind and Body Therapies | Consult/Referral for Musculoskeletal Health |
| Mind and Body Therapies | Consult/Referral Massage Therapy |
| Mind and Body Therapies | Massage Therapy |
| MUSCLE RELAXANT | Baclofen |
| MUSCLE RELAXANT | Carisoprodol |
| MUSCLE RELAXANT | Chlorzoxazone |
| MUSCLE RELAXANT | Cyclobenzaprine |
| MUSCLE RELAXANT | Flexeril |
| MUSCLE RELAXANT | Metaxalone |
| MUSCLE RELAXANT | Methocarbamol |
| MUSCLE RELAXANT | Orphenadrine |
| MUSCLE RELAXANT | Tizanidine |
| Neurology | Consult/Referral to Neurology |
| NSAIDS | Celecoxib |
| NSAIDS | Diclofenac |
| NSAIDS | Diclofenac-epolamine |
| NSAIDS | Diflunisal |
| NSAIDS | Etodolac |
| NSAIDS | Flurbiprofen |
| NSAIDS | Ibuprofen |
| NSAIDS | Ibuprofen-famotidine |
| NSAIDS | Indomethacin |
| NSAIDS | Ketorolac |
| NSAIDS | Meloxicam |
| NSAIDS | Motrin |
| NSAIDS | Nabumetone |
| NSAIDS | Naprosyn |
| NSAIDS | Naproxen |
| NSAIDS | Oxaprozin |
| NSAIDS | Piroxicam |
| NSAIDS | Sulindac |
| NSAIDS | Toradol |
| NSAIDS-topical | Diclofenac cream |
| NSAIDS-topical | Voltaren cream |
| Opioids | Acetaminophen-codeine |
| Opioids | Butabital-acetaminophen-caffeine-codeine |
| Opioids | Fentanyl |
| Opioids | Hydrocodone |
| Opioids | Hydrocodone-acetaminophen |
| Opioids | Hydromorphone |
| Opioids | Methadone |
| Opioids | Morphine |
| Opioids | Morphone |
| Opioids | Oxycodone |
| Opioids | Oxycodone-acetaminophen |
| Opioids | Oxymorphone |
| Opioids | Tramadol |
| Opioids | Tramadol HCL |
| Opioids | Tramadol-acetaminophen |
| Opioids | Vicodine |
| Pain Management | Consult/Referral for Peti-Chronic Pain Treatment |
| Pain Management | Consult/Referral to Pain Clinic |
| Pain Management | Consult/Referral to Pain Management |
| Pain Management | Consult/Referral to Physical Medicine and Rehabilitation |
| Pain Management | Consult/Referral to Sports Medicine |
| Physical Therapy/Rehabilitation | Consult/Referral to Aqua Therapy |
| Physical Therapy/Rehabilitation | Consult/Referral to Flexibility Exercise |
| Physical Therapy/Rehabilitation | Consult/Referral to Physical Therapy |
| Physical Therapy/Rehabilitation | Physical Therapy (PT) Evaluation and Treatment |
| Physical Therapy/Rehabilitation | Physical Therapy (PT) Outpatient Evaluation and Treatment |
| Psychologically Informed Physical Therapy | Consult/Referral to Psychologically Informed Physical Therapy (Stratified approach for LBP) |
| Social Work | Consult/Referral to Social Work |
| Social Work | Consult/Referral to Social Work/Case Management |
| Spine Surgery | Consult/Referral to Neurosurgery |
| Spine Surgery | Consult/Referral to Neurosurgery spine |
| Spine Surgery | Consult/Referral to Orthopedics |
| Spine Surgery | Consult/Referral to Orthopedics-spine |
| Steroids | Dexamethasone |
| Steroids | Dexamethasone - injection |
| Steroids | Hydrocortisone |
| Steroids | Medrol |
| Steroids | Methylprednisolone |
| Steroids | Methylprednisolone acetate - injection |
| Steroids | Methylprednisolone sodium succinate - injection |
| Steroids | Prednisone |
Abbreviations: NSAID, non-steroidal anti-inflammatory drugs; MRI, magnetic resonance imaging; CT, computed tomography.