Exhibit 1

110.1 – Exhibit 1 (Rev. 45, 05-28-04) Medicare Program - Intermediary Part A and Part B Appeals Report - Form CMS-2591, Screen 1. INTERMEDIARY APPEALS REPORT INTERMEDIARY ID REPORTING PERIOD PART A RECONSIDERATIONS PART B A. INTERMEDIARY APPEAL REQUESTS TOT AL (1) SNF (2) HHA/ HOSPIC E (3) OTHE R (4) REVIE WS (5) HEARIN GS (6) 1. OPENING PENDING 2. ADJUSTMENTS TO PENDING 3. ADJUSTED PENDING 4. REQUESTS RECEIVED 4A. MED. NEC. DOC. DENIALS 5. REQUESTS TRANSFERRED 6. REQUESTS CLEARED 7. NO. OF CLAIMS INVOLVED 8. AMOUNT IN CONTROVERSY 9. AFFIRMATIONS 10. DISMISSAL/WITHDRAWALS 11. REVERSALS (FULL OR PART) 12. AMOUNT AWARDED Form CMS-2591 Screen 1