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Dates of service in dispute: 10 22 2003 - 08 25 2004 MCMC llc MCMC ; is an Independent Review Organization IRO ; that was selected by The Texas Workers' Compensation Commission to render a recommendation regarding the medical necessity of the above Requested Service. Please be advised that a MCMC Physician Advisor has determined that your request for M5 Retrospective Medical Dispute Resolution on 11 22 2004, concerning the medical necessity of the above referenced requested service, hereby finds the following: Each medication will be addressed separately. Please note, there were no Attending Physician AP ; notes to refer to. The only clinical information provided is a chart review done 03 31 2003. It is quite comprehensive and indicates current medications, prior therapy, and prior medications: 1. 2. 3. Darisoprodol soma ; is not medically necessary nor supported by the clinicals provided. Hydrocodone is not medically necessary. Tramadol ulracet ; is not medically necessary nor supported by the clinicals provided. Augmentin XR is not medically necessary nor related. Methocarbamol robaxin ; is not medically necessary nor supported by the clinicals provided. Axert is not medically necessary nor supported by the clinicals. Mobic an NSAID ; is not medically necessary nor supported by the clinicals provided. Lidoderm patch is not medically necessary nor supported by the clinicals and celebrex. 5 Merger of Glaxo Wellcome and SmithKline Beecham The combination of Glaxo Wellcome plc and SmithKline Beecham plc was treated as a merger at 27th December 2000 under UK GAAP. Under the merger relief provisions of the Companies Act 1985, the shares issued by GlaxoSmithKline plc to acquire Glaxo Wellcome and SmithKline Beecham were accounted for at par and no share premium arose; the shares acquired by GlaxoSmithKline in Glaxo Wellcome and SmithKline Beecham were similarly accounted for at the nominal value of the shares issued. In the consolidated Financial statements of GlaxoSmithKline, the results and net assets of Glaxo Wellcome and SmithKline Beecham were combined at their book amounts, subject to alignment adjustments. 6 Segment information An analysis of turnover, profit before taxation, total assets and net assets by business and geographical sector, tangible fixed assets by geographical sector and turnover by location of customer are set out below. The business sectors consist of Pharmaceuticals prescription pharmaceuticals and vaccines ; and Consumer Healthcare oral care, OTC medicines and nutritional healthcare ; . Assets by business sector in 2003 have been adjusted to ensure consistency with 2004. The geographical sectors reflect the Group's most significant regional markets and are consistent with the Group's regional market management reporting structure. Business sector data includes an allocation of corporate costs to each sector. There are no sales between business sectors. The Group's activities are organised on a global basis. The geographical sector figures are therefore influenced by the location of the Group's operating resources, in particular manufacturing and research, and by variations over time in intra-Group trading and funding arrangements. Where the Group co-promotes a product and the third party records the sale, the Group records its share of revenue as co-promotion income within turnover. The nature of co-promotion activities is such that the Group records no costs of sales. Pharmaceutical turnover includes co-promotion income of 65 million 2003 35 million, 2002 nil. The muscle relaxants baclofen and tizanidine may also be effective and are not habituating, whereas the muscle relaxant carisoprodol can be habituating and celexa. 10, 11 after oral administration of either drug, prolactin levels fall rapidly and gonadal function is usually restored within 3 months.

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Lowered pressure rather thn, n by gravity d .rainu c . The specifi c water-yielding capacity is called the "coefficient cf storage" an d is generally much smaller than the porosity of the material composin g the aquifer . If the pore spoceo are large : nd interconnected, ns they commonl y ore in sand and. gravel, the water is transmitted more or less freely , and the rock is said to be permeable, but if the pore maces ar o very small, as they arc in clay, the water is transmitted very slowl y or not at oil and the rock is said to be imp ormea.ble . There are, then, two fundamental physical properties of an aauifo r that largely control the movement of water through it, the "specifi c yield" or "coefficient of storage" and the "permeability ." Th e "specific yield" water table conditions ; is defined as the amoun t of water in cubic feet, that and clonidine. However, it is being increasingly recognized that: i ; significant number of patients with adequate plasma levels do not respond to psychoactive drugs; and ii ; patients with acceptable plasma levels of drugs exhibit toxic side effects due to the drug.

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