1. In the insurance industry, state association that conducts utilization reviews for property and casualty insurers. 2. In health care, entity that has established one or more utilization review programs, which evaluates the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities.

Information that is aggregated by the capitated managed care entity (e.g., the number of primary care visits provided by the plan during the calendar year).