| Sentara Health Plans | Doula Services, OB 13 - Medicaid | 2025-12-01 |
| Sentara Health Plans | Cervical Laminectomy, Surgical 122 - Commercial | 2025-12-01 |
| Sentara Health Plans | Cervical Laminectomy, Surgical 122 - Medicaid | 2025-12-01 |
| Sentara Health Plans | Cervical Laminectomy, Surgical 122 - Medicare | 2025-12-01 |
| Sentara Health Plans | Lumbar Discectomy, Surgical 120 - Commercial | 2025-12-01 |
| Sentara Health Plans | Lumbar Discectomy, Surgical 120 - Medicaid | 2025-12-01 |
| Sentara Health Plans | Lumbar Discectomy, Surgical 120 - Medicare | 2025-12-01 |
| Sentara Health Plans | Lumbar Fusion, Surgical 118 - Commercial | 2025-12-01 |
| Sentara Health Plans | Lumbar Fusion, Surgical 118 - Medicaid | 2025-12-01 |
| Sentara Health Plans | Lumbar Laminectomy, Surgical 121 - Commercial | 2025-12-01 |