| Wellcare Hawai'i Medicaid Clinical | Multiple Sleep Latency Testing | 2025-04-01 |
| Wellcare Hawai'i Medicaid Clinical | Sacroiliac Joint Fusion | 2025-04-01 |
| Wellcare Hawai'i Medicaid Clinical | Bariatric Surgery | 2025-04-01 |
| Wellcare Hawai'i Medicaid Clinical | Disc Decompression Procedures | 2025-04-01 |
| Wellcare Hawai'i Medicaid Clinical | Discography | 2025-04-01 |
| Wellcare Hawai'i Medicaid Clinical | Heart-Lung Transplant | 2025-04-01 |
| Wellcare Hawai'i Medicaid Clinical | Liposuction for Lipedema | 2025-04-01 |
| Wellcare Hawai'i Medicaid Clinical | Lysis of Epidural Lesions | 2025-04-01 |
| Wellcare Hawai'i Medicaid Clinical | Pediatric Oral Function Therapy | 2025-04-01 |
| Wellcare Hawai'i Medicaid Clinical | Repair of Nasal Valve Compromise | 2025-04-01 |