| Paramount Healthcare | Bio-Engineered Skin and Soft Tissue Substitutes
(Excluding Skin Substitute Grafts for Diabetic
Foot Ulcers and Venous Leg Ulcers) | 2025-06-01 |
| Paramount Healthcare | Neuromuscular, Functional, &
Therapeutic Electrical Stimulation Therapy | 2025-06-01 |
| Paramount Healthcare | Stem Cell Therapy for Orthopedic Applications | 2025-06-01 |
| Paramount Healthcare | Manipulation Under Anesthesia | 2025-06-01 |
| Paramount Healthcare | Myoelectric Upper Extremity Prosthetic Devices | 2025-06-01 |
| Paramount Healthcare | Genetic Testing for Epilepsy | 2025-06-01 |
| Paramount Healthcare | Lutathera (Lutetium Lu 177 Dotatate) | 2025-06-01 |
| Paramount Healthcare | Skin Substitute Grafts/Cellular and/or
Tissue-Based Products for the
Treatment of Diabetic Foot Ulcers
and Venous Leg Ulcers | 2025-06-01 |
| BCBS Louisiana | Auto-injectable Methotrexate (Otrexup™) | 2025-06-01 |
| BCBS Louisiana | Intravitreal and Suprachoroidal Corticosteroid Products | 2025-06-01 |