| 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 |
| Wellcare Hawai'i Medicaid Clinical | Therapeutic Utilization of Inhaled Nitric Oxide | 2025-04-01 |
| Wellcare Hawai'i Medicaid Clinical | Transcranial Magnetic Stimulation for Treatment | 2025-04-01 |
| Wellcare Hawai'i Medicare Clinical | Skin Substitutes for Chronic Wounds of the Lower | 2025-04-01 |
| Wellcare Illinois Medicare Clinical | Skin Substitutes for Chronic Wounds of the Lower | 2025-04-01 |
| Wellcare Mississippi Medicare Clinical | Skin Substitutes for Chronic Wounds of the Lower | 2025-04-01 |