| Wellcare Hawai'i Medicaid Clinical | Circulating Tumor DNA and Circulating Tumor Cells (Liquid Biopsy): V1.2025 | 2024-11-01 |
| Wellcare Hawai'i Medicaid Clinical | Cytogenetic Testing: V1.2025 | 2024-11-01 |
| Wellcare Hawai'i Medicaid Clinical | Concert Genetic Testing Oncology: Molecular Analysis of Solid Tumors and | 2024-11-01 |
| Wellcare Hawai'i Medicaid Clinical | Implantable Intrathecal or Epidural Pain Pump | 2024-11-01 |
| Wellcare Hawai'i Medicaid Clinical | Implantable Loop Recorder | 2024-11-01 |
| Wellcare Hawai'i Medicaid Clinical | Outpatient Oxygen Use | 2024-11-01 |
| Wellcare Hawai'i Medicaid Clinical | Selective Dorsal Rhizotomy for Spasticity in Cerebral Palsy | 2024-11-01 |
| Wellcare Hawai'i Medicaid Clinical | Spinal Cord, Peripheral Nerve, and Percutaneous | 2024-11-01 |
| Wellcare Hawai'i Medicaid Clinical | Urinary Incontinence Devices and Treatments | 2024-11-01 |
| Wellcare Hawai'i Medicaid Clinical | Ventricular Assist Devices | 2024-11-01 |