| Ambetter Health Texas Superior Medicaid Clinical | Bilateral Procedures (CC.PP.037) | 2023-02-01 |
| Ambetter Health Texas Superior Medicaid Clinical | New Patient (CC.PP.036) | 2023-02-01 |
| Ambetter Health Texas Superior Marketplace Clinical | Bilateral Procedures (CC.PP.037) | 2023-02-01 |
| Ambetter Health Texas Wellcare Allwell Medicare Clinical | Bilateral Procedures (CC.PP.037) | 2023-02-01 |
| Ambetter Health Texas Superior Marketplace Clinical | New Patient (CC.PP.036) | 2023-02-01 |
| Ambetter Health Texas Wellcare Allwell Medicare Clinical | New Patient (CC.PP.036) | 2023-02-01 |
| Ambetter Health Texas Wellcare Allwell Medicare Clinical | Ferric Gluconate | 2023-02-01 |
| Ambetter Health Texas Wellcare Allwell Medicare Clinical | Iron Sucrose | 2023-02-01 |
| Ambetter Health Texas Wellcare Allwell Medicare Clinical | Tixagevimab and Cilgavimab | 2023-02-01 |
| Meridian Illinois Medicaid Clinical | Glaucoma Agents | 2023-02-01 |