| Aetna | Histamine Desensitization Therapy for Intractable Headaches | 2025-12-08 |
| Aetna | Therapeutic Phlebotomy | 2025-12-08 |
| Aetna | Diphtheria, Tetanus, and Pertussis Vaccines | 2025-12-08 |
| Aetna | Tubal Sterilization | 2025-12-08 |
| Aetna | Autoimmune Antibody and Coagulation Testing | 2025-12-08 |
| Aetna | Esophageal and Airway pH Monitoring | 2025-12-08 |
| Aetna | Repository Corticotropin Injection (Acthar Gel and Purified Cortrophin Gel) | 2025-12-08 |
| Aetna | Emapalumab-lzsg (Gamifant) | 2025-12-08 |
| Aetna | Signal-Averaged Electrocardiography (SAECG) and Artificial Intelligence Algorithmic Electrocardiogram | 2025-12-08 |
| Humana Medicaid | 23 Hour Behavioral Health Observation - In Lieu of Service - MEDICAID - LOUISIANA | 2025-12-08 |