| BCBS Premera WA AK Clinical | Sinus Surgery in Adults | 2025-12-01 |
| Medical Mutual | Epkinly® (epcoritamab-bysp) (Subcutaneous) (EOV) | 2025-12-01 |
| Medical Mutual | Imdelltra® (tarlatamab-dlle) (Intravenous) (EOV) | 2025-12-01 |
| Medical Mutual | Imlygic® (talimogene laherparepvec): Intralesional (EOV) | 2025-12-01 |
| Medical Mutual | Laser Interstitial Thermal Therapy (LITT) | 2025-12-01 |
| Medical Mutual | Libtayo® (cemiplimab-rwlc) (Intravenous) (EOV) | 2025-12-01 |
| Medical Mutual | Lymphir™ (denileukin diftitox-cxdl) (Intravenous) (EOV) | 2025-12-01 |
| Medical Mutual | Monjuvi® (tafasitamab-cxix) (Intravenous) (EOV) | 2025-12-01 |
| Medical Mutual | Non-Wearable Automatic External Defibrillator | 2025-12-01 |
| Medical Mutual | Paclitaxel Albumin-Bound: Abraxane® (Intravenous) (EOV) | 2025-12-01 |