| Presbyterian Health Plan | Radiofrequency Ablation for Uterine Fibroid | 2025-11-19 |
| Presbyterian Health Plan | Sleep Studies, Attended (In-Laboratory) Full-Channel Polysomnography | 2025-11-19 |
| Presbyterian Health Plan | Transoral Incisionless Fundoplication (TIF) for Treatment of GERD | 2025-11-19 |
| Aetna | Blood and Adipose Tissue Derived Products for Selected Indications | 2025-11-19 |
| Presbyterian Health Plan | Mobile Cardiac Outpatient Telemetry™ (MCOT™) for | 2025-11-19 |
| Humana Military TRICARE | Blepharoplasty | 2025-11-19 |
| Humana Military TRICARE | Botulinum toxins | 2025-11-19 |
| Humana Military TRICARE | Breast MRI | 2025-11-19 |
| Humana Military TRICARE | Occipital nerve block | 2025-11-19 |
| Humana Military TRICARE | Oncotype DX® breast cancer assay | 2025-11-19 |