| Ambetter Health Arizona Clinical | FACILITY-BASED PSG FOR OSA | 2011-06-01 |
| BCBS Kansas | Panniculectomy and Abdominoplasty | 2011-03-07 |
| Wellcare North Carolina Medicaid Clinical | Caudal or Interlaminar Epidural Steroid | 2011-01-01 |
| Wellcare North Carolina Medicaid Clinical | Helicobacter Pylori Serology Testing | 2010-09-01 |
| BCBS Kansas | Periureteral Bulking Agents as a Treatment of Vesicoureteral Reflux (VUR) | 2010-08-17 |
| Medicare NCD | NCD 20.31 - Intensive Cardiac Rehabilitation (ICR) Programs | 2010-08-12 |
| Medicare NCD | NCD 20.31.2 - Ornish Program for Reversing Heart Disease | 2010-08-12 |
| Medicare NCD | NCD 20.31.1 - The Pritikin Program | 2010-08-12 |
| Wellcare North Carolina Medicaid Clinical | Lyfgenia - Pharmacy Prior Approval Criteria | 2010-08-01 |
| Medicare NCD | NCD 150.12 - Collagen Meniscus Implant | 2010-05-25 |