| Wellcare North Carolina Medicaid Clinical | Liver Transplantation | 2025-02-01 |
| Wellcare North Carolina Medicaid Clinical | Lung Transplantation | 2025-02-01 |
| Wellcare North Carolina Medicaid Clinical | Outpatient Behavioral Health Services Provided by | 2025-02-01 |
| Wellcare North Carolina Medicaid Clinical | Outpatient Specialized Therapies | 2025-02-01 |
| Wellcare North Carolina Medicaid Clinical | Pancreas Transplant | 2025-02-01 |
| Wellcare North Carolina Medicaid Clinical | Polymerase Chain Reaction Respiratory Viral Panel | 2025-02-01 |
| Wellcare North Carolina Medicaid Clinical | Routine Eye Examination and Visual Aids for | 2025-02-01 |
| Wellcare North Carolina Medicaid Clinical | Small Bowel and Small Bowel/Liver and | 2025-02-01 |
| Wellcare North Carolina Medicaid Clinical | Special Ophthalmological Services | 2025-02-01 |
| Wellcare North Carolina Medicaid Clinical | Testing for Select Genitourinary Conditions | 2025-02-01 |