| Aetna | Balloon-Expandable Venous Stents | 2025-08-21 |
| Aetna | Vitamin B-12 Therapy | 2025-08-21 |
| Aetna | Fundus Photography | 2025-08-21 |
| Aetna | Extracorporeal Membrane Oxygenation (ECMO) | 2025-08-21 |
| Medical Mutual | Amvuttra ® (vutrisiran) | 2025-08-21 |
| Medical Mutual | Berinert ® (C1 esterase inhibitor [human]) | 2025-08-21 |
| Medical Mutual | Elevidys (delandistrogene moxeparvovec-rokl) | 2025-08-21 |
| Medical Mutual | icatibant (Firazyr, Sajazir) | 2025-08-21 |
| Medical Mutual | Ilumya ® (tildrakizumab-asmn) | 2025-08-21 |
| Medical Mutual | Kalbitor (ecallantide) | 2025-08-21 |