- Bathroom safety items (PDF)
- Chiropractic care (PDF)
- Clinical trial (PDF)
- Consultation services by a clinical psychologist (PDF)
- Contraceptive devices (PDF)
- Dental care (PDF)
- Determination of refractive state (PDF)
- Emergency department care (PDF)
- Foreign travel: Nonemergent, nonurgent care (PDF)
- Gradient compression stockings (PDF)
- Home infusion therapy (PDF)
- Hospice care (PDF)
- Human organ transplant (PDF)
- Inpatient hospital care (PDF)
- LASIK, radial keratotomy (PDF)
- Outpatient rehabilitation therapy caps (PDF)
- Private duty nursing (PDF)
- Routine hepatitis C screening (PDF)
- Screening mammography (PDF)
- Screening pap tests and pelvic exams (PDF)
- Skilled nursing facility (PDF)
- Temporomandibular joint appliance (PDF)
- Vision care (PDF)
- Voluntary abortion (PDF)
- Weight loss surgery - 2012 NEW (PDF)