hydrocortisone — CareFirst (Caremark)
treatment of atopic dermatitis (fluticasone lotion, Derma-Smooth/FS (Body) Oil, desonide gel, Locoid Lipocream, Locoid Lotion, Verdeso Foam)
Initial criteria
- Authorization may be granted when the requested drug is being prescribed for a corticosteroid-responsive dermatosis or condition (e.g., atopic dermatitis, eczema, psoriasis, seborrheic dermatitis) AND the requested drug is NOT being used in a footbath.
Approval duration
6 months