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Mentax — CareFirst (Caremark)

Tinea versicolor

Preferred products

  • generic topical antifungal agents

Initial criteria

  • The requested drug is NOT being used in a footbath.
  • The patient experienced an inadequate treatment response to a generic topical antifungal agent OR
  • The patient experienced an intolerance to a generic topical antifungal agent OR
  • The patient has a contraindication that would prohibit a trial of a generic topical antifungal agent.

Approval duration

3 months