Proctocort (30 mg) — Cigna
cryptitis
Preferred products
- generic hydrocortisone acetate suppository (25 mg or 30 mg)
- Anucort-HC (25 mg)
- Hemmorex-HC (25 mg or 30 mg)
Initial criteria
- Patient has tried one Step 1 Product (generic hydrocortisone acetate suppository 25 mg or 30 mg, Anucort-HC 25 mg, or Hemmorex-HC 25 mg or 30 mg)
Approval duration
1 year