Synera (lidocaine 70 mg/tetracaine 70 mg topical patches) — Cigna
Superficial dermatological procedures (non-cosmetic)
Preferred products
- lidocaine cream product
- lidocaine/prilocaine cream product
Initial criteria
- Patient is age ≥ 3 years
- The procedure is for a non-cosmetic condition
- The medication will be applied to intact skin
- Patient has tried BOTH of the following topical anesthetics (i and ii):
- i. One lidocaine cream product
- ii. One lidocaine/prilocaine cream product
Approval duration
1 week