Zelsuvmi (berdazimer) — Highmark
molluscum contagiosum
Initial criteria
- age ≥ 1 year
- diagnosis of molluscum contagiosum (ICD-10: B08.1)
Reauthorization criteria
- prescriber attests that the member has previously experienced complete or partial clearance of molluscum contagiosum lesions with Zelsuvmi
- prescriber attests that an additional course of therapy is required for recurrence of molluscum contagiosum
Approval duration
12 weeks