To order additional copies, please call Massachusetts Medical

Dermatologic Agents (Steroids — Medium Potency)
30
Name AETNA BCBSMA BMCHP FCHP HPHC HNE NHP NTWK MAHLTH THP
HyDROCORTIsONE PROBUTATE X X PA X PA X
[Pandel]
HyDROCORTIsONE VALERATE X* X* X X X X X X X X
HyDROCORTIsONE VALERATE 0 .2%
cream [Westcort]
X X PA X NC PA X
MOMETAsONE FUROATE 0 .1% X* X* X X X X X X X X
MOMETAsONE FUROATE 0 .1%
[Elocon]
X X PA X NC PA X
PREDNICARBATE 0 .1% cream,
ointment
X* X* X X X X X X X
TRIAMCINOLONE ACETONIDE X* X* X X X X X X X X
TRIAMCINOLONE ACETONIDE 0 .1%
[Kenalog]
X X PA X X NC PA X
TRIAMCINOLONE spray [Kenalog] X X X X PA X
Dermatologic Agents (Steroids — High Potency)
AMCINONIDE X* X* X X X X X X X X
AUgMENTED BETAMETHAsONE
DIPROPIONATE 0 .05% cream, lotion
X* X* X X X X X X X X
AUgMENTED BETAMETHAsONE
DIPROPIONATE 0 .05% cream
[Diprolene AF]
FE X PA X NC PA X
BETAMETHAsONE DIPROPIONATE
cream, ointment, lotion
X* X* X X X X X X X X
BETAMETHAsONE DIPROPIONATE
[Diprolene]
FE X PA X NC PA X
BETAMETHAsONE DIPROPIONATE
0 .05% lotion [Diprolene]
FE X PA X X NC PA X
BETAMETHAsONE VALERATE
0 .1% ointment
X* X* X X X X X X X X
DEsOXIMETAsONE 0 .25% cream,
ointment
X* X* X X X X X X X X
DEsOXIMETAsONE 0 .05% gel X* X* X X X X X X X X
DEsOXIMETAsONE 0 .25% [Topicort] X X PA X NC PA X
DIFLORAsONE DIACETATE 0 .05%
cream
X* X* X X X X X X X X
DIFLORAsONE DIACETATE cream
[Psorcon E cream]
X X PA X NC PA X