Approved Drug Utilization Review Board Edits
The ICD-10 code for Primary focal hyperhidrosis, axilla (L74.510) is in Medicaid medical diagnosis history in the previous 365 days; AND Must have documentation of a trial or intolerance to an aluminum based antiperspirant such as Drysol, Certain Dri,, Xerac AC, and Hypercare ; ................
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