Clotrimazole 1% / Betamethasone Dipropionate 0.05% Lotion (Generic for Lotrisone)

Coverage Level – 100%

Copay – $0

Limitations – No more than 30 days’ supply; Limit 30 ml in 30 days

Restrictions – Health Pals Mail Order Pharmacy Network

Comments – Cream is preferred to lotion and has more generous limitations. Generic for Lotrisone.