Standard Health Pals Formulary
Skin Pals – Formula A™ – Creamy + Foaming Cleanser
Active Ingredients – Salicylic Acid 5% + Ascorbic Acid 5% + Citric Acid 2.5%
Coverage Level – 100%
Copay – $0
Limitations – No more than 30 days’ supply
Restrictions – Health Pals Mail Order Pharmacy Network
Comments – In order to receive this medication at no cost, you must utilize a Skin Pals Clinic Healthcare Provider. Visit the Skin Pals website, using the link below, to get started.