clotrimazole/betamethasone/menthol/zinc oxide/petrolatum,wht

1 %-0.05 %-0.44 %-20.6 %-53 % — Pack

Also known as: CLOBEZIN

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

1 plan

Source: Excel (XLSX) · Formulary date: Jan 5, 2026 · Checked: 3 hours, 37 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026	Tier 3 - Non-Formulary	—	—	—	None