Displaying 1 - 19 of 19
Contract Number Brand Code Brand Name Package Size Formulary Category Unit Price Strength Max. Reimbursable / Month Drug Contract Start Date Drug Contract End Date Restrict To Ophthalmologist Restrict To Pulmonologist Status Description Max Repeats
40 6711CR ELEQUINE 500MG TAB (JAC/STO) LEVOFLOXACIN 24'S C 7.92 500MG 0 2022-04-01 2024-03-31 0
41 6711CR ELEQUINE 500MG TAB (JAC) LEVOFLOXACIN (C) 24'S C 7.9228 500MG 14 2024-04-01 2026-03-31 0
42 6711CR ELEQUINE 500MG TAB (JAC) LEVOFLOXACIN 24'S C 7.92 500MG 14 2026-04-01 No No 0
40 6711CT ELEQUINE 750MG TAB (JAC/STO) LEVOFLOXACIN 20'S C 15.07 750MG 0 2022-04-01 2024-03-31 0
41 6711CT ELEQUINE 750MG TAB (JAC) LEVOFLOXACIN (C) 20'S C 15.0731 750MG 14 2024-04-01 2026-03-31 0
42 6711CT ELEQUINE 750MG TAB (JAC) LEVOFLOXACIN 20'S C 15.07 750MG 14 2026-04-01 No No 0
40 6711FY APO-LEVOFLOXACIN 500MG TAB (APO/COL) 100'S BQ 0.57 500MG 0 2022-04-01 2024-03-31 6
40 6711FZ APO-LEVOFLOXACIN 750MG TAB (APO/COL) 100'S BQ 1.06 750MG 0 2022-04-01 2024-03-31 6
41 6711HH LEVOFLOXACIN 750MG TAB (CIP) (BQ) 50'S BQ 0.5855 750MG 14 2024-04-01 2026-03-31 0
41 6711KD OVEL 500MG TAB (ARP) LEVOFLOXACIN (BQ) 30'S BQ 0.521 500MG 14 2024-04-01 2026-03-31 0
41 6711MC LEVOFLOXACIN 500MG TAB (MCP) 10X10 BQ 0.4167 500MG 14 2024-04-01 2026-03-31
42 6711MJ APO-LEVOFLOXACIN 500MG TAB (APO) 50'S B 0.75 500MG 14 2026-04-01 No No 0
42 6711MK APO-LEVOFLOXACIN 750MG TAB (APO) 30'S B 1.17 750MG 14 2026-04-01 No No 0
40 67127 TAVANIC 500MG INJ (SFA/COL) LEVOFLOXACIN 100ML C 23.11 500MG 0 2022-04-01 2024-03-31 0
40 6712BW LEVOFLOXACIN 500MG INJ (BAX/STO) 100ML BQ 12.07 500MG 0 2022-04-01 2024-03-31 6
41 6712CC LEVOFLOX DENK 5MG/ML INJ (EDK) LEVOFLOXACIN (BQ) 100ML BQ 14.8149 5MG/ML 14 2024-04-01 2026-03-31 0
41 6712CD LEVOFLOX DENK 5MG/ML INJ (EDK) LEVOFLOXACIN (BQ) 100ML BQ 15.6304 5MG/ML 14 2024-04-01 2026-03-31 0
42 6712CF GLEVO 5MG/ML INJ (GLP) LEVOFLOXACIN 100ML B 6.80 5MG/ML 14 2026-04-01 No No 0
42 6712CG GLEVO 5MG/ML INJ (GLP) LEVOFLOXACIN 100ML B 6.60 5MG/ML 14 2026-04-01 No No 0