Product Details

Mint-Levofloxacin

Levofloxacin
500 mg
Tablet


DIN/PIN/NPN

02505819

Manufacturer

Mint Pharmaceuticals Inc.

Formulary Listing Date

2021-10-29  

Unit Price

1.3718

Amount MOH Pays

1.3718

Coverage Status

General Benefit

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

J01MA12

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02298643 Sandoz Levofloxacin 1.3718 1.3718
02492733 Riva-Levofloxacin 1.3718 1.3718
02248263 Novo-Levofloxacin 1.3718 1.3718
02505819 Mint-Levofloxacin 1.3718 1.3718
02236842 Levaquin NA NA
02284715 Apo-Levofloxacin 1.3718 1.3718
02315432 Act Levofloxacin 1.3718 1.3718
02508451 Jamp Levofloxacin 1.3718 1.3718
 

LU Clinical Criteria

NO  

EAP Criteria

NO

Product Monograph

View Monograph