Product Details

Levitra

Vardenafil HCl
5 mg
Tablet


DIN/PIN/NPN

02250462

Manufacturer

Bayer Inc., Consumer Care Division

Formulary Listing Date

2018-12-21  

Unit Price

NA

Amount MOH Pays

NA

Coverage Status

Off-Formulary Interchangeable

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

G04BE09

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02464209 Mylan-Vardenafil 9.3203 NA
02250462 Levitra NA NA
02475677 Jamp-Vardenafil IR 9.3203 NA
02471647 Apo-Vardenafil 9.3203 NA
 

LU Clinical Criteria

NO  

EAP Criteria

NO

Product Monograph

View Monograph