73
December 2023
73
DRUG PAGE DRUG PAGE
Covered Drugs Index
lamotrigine oral tablet, chewable dispersible ..............21
lamotrigine oral tablet,disintegrating
.....................22
lamotrigine oral tablet extended release 24hr
.............21
lamotrigine oral tablets,dose pack
.......................22
LANOXIN PEDIATRIC
..................................34
lansoprazole oral capsule,delayed release(dr/ec)
.........45
LANTUS SOLOSTAR U-100 INSULIN
...................41
LANTUS U-100 INSULIN
...............................41
lapatinib
...............................................17
larin 1.5/30 (21)
........................................49
larin 1/20 (21)
..........................................49
larin 24 fe
..............................................49
larin fe 1.5/30 (28)
......................................49
larin fe 1/20 (28)
........................................49
latanoprost
.............................................51
LAYOLIS FE
...........................................49
leena 28
...............................................49
leunomide
............................................47
LENALIDOMIDE ORAL CAPSULE 2.5 MG, 20 MG
.......17
lenalidomide oral capsule 10 mg, 15 mg, 25 mg, 5 mg
....17
LENVIMA ORAL CAPSULE 10 MG/DAY
(10 MG X 1), 4 MG
.....................................17
LENVIMA ORAL CAPSULE 12 MG/DAY (4 MG X 3),
18 MG/DAY (10 MG X 1-4 MG X2), 24 MG/DAY
(10 MG X 2-4 MG X 1)
..................................17
LENVIMA ORAL CAPSULE 14 MG/DAY(
10 MG X 1-4 MG X 1), 20 MG/DAY (10 MG X 2),
8 MG/DAY (4 MG X 2)
..................................17
lessina
.................................................49
letrozole
...............................................17
leucovorin calcium injection
.............................13
leucovorin calcium oral tablet 5 mg
......................14
leucovorin calcium oral tablet 10 mg, 15 mg, 25 mg
.......14
LEUKERAN
............................................17
leuprolide (3 month)
....................................17
leuprolide subcutaneous kit
.............................17
LEVEMIR FLEXPEN
....................................41
LEVEMIR U-100 INSULIN
..............................41
levetiracetam in nacl (iso-os) intravenous piggyback
1,000 mg/100 ml, 1,500 mg/100 ml, 500 mg/100 ml
.......22
levetiracetam intravenous
...............................22
levetiracetam oral solution
..............................22
levetiracetam oral tablet
.................................22
levetiracetam oral tablet extended release 24 hr
..........22
levobunolol ophthalmic (eye) drops 0.5%
.................50
levocarnitine oral solution 100 mg/ml
....................38
LEVOCARNITINE ORAL TABLET
.......................38
levocarnitine (with sugar)
................................38
levocetirizine oral tablet
.................................52
levooxacin in d5w
.....................................13
levooxacin intravenous
................................13
levooxacin oral solution
................................13
levooxacin oral tablet
..................................13
levonest (28)
...........................................49
levonorgestrel-ethinyl estrad
............................49
levonorg-eth estrad triphasic
............................49
levora-28
...............................................49
LEVO-T
................................................43
levothyroxine oral tablet
.................................43
LEVOXYL ORAL TABLET 100 MCG, 112 MCG,
125 MCG, 137 MCG, 150 MCG, 175 MCG, 200 MCG,
25 MCG, 50 MCG, 75 MCG, 88 MCG
....................43
LEXIVA ORAL SUSPENSION
............................9
LIBTAYO
...............................................17
lidocaine hcl injection solution
...........................35
lidocaine hcl laryngotracheal
............................35
lidocaine hcl mucous membrane jelly in applicator
........36
lidocaine hcl mucous membrane solution 2%
.............36
lidocaine hcl mucous membrane solution 4% (40 mg/ml)
..35
lidocaine (pf) injection solution
...........................35
LIDOCAINE (PF) INTRAVENOUS SOLUTION
...........31
lidocaine (pf) intravenous syringe
........................31
lidocaine-prilocaine topical cream
........................35
lidocaine topical adhesive patch,medicated 5%
...........35
lidocaine topical ointment
...............................35
lidocaine viscous
.......................................35
lincomycin
.............................................11
LINEZOLID-0.9% SODIUM CHLORIDE
..................12
linezolid in dextrose 5%
.................................11
linezolid oral suspension for reconstitution
...............12
linezolid oral tablet
......................................12