levofloxacin (ophth)

5%, 1.5% — Solution

OPHTHALMIC ANTI-INFECTIVES

Also known as: levofloxacin (ophth) soln .5%, 1.5% levofloxacin (ophth) soln .5%

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 20 hours, 41 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Standard Option 2026 Tier 1 - Generic None
BCBS Federal Basic Option 2026 Tier 1 - Generic None
BCBS Federal Focus 2026 Tier 1 - Generic None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 20 hours, 41 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 Tier 1 - Preferred Generic None
NC State Health Plan - 70/30 Standard PPO 2026 Tier 1 - Preferred Generic None
NC State Health Plan - HDHP 2026 Tier 1 - Preferred Generic None
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