All *FLUOROQUINOLONES*

Avelox Solution 400 MG/250ML Intravenous
Avelox Solution 400 MG/250ML Intravenous

Moxifloxacin HCl in NaCl

Tier: 3
PA Type: No Prior Authorization
ST: N
Avelox Solution 400 MG/250ML Intravenous
Avelox Solution 400 MG/250ML Intravenous

Moxifloxacin HCl in NaCl

Tier: 3
PA Type: No Prior Authorization
ST: N
Avelox Tablet 400 MG Oral
Avelox Tablet 400 MG Oral

Moxifloxacin HCl

Tier: 3
PA Type: No Prior Authorization
ST: N
Avelox Tablet 400 MG Oral
Avelox Tablet 400 MG Oral

Moxifloxacin HCl

Tier: 3
PA Type: No Prior Authorization
ST: N
Avelox Tablet 400 MG Oral
Avelox Tablet 400 MG Oral

Moxifloxacin HCl

Tier: 3
PA Type: No Prior Authorization
ST: N
Baxdela SOLUTION RECONSTITUTED 300 MG Intravenous
Baxdela SOLUTION RECONSTITUTED 300 MG Intravenous

Delafloxacin Meglumine

Tier: 3
PA Type: No Prior Authorization
ST: N
Baxdela Tablet 450 MG Oral
Baxdela Tablet 450 MG Oral

Delafloxacin Meglumine

Tier: 3
PA Type: No Prior Authorization
ST: N
Baxdela Tablet 450 MG Oral
Baxdela Tablet 450 MG Oral

Delafloxacin Meglumine

Tier: 3
PA Type: No Prior Authorization
ST: N
Baxdela Tablet 450 MG Oral
Baxdela Tablet 450 MG Oral

Delafloxacin Meglumine

Tier: 3
PA Type: No Prior Authorization
ST: N
Cipro SUSPENSION RECONSTITUTED 250 MG/5ML (5%) Oral
Cipro SUSPENSION RECONSTITUTED 250 MG/5ML (5%) Oral

Ciprofloxacin

Tier: 3
PA Type: No Prior Authorization
ST: Y
Cipro Suspension Reconstituted 500 MG/5ML (10%) Oral
Cipro Suspension Reconstituted 500 MG/5ML (10%) Oral

Ciprofloxacin

Tier: 3
PA Type: No Prior Authorization
ST: Y
Cipro Tablet 250 MG Oral
Cipro Tablet 250 MG Oral

Ciprofloxacin HCl

Tier: 3
PA Type: No Prior Authorization
ST: Y