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Updated April 14, 2014
Levobunolol HCL

Xubex Patient Assistance Program

This program provides generic medications at a discount.

Provided by: Xubex

PO Box 1244
Winter Park, Fl 32790-1244

TEL: 866-699-8239


ALT PHONE: 407-478-2663
FAX: 407-671-7960
Languages Spoken:

English

Program Website
 

Patient Assistance Applications

Xubex Patient Assistance Program Registration Form

Xubex Patient Assistance Program Physician Order Sheet

 

 

Medications

  • Levobunolol HCl Ophthalmic Drops 0.5% (levobunolol HCl)
 

Eligibility Requirements

Insurance Status May have insurance
Those with Part D Eligible? Yes
Income No limits
Diagnosis/Medical Criteria Not specified
US Residency Required? Yes
   

Application

Obtaining Call or download
Receiving Faxed, mailed or downloaded from website
Returning Mail or fax
Doctor's Action Give prescription to patient
Applicant's Action Complete section, sign
Decision Communicated Not specified
Decision Timeframe Not specified
   

Medication

Amount/Supply Varies
Sent To Doctor's office or patient's home
Delivery Time Within 10 days
Refill Process Automatically sent out
Limit Varies per medication
Re-application New application, new documentation yearly
   

Additional Information

No proof of income is required. Check the website for the exact price.