Product Details
Apo-Levothyroxine
Levothyroxine (Sodium)0.112 mg
Tablet
DIN/PIN/NPN
02550741
Manufacturer
Apotex Inc.
Formulary Listing Date
2025-04-30
Unit Price
0.0682
Amount MOH Pays
0.0682
Coverage Status
General Benefit
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
H03AA01
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 02171228 | Synthroid | 0.1289 | 0.0682 |
| 02550741 | Apo-Levothyroxine | 0.0682 | 0.0682 |
LU Clinical Criteria
NORequirements
NA