Product Details

Apo-Levothyroxine

Levothyroxine (Sodium)
0.175 mg
Tablet


DIN/PIN/NPN

02550792

Manufacturer

Apotex Inc.

Formulary Listing Date

2025-04-30  

Unit Price

0.0740

Amount MOH Pays

0.0740

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
02172135 Synthroid 0.1398 0.0740
02550792 Apo-Levothyroxine 0.0740 0.0740
 

LU Clinical Criteria

NO  

EAP Criteria

NO

Product Monograph

View Monograph