Product Details

Eltroxin

Levothyroxine (Sodium)
0.3 mg
Tablet


DIN/PIN/NPN

02213230

Manufacturer

Glaxo Wellcome Inc.

Formulary Listing Date

1997-01-20  

Unit Price

NA

Amount MOH Pays

NA

Coverage Status

Not a Benefit

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

H03AA01

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02172151 Synthroid 0.1449 0.1449
02213230 Eltroxin NA NA
 

LU Clinical Criteria

NO  

EAP Criteria

NO

Product Monograph

View Monograph