Product Details

Synthroid

Levothyroxine (Sodium)
0.15 mg
Tablet


DIN/PIN/NPN

02172127

Manufacturer

Abbott Laboratories Limited

Formulary Listing Date

1996-10-01  

Unit Price

0.0990

Amount MOH Pays

0.0528

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
02172127 Synthroid 0.0990 0.0528
02213214 Eltroxin 0.0528 0.0528
 

LU Clinical Criteria

NO  

EAP Criteria

NO

Product Monograph

View Monograph