Product Details

Eltroxin

Levothyroxine (Sodium)
0.1 mg
Tablet


DIN/PIN/NPN

02213206

Manufacturer

Aspen Pharma Trading Limited

Formulary Listing Date

1997-07-12  

Unit Price

0.0480

Amount MOH Pays

0.0480

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
02172100 Synthroid 0.0920 0.0480
02213206 Eltroxin 0.0480 0.0480
 

LU Clinical Criteria

NO  

EAP Criteria

NO

Product Monograph

View Monograph