DIN/PIN/NPN Detail

68:00 HORMONES AND SUBSTITUTES

68:36:00 THYROIDS

Synthroid (LEVOTHYROXINE (SODIUM))0.125mg Tab

DIN/PIN/NPN:02172119

Interchangeables:

NO

Manufacturer:

Abbott Laboratories Limited

Formulary Listing Date:

1996-10-01

Drug Benefit Price or Unit Price:

0.1255

Amount MOH Pays:

0.1255

Coverage Status:

General Benefit