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Products found: 38

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DIN/ PIN/ NPN	Generic Name	Brand Name, Strength & Dosage Form	MFR	Drug Benefit Price or Unit Price	Amount MOH Pays	Inter- change- able	Limited Use	Thera- peutic Notes
02550741	LEVOTHYROXINE (SODIUM)	Apo-Levothyroxine 0.112mg Tab	APX	0.0682	0.0682	YES	NO	NO
02550717	LEVOTHYROXINE (SODIUM)	Apo-Levothyroxine 0.05mg Tab	APX	0.0373	0.0373	YES	NO	NO
02550709	LEVOTHYROXINE (SODIUM)	Apo-Levothyroxine 0.025mg Tab	APX	0.0597	0.0597	YES	NO	NO
02550776	LEVOTHYROXINE (SODIUM)	Apo-Levothyroxine (Off-Formulary Interchangeable) 0.137mg Tab	APX	0.1906	N/A	YES	NO	NO
02534703	LEVOTHYROXINE (SODIUM)	Apo-Levothyroxine 0.3mg Tab	APX	0.0797	0.0797	YES	NO	NO
02550806	LEVOTHYROXINE (SODIUM)	Apo-Levothyroxine 0.2mg Tab	APX	0.0526	0.0526	YES	NO	NO
02550792	LEVOTHYROXINE (SODIUM)	Apo-Levothyroxine 0.175mg Tab	APX	0.0740	0.0740	YES	NO	NO
02550784	LEVOTHYROXINE (SODIUM)	Apo-Levothyroxine 0.15mg Tab	APX	0.0495	0.0495	YES	NO	NO
02550768	LEVOTHYROXINE (SODIUM)	Apo-Levothyroxine 0.125mg Tab	APX	0.0690	0.0690	YES	NO	NO
02550725	LEVOTHYROXINE (SODIUM)	Apo-Levothyroxine 0.075mg Tab	APX	0.0646	0.0646	YES	NO	NO
02534681	LEVOTHYROXINE (SODIUM)	Apo-Levothyroxine 0.1mg Tab	APX	0.0460	0.0460	YES	NO	NO
02550733	LEVOTHYROXINE (SODIUM)	Apo-Levothyroxine 0.088mg Tab	APX	0.0646	0.0646	YES	NO	NO
02213214	LEVOTHYROXINE (SODIUM)	Eltroxin 0.15mg Tab	ASN	0.0495	0.0495	YES	NO	NO
02213222	LEVOTHYROXINE (SODIUM)	Eltroxin 0.2mg Tab	ASN	0.0526	0.0526	YES	NO	NO
02213192	LEVOTHYROXINE (SODIUM)	Eltroxin 0.05mg Tab	ASN	0.0373	0.0373	YES	NO	NO
02213206	LEVOTHYROXINE (SODIUM)	Eltroxin 0.1mg Tab	ASN	0.0460	0.0460	YES	NO	NO
02172151	LEVOTHYROXINE (SODIUM)	Synthroid 0.3mg Tab	ABB	0.1506	0.0797	YES	NO	NO
02172143	LEVOTHYROXINE (SODIUM)	Synthroid 0.2mg Tab	ABB	0.1092	0.0526	YES	NO	NO
02172135	LEVOTHYROXINE (SODIUM)	Synthroid 0.175mg Tab	ABB	0.1398	0.0740	YES	NO	NO
02172127	LEVOTHYROXINE (SODIUM)	Synthroid 0.15mg Tab	ABB	0.1028	0.0495	YES	NO	NO
02172119	LEVOTHYROXINE (SODIUM)	Synthroid 0.125mg Tab	ABB	0.1304	0.0690	YES	NO	NO
02171228	LEVOTHYROXINE (SODIUM)	Synthroid 0.112mg Tab	ABB	0.1289	0.0682	YES	NO	NO
02172100	LEVOTHYROXINE (SODIUM)	Synthroid 0.1mg Tab	ABB	0.0956	0.0460	YES	NO	NO
02172097	LEVOTHYROXINE (SODIUM)	Synthroid 0.088mg Tab	ABB	0.1220	0.0646	YES	NO	NO
02172089	LEVOTHYROXINE (SODIUM)	Synthroid 0.075mg Tab	ABB	0.1220	0.0646	YES	NO	NO
02172070	LEVOTHYROXINE (SODIUM)	Synthroid 0.05mg Tab	ABB	0.0775	0.0373	YES	NO	NO
02172062	LEVOTHYROXINE (SODIUM)	Synthroid 0.025mg Tab	ABB	0.1129	0.0597	YES	NO	NO
02233852	LEVOTHYROXINE (SODIUM)	Synthroid (Off-Formulary Interchangeable) 0.137mg Tab	BGP	N/A	N/A	YES	NO	NO
02549999	LIOTHYRONINE (SODIUM)	Auro-Liothyronine (Off-Formulary Interchangeable) 5mcg Tab	AUR	1.1587	1.1587	YES	NO	NO
02550008	LIOTHYRONINE (SODIUM)	Auro-Liothyronine (Off-Formulary Interchangeable) 25mcg Tab	AUR	1.2595	1.2595	YES	NO	NO
01919466	LIOTHYRONINE (SODIUM)	Cytomel (Off-Formulary Interchangeable) 25mcg Tab	SKB	N/A	N/A	YES	NO	NO
01919458	LIOTHYRONINE (SODIUM)	Cytomel (Off-Formulary Interchangeable) 5mcg Tab	SKB	N/A	N/A	YES	NO	NO
02494337	LIOTHYRONINE (SODIUM)	Teva-Liothyronine (Off-Formulary Interchangeable) 5mcg Tab	TEV	1.1587	1.1587	YES	NO	NO
02494345	LIOTHYRONINE (SODIUM)	Teva-Liothyronine (Off-Formulary Interchangeable) 25mcg Tab	TEV	1.2595	1.2595	YES	NO	NO
02521059	PROPYLTHIOURACIL	Halycil (Temporary Benefit) 50mg Tab	HAL	0.5000	0.5000	NO	NO	NO
09858122	PROPYLTHIOURACIL	PTU (Temporary Benefit) 50mg Tab	PHB	0.5000	0.5000	NO	NO	NO
09858135	PROPYLTHIOURACIL	Propylthiouracil (Temporary Benefit) 50mg Tab	ACP	0.5000	0.5000	NO	NO	NO
02523019	PROPYLTHIOURACIL	Propylthiouracil Tablets (Temporary Benefit) 50mg Tab	PHB	0.5000	0.5000	NO	NO	NO

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