Search Results

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Products found: 12

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
02172062	LEVOTHYROXINE (SODIUM)	Synthroid 0.025mg Tab	ABB	0.1129	0.0597	YES	NO	NO
02172070	LEVOTHYROXINE (SODIUM)	Synthroid 0.05mg Tab	ABB	0.0775	0.0373	YES	NO	NO
02172089	LEVOTHYROXINE (SODIUM)	Synthroid 0.075mg Tab	ABB	0.1220	0.0646	YES	NO	NO
02172097	LEVOTHYROXINE (SODIUM)	Synthroid 0.088mg Tab	ABB	0.1220	0.0646	YES	NO	NO
02172100	LEVOTHYROXINE (SODIUM)	Synthroid 0.1mg Tab	ABB	0.0956	0.0460	YES	NO	NO
02233852	LEVOTHYROXINE (SODIUM)	Synthroid (Off-Formulary Interchangeable) 0.137mg Tab	BGP	N/A	N/A	YES	NO	NO
02172119	LEVOTHYROXINE (SODIUM)	Synthroid 0.125mg Tab	ABB	0.1304	0.0690	YES	NO	NO
02172127	LEVOTHYROXINE (SODIUM)	Synthroid 0.15mg Tab	ABB	0.1028	0.0495	YES	NO	NO
02172135	LEVOTHYROXINE (SODIUM)	Synthroid 0.175mg Tab	ABB	0.1398	0.0740	YES	NO	NO
02172143	LEVOTHYROXINE (SODIUM)	Synthroid 0.2mg Tab	ABB	0.1092	0.0526	YES	NO	NO
02172151	LEVOTHYROXINE (SODIUM)	Synthroid 0.3mg Tab	ABB	0.1506	0.0797	YES	NO	NO
02171228	LEVOTHYROXINE (SODIUM)	Synthroid 0.112mg Tab	ABB	0.1289	0.0682	YES	NO	NO