LEVOTHYROXINE

levothyroxine sodium 75 microgram tablet, 200

LEVOTHYROXINE (9287T)

levothyroxine sodium 75 microgram tablet, 200
9287T
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: For prescribing by certain health practitioners
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 200 # of repeats: 1 DPMQ: $22.88 Max safety net: $24.42 General Patient Charge: $25.00
Available brands
APO-Levothyroxine
Eltroxin
Eutroxsig
Levothox
Levothyroxine Lup
Levothyroxine Sandoz
Oroxine
*Additional charge for this brand is $1.10
 DPMQ: $23.98 Max safety net: $24.42 General Patient Charge: $26.10