LEVOTHYROXINE

LEVOTHYROXINE (12960D)

levothyroxine sodium 75 microgram tablet, 2 x 100
12960D
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: $22.57 Max safety net: $24.05 General Patient Charge: $25.00
Available brands
LEVOXINE
Thyrox

LEVOTHYROXINE (12968M)

levothyroxine sodium 100 microgram tablet, 2 x 100
12968M
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: $22.74 Max safety net: $24.22 General Patient Charge: $25.00
Available brands
LEVOXINE
Thyrox

LEVOTHYROXINE (12969N)

levothyroxine sodium 50 microgram tablet, 2 x 100
12969N
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: $22.42 Max safety net: $23.90 General Patient Charge: $25.00
Available brands
LEVOXINE
Thyrox

LEVOTHYROXINE (12970P)

levothyroxine sodium 200 microgram tablet, 2 x 100
12970P
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: $24.28 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
LEVOXINE
Thyrox