| Image | NDC Number | Product Description | List Price | WAC Price | Others |
|
00074662411
|
SYNTHROID, TABLETS, 100 MCG, 10 X 10'S
|
$136.18
|
$136.18
|
|
|
00074662419
|
SYNTHROID, TABLETS, 100 MCG, 1000'S
|
$1,433.86
|
$1,362.17
|
|
|
00074662490
|
SYNTHROID, TABLETS, 100 MCG, 90'S
|
$129.04
|
$122.59
|
|
|
00074929619
|
SYNTHROID, TABLETS, 112 MCG, 1000'S
|
$1,433.61
|
$1,361.93
|
|
|
00074929690
|
SYNTHROID, TABLETS, 112 MCG, 90'S
|
$129.05
|
$122.60
|
|
|
00074706811
|
SYNTHROID, TABLETS, 125 MCG, 10 X 10'S
|
$136.18
|
$136.18
|
|
|
00074706819
|
SYNTHROID, TABLETS, 125 MCG, 1000'S
|
$1,434.42
|
$1,362.70
|
|
|
00074706890
|
SYNTHROID, TABLETS, 125 MCG, 90'S
|
$129.12
|
$122.66
|
|
|
00074372719
|
SYNTHROID, TABLETS, 137 MCG, 1000'S
|
$1,434.35
|
$1,362.63
|
|
|
00074372790
|
SYNTHROID, TABLETS, 137 MCG, 90'S
|
$129.10
|
$122.64
|
|
|
00074706911
|
SYNTHROID, TABLETS, 150 MCG, 10 X 10'S
|
$136.18
|
$136.18
|
|
|
00074706919
|
SYNTHROID, TABLETS, 150 MCG, 1000'S
|
$1,434.49
|
$1,362.77
|
|
|
00074706990
|
SYNTHROID, TABLETS, 150 MCG, 90'S
|
$129.12
|
$122.66
|
|
|
00074707019
|
SYNTHROID, TABLETS, 175 MCG, 1000'S
|
$1,432.54
|
$1,360.91
|
|
|
00074707090
|
SYNTHROID, TABLETS, 175 MCG, 90'S
|
$128.93
|
$122.48
|
|
|
00074714811
|
SYNTHROID, TABLETS, 200 MCG, 10 X 10'S
|
$136.17
|
$136.17
|
|
|
00074714819
|
SYNTHROID, TABLETS, 200 MCG, 1000'S
|
$1,434.25
|
$1,362.54
|
|
|
00074714890
|
SYNTHROID, TABLETS, 200 MCG, 90'S
|
$129.10
|
$122.64
|
|
|
00074434119
|
SYNTHROID, TABLETS, 25 MCG, 1000'S
|
$1,434.42
|
$1,362.70
|
|
|
00074434190
|
SYNTHROID, TABLETS, 25 MCG, 90'S
|
$129.10
|
$122.64
|
|
|
00074714919
|
SYNTHROID, TABLETS, 300 MCG, 1000'S
|
$1,433.45
|
$1,361.78
|
|
|
00074714990
|
SYNTHROID, TABLETS, 300 MCG, 90'S
|
$129.01
|
$122.56
|
|
|
00074455211
|
SYNTHROID, TABLETS, 50 MCG, 10 X 10
|
$136.17
|
$136.17
|
|
|
00074455219
|
SYNTHROID, TABLETS, 50 MCG, 1000'S
|
$1,433.83
|
$1,362.14
|
|
|
00074455290
|
SYNTHROID, TABLETS, 50 MCG, 90'S
|
$129.05
|
$122.60
|
|
|
00074518211
|
SYNTHROID, TABLETS, 75 MCG, 10 X 10
|
$136.17
|
$136.17
|
|
|
00074518219
|
SYNTHROID, TABLETS, 75 MCG, 1000'S
|
$1,434.44
|
$1,362.72
|
|
|
00074518290
|
SYNTHROID, TABLETS, 75 MCG, 90'S
|
$129.09
|
$122.64
|
|
|
00074659419
|
SYNTHROID, TABLETS, 88 MCG, 1000'S
|
$1,434.21
|
$1,362.50
|
|
|
00074659490
|
SYNTHROID, TABLETS, 88 MCG, 90'S
|
$129.09
|
$122.64
|
|