| Image | NDC Number | Product Description | List Price | WAC Price | Others |
|
00074662411
|
SYNTHROID, TABLETS, 100 MCG, 10 X 10'S
|
$129.82
|
$129.82
|
|
|
00074662419
|
SYNTHROID, TABLETS, 100 MCG, 1000'S
|
$1,366.88
|
$1,298.54
|
|
|
00074662490
|
SYNTHROID, TABLETS, 100 MCG, 90'S
|
$123.01
|
$116.86
|
|
|
00074929619
|
SYNTHROID, TABLETS, 112 MCG, 1000'S
|
$1,366.64
|
$1,298.31
|
|
|
00074929690
|
SYNTHROID, TABLETS, 112 MCG, 90'S
|
$123.02
|
$116.87
|
|
|
00074706811
|
SYNTHROID, TABLETS, 125 MCG, 10 X 10'S
|
$129.82
|
$129.82
|
|
|
00074706819
|
SYNTHROID, TABLETS, 125 MCG, 1000'S
|
$1,367.42
|
$1,299.05
|
|
|
00074706890
|
SYNTHROID, TABLETS, 125 MCG, 90'S
|
$123.09
|
$116.94
|
|
|
00074372719
|
SYNTHROID, TABLETS, 137 MCG, 1000'S
|
$1,367.35
|
$1,298.98
|
|
|
00074372790
|
SYNTHROID, TABLETS, 137 MCG, 90'S
|
$123.07
|
$116.92
|
|
|
00074706911
|
SYNTHROID, TABLETS, 150 MCG, 10 X 10'S
|
$129.82
|
$129.82
|
|
|
00074706919
|
SYNTHROID, TABLETS, 150 MCG, 1000'S
|
$1,367.48
|
$1,299.11
|
|
|
00074706990
|
SYNTHROID, TABLETS, 150 MCG, 90'S
|
$123.09
|
$116.94
|
|
|
00074707019
|
SYNTHROID, TABLETS, 175 MCG, 1000'S
|
$1,365.62
|
$1,297.34
|
|
|
00074707090
|
SYNTHROID, TABLETS, 175 MCG, 90'S
|
$122.91
|
$116.76
|
|
|
00074714811
|
SYNTHROID, TABLETS, 200 MCG, 10 X 10'S
|
$129.81
|
$129.81
|
|
|
00074714819
|
SYNTHROID, TABLETS, 200 MCG, 1000'S
|
$1,367.25
|
$1,298.89
|
|
|
00074714890
|
SYNTHROID, TABLETS, 200 MCG, 90'S
|
$123.07
|
$116.92
|
|
|
00074434119
|
SYNTHROID, TABLETS, 25 MCG, 1000'S
|
$1,367.42
|
$1,299.05
|
|
|
00074434190
|
SYNTHROID, TABLETS, 25 MCG, 90'S
|
$123.07
|
$116.92
|
|
|
00074714919
|
SYNTHROID, TABLETS, 300 MCG, 1000'S
|
$1,366.49
|
$1,298.17
|
|
|
00074714990
|
SYNTHROID, TABLETS, 300 MCG, 90'S
|
$122.98
|
$116.83
|
|
|
00074455211
|
SYNTHROID, TABLETS, 50 MCG, 10 X 10
|
$129.81
|
$129.81
|
|
|
00074455219
|
SYNTHROID, TABLETS, 50 MCG, 1000'S
|
$1,366.85
|
$1,298.51
|
|
|
00074455290
|
SYNTHROID, TABLETS, 50 MCG, 90'S
|
$123.02
|
$116.87
|
|
|
00074518211
|
SYNTHROID, TABLETS, 75 MCG, 10 X 10
|
$129.81
|
$129.81
|
|
|
00074518219
|
SYNTHROID, TABLETS, 75 MCG, 1000'S
|
$1,367.44
|
$1,299.07
|
|
|
00074518290
|
SYNTHROID, TABLETS, 75 MCG, 90'S
|
$123.06
|
$116.91
|
|
|
00074659419
|
SYNTHROID, TABLETS, 88 MCG, 1000'S
|
$1,367.22
|
$1,298.86
|
|
|
00074659490
|
SYNTHROID, TABLETS, 88 MCG, 90'S
|
$123.06
|
$116.91
|
|