LIOTHYRONINE

LIOTHYRONINE (13966C)

liothyronine sodium 20 microgram tablet, 100
13966C
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 16698)

Indication: Thyroid cancer

Restriction (Streamlined authority code: 16510)

Indication: Hypothyroidism
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 200 # of repeats: 2 DPMQ: $102.38 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Tertroxin

LIOTHYRONINE (14841D)

liothyronine sodium 20 microgram tablet, 100
14841D
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 6475)

Indication: Hypothyroidism
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 100 # of repeats: 2 DPMQ: $58.08 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Tertroxin

LIOTHYRONINE (2318B)

liothyronine sodium 20 microgram tablet, 100
2318B
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 16607)

Indication: Thyroid cancer

Restriction (Streamlined authority code: 16676)

Indication: Hypothyroidism
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 100 # of repeats: 2 DPMQ: $58.08 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Tertroxin