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    NDC 69238-1836-01 Levothyroxine Sodium 0.125 mg/1 Details

    Levothyroxine Sodium 0.125 mg/1

    Levothyroxine Sodium is a ORAL TABLET in the HUMAN PRESCRIPTION DRUG category. It is labeled and distributed by Amneal Pharmaceuticals NY LLC. The primary component is LEVOTHYROXINE SODIUM.

    Product Information

    NDC 69238-1836
    Product ID 69238-1836_2f03ad88-26a0-4d92-8d5a-0fe82f37ff46
    Associated GPIs 28100010100325
    GCN Sequence Number 006653
    GCN Sequence Number Description levothyroxine sodium TABLET 125 MCG ORAL
    HIC3 P3A
    HIC3 Description THYROID HORMONES
    GCN 26326
    HICL Sequence Number 002849
    HICL Sequence Number Description LEVOTHYROXINE SODIUM
    Brand/Generic Generic
    Proprietary Name Levothyroxine Sodium
    Proprietary Name Suffix n/a
    Non-Proprietary Name Levothyroxine Sodium
    Product Type HUMAN PRESCRIPTION DRUG
    Dosage Form TABLET
    Route ORAL
    Active Ingredient Strength 0.125
    Active Ingredient Units mg/1
    Substance Name LEVOTHYROXINE SODIUM
    Labeler Name Amneal Pharmaceuticals NY LLC
    Pharmaceutical Class Thyroxine [CS], l-Thyroxine [EPC]
    DEA Schedule n/a
    Marketing Category NDA
    Application Number NDA021210
    Listing Certified Through 2022-12-31

    Package

    NDC 69238-1836-01 (69238183601)

    NDC Package Code 69238-1836-1
    Billing NDC 69238183601
    Package 100 TABLET in 1 BOTTLE, PLASTIC (69238-1836-1)
    Marketing Start Date 2003-12-01
    NDC Exclude Flag N
    Pricing Information
    Price Per Unit 0.08204
    Pricing Unit EA
    Effective Date 2024-02-21
    NDC Description LEVOTHYROXINE 125 MCG TABLET
    Pharmacy Type Indicator C/I
    OTC N
    Explanation Code 1
    Classification for Rate Setting G
    As of Date 2024-02-21
    This pricing file, entitled the NADAC (National Average Drug Acquisition Cost) files, provide state Medicaid agencies with covered outpatient drug prices by averaging survey invoice prices from retail community pharmacies across the United States. These pharmacies include independent retail community pharmacies and chain pharmacies. The prices are updated on a weekly and monthly basis