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    NDC 71858-0005-04 Tirosint 13 ug/1 Details

    Tirosint 13 ug/1

    Tirosint is a ORAL CAPSULE in the HUMAN PRESCRIPTION DRUG category. It is labeled and distributed by IBSA Pharma Inc.. The primary component is LEVOTHYROXINE SODIUM.

    Product Information

    NDC 71858-0005
    Product ID 71858-0005_0b274758-a84c-4e19-e063-6294a90a3b89
    Associated GPIs 28100010100105
    GCN Sequence Number 066134
    GCN Sequence Number Description levothyroxine sodium CAPSULE 13 MCG ORAL
    HIC3 P3A
    HIC3 Description THYROID HORMONES
    GCN 28336
    HICL Sequence Number 002849
    HICL Sequence Number Description LEVOTHYROXINE SODIUM
    Brand/Generic Brand
    Proprietary Name Tirosint
    Proprietary Name Suffix n/a
    Non-Proprietary Name levothyroxine sodium
    Product Type HUMAN PRESCRIPTION DRUG
    Dosage Form CAPSULE
    Route ORAL
    Active Ingredient Strength 13
    Active Ingredient Units ug/1
    Substance Name LEVOTHYROXINE SODIUM
    Labeler Name IBSA Pharma Inc.
    Pharmaceutical Class Thyroxine [CS], l-Thyroxine [EPC]
    DEA Schedule n/a
    Marketing Category NDA
    Application Number NDA021924
    Listing Certified Through 2024-12-31

    Package

    NDC 71858-0005-04 (71858000504)

    NDC Package Code 71858-0005-4
    Billing NDC 71858000504
    Package 3 BLISTER PACK in 1 CARTON (71858-0005-4) / 10 CAPSULE in 1 BLISTER PACK
    Marketing Start Date 2018-12-01
    NDC Exclude Flag N
    Pricing Information
    Price Per Unit 4.43222
    Pricing Unit EA
    Effective Date 2023-07-01
    NDC Description TIROSINT 13 MCG CAPSULE
    Pharmacy Type Indicator C/I
    OTC N
    Explanation Code 4
    Classification for Rate Setting B
    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