Generic Ingredient LEVOTHYROXINE SODIUM Medication Lists Not Covered Strength Information LEVOTHYROXINE-13MCG-CAPS LEVOTHYROXINE-25MCG-CAPS LEVOTHYROXINE-50MCG-CAPS LEVOTHYROXINE-75MCG-CAPS LEVOTHYROXINE-88MCG-CAPS LEVOTHYROXINE-100MCG-CAPS LEVOTHYROXINE-112MCG-CAPS LEVOTHYROXINE-125MCG-CAPS LEVOTHYROXINE-137MCG-CAPS LEVOTHYROXINE-150MCG-CAPS LEVOTHYROXINE-175MCG-CAPS LEVOTHYROXINE-200MCG-CAPS Covered Alternatives Group THYROID REPLACEMENT gpi6 Thyroid Hormones