August 31, 2012 - Iowa Medicaid Enterprise

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NDC Product Description Termination Date Quarter Covered 00641601310 DILTIAZEM INJ 25MG/5ML 12/31/9999 20121 10019051079 DILTIAZEM INJ 25MG/5ML 12/31/9999 20121 55390037405 DILTIAZEM INJ 25MG/5ML 12/31/9999 20121 55390056505 DILTIAZEM INJ 25MG/5ML 12/31/9999 20121 55390056605 DILTIAZEM INJ 25MG/5ML 12/31/9999 20121 00409117102 DILTIAZEM INJ 50/10ML 12/31/9999 20121 00641601410 DILTIAZEM INJ 50/10ML 12/31/9999 20121 10019051078 DILTIAZEM INJ 50/10ML 12/31/9999 20121 55390037410 DILTIAZEM INJ 50/10ML 12/31/9999 20121 55390056510 DILTIAZEM INJ 50/10ML 12/31/9999 20121 55390056610 DILTIAZEM INJ 50/10ML 12/31/9999 20121 00093032101 DILTIAZEM TAB 120MG 12/31/9999 20121 00378052501 DILTIAZEM TAB 120MG 12/31/9999 20121 00093031801 DILTIAZEM TAB 30MG 12/31/9999 20121 00093031805 DILTIAZEM TAB 30MG 12/31/9999 20121 00378002301 DILTIAZEM TAB 30MG 12/31/9999 20121 00378002305 DILTIAZEM TAB 30MG 12/31/9999 20121 51079074501 DILTIAZEM TAB 30MG 12/31/9999 20121 51079074517 DILTIAZEM TAB 30MG 12/31/9999 20121 51079074519 DILTIAZEM TAB 30MG 12/31/9999 20121 51079074520 DILTIAZEM TAB 30MG 12/31/9999 20121 63739007910 DILTIAZEM TAB 30MG 12/31/9999 20121 00093031901 DILTIAZEM TAB 60MG 12/31/9999 20121 00093031905 DILTIAZEM TAB 60MG 12/31/9999 20121 00378004501 DILTIAZEM TAB 60MG 12/31/9999 20121 00378004505 DILTIAZEM TAB 60MG 12/31/9999 20121 51079074601 DILTIAZEM TAB 60MG 12/31/9999 20121 51079074617 DILTIAZEM TAB 60MG 12/31/9999 20121 51079074619 DILTIAZEM TAB 60MG 12/31/9999 20121 51079074620 DILTIAZEM TAB 60MG 12/31/9999 20121 63739008010 DILTIAZEM TAB 60MG 12/31/9999 20121 00093032001 DILTIAZEM TAB 90MG 12/31/9999 20121 00378013501 DILTIAZEM TAB 90MG 12/31/9999 20121 00378013505 DILTIAZEM TAB 90MG 12/31/9999 20121 51079074701 DILTIAZEM TAB 90MG 12/31/9999 20121 51079074720 DILTIAZEM TAB 90MG 12/31/9999 20121 60505001406 DILT-XR CAP 120MG 12/31/9999 20121 60505001408 DILT-XR CAP 120MG 12/31/9999 20121 60505001506 DILT-XR CAP 180MG 12/31/9999 20121 60505001508 DILT-XR CAP 180MG 12/31/9999 20121 60505001606 DILT-XR CAP 240MG 12/31/9999 20121 60505001608 DILT-XR CAP 240MG 12/31/9999 20121 60505021003 DILTZAC CAP 120MG/24 12/31/9999 20121 60505021009 DILTZAC CAP 120MG/24 12/31/9999 20121 60505021103 DILTZAC CAP 180MG/24 12/31/9999 20121 60505021109 DILTZAC CAP 180MG/24 12/31/9999 20121 60505021203 DILTZAC CAP 240MG/24 12/31/9999 20121 60505021209 DILTZAC CAP 240MG/24 12/31/9999 20121 60505021303 DILTZAC CAP 300MG/24 12/31/9999 20121 60505021309 DILTZAC CAP 300MG/24 12/31/9999 20121 60505021403 DILTZAC CAP 360MG/24 12/31/9999 20121 60505021409 DILTZAC CAP 360MG/24 12/31/9999 20121 00904578109 DIMAPHEN ELX CHILDREN 12/31/9999 20121 00904578120 DIMAPHEN ELX CHILDREN 12/31/9999 20121 00904578220 DIMAPHEN DM ELX COLD/CGH 12/31/9999 20121 63323036601 DIMENHYDRIN INJ 50MG/ML 12/31/9999 20121 38779028105 DIMENHYDRIN POW USP 12/31/9999 20121 38779028108 DIMENHYDRIN POW USP 12/31/9999 20121 00603332721 DIMENHYDRIN TAB 50MG 12/31/9999 20121 00603332732 DIMENHYDRIN TAB 50MG 12/31/9999 20121 15310010604 DIMETANE DX SYP 12/31/9999 20121 00031224713 DIMETAPP LIQ NIGHTTIM 12/31/9999 20121 00031223813 DIMETAPP SYP CGH/COLD 12/31/9999 20121 00031229321 DIMETAPP CLD CHW /ALLERGY 06/30/2012 20121 00031223512 DIMETAPP CLD ELX /ALLERGY 12/31/9999 20121 00031223513 DIMETAPP CLD ELX /ALLERGY 12/31/9999 20121 00031223518 DIMETAPP CLD ELX /ALLERGY 12/31/9999 20121
NDC Product Description Termination Date Quarter Covered 00031223519 DIMETAPP CLD ELX /ALLERGY 12/31/9999 20121 00031223524 DIMETAPP CLD ELX /ALLERGY 12/31/9999 20121 00031223412 DIMETAPP DM LIQ COLD/CGH 12/31/9999 20121 00031223413 DIMETAPP DM LIQ COLD/CGH 12/31/9999 20121 00031223418 DIMETAPP DM LIQ COLD/CGH 12/31/9999 20121 00031223419 DIMETAPP DM LIQ COLD/CGH 12/31/9999 20121 00031224612 DIMETAPP MS LIQ COLD/FLU 12/31/9999 20121 00182177440 DIOCTO LIQ 150/15ML 09/30/2012 20121 00472093616 DIOCTO LIQ 150/15ML 12/31/9999 20121 00472093628 DIOCTO LIQ 150/15ML 12/31/9999 20121 00536059085 DIOCTO LIQ 50MG/5ML 12/31/9999 20121 00904093616 DIOCTO LIQ 50MG/5ML 12/31/9999 20121 00472092416 DIOCTO SYP 60/15ML 12/31/9999 20121 00472092428 DIOCTO SYP 60/15ML 12/31/9999 20121 00536060085 DIOCTO SYP 60/15ML 12/31/9999 20121 00472093016 DIOCTO-C SYP 60-30/15 12/31/9999 20121 00472093028 DIOCTO-C SYP 60-30/15 12/31/9999 20121 00078035906 DIOVAN TAB 160MG 12/31/9999 20121 00078035917 DIOVAN TAB 160MG 12/31/9999 20121 00078035934 DIOVAN TAB 160MG 12/31/9999 20121 00078035961 DIOVAN TAB 160MG 12/31/9999 20121 00078036011 DIOVAN TAB 320MG 12/31/9999 20121 00078036034 DIOVAN TAB 320MG 12/31/9999 20121 00078042306 DIOVAN TAB 40MG 12/31/9999 20121 00078042315 DIOVAN TAB 40MG 12/31/9999 20121 00078042361 DIOVAN TAB 40MG 12/31/9999 20121 00078035806 DIOVAN TAB 80MG 12/31/9999 20121 00078035833 DIOVAN TAB 80MG 12/31/9999 20121 00078035834 DIOVAN TAB 80MG 12/31/9999 20121 00078035861 DIOVAN TAB 80MG 12/31/9999 20121 00078031506 DIOVAN HCT TAB 160/12.5 12/31/9999 20121 00078031515 DIOVAN HCT TAB 160/12.5 12/31/9999 20121 00078031517 DIOVAN HCT TAB 160/12.5 12/31/9999 20121 00078031534 DIOVAN HCT TAB 160/12.5 12/31/9999 20121 00078031561 DIOVAN HCT TAB 160/12.5 12/31/9999 20121 00078031567 DIOVAN HCT TAB 160/12.5 12/31/9999 20121 00078038306 DIOVAN HCT TAB 160-25MG 12/31/9999 20121 00078038315 DIOVAN HCT TAB 160-25MG 12/31/9999 20121 00078038317 DIOVAN HCT TAB 160-25MG 12/31/9999 20121 00078038334 DIOVAN HCT TAB 160-25MG 12/31/9999 20121 00078038361 DIOVAN HCT TAB 160-25MG 12/31/9999 20121 00078038367 DIOVAN HCT TAB 160-25MG 12/31/9999 20121 00078047111 DIOVAN HCT TAB 320/12.5 12/31/9999 20121 00078047115 DIOVAN HCT TAB 320/12.5 12/31/9999 20121 00078047134 DIOVAN HCT TAB 320/12.5 12/31/9999 20121 00078047167 DIOVAN HCT TAB 320/12.5 12/31/9999 20121 00078047211 DIOVAN HCT TAB 320-25MG 12/31/9999 20121 00078047215 DIOVAN HCT TAB 320-25MG 12/31/9999 20121 00078047234 DIOVAN HCT TAB 320-25MG 12/31/9999 20121 00078047267 DIOVAN HCT TAB 320-25MG 12/31/9999 20121 00078031406 DIOVAN HCT TAB 80/12.5 12/31/9999 20121 00078031433 DIOVAN HCT TAB 80/12.5 12/31/9999 20121 00078031434 DIOVAN HCT TAB 80/12.5 12/31/9999 20121 00078031461 DIOVAN HCT TAB 80/12.5 12/31/9999 20121 50474060001 DIPENTUM CAP 250MG 12/31/9999 20121 68220016010 DIPENTUM CAP 250MG 12/31/9999 20121 00113037934 DIPHEDRYL ELX 12.5/5ML 12/31/2012 20121 00054319446 DIPHEN/ATROP LIQ 2.5/5 12/31/9999 20121 00378041501 DIPHEN/ATROP TAB 2.5MG 12/31/9999 20121 00378041510 DIPHEN/ATROP TAB 2.5MG 12/31/9999 20121 00378041577 DIPHEN/ATROP TAB 2.5MG 12/31/9999 20121 51079006701 DIPHEN/ATROP TAB 2.5MG 12/31/9999 20121 51079006720 DIPHEN/ATROP TAB 2.5MG 12/31/9999 20121 59762106101 DIPHEN/ATROP TAB 2.5MG 12/31/9999 20121 00536359401 DIPHENHIST CAP 25MG 12/31/9999 20121 00536418095 DIPHENHIST CRE /ZN ACE 08/31/2012 20121 00536077085 DIPHENHIST LIQ 12.5/5ML 12/31/9999 20121
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August 31, 2012 - Iowa Medicaid Enterprise

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