August 31, 2012 - Iowa Medicaid Enterprise

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NDC Product Description Termination Date Quarter Covered 47335028541 DOCEFREZ INJ 20MG 12/31/9999 20121 47335028641 DOCEFREZ INJ 80MG 12/31/9999 20121 00409020120 DOCETAXEL INJ 160/16ML 12/31/9999 20121 66758005003 DOCETAXEL INJ 160/16ML 12/31/9999 20121 16729012049 DOCETAXEL INJ 20/0.5ML 12/31/9999 20121 00409020102 DOCETAXEL INJ 20MG/2ML 12/31/9999 20121 66758005001 DOCETAXEL INJ 20MG/2ML 12/31/9999 20121 00955102001 DOCETAXEL INJ 20MG/ML 12/31/9999 20121 16729022850 DOCETAXEL INJ 80MG/2ML 12/31/9999 20121 00955102104 DOCETAXEL INJ 80MG/4ML 12/31/9999 20121 00409020110 DOCETAXEL INJ 80MG/8ML 12/31/9999 20121 66758005002 DOCETAXEL INJ 80MG/8ML 12/31/9999 20121 00603014521 DOCQLACE CAP 100MG 07/31/2013 20121 00603014532 DOCQLACE CAP 100MG 01/31/2013 20121 00603015021 DOCQLACE CAP 100MG 12/31/9999 20121 00603015032 DOCQLACE CAP 100MG 12/31/9999 20121 00603074658 DOC-Q-LACE LIQ 150/15ML 07/13/2013 20121 00603074758 DOC-Q-LACE SYP 60/15ML 12/31/9999 20121 00603014921 DOC-Q-LAX TAB 8.6-50MG 12/31/9999 20121 00603014932 DOC-Q-LAX TAB 8.6-50MG 12/31/9999 20121 50383077116 DOCU LIQ 150/15ML 12/31/9999 20121 00536375501 DOCUSATE CAL CAP 240MG 12/31/9999 20121 00536375505 DOCUSATE CAL CAP 240MG 12/31/9999 20121 00536375510 DOCUSATE CAL CAP 240MG 12/31/9999 20121 24385043578 DOCUSATE CAL CAP 240MG 12/31/9999 20121 49348028010 DOCUSATE CAL CAP 240MG 12/31/9999 20121 63868001701 DOCUSATE CAL CAP 240MG 12/31/9999 20121 00536375601 DOCUSATE SOD CAP 100MG 12/31/9999 20121 00536375610 DOCUSATE SOD CAP 100MG 12/31/9999 20121 15127028810 DOCUSATE SOD CAP 100MG 12/31/9999 20121 16103038408 DOCUSATE SOD CAP 100MG 12/31/9999 20121 45802048678 DOCUSATE SOD CAP 100MG 12/31/9999 20121 60258095501 DOCUSATE SOD CAP 100MG 12/31/9999 20121 62584068301 DOCUSATE SOD CAP 100MG 12/31/9999 20121 63739008910 DOCUSATE SOD CAP 100MG 08/31/2012 20121 63739047801 DOCUSATE SOD CAP 100MG 12/31/9999 20121 63739047810 DOCUSATE SOD CAP 100MG 12/31/9999 20121 00536375701 DOCUSATE SOD CAP 250MG 12/31/9999 20121 00536375710 DOCUSATE SOD CAP 250MG 12/31/9999 20121 00121054410 DOCUSATE SOD LIQ 50MG/5ML 12/31/9999 20121 00121054416 DOCUSATE SOD LIQ 50MG/5ML 12/31/9999 20121 00121054425 DOCUSATE SOD LIQ 50MG/5ML 12/31/9999 20121 24385046843 DOCUSATE SOD LIQ 50MG/5ML 12/31/9999 20121 00121074316 DOCUSATE SOD SYP 20MG/5ML 12/31/9999 20121 00121074325 DOCUSATE SOD SYP 20MG/5ML 12/31/9999 20121 51645075001 DOCUSATE SOD TAB 100MG 12/31/9999 20121 62107003301 DOCUSIL CAP 100MG 12/31/9999 20121 62107003310 DOCUSIL CAP 100MG 12/31/9999 20121 62107003401 DOCUSIL PLUS CAP 100-30 12/31/9999 20121 62107003410 DOCUSIL PLUS CAP 100-30 12/31/9999 20121 00713040599 DOCUSOFT S CAP 100MG 12/31/9999 20121 00713040560 DOCUSOFT-S CAP 100MG 12/31/9999 20121 00713042560 DOCUSOFT-S CAP 100MG 12/31/9999 20121 17433987805 DOCUSOL MINI ENE 12/31/9999 20121 00904224461 DOK CAP 100MG 12/31/9999 20121 00904788959 DOK CAP 100MG 12/31/9999 20121 00904788960 DOK CAP 100MG 12/31/9999 20121 00904788980 DOK CAP 100MG 12/31/9999 20121 00904789159 DOK CAP 250MG 12/31/9999 20121 00904586960 DOK TAB 100MG 12/31/9999 20121 00904564360 DOK PLUS TAB NEW FORM 12/31/9999 20121 00904564361 DOK PLUS TAB NEW FORM 12/31/9999 20121 00904564380 DOK PLUS TAB NEW FORM 12/31/9999 20121 59630007410 DOLGIC PLUS TAB 12/31/9999 20121 68453007410 DOLGIC PLUS TAB 12/31/9999 20121 54859051206 DOLOGESIC LIQ 30-500MG 12/31/9999 20121 54859010150 DOLOGESIC TAB 30-500MG 12/31/9999 20121
NDC Product Description Termination Date Quarter Covered 54859011010 DOLOGESIC TAB 30-500MG 12/31/9999 20121 00054421925 DOLOPHINE TAB 10MG 12/31/9999 20121 00054421825 DOLOPHINE TAB 5MG 12/31/9999 20121 16477013616 DONATUSS DC SYP 12/31/9999 20121 16477010630 DONATUSSIN DRO 12/31/9999 20121 16477081130 DONATUSSIN DRO DM 12/31/9999 20121 00277018541 DONATUSSIN SYP 08/31/2012 20121 16477018501 DONATUSSIN SYP 12/31/9999 20121 00093073905 DONEPEZIL TAB 10MG 12/31/9999 20121 00093073956 DONEPEZIL TAB 10MG 12/31/9999 20121 00093073998 DONEPEZIL TAB 10MG 12/31/9999 20121 00143974809 DONEPEZIL TAB 10MG 12/31/9999 20121 00143974830 DONEPEZIL TAB 10MG 12/31/9999 20121 00378514505 DONEPEZIL TAB 10MG 12/31/9999 20121 00378514577 DONEPEZIL TAB 10MG 12/31/9999 20121 00378514593 DONEPEZIL TAB 10MG 12/31/9999 20121 00781527510 DONEPEZIL TAB 10MG 12/31/9999 20121 00781527513 DONEPEZIL TAB 10MG 12/31/9999 20121 00781527531 DONEPEZIL TAB 10MG 12/31/9999 20121 00781527592 DONEPEZIL TAB 10MG 12/31/9999 20121 00904624361 DONEPEZIL TAB 10MG 12/31/9999 20121 13668010310 DONEPEZIL TAB 10MG 12/31/9999 20121 13668010326 DONEPEZIL TAB 10MG 12/31/9999 20121 13668010330 DONEPEZIL TAB 10MG 12/31/9999 20121 13668010374 DONEPEZIL TAB 10MG 12/31/9999 20121 13668010390 DONEPEZIL TAB 10MG 12/31/9999 20121 43547027603 DONEPEZIL TAB 10MG 12/31/9999 20121 43547027609 DONEPEZIL TAB 10MG 12/31/9999 20121 43547027611 DONEPEZIL TAB 10MG 12/31/9999 20121 45963056104 DONEPEZIL TAB 10MG 12/31/9999 20121 45963056108 DONEPEZIL TAB 10MG 12/31/9999 20121 45963056130 DONEPEZIL TAB 10MG 12/31/9999 20121 51079013930 DONEPEZIL TAB 10MG 12/31/9999 20121 51079013956 DONEPEZIL TAB 10MG 12/31/9999 20121 55111035705 DONEPEZIL TAB 10MG 12/31/9999 20121 55111035710 DONEPEZIL TAB 10MG 12/31/9999 20121 55111035730 DONEPEZIL TAB 10MG 12/31/9999 20121 55111035790 DONEPEZIL TAB 10MG 12/31/9999 20121 59746033030 DONEPEZIL TAB 10MG 12/31/9999 20121 59746033090 DONEPEZIL TAB 10MG 12/31/9999 20121 59762024601 DONEPEZIL TAB 10MG 12/31/9999 20121 59762024602 DONEPEZIL TAB 10MG 12/31/9999 20121 59762024603 DONEPEZIL TAB 10MG 12/31/9999 20121 59762024604 DONEPEZIL TAB 10MG 12/31/9999 20121 62756044518 DONEPEZIL TAB 10MG 12/31/9999 20121 62756044581 DONEPEZIL TAB 10MG 12/31/9999 20121 62756044583 DONEPEZIL TAB 10MG 12/31/9999 20121 63304012910 DONEPEZIL TAB 10MG 12/31/9999 20121 63304012930 DONEPEZIL TAB 10MG 12/31/9999 20121 63304012977 DONEPEZIL TAB 10MG 12/31/9999 20121 63304012990 DONEPEZIL TAB 10MG 12/31/9999 20121 64679031201 DONEPEZIL TAB 10MG 12/31/9999 20121 64679031203 DONEPEZIL TAB 10MG 12/31/9999 20121 64679031205 DONEPEZIL TAB 10MG 12/31/9999 20121 65862032630 DONEPEZIL TAB 10MG 12/31/9999 20121 65862032690 DONEPEZIL TAB 10MG 12/31/9999 20121 65862032699 DONEPEZIL TAB 10MG 12/31/9999 20121 68084047801 DONEPEZIL TAB 10MG 12/31/9999 20121 00093540865 DONEPEZIL TAB 10MG ODT 09/30/2012 20121 00781527764 DONEPEZIL TAB 10MG ODT 12/31/9999 20121 59762025201 DONEPEZIL TAB 10MG ODT 12/31/9999 20121 68382034706 DONEPEZIL TAB 10MG ODT 12/31/9999 20121 00093073805 DONEPEZIL TAB 5MG 12/31/9999 20121 00093073856 DONEPEZIL TAB 5MG 12/31/9999 20121 00093073898 DONEPEZIL TAB 5MG 12/31/9999 20121 00143974709 DONEPEZIL TAB 5MG 12/31/9999 20121 00143974730 DONEPEZIL TAB 5MG 12/31/9999 20121
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Rebatable Drug List for Iowa Medica
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August 31, 2012 - Iowa Medicaid Enterprise

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