August 31, 2012 - Iowa Medicaid Enterprise

More documents

Recommendations

Info

NDC Product Description Termination Date Quarter Covered 51672405201 ETODOLAC ER TAB 500MG 12/31/9999 20121 51672405204 ETODOLAC ER TAB 500MG 12/31/9999 20121 00093111801 ETODOLAC ER TAB 600MG 12/31/9999 20121 51672405301 ETODOLAC ER TAB 600MG 12/31/9999 20121 51672405304 ETODOLAC ER TAB 600MG 12/31/9999 20121 00069000601 ETOMIDATE INJ 2MG/ML 12/31/9999 20121 00069000602 ETOMIDATE INJ 2MG/ML 12/31/9999 20121 00069000603 ETOMIDATE INJ 2MG/ML 12/31/9999 20121 00069000604 ETOMIDATE INJ 2MG/ML 12/31/9999 20121 00517078010 ETOMIDATE INJ 2MG/ML 12/31/9999 20121 00517078110 ETOMIDATE INJ 2MG/ML 12/31/9999 20121 55390076210 ETOMIDATE INJ 2MG/ML 12/31/9999 20121 55390076320 ETOMIDATE INJ 2MG/ML 12/31/9999 20121 00015340420 ETOPOPHOS INJ 100MG 12/31/9999 20121 00378326694 ETOPOSIDE CAP 50MG 12/31/9999 20121 16729011431 ETOPOSIDE INJ 20MG/ML 12/31/9999 20121 55390029101 ETOPOSIDE INJ 20MG/ML 12/31/9999 20121 55390029201 ETOPOSIDE INJ 20MG/ML 12/31/9999 20121 55390029301 ETOPOSIDE INJ 20MG/ML 12/31/9999 20121 55390049101 ETOPOSIDE INJ 20MG/ML 12/31/9999 20121 55390049201 ETOPOSIDE INJ 20MG/ML 12/31/9999 20121 55390049301 ETOPOSIDE INJ 20MG/ML 12/31/9999 20121 63323010405 ETOPOSIDE INJ 20MG/ML 12/31/9999 20121 63323010425 ETOPOSIDE INJ 20MG/ML 12/31/9999 20121 63323010450 ETOPOSIDE INJ 20MG/ML 12/31/9999 20121 51552077004 EUCALYPTOL LIQ 12/31/9999 20121 51552018202 EUCALYPTUS OIL 12/31/9999 20121 51552018203 EUCALYPTUS OIL 12/31/9999 20121 51552018205 EUCALYPTUS OIL 12/31/9999 20121 51552018206 EUCALYPTUS OIL 12/31/9999 20121 10631009160 EURAX CRE 10% 12/31/9999 20121 10631009216 EURAX LOT 10% 12/31/9999 20121 10631009260 EURAX LOT 10% 12/31/9999 20121 64011021541 EVAMIST SPR 1.53MG 12/31/9999 20121 00002416502 EVISTA TAB 60MG 12/31/9999 20121 00002416507 EVISTA TAB 60MG 12/31/9999 20121 00002416530 EVISTA TAB 60MG 12/31/9999 20121 63032006100 EVOCLIN AER 1% 12/31/9999 20121 63032006150 EVOCLIN AER 1% 12/31/9999 20121 63395020113 EVOXAC CAP 30MG 12/31/9999 20121 36800004662 EX STR PAIN TAB RELIEF 12/31/9999 20121 36800004671 EX STR PAIN TAB RELIEF 12/31/9999 20121 36800004678 EX STR PAIN TAB RELIEF 12/31/9999 20121 36800004683 EX STR PAIN TAB RELIEF 12/31/9999 20121 16781011360 EXACTACAIN AER 12/31/9999 20121 23635041201 EXALGO TAB 12MG 12/31/9999 20121 23635041601 EXALGO TAB 16MG 12/31/9999 20121 23635040801 EXALGO TAB 8MG 12/31/9999 20121 00067623877 EXCEDRIN TAB BACK/BOD 12/31/9999 20121 00067200024 EXCEDRIN TAB EX ST 12/31/9999 20121 00067200050 EXCEDRIN TAB EX ST 12/31/9999 20121 00067200077 EXCEDRIN TAB EX ST 12/31/9999 20121 00067200091 EXCEDRIN TAB EX ST 12/31/9999 20121 00067202124 EXCEDRIN TAB EX ST 12/31/9999 20121 00067202150 EXCEDRIN TAB EX ST 12/31/9999 20121 00067202191 EXCEDRIN TAB EX ST 12/31/9999 20121 00067203008 EXCEDRIN TAB EX ST 12/31/9999 20121 00067203010 EXCEDRIN TAB EX ST 12/31/9999 20121 00067203091 EXCEDRIN TAB EX ST 12/31/9999 20121 00067634120 EXCEDRIN TAB MENSTRUA 12/31/9999 20121 00067634140 EXCEDRIN TAB MENSTRUA 12/31/9999 20121 00067203516 EXCEDRIN TAB MIGRAINE 12/31/9999 20121 00067203524 EXCEDRIN TAB MIGRAINE 12/31/9999 20121 00067203550 EXCEDRIN TAB MIGRAINE 12/31/9999 20121 00067203777 EXCEDRIN TAB MIGRAINE 12/31/9999 20121 00067203791 EXCEDRIN TAB MIGRAINE 12/31/9999 20121 00067203908 EXCEDRIN TAB MIGRAINE 12/31/9999 20121
NDC Product Description Termination Date Quarter Covered 00067203924 EXCEDRIN TAB MIGRAINE 12/31/9999 20121 00067203950 EXCEDRIN TAB MIGRAINE 12/31/9999 20121 00067203977 EXCEDRIN TAB MIGRAINE 12/31/9999 20121 00067203991 EXCEDRIN TAB MIGRAINE 12/31/9999 20121 00067205308 EXCEDRIN PM TAB 12/31/9999 20121 00067205324 EXCEDRIN PM TAB 12/31/9999 20121 00067205350 EXCEDRIN PM TAB 12/31/9999 20121 00067205391 EXCEDRIN PM TAB 12/31/9999 20121 00067205524 EXCEDRIN PM TAB 12/31/9999 20121 00067205550 EXCEDRIN PM TAB 12/31/9999 20121 00067205591 EXCEDRIN PM TAB 12/31/9999 20121 00067640520 EXCEDRIN PM TAB 38-500MG 12/31/9999 20121 00067206224 EXCEDRIN SIN TAB HEADACHE 12/31/9999 20121 00067204124 EXCEDRIN TNS TAB HEADACHE 12/31/9999 20121 00067204150 EXCEDRIN TNS TAB HEADACHE 12/31/9999 20121 00067204177 EXCEDRIN TNS TAB HEADACHE 12/31/9999 20121 00067204191 EXCEDRIN TNS TAB HEADACHE 12/31/9999 20121 00067204524 EXCEDRIN TNS TAB HEADACHE 12/31/9999 20121 00067204550 EXCEDRIN TNS TAB HEADACHE 12/31/9999 20121 00067204577 EXCEDRIN TNS TAB HEADACHE 12/31/9999 20121 00067204591 EXCEDRIN TNS TAB HEADACHE 12/31/9999 20121 00067205024 EXCEDRIN TNS TAB HEADACHE 12/31/9999 20121 00067205050 EXCEDRIN TNS TAB HEADACHE 12/31/9999 20121 00067205091 EXCEDRIN TNS TAB HEADACHE 12/31/9999 20121 68047015501 EXEFEN DMX TAB 12/31/9999 20121 68047015701 EXEFEN-IR TAB 60-400MG 12/31/9999 20121 10631010115 EXELDERM CRE 1% 12/31/9999 20121 10631010130 EXELDERM CRE 1% 12/31/9999 20121 10631010160 EXELDERM CRE 1% 12/31/9999 20121 10631010004 EXELDERM SOL 1% 12/31/9999 20121 10631010030 EXELDERM SOL 1% 12/31/9999 20121 00078032306 EXELON CAP 1.5MG 12/31/9999 20121 00078032344 EXELON CAP 1.5MG 12/31/9999 20121 00078032361 EXELON CAP 1.5MG 12/31/9999 20121 00078032406 EXELON CAP 3MG 12/31/9999 20121 00078032444 EXELON CAP 3MG 12/31/9999 20121 00078032461 EXELON CAP 3MG 12/31/9999 20121 00078032506 EXELON CAP 4.5MG 12/31/9999 20121 00078032544 EXELON CAP 4.5MG 12/31/9999 20121 00078032561 EXELON CAP 4.5MG 12/31/9999 20121 00078032606 EXELON CAP 6MG 12/31/9999 20121 00078032644 EXELON CAP 6MG 12/31/9999 20121 00078032661 EXELON CAP 6MG 12/31/9999 20121 00078050115 EXELON DIS 4.6MG/24 12/31/9999 20121 00078050161 EXELON DIS 4.6MG/24 12/31/9999 20121 00078050215 EXELON DIS 9.5MG/24 12/31/9999 20121 00078050261 EXELON DIS 9.5MG/24 12/31/9999 20121 00078033931 EXELON SOL 2MG/ML 12/31/9999 20121 00054008013 EXEMESTANE TAB 25MG 12/31/9999 20121 59762285801 EXEMESTANE TAB 25MG 12/31/9999 20121 00078048915 EXFORGE TAB 10-160MG 12/31/9999 20121 00078049115 EXFORGE TAB 10-320MG 12/31/9999 20121 00078048815 EXFORGE TAB 5-160MG 12/31/9999 20121 00078049015 EXFORGE TAB 5-320MG 12/31/9999 20121 00078056115 EXFORGEH/10- TAB 160-12.5 12/31/9999 20121 00078056215 EXFORGEH/10- TAB 160-25 12/31/9999 20121 00078056315 EXFORGEH/10- TAB 320-25 12/31/9999 20121 00078055915 EXFORGEH/5- TAB 160-12.5 12/31/9999 20121 00078056015 EXFORGEH/5- TAB 160-25 12/31/9999 20121 00078046815 EXJADE TAB 125MG 12/31/9999 20121 00078046915 EXJADE TAB 250MG 12/31/9999 20121 00078047015 EXJADE TAB 500MG 12/31/9999 20121 00067000518 EX-LAX CHW 15MG 12/31/9999 20121 00067000548 EX-LAX CHW 15MG 12/31/9999 20121 00067000308 EX-LAX TAB 15MG 12/31/9999 20121 00067000330 EX-LAX TAB 15MG 12/31/9999 20121 00067001624 EX-LAX TAB MAX ST 12/31/9999 20121
Page 1 and 2:
Rebatable Drug List for Iowa Medica
Page 3 and 4:
NDC Product Description Termination
Page 5 and 6:
Page 7 and 8:
Page 9 and 10:
Page 11 and 12:
Page 13 and 14:
Page 15 and 16:
Page 17 and 18:
Page 19 and 20:
Page 21 and 22:
Page 23 and 24:
Page 25 and 26:
Page 27 and 28:
Page 29 and 30:
Page 31 and 32:
Page 33 and 34:
Page 35 and 36:
Page 37 and 38:
Page 39 and 40:
Page 41 and 42:
Page 43 and 44:
Page 45 and 46:
Page 47 and 48:
Page 49 and 50:
Page 51 and 52:
Page 53 and 54:
Page 55 and 56:
Page 57 and 58:
Page 59 and 60:
Page 61 and 62:
Page 63 and 64:
Page 65 and 66:
Page 67 and 68:
Page 69 and 70:
Page 71 and 72:
Page 73 and 74:
Page 75 and 76:
Page 77 and 78:
Page 79 and 80:
Page 81 and 82:
Page 83 and 84:
Page 85 and 86:
Page 87 and 88:
Page 89 and 90:
Page 91 and 92:
Page 93 and 94:
Page 95 and 96:
Page 97 and 98:
Page 99 and 100:
Page 101 and 102:
Page 103 and 104: NDC Product Description Termination
Page 153: NDC Product Description Termination
Page 205 and 206:
Page 207 and 208:
Page 209 and 210:
Page 211 and 212:
Page 213 and 214:
Page 215 and 216:
Page 217 and 218:
Page 219 and 220:
Page 221 and 222:
Page 223 and 224:
Page 225 and 226:
Page 227 and 228:
Page 229 and 230:
Page 231 and 232:
Page 233 and 234:
Page 235 and 236:
Page 237 and 238:
Page 239 and 240:
Page 241 and 242:
Page 243 and 244:
Page 245 and 246:
Page 247 and 248:
Page 249 and 250:
Page 251 and 252:
Page 253 and 254:
Page 255 and 256:
Page 257 and 258:
Page 259 and 260:
Page 261 and 262:
Page 263 and 264:
Page 265 and 266:
Page 267 and 268:
Page 269 and 270:
Page 271 and 272:
Page 273 and 274:
Page 275 and 276:
Page 277 and 278:
Page 279 and 280:
Page 281 and 282:
Page 283 and 284:
Page 285 and 286:
Page 287 and 288:
Page 289 and 290:
Page 291 and 292:
Page 293 and 294:
Page 295 and 296:
Page 297 and 298:
Page 299 and 300:
Page 301 and 302:
Page 303 and 304:
Page 305 and 306:
Page 307 and 308:
Page 309 and 310:
Page 311 and 312:
Page 313 and 314:
Page 315 and 316:
Page 317 and 318:
Page 319 and 320:
Page 321 and 322:
Page 323 and 324:
Page 325 and 326:
Page 327 and 328:
Page 329 and 330:
Page 331 and 332:
Page 333 and 334:
Page 335 and 336:
Page 337 and 338:
Page 339 and 340:
Page 341 and 342:
Page 343 and 344:
Page 345 and 346:
Page 347 and 348:
Page 349 and 350:
Page 351 and 352:
Page 353 and 354:
Page 355 and 356:
Page 357 and 358:
Page 359 and 360:
Page 361 and 362:
Page 363 and 364:
Page 365 and 366:
Page 367 and 368:
Page 369 and 370:
Page 371 and 372:
Page 373 and 374:
Page 375 and 376:
Page 377 and 378:
Page 379 and 380:
Page 381 and 382:
Page 383 and 384:
Page 385 and 386:
Page 387 and 388:
Page 389 and 390:
Page 391 and 392:
Page 393 and 394:
Page 395 and 396:
Page 397 and 398:
Page 399 and 400:
Page 401 and 402:
Page 403 and 404:
Page 405 and 406:
Page 407 and 408:
Page 409 and 410:
Page 411 and 412:
Page 413 and 414:
Page 415 and 416:
Page 417 and 418:
Page 419 and 420:
Page 421 and 422:
Page 423 and 424:
Page 425 and 426:
Page 427 and 428:
Page 429 and 430:
Page 431 and 432:
Page 433 and 434:
Page 435 and 436:
Page 437 and 438:
Page 439 and 440:
Page 441 and 442:
Page 443 and 444:
Page 445 and 446:
Page 447 and 448:
Page 449 and 450:
Page 451 and 452:
Page 453 and 454:
Page 455 and 456:
Page 457 and 458:
Page 459 and 460:
Page 461 and 462:
Page 463 and 464:
Page 465 and 466:
Page 467 and 468:
Page 469:
show all

August 31, 2012 - Iowa Medicaid Enterprise

Create successful ePaper yourself

Delete template?

Save as template?