August 31, 2012 - Iowa Medicaid Enterprise

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NDC Product Description Termination Date Quarter Covered 00093103993 GABAPENTIN CAP 300MG 12/31/9999 20121 00143999301 GABAPENTIN CAP 300MG 12/31/9999 20121 00228266611 GABAPENTIN CAP 300MG 12/31/9999 20121 00228266650 GABAPENTIN CAP 300MG 12/31/9999 20121 00378542701 GABAPENTIN CAP 300MG 12/31/9999 20121 00378542705 GABAPENTIN CAP 300MG 12/31/9999 20121 00904607961 GABAPENTIN CAP 300MG 12/31/9999 20121 14550051202 GABAPENTIN CAP 300MG 12/31/9999 20121 14550051204 GABAPENTIN CAP 300MG 12/31/9999 20121 16714066201 GABAPENTIN CAP 300MG 12/31/2020 20121 16714066202 GABAPENTIN CAP 300MG 12/31/2020 20121 31722022201 GABAPENTIN CAP 300MG 12/31/9999 20121 31722022205 GABAPENTIN CAP 300MG 12/31/9999 20121 53746010201 GABAPENTIN CAP 300MG 12/31/9999 20121 53746010205 GABAPENTIN CAP 300MG 12/31/9999 20121 53746010210 GABAPENTIN CAP 300MG 12/31/9999 20121 59762502701 GABAPENTIN CAP 300MG 12/31/9999 20121 59762502702 GABAPENTIN CAP 300MG 12/31/9999 20121 60505011300 GABAPENTIN CAP 300MG 12/31/9999 20121 60505011301 GABAPENTIN CAP 300MG 12/31/9999 20121 60505011307 GABAPENTIN CAP 300MG 12/31/9999 20121 60505011308 GABAPENTIN CAP 300MG 12/31/9999 20121 62756013802 GABAPENTIN CAP 300MG 12/31/9999 20121 62756013805 GABAPENTIN CAP 300MG 12/31/9999 20121 63304062801 GABAPENTIN CAP 300MG 12/31/9999 20121 63304062805 GABAPENTIN CAP 300MG 12/31/9999 20121 63739037510 GABAPENTIN CAP 300MG 12/31/9999 20121 65862019901 GABAPENTIN CAP 300MG 12/31/9999 20121 65862019905 GABAPENTIN CAP 300MG 12/31/9999 20121 65862019999 GABAPENTIN CAP 300MG 12/31/9999 20121 67877022301 GABAPENTIN CAP 300MG 12/31/9999 20121 67877022305 GABAPENTIN CAP 300MG 12/31/9999 20121 67877022310 GABAPENTIN CAP 300MG 12/31/9999 20121 68084008001 GABAPENTIN CAP 300MG 12/31/9999 20121 68084008065 GABAPENTIN CAP 300MG 12/31/9999 20121 68084056301 GABAPENTIN CAP 300MG 12/31/9999 20121 00143999401 GABAPENTIN CAP 400MG 12/31/9999 20121 00172438300 GABAPENTIN CAP 400MG 12/31/9999 20121 00172438310 GABAPENTIN CAP 400MG 12/31/9999 20121 00172438370 GABAPENTIN CAP 400MG 12/31/9999 20121 00185009410 GABAPENTIN CAP 400MG 12/31/9999 20121 00228266711 GABAPENTIN CAP 400MG 12/31/9999 20121 00228266750 GABAPENTIN CAP 400MG 12/31/9999 20121 00378542801 GABAPENTIN CAP 400MG 12/31/9999 20121 00378542805 GABAPENTIN CAP 400MG 12/31/9999 20121 00904563361 GABAPENTIN CAP 400MG 12/31/9999 20121 00904610561 GABAPENTIN CAP 400MG 12/31/9999 20121 14550051302 GABAPENTIN CAP 400MG 12/31/9999 20121 14550051304 GABAPENTIN CAP 400MG 12/31/9999 20121 16714066301 GABAPENTIN CAP 400MG 12/31/2020 20121 16714066302 GABAPENTIN CAP 400MG 12/31/2020 20121 31722022301 GABAPENTIN CAP 400MG 12/31/9999 20121 31722022305 GABAPENTIN CAP 400MG 12/31/9999 20121 53746010301 GABAPENTIN CAP 400MG 12/31/9999 20121 53746010305 GABAPENTIN CAP 400MG 12/31/9999 20121 59762502801 GABAPENTIN CAP 400MG 12/31/9999 20121 60505011400 GABAPENTIN CAP 400MG 12/31/9999 20121 60505011401 GABAPENTIN CAP 400MG 12/31/9999 20121 60505011405 GABAPENTIN CAP 400MG 12/31/9999 20121 60505011407 GABAPENTIN CAP 400MG 12/31/9999 20121 62756013902 GABAPENTIN CAP 400MG 12/31/9999 20121 62756013905 GABAPENTIN CAP 400MG 12/31/9999 20121 63304062901 GABAPENTIN CAP 400MG 12/31/9999 20121 63304062905 GABAPENTIN CAP 400MG 12/31/9999 20121 63739037610 GABAPENTIN CAP 400MG 12/31/9999 20121 65862020001 GABAPENTIN CAP 400MG 12/31/9999 20121 65862020005 GABAPENTIN CAP 400MG 12/31/9999 20121
NDC Product Description Termination Date Quarter Covered 67877022401 GABAPENTIN CAP 400MG 12/31/9999 20121 67877022405 GABAPENTIN CAP 400MG 12/31/9999 20121 67877022410 GABAPENTIN CAP 400MG 12/31/9999 20121 68084008101 GABAPENTIN CAP 400MG 12/31/9999 20121 68084008165 GABAPENTIN CAP 400MG 12/31/9999 20121 38779198001 GABAPENTIN POW 12/31/9999 20121 38779198004 GABAPENTIN POW 12/31/9999 20121 38779198005 GABAPENTIN POW 12/31/9999 20121 50383031147 GABAPENTIN SOL 250/5ML 12/31/9999 20121 59762502501 GABAPENTIN SOL 250/5ML 12/31/9999 20121 65162069890 GABAPENTIN SOL 250/5ML 12/31/9999 20121 00093444301 GABAPENTIN TAB 600MG 12/31/9999 20121 00093444305 GABAPENTIN TAB 600MG 12/31/9999 20121 00093444310 GABAPENTIN TAB 600MG 12/31/9999 20121 00172444300 GABAPENTIN TAB 600MG 12/31/9999 20121 00172444310 GABAPENTIN TAB 600MG 12/31/9999 20121 00228263611 GABAPENTIN TAB 600MG 12/31/9999 20121 00228263650 GABAPENTIN TAB 600MG 12/31/9999 20121 00378542401 GABAPENTIN TAB 600MG 12/31/9999 20121 00378542405 GABAPENTIN TAB 600MG 12/31/9999 20121 59762502301 GABAPENTIN TAB 600MG 12/31/9999 20121 60505255101 GABAPENTIN TAB 600MG 12/31/9999 20121 60505255105 GABAPENTIN TAB 600MG 12/31/9999 20121 62756020201 GABAPENTIN TAB 600MG 12/31/9999 20121 62756020203 GABAPENTIN TAB 600MG 12/31/9999 20121 63304059201 GABAPENTIN TAB 600MG 12/31/9999 20121 63304059205 GABAPENTIN TAB 600MG 12/31/9999 20121 63739039110 GABAPENTIN TAB 600MG 12/31/9999 20121 65862052301 GABAPENTIN TAB 600MG 12/31/9999 20121 65862052305 GABAPENTIN TAB 600MG 12/31/9999 20121 68084012201 GABAPENTIN TAB 600MG 12/31/9999 20121 68462012601 GABAPENTIN TAB 600MG 12/31/9999 20121 68462012605 GABAPENTIN TAB 600MG 12/31/9999 20121 00093444401 GABAPENTIN TAB 800MG 12/31/9999 20121 00093444405 GABAPENTIN TAB 800MG 12/31/9999 20121 00172444400 GABAPENTIN TAB 800MG 12/31/9999 20121 00172444410 GABAPENTIN TAB 800MG 12/31/9999 20121 00228263711 GABAPENTIN TAB 800MG 12/31/9999 20121 00228263750 GABAPENTIN TAB 800MG 12/31/9999 20121 00378542501 GABAPENTIN TAB 800MG 12/31/9999 20121 00378542505 GABAPENTIN TAB 800MG 12/31/9999 20121 51079009701 GABAPENTIN TAB 800MG 12/31/9999 20121 51079009720 GABAPENTIN TAB 800MG 05/31/2013 20121 59762502401 GABAPENTIN TAB 800MG 12/31/9999 20121 60505255201 GABAPENTIN TAB 800MG 12/31/9999 20121 60505255205 GABAPENTIN TAB 800MG 12/31/9999 20121 62756020401 GABAPENTIN TAB 800MG 12/31/9999 20121 62756020403 GABAPENTIN TAB 800MG 12/31/9999 20121 63304059301 GABAPENTIN TAB 800MG 12/31/9999 20121 63304059305 GABAPENTIN TAB 800MG 12/31/9999 20121 65862052401 GABAPENTIN TAB 800MG 12/31/9999 20121 65862052405 GABAPENTIN TAB 800MG 12/31/9999 20121 68084012301 GABAPENTIN TAB 800MG 12/31/9999 20121 68462012701 GABAPENTIN TAB 800MG 12/31/9999 20121 68462012705 GABAPENTIN TAB 800MG 12/31/9999 20121 68405805426 GABAVALE-5 PAK 12/31/9999 20121 68405802426 GABAZOLAMINE PAK 12/31/9999 20121 68405803426 GABAZOLAMINE PAK 0.5MG 12/31/9999 20121 68405804426 GABAZOLPIDEM PAK 5MG 12/31/9999 20121 68405800426 GABITIDINE PAK 12/31/9999 20121 63459041201 GABITRIL TAB 12MG 06/01/2012 20121 63459041230 GABITRIL TAB 12MG 12/31/9999 20121 63459041630 GABITRIL TAB 16MG 12/31/9999 20121 63459040230 GABITRIL TAB 2MG 12/31/9999 20121 63459040430 GABITRIL TAB 4MG 12/31/9999 20121 45945015702 GABLOFEN INJ 2000MCG 12/31/9999 20121 45945015502 GABLOFEN INJ 500MCG 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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