August 31, 2012 - Iowa Medicaid Enterprise

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NDC Product Description Termination Date Quarter Covered 00378400377 ALPRAZOLAM TAB 0.5MG 12/31/9999 20121 00603212821 ALPRAZOLAM TAB 0.5MG 12/31/9999 20121 00603212828 ALPRAZOLAM TAB 0.5MG 12/31/9999 20121 00603212832 ALPRAZOLAM TAB 0.5MG 12/31/9999 20121 00781107701 ALPRAZOLAM TAB 0.5MG 12/31/9999 20121 00781107705 ALPRAZOLAM TAB 0.5MG 12/31/9999 20121 00781107710 ALPRAZOLAM TAB 0.5MG 12/31/9999 20121 00904585961 ALPRAZOLAM TAB 0.5MG 12/31/9999 20121 47335060413 ALPRAZOLAM TAB 0.5MG 12/31/9999 20121 47335060418 ALPRAZOLAM TAB 0.5MG 12/31/9999 20121 47335060488 ALPRAZOLAM TAB 0.5MG 12/31/9999 20121 51079078901 ALPRAZOLAM TAB 0.5MG 12/31/9999 20121 51079078920 ALPRAZOLAM TAB 0.5MG 12/31/9999 20121 51079078921 ALPRAZOLAM TAB 0.5MG 06/30/2012 20121 59762372001 ALPRAZOLAM TAB 0.5MG 12/31/9999 20121 59762372003 ALPRAZOLAM TAB 0.5MG 12/31/9999 20121 59762372004 ALPRAZOLAM TAB 0.5MG 12/31/9999 20121 64376063101 ALPRAZOLAM TAB 0.5MG 12/31/9999 20121 64376063105 ALPRAZOLAM TAB 0.5MG 12/31/9999 20121 64376063110 ALPRAZOLAM TAB 0.5MG 12/31/9999 20121 67253090110 ALPRAZOLAM TAB 0.5MG 12/31/9999 20121 67253090111 ALPRAZOLAM TAB 0.5MG 12/31/9999 20121 67253090150 ALPRAZOLAM TAB 0.5MG 12/31/9999 20121 68084001901 ALPRAZOLAM TAB 0.5MG 12/31/9999 20121 00093545006 ALPRAZOLAM TAB 0.5MG ER 12/31/9999 20121 00228308306 ALPRAZOLAM TAB 0.5MG ER 12/31/9999 20121 00378502191 ALPRAZOLAM TAB 0.5MG ER 12/31/9999 20121 64980014006 ALPRAZOLAM TAB 0.5MG ER 12/31/9999 20121 65162080906 ALPRAZOLAM TAB 0.5MG ER 12/31/9999 20121 00228402211 ALPRAZOLAM TAB 0.5MG OD 12/31/9999 20121 49884011174 ALPRAZOLAM TAB 0.5MG OD 12/31/9999 20121 00228203110 ALPRAZOLAM TAB 1MG 12/31/9999 20121 00228203150 ALPRAZOLAM TAB 1MG 12/31/9999 20121 00228203196 ALPRAZOLAM TAB 1MG 12/31/9999 20121 00378400501 ALPRAZOLAM TAB 1MG 12/31/9999 20121 00378400505 ALPRAZOLAM TAB 1MG 12/31/9999 20121 00378400577 ALPRAZOLAM TAB 1MG 12/31/9999 20121 00603212921 ALPRAZOLAM TAB 1MG 12/31/9999 20121 00603212928 ALPRAZOLAM TAB 1MG 12/31/9999 20121 00603212932 ALPRAZOLAM TAB 1MG 12/31/9999 20121 00781107901 ALPRAZOLAM TAB 1MG 12/31/9999 20121 00781107905 ALPRAZOLAM TAB 1MG 12/31/9999 20121 00781107910 ALPRAZOLAM TAB 1MG 12/31/9999 20121 00904586061 ALPRAZOLAM TAB 1MG 12/31/9999 20121 47335060513 ALPRAZOLAM TAB 1MG 12/31/9999 20121 47335060518 ALPRAZOLAM TAB 1MG 12/31/9999 20121 47335060588 ALPRAZOLAM TAB 1MG 12/31/9999 20121 51079079001 ALPRAZOLAM TAB 1MG 12/31/9999 20121 51079079020 ALPRAZOLAM TAB 1MG 12/31/9999 20121 59762372101 ALPRAZOLAM TAB 1MG 12/31/9999 20121 59762372103 ALPRAZOLAM TAB 1MG 12/31/9999 20121 59762372104 ALPRAZOLAM TAB 1MG 12/31/9999 20121 64376063201 ALPRAZOLAM TAB 1MG 12/31/9999 20121 64376063205 ALPRAZOLAM TAB 1MG 12/31/9999 20121 64376063210 ALPRAZOLAM TAB 1MG 12/31/9999 20121 67253090210 ALPRAZOLAM TAB 1MG 12/31/9999 20121 67253090211 ALPRAZOLAM TAB 1MG 12/31/9999 20121 67253090250 ALPRAZOLAM TAB 1MG 12/31/9999 20121 68084002001 ALPRAZOLAM TAB 1MG 12/31/9999 20121 00093545106 ALPRAZOLAM TAB 1MG ER 12/31/9999 20121 00228308406 ALPRAZOLAM TAB 1MG ER 12/31/9999 20121 00378502291 ALPRAZOLAM TAB 1MG ER 12/31/9999 20121 64980014106 ALPRAZOLAM TAB 1MG ER 12/31/9999 20121 65162081006 ALPRAZOLAM TAB 1MG ER 12/31/9999 20121 00228402411 ALPRAZOLAM TAB 1MG ODT 12/31/9999 20121 49884021374 ALPRAZOLAM TAB 1MG ODT 12/31/9999 20121 00228203910 ALPRAZOLAM TAB 2MG 12/31/9999 20121
NDC Product Description Termination Date Quarter Covered 00228203950 ALPRAZOLAM TAB 2MG 12/31/9999 20121 00378400701 ALPRAZOLAM TAB 2MG 12/31/9999 20121 00603213021 ALPRAZOLAM TAB 2MG 12/31/9999 20121 00603213028 ALPRAZOLAM TAB 2MG 12/31/9999 20121 00781108901 ALPRAZOLAM TAB 2MG 12/31/9999 20121 00781108905 ALPRAZOLAM TAB 2MG 12/31/9999 20121 00904586161 ALPRAZOLAM TAB 2MG 12/31/9999 20121 47335060688 ALPRAZOLAM TAB 2MG 12/31/9999 20121 59762372201 ALPRAZOLAM TAB 2MG 12/31/9999 20121 59762372203 ALPRAZOLAM TAB 2MG 12/31/9999 20121 64376063301 ALPRAZOLAM TAB 2MG 12/31/9999 20121 64376063305 ALPRAZOLAM TAB 2MG 12/31/9999 20121 67253090310 ALPRAZOLAM TAB 2MG 12/31/9999 20121 67253090350 ALPRAZOLAM TAB 2MG 12/31/9999 20121 00093545206 ALPRAZOLAM TAB 2MG ER 12/31/9999 20121 00228308706 ALPRAZOLAM TAB 2MG ER 12/31/9999 20121 00378502391 ALPRAZOLAM TAB 2MG ER 12/31/9999 20121 64980014206 ALPRAZOLAM TAB 2MG ER 12/31/9999 20121 65162081206 ALPRAZOLAM TAB 2MG ER 12/31/9999 20121 00228402511 ALPRAZOLAM TAB 2MG ODT 12/31/9999 20121 49884021474 ALPRAZOLAM TAB 2MG ODT 12/31/9999 20121 00093545306 ALPRAZOLAM TAB 3MG ER 12/31/9999 20121 00228308606 ALPRAZOLAM TAB 3MG ER 12/31/9999 20121 00378502491 ALPRAZOLAM TAB 3MG ER 11/30/2012 20121 64980014306 ALPRAZOLAM TAB 3MG ER 12/31/9999 20121 65162081306 ALPRAZOLAM TAB 3MG ER 12/31/9999 20121 59762005701 ALPRAZOLAM TAB XR 0.5MG 12/31/9999 20121 59762005901 ALPRAZOLAM TAB XR 1MG 12/31/9999 20121 59762006601 ALPRAZOLAM TAB XR 2MG 12/31/9999 20121 59762006801 ALPRAZOLAM TAB XR 3MG 12/31/9999 20121 00703150101 ALPROSTADIL INJ 500MCG 12/31/9999 20121 00703150102 ALPROSTADIL INJ 500MCG 12/31/9999 20121 24208035305 ALREX SUS 0.2% 12/31/9999 20121 24208035310 ALREX SUS 0.2% 12/31/9999 20121 00007518022 ALTABAX OIN 1% 12/31/9999 20121 00007518025 ALTABAX OIN 1% 12/31/9999 20121 61570011001 ALTACE CAP 1.25MG 12/31/9999 20121 61570012001 ALTACE CAP 10MG 12/31/9999 20121 61570011101 ALTACE CAP 2.5MG 12/31/9999 20121 61570011201 ALTACE CAP 5MG 12/31/9999 20121 00781558307 ALTAVERA TAB 12/31/9999 20121 00781558315 ALTAVERA TAB 12/31/9999 20121 00781558336 ALTAVERA TAB 06/30/2013 20121 59630062830 ALTOPREV TAB 20MG ER 12/31/9999 20121 59630062930 ALTOPREV TAB 40MG ER 12/31/9999 20121 59630063030 ALTOPREV TAB 60MG ER 12/31/9999 20121 00121073330 ALUM HYDROX SUS 320/5ML 12/31/9999 20121 00536009185 ALUM HYDROX SUS 320/5ML 12/31/9999 20121 00121060112 ALUM HYDROX SUS 600/5ML 12/31/9999 20121 51552071406 ALUM POTASS GRA 12/31/9999 20121 51552071409 ALUM POTASS POW SULFATE 12/31/9999 20121 51224015324 ALUMINUM ACE POW ASTRINGN 12/31/9999 20121 38779068505 ALUMINUM CHL POW ANHYDROU 12/31/9999 20121 38779068508 ALUMINUM CHL POW ANHYDROU 12/31/9999 20121 38779068509 ALUMINUM CHL POW ANHYDROU 12/31/9999 20121 00259113980 ALUVEA CRE 39% 12/31/9999 20121 63402071201 ALVESCO AER 160MCG 12/31/9999 20121 63402071101 ALVESCO AER 80MCG 12/31/9999 20121 00527170401 AMANTADINE CAP 100MG 12/31/9999 20121 00527170405 AMANTADINE CAP 100MG 12/31/9999 20121 00781204801 AMANTADINE CAP 100MG 12/31/9999 20121 00781204805 AMANTADINE CAP 100MG 12/31/9999 20121 00832101500 AMANTADINE CAP 100MG 12/31/9999 20121 00832101550 AMANTADINE CAP 100MG 12/31/9999 20121 00832201200 AMANTADINE CAP 100MG 12/31/9999 20121 00832201250 AMANTADINE CAP 100MG 12/31/9999 20121 51079048101 AMANTADINE CAP 100MG 12/31/9999 20121
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August 31, 2012 - Iowa Medicaid Enterprise

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