August 31, 2012 - Iowa Medicaid Enterprise

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NDC Product Description Termination Date Quarter Covered 50458017001 LEVAQUIN SOL 25MG/ML 12/31/9999 20121 00045152010 LEVAQUIN TAB 250MG 05/31/2012 20121 50458092010 LEVAQUIN TAB 250MG 12/31/9999 20121 50458092050 LEVAQUIN TAB 250MG 12/31/9999 20121 50458092510 LEVAQUIN TAB 500MG 12/31/9999 20121 50458092550 LEVAQUIN TAB 500MG 12/31/9999 20121 50458093010 LEVAQUIN TAB 750MG 12/31/9999 20121 50458093020 LEVAQUIN TAB 750MG 12/31/9999 20121 50458016701 LEVAQUIN/D5W INJ 250/50ML 12/31/9999 20121 50458016801 LEVAQUIN/D5W INJ 500/100 12/31/9999 20121 50458016601 LEVAQUIN/D5W INJ 750/150 12/31/9999 20121 00091450015 LEVATOL TAB 20MG 12/31/9999 20121 52244045010 LEVATOL TAB 20MG 12/31/9999 20121 00169368712 LEVEMIR INJ 12/31/9999 20121 00169643910 LEVEMIR INJ FLEXPEN 12/31/9999 20121 67457026510 LEVETIRACETA INJ 10MG/ML 12/31/9999 20121 67457026610 LEVETIRACETA INJ 15MG/ML 12/31/9999 20121 67457025510 LEVETIRACETA INJ 5MG/ML 12/31/9999 20121 51552130604 LEVETIRACETA POW 12/31/9999 20121 51552130605 LEVETIRACETA POW 12/31/9999 20121 00054022463 LEVETIRACETA SOL 100MG/ML 12/31/9999 20121 00472023516 LEVETIRACETA SOL 100MG/ML 12/31/9999 20121 00781614116 LEVETIRACETA SOL 100MG/ML 12/31/9999 20121 51672413609 LEVETIRACETA SOL 100MG/ML 12/31/9999 20121 51991065116 LEVETIRACETA SOL 100MG/ML 12/31/9999 20121 54838054880 LEVETIRACETA SOL 100MG/ML 12/31/9999 20121 60258086516 LEVETIRACETA SOL 100MG/ML 12/31/9999 20121 60432083116 LEVETIRACETA SOL 100MG/ML 12/31/9999 20121 65162068586 LEVETIRACETA SOL 100MG/ML 12/31/9999 20121 65162068590 LEVETIRACETA SOL 100MG/ML 12/31/9999 20121 65862025047 LEVETIRACETA SOL 100MG/ML 12/31/9999 20121 66689002801 LEVETIRACETA SOL 100MG/ML 12/31/9999 20121 66689002850 LEVETIRACETA SOL 100MG/ML 12/31/9999 20121 00121480205 LEVETIRACETA SOL 500/5ML 12/31/9999 20121 63739053950 LEVETIRACETA SOL 500/5ML 12/31/9999 20121 68094081659 LEVETIRACETA SOL 500/5ML 12/31/9999 20121 68094081662 LEVETIRACETA SOL 500/5ML 12/31/9999 20121 00054025721 LEVETIRACETA TAB 1000MG 11/30/2012 20121 00093749306 LEVETIRACETA TAB 1000MG 12/31/9999 20121 00378561918 LEVETIRACETA TAB 1000MG 12/31/9999 20121 00378561991 LEVETIRACETA TAB 1000MG 12/31/9999 20121 00781511460 LEVETIRACETA TAB 1000MG 12/31/9999 20121 13668001705 LEVETIRACETA TAB 1000MG 12/31/9999 20121 13668001712 LEVETIRACETA TAB 1000MG 12/31/9999 20121 13668001725 LEVETIRACETA TAB 1000MG 12/31/9999 20121 13668001760 LEVETIRACETA TAB 1000MG 12/31/9999 20121 13668001761 LEVETIRACETA TAB 1000MG 12/31/9999 20121 31722053960 LEVETIRACETA TAB 1000MG 12/31/9999 20121 42043019306 LEVETIRACETA TAB 1000MG 12/31/9999 20121 43547022406 LEVETIRACETA TAB 1000MG 12/31/9999 20121 51079086001 LEVETIRACETA TAB 1000MG 12/31/9999 20121 51079086006 LEVETIRACETA TAB 1000MG 12/31/9999 20121 55111024860 LEVETIRACETA TAB 1000MG 12/31/9999 20121 59762006301 LEVETIRACETA TAB 1000MG 03/31/2013 20121 59762006303 LEVETIRACETA TAB 1000MG 03/31/2013 20121 59762006305 LEVETIRACETA TAB 1000MG 12/31/2012 20121 65162053906 LEVETIRACETA TAB 1000MG 12/31/9999 20121 65862031560 LEVETIRACETA TAB 1000MG 12/31/9999 20121 68084035601 LEVETIRACETA TAB 1000MG 12/31/9999 20121 68180011502 LEVETIRACETA TAB 1000MG 12/31/9999 20121 68180011507 LEVETIRACETA TAB 1000MG 12/31/9999 20121 00054015023 LEVETIRACETA TAB 250MG 11/30/2012 20121 00093728589 LEVETIRACETA TAB 250MG 12/31/9999 20121 00378561305 LEVETIRACETA TAB 250MG 12/31/9999 20121 00378561307 LEVETIRACETA TAB 250MG 12/31/9999 20121 00378561312 LEVETIRACETA TAB 250MG 12/31/9999 20121 00378561378 LEVETIRACETA TAB 250MG 12/31/9999 20121
NDC Product Description Termination Date Quarter Covered 00781511172 LEVETIRACETA TAB 250MG 12/31/9999 20121 00904600161 LEVETIRACETA TAB 250MG 12/31/9999 20121 13668001405 LEVETIRACETA TAB 250MG 12/31/9999 20121 13668001412 LEVETIRACETA TAB 250MG 12/31/9999 20121 13668001425 LEVETIRACETA TAB 250MG 12/31/9999 20121 13668001460 LEVETIRACETA TAB 250MG 12/31/9999 20121 13668001477 LEVETIRACETA TAB 250MG 12/31/9999 20121 31722053605 LEVETIRACETA TAB 250MG 12/31/9999 20121 31722053612 LEVETIRACETA TAB 250MG 12/31/9999 20121 42043019004 LEVETIRACETA TAB 250MG 12/31/9999 20121 42043019005 LEVETIRACETA TAB 250MG 12/31/9999 20121 43547022115 LEVETIRACETA TAB 250MG 12/31/9999 20121 50268046711 LEVETIRACETA TAB 250MG 12/31/9999 20121 50268046715 LEVETIRACETA TAB 250MG 12/31/9999 20121 51079082001 LEVETIRACETA TAB 250MG 12/31/9999 20121 51079082020 LEVETIRACETA TAB 250MG 12/31/9999 20121 55111018104 LEVETIRACETA TAB 250MG 12/31/9999 20121 59762006002 LEVETIRACETA TAB 250MG 12/31/2012 20121 59762006005 LEVETIRACETA TAB 250MG 12/31/2012 20121 64376013605 LEVETIRACETA TAB 250MG 12/31/9999 20121 64376013612 LEVETIRACETA TAB 250MG 12/31/9999 20121 64376013661 LEVETIRACETA TAB 250MG 12/31/9999 20121 64376013690 LEVETIRACETA TAB 250MG 12/31/9999 20121 65162052816 LEVETIRACETA TAB 250MG 12/31/9999 20121 65862024508 LEVETIRACETA TAB 250MG 12/31/9999 20121 68084033601 LEVETIRACETA TAB 250MG 12/31/9999 20121 68180011202 LEVETIRACETA TAB 250MG 12/31/9999 20121 68180011209 LEVETIRACETA TAB 250MG 12/31/9999 20121 68180011216 LEVETIRACETA TAB 250MG 12/31/9999 20121 68462054508 LEVETIRACETA TAB 250MG 12/31/9999 20121 00054015120 LEVETIRACETA TAB 500MG 12/31/9999 20121 00054015123 LEVETIRACETA TAB 500MG 01/31/2013 20121 00093728689 LEVETIRACETA TAB 500MG 12/31/9999 20121 00378561505 LEVETIRACETA TAB 500MG 12/31/9999 20121 00378561507 LEVETIRACETA TAB 500MG 12/31/9999 20121 00378561512 LEVETIRACETA TAB 500MG 12/31/9999 20121 00378561578 LEVETIRACETA TAB 500MG 12/31/9999 20121 00781511272 LEVETIRACETA TAB 500MG 12/31/9999 20121 00904605261 LEVETIRACETA TAB 500MG 12/31/9999 20121 13668001505 LEVETIRACETA TAB 500MG 12/31/9999 20121 13668001512 LEVETIRACETA TAB 500MG 12/31/9999 20121 13668001525 LEVETIRACETA TAB 500MG 12/31/9999 20121 13668001560 LEVETIRACETA TAB 500MG 12/31/9999 20121 13668001562 LEVETIRACETA TAB 500MG 12/31/9999 20121 31722053705 LEVETIRACETA TAB 500MG 12/31/9999 20121 31722053712 LEVETIRACETA TAB 500MG 12/31/9999 20121 42043019104 LEVETIRACETA TAB 500MG 12/31/9999 20121 42043019105 LEVETIRACETA TAB 500MG 12/31/9999 20121 43547022215 LEVETIRACETA TAB 500MG 12/31/9999 20121 50268046811 LEVETIRACETA TAB 500MG 12/31/9999 20121 50268046815 LEVETIRACETA TAB 500MG 12/31/9999 20121 51079082101 LEVETIRACETA TAB 500MG 12/31/9999 20121 51079082117 LEVETIRACETA TAB 500MG 12/31/9999 20121 51079082119 LEVETIRACETA TAB 500MG 12/31/9999 20121 51079082120 LEVETIRACETA TAB 500MG 12/31/9999 20121 51079082130 LEVETIRACETA TAB 500MG 12/31/9999 20121 51079082156 LEVETIRACETA TAB 500MG 12/31/9999 20121 55111018204 LEVETIRACETA TAB 500MG 12/31/9999 20121 59762006102 LEVETIRACETA TAB 500MG 12/31/2012 20121 59762006105 LEVETIRACETA TAB 500MG 12/31/2012 20121 64376013705 LEVETIRACETA TAB 500MG 12/31/9999 20121 64376013712 LEVETIRACETA TAB 500MG 12/31/9999 20121 64376013761 LEVETIRACETA TAB 500MG 12/31/9999 20121 64376013790 LEVETIRACETA TAB 500MG 12/31/9999 20121 65162052916 LEVETIRACETA TAB 500MG 12/31/9999 20121 65862024608 LEVETIRACETA TAB 500MG 12/31/9999 20121 68084033701 LEVETIRACETA TAB 500MG 12/31/9999 20121
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August 31, 2012 - Iowa Medicaid Enterprise

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