August 31, 2012 - Iowa Medicaid Enterprise

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NDC Product Description Termination Date Quarter Covered 65862047030 LOSARTAN/HCT TAB 100-25 12/31/9999 20121 65862047090 LOSARTAN/HCT TAB 100-25 12/31/9999 20121 65862047099 LOSARTAN/HCT TAB 100-25 12/31/9999 20121 68180021703 LOSARTAN/HCT TAB 100-25 12/31/9999 20121 68180021706 LOSARTAN/HCT TAB 100-25 12/31/9999 20121 68180021709 LOSARTAN/HCT TAB 100-25 12/31/9999 20121 68382014306 LOSARTAN/HCT TAB 100-25 12/31/9999 20121 68382014310 LOSARTAN/HCT TAB 100-25 12/31/9999 20121 68382014316 LOSARTAN/HCT TAB 100-25 12/31/9999 20121 00054012622 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 00093736710 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 00093736756 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 00093736798 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 00378141877 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 00378141893 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 00781520610 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 00781520631 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 00781520692 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 00781581610 LOSARTAN/HCT TAB 50-12.5 06/30/2013 20121 00781581631 LOSARTAN/HCT TAB 50-12.5 06/30/2013 20121 00781581692 LOSARTAN/HCT TAB 50-12.5 06/30/2013 20121 13668011610 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 13668011630 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 13668011690 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 16714022601 LOSARTAN/HCT TAB 50-12.5 12/31/2020 20121 16714022602 LOSARTAN/HCT TAB 50-12.5 12/31/2020 20121 16714022604 LOSARTAN/HCT TAB 50-12.5 12/31/2020 20121 51079075701 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 51079075720 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 59762001101 LOSARTAN/HCT TAB 50-12.5 08/31/2012 20121 60505291503 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 60505291509 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 63739052710 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 65862046830 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 65862046890 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 65862046899 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 68180021503 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 68180021506 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 68180021509 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 68382014206 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 68382014210 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 68382014216 LOSARTAN/HCT TAB 50-12.5 12/31/9999 20121 51285009287 LOSEASONIQUE TAB 12/31/9999 20121 24208044335 LOTEMAX OIN 0.5% 12/31/9999 20121 24208029905 LOTEMAX SUS 0.5% 12/31/9999 20121 24208029910 LOTEMAX SUS 0.5% 12/31/9999 20121 24208029915 LOTEMAX SUS 0.5% 12/31/9999 20121 24208029925 LOTEMAX SUS 0.5% 07/18/2013 20121 00078044805 LOTENSIN TAB 10MG 12/31/9999 20121 00078044905 LOTENSIN TAB 20MG 12/31/9999 20121 00078045005 LOTENSIN TAB 40MG 12/31/9999 20121 00078045205 LOTENSIN HCT TAB 10-12.5 12/31/9999 20121 00078045305 LOTENSIN HCT TAB 20-12.5 12/31/9999 20121 00078045405 LOTENSIN HCT TAB 20-25MG 12/31/9999 20121 00078036405 LOTREL CAP 10-20MG 12/31/9999 20121 00078037905 LOTREL CAP 10-40MG 12/31/9999 20121 00078040405 LOTREL CAP 2.5-10MG 12/31/9999 20121 00078040505 LOTREL CAP 5-10MG 12/31/9999 20121 00078040605 LOTREL CAP 5-20MG 12/31/9999 20121 00078038405 LOTREL CAP 5-40MG 12/31/9999 20121 11523721501 LOTRIMIN AF CRE 1% 12/31/9999 20121 00085092401 LOTRISONE CRE 12/31/9999 20121 00085092402 LOTRISONE CRE 12/31/9999 20121 00085080901 LOTRISONE LOT 12/31/9999 20121 65483089403 LOTRONEX TAB 0.5MG 12/31/9999 20121 65483089503 LOTRONEX TAB 1MG 12/31/9999 20121 00093092606 LOVASTATIN TAB 10MG 12/31/9999 20121
NDC Product Description Termination Date Quarter Covered 00093092610 LOVASTATIN TAB 10MG 12/31/9999 20121 00093092619 LOVASTATIN TAB 10MG 12/31/9999 20121 00093092693 LOVASTATIN TAB 10MG 12/31/9999 20121 00185007001 LOVASTATIN TAB 10MG 12/31/9999 20121 00185007005 LOVASTATIN TAB 10MG 12/31/9999 20121 00185007010 LOVASTATIN TAB 10MG 12/31/9999 20121 00185007060 LOVASTATIN TAB 10MG 12/31/9999 20121 00228263306 LOVASTATIN TAB 10MG 03/31/2014 20121 00228263350 LOVASTATIN TAB 10MG 03/31/2014 20121 00378651091 LOVASTATIN TAB 10MG 12/31/9999 20121 45963063301 LOVASTATIN TAB 10MG 12/31/9999 20121 45963063304 LOVASTATIN TAB 10MG 12/31/9999 20121 51079097401 LOVASTATIN TAB 10MG 12/31/9999 20121 51079097420 LOVASTATIN TAB 10MG 12/31/9999 20121 53489060701 LOVASTATIN TAB 10MG 01/31/2013 20121 53489060706 LOVASTATIN TAB 10MG 01/31/2013 20121 54458093810 LOVASTATIN TAB 10MG 12/31/9999 20121 54458098410 LOVASTATIN TAB 10MG 12/31/9999 20121 60505017700 LOVASTATIN TAB 10MG 12/31/9999 20121 61442014101 LOVASTATIN TAB 10MG 12/31/9999 20121 61442014110 LOVASTATIN TAB 10MG 12/31/9999 20121 61442014160 LOVASTATIN TAB 10MG 12/31/9999 20121 68084013101 LOVASTATIN TAB 10MG 12/31/9999 20121 68180046701 LOVASTATIN TAB 10MG 12/31/9999 20121 68180046703 LOVASTATIN TAB 10MG 12/31/9999 20121 68180046707 LOVASTATIN TAB 10MG 12/31/9999 20121 00093057606 LOVASTATIN TAB 20MG 12/31/9999 20121 00093057610 LOVASTATIN TAB 20MG 12/31/9999 20121 00093057619 LOVASTATIN TAB 20MG 12/31/9999 20121 00093057693 LOVASTATIN TAB 20MG 12/31/9999 20121 00185007201 LOVASTATIN TAB 20MG 12/31/9999 20121 00185007210 LOVASTATIN TAB 20MG 12/31/9999 20121 00185007260 LOVASTATIN TAB 20MG 12/31/9999 20121 00228263406 LOVASTATIN TAB 20MG 03/31/2014 20121 00228263450 LOVASTATIN TAB 20MG 03/31/2014 20121 00378652005 LOVASTATIN TAB 20MG 12/31/9999 20121 00378652091 LOVASTATIN TAB 20MG 12/31/9999 20121 45963063401 LOVASTATIN TAB 20MG 12/31/9999 20121 45963063404 LOVASTATIN TAB 20MG 12/31/9999 20121 51079097501 LOVASTATIN TAB 20MG 12/31/9999 20121 51079097520 LOVASTATIN TAB 20MG 12/31/9999 20121 53489060801 LOVASTATIN TAB 20MG 01/31/2013 20121 53489060806 LOVASTATIN TAB 20MG 01/31/2013 20121 53489060810 LOVASTATIN TAB 20MG 01/31/2013 20121 54458091510 LOVASTATIN TAB 20MG 12/31/9999 20121 54458093710 LOVASTATIN TAB 20MG 12/31/9999 20121 54458098310 LOVASTATIN TAB 20MG 12/31/9999 20121 60505017800 LOVASTATIN TAB 20MG 12/31/9999 20121 61442014201 LOVASTATIN TAB 20MG 12/31/9999 20121 61442014205 LOVASTATIN TAB 20MG 12/31/9999 20121 61442014210 LOVASTATIN TAB 20MG 12/31/9999 20121 61442014260 LOVASTATIN TAB 20MG 12/31/9999 20121 62037079260 LOVASTATIN TAB 20MG 06/30/2012 20121 63739028110 LOVASTATIN TAB 20MG 12/31/9999 20121 68084013201 LOVASTATIN TAB 20MG 12/31/9999 20121 68084055901 LOVASTATIN TAB 20MG 12/31/9999 20121 68180046801 LOVASTATIN TAB 20MG 12/31/9999 20121 68180046803 LOVASTATIN TAB 20MG 12/31/9999 20121 68180046805 LOVASTATIN TAB 20MG 12/31/9999 20121 68180046807 LOVASTATIN TAB 20MG 12/31/9999 20121 00093092806 LOVASTATIN TAB 40MG 12/31/9999 20121 00093092810 LOVASTATIN TAB 40MG 12/31/9999 20121 00093092819 LOVASTATIN TAB 40MG 12/31/9999 20121 00093092893 LOVASTATIN TAB 40MG 12/31/9999 20121 00185007401 LOVASTATIN TAB 40MG 12/31/9999 20121 00185007410 LOVASTATIN TAB 40MG 12/31/9999 20121 00185007460 LOVASTATIN TAB 40MG 12/31/9999 20121
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Rebatable Drug List for Iowa Medica
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NDC Product Description Termination
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August 31, 2012 - Iowa Medicaid Enterprise

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