August 31, 2012 - Iowa Medicaid Enterprise

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NDC Product Description Termination Date Quarter Covered 63323013215 MITOXANTRON INJ 2MG/ML 12/31/9999 20121 00064065001 MITRAZOL POW 2% 12/31/9999 20121 63481007370 MOBAN TAB 10MG 12/31/9999 20121 63481007670 MOBAN TAB 50MG 12/31/9999 20121 00597003401 MOBIC SUS 7.5/5ML 12/31/9999 20121 00597003001 MOBIC TAB 15MG 12/31/9999 20121 00597002901 MOBIC TAB 7.5MG 12/31/9999 20121 00225036011 MOBISYL CRE 10% 12/31/9999 20121 00225036033 MOBISYL CRE 10% 12/31/9999 20121 00225036035 MOBISYL CRE 10% 12/31/9999 20121 55253080130 MODAFINIL TAB 100MG 12/31/9999 20121 55253080190 MODAFINIL TAB 100MG 12/31/9999 20121 55253080230 MODAFINIL TAB 200MG 12/31/9999 20121 55253080290 MODAFINIL TAB 200MG 12/31/9999 20121 00062171415 MODICON TAB 0.5/35 07/31/2012 20121 50458017115 MODICON TAB 0.5/35 12/31/9999 20121 00093521401 MOEXIPR/HCTZ TAB 15-12.5 12/31/9999 20121 00574013401 MOEXIPR/HCTZ TAB 15-12.5 08/31/2013 20121 16252061301 MOEXIPR/HCTZ TAB 15-12.5 03/31/2013 20121 62175072037 MOEXIPR/HCTZ TAB 15-12.5 12/31/9999 20121 68462020601 MOEXIPR/HCTZ TAB 15-12.5 12/31/9999 20121 00093521501 MOEXIPR/HCTZ TAB 15-25MG 12/31/9999 20121 00574013501 MOEXIPR/HCTZ TAB 15-25MG 08/31/2013 20121 16252061401 MOEXIPR/HCTZ TAB 15-25MG 12/31/9999 20121 62175072537 MOEXIPR/HCTZ TAB 15-25MG 12/31/9999 20121 68462020501 MOEXIPR/HCTZ TAB 15-25MG 12/31/9999 20121 00093521301 MOEXIPR/HCTZ TAB 7.5-12.5 12/31/9999 20121 00574013301 MOEXIPR/HCTZ TAB 7.5-12.5 10/31/2012 20121 16252061201 MOEXIPR/HCTZ TAB 7.5-12.5 03/31/2013 20121 62175071237 MOEXIPR/HCTZ TAB 7.5-12.5 12/31/9999 20121 68462020701 MOEXIPR/HCTZ TAB 7.5-12.5 12/31/9999 20121 00093515001 MOEXIPRIL TAB 15MG 12/31/9999 20121 00574011215 MOEXIPRIL TAB 15MG 12/31/9999 20121 16252061101 MOEXIPRIL TAB 15MG 12/31/9999 20121 60505027201 MOEXIPRIL TAB 15MG 12/31/9999 20121 62175017737 MOEXIPRIL TAB 15MG 12/31/9999 20121 68462020801 MOEXIPRIL TAB 15MG 12/31/9999 20121 00093001701 MOEXIPRIL TAB 7.5MG 12/31/9999 20121 00574011001 MOEXIPRIL TAB 7.5MG 12/31/9999 20121 16252061001 MOEXIPRIL TAB 7.5MG 02/28/2013 20121 60505027101 MOEXIPRIL TAB 7.5MG 12/31/9999 20121 62175017137 MOEXIPRIL TAB 7.5MG 12/31/9999 20121 68462020901 MOEXIPRIL TAB 7.5MG 12/31/9999 20121 00430350008 MOISTUREL CRE 12/31/9999 20121 00430350011 MOISTUREL CRE 12/31/9999 20121 00430310010 MOISTUREL LOT 12/31/9999 20121 00430310011 MOISTUREL LOT 12/31/9999 20121 45802061204 MOISTURIN CRE 01/01/2014 20121 45802061205 MOISTURIN CRE 11/01/2012 20121 00182507945 MOISTURIN CRE DRY SKIN 09/30/2013 20121 00168027046 MOMETASONE CRE 0.1% 12/31/9999 20121 00713063415 MOMETASONE CRE 0.1% 12/31/9999 20121 00713063437 MOMETASONE CRE 0.1% 12/31/9999 20121 00781706619 MOMETASONE CRE 0.1% 12/31/9999 20121 00781706627 MOMETASONE CRE 0.1% 12/31/9999 20121 45802025735 MOMETASONE CRE 0.1% 12/31/9999 20121 45802025742 MOMETASONE CRE 0.1% 12/31/9999 20121 67405010015 MOMETASONE CRE 0.1% 12/31/9999 20121 67405010045 MOMETASONE CRE 0.1% 12/31/9999 20121 68462019217 MOMETASONE CRE 0.1% 12/31/9999 20121 68462019255 MOMETASONE CRE 0.1% 12/31/9999 20121 00168027115 MOMETASONE OIN 0.1% 12/31/9999 20121 00168027146 MOMETASONE OIN 0.1% 12/31/9999 20121 00713063515 MOMETASONE OIN 0.1% 12/31/9999 20121 00713063537 MOMETASONE OIN 0.1% 12/31/9999 20121 00781706819 MOMETASONE OIN 0.1% 12/31/9999 20121 00781706827 MOMETASONE OIN 0.1% 12/31/9999 20121
NDC Product Description Termination Date Quarter Covered 45802011937 MOMETASONE OIN 0.1% 12/31/9999 20121 45802011942 MOMETASONE OIN 0.1% 12/31/9999 20121 67405030015 MOMETASONE OIN 0.1% 12/31/9999 20121 67405030045 MOMETASONE OIN 0.1% 12/31/9999 20121 68462022517 MOMETASONE OIN 0.1% 12/31/9999 20121 68462022555 MOMETASONE OIN 0.1% 12/31/9999 20121 00168027230 MOMETASONE SOL 0.1% 12/31/9999 20121 00168027260 MOMETASONE SOL 0.1% 12/31/9999 20121 00713070153 MOMETASONE SOL 0.1% 12/31/9999 20121 00713070185 MOMETASONE SOL 0.1% 12/31/9999 20121 00781706730 MOMETASONE SOL 0.1% 12/31/9999 20121 00781706761 MOMETASONE SOL 0.1% 12/31/9999 20121 45802011846 MOMETASONE SOL 0.1% 12/31/9999 20121 45802011859 MOMETASONE SOL 0.1% 12/31/9999 20121 51672130503 MOMETASONE SOL 0.1% 12/31/9999 20121 51672130504 MOMETASONE SOL 0.1% 12/31/9999 20121 67405027530 MOMETASONE SOL 0.1% 12/31/9999 20121 67405027560 MOMETASONE SOL 0.1% 12/31/9999 20121 68462038502 MOMETASONE SOL 0.1% 12/31/9999 20121 68462038537 MOMETASONE SOL 0.1% 12/31/9999 20121 68712003201 MOMEXIN KIT 12/31/9999 20121 00053763302 MONOCLATE-P INJ 1000UNIT 12/31/9999 20121 00053765604 MONOCLATE-P INJ 1000UNIT 11/05/2012 20121 00053763402 MONOCLATE-P INJ 1500UNIT 12/31/9999 20121 00053765605 MONOCLATE-P INJ 1500UNIT 10/28/2012 20121 00091361001 MONOKET TAB 10MG 12/31/9999 20121 00091362001 MONOKET TAB 20MG 12/31/9999 20121 52544024728 MONONESSA TAB 12/31/9999 20121 00053623302 MONONINE INJ 1000UNIT 12/31/9999 20121 00053766804 MONONINE INJ 1000UNIT 01/07/2013 20121 00456430008 MONUROL PAK GRANULES 12/31/9999 20121 43538060030 MORGIDOX CAP 1X100MG 12/31/9999 20121 43538061060 MORGIDOX CAP 2X100MG 12/31/9999 20121 43538060130 MORGIDOX KIT 1X100MG 12/31/9999 20121 43538061160 MORGIDOX KIT 2X100MG 12/31/9999 20121 00228350711 MORPHINE SUL CAP 100MG ER 12/31/9999 20121 00591345301 MORPHINE SUL CAP 100MG ER 12/31/9999 20121 00228350211 MORPHINE SUL CAP 20MG ER 12/31/9999 20121 00591344901 MORPHINE SUL CAP 20MG ER 12/31/9999 20121 00228350311 MORPHINE SUL CAP 30MG ER 12/31/9999 20121 00591345001 MORPHINE SUL CAP 30MG ER 12/31/9999 20121 00228350411 MORPHINE SUL CAP 50MG ER 12/31/9999 20121 00591345101 MORPHINE SUL CAP 50MG ER 12/31/9999 20121 00228350511 MORPHINE SUL CAP 60MG ER 12/31/9999 20121 00591345201 MORPHINE SUL CAP 60MG ER 12/31/9999 20121 00228350611 MORPHINE SUL CAP 80MG ER 12/31/9999 20121 00591357601 MORPHINE SUL CAP 80MG ER 12/31/9999 20121 00409381412 MORPHINE SUL INJ 0.5MG/ML 12/31/9999 20121 00409126130 MORPHINE SUL INJ 10MG/ML 12/31/9999 20121 00641606801 MORPHINE SUL INJ 10MG/ML 12/31/9999 20121 00641607025 MORPHINE SUL INJ 10MG/ML 12/31/9999 20121 10019017836 MORPHINE SUL INJ 10MG/ML 12/31/9999 20121 10019017837 MORPHINE SUL INJ 10MG/ML 12/31/9999 20121 10019017839 MORPHINE SUL INJ 10MG/ML 12/31/9999 20121 10019017844 MORPHINE SUL INJ 10MG/ML 12/31/9999 20121 10019017862 MORPHINE SUL INJ 10MG/ML 12/31/9999 20121 00409602804 MORPHINE SUL INJ 150/30ML 12/31/9999 20121 00409126431 MORPHINE SUL INJ 15MG/ML 12/31/9999 20121 00641607125 MORPHINE SUL INJ 15MG/ML 12/31/9999 20121 10019017936 MORPHINE SUL INJ 15MG/ML 12/31/9999 20121 10019017939 MORPHINE SUL INJ 15MG/ML 12/31/9999 20121 10019017944 MORPHINE SUL INJ 15MG/ML 12/31/9999 20121 10019017963 MORPHINE SUL INJ 15MG/ML 12/31/9999 20121 00409202902 MORPHINE SUL INJ 1MG/ML 12/31/9999 20121 00409381512 MORPHINE SUL INJ 1MG/ML 12/31/9999 20121 00409113502 MORPHINE SUL INJ 25MG/ML 12/31/9999 20121 00409617714 MORPHINE SUL INJ 25MG/ML 12/31/9999 20121
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August 31, 2012 - Iowa Medicaid Enterprise

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