August 31, 2012 - Iowa Medicaid Enterprise

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NDC Product Description Termination Date Quarter Covered 60505014602 OMEPRAZOLE CAP 40MG 12/31/9999 20121 60505014609 OMEPRAZOLE CAP 40MG 12/31/9999 20121 62037064001 OMEPRAZOLE CAP 40MG 12/31/9999 20121 62037064010 OMEPRAZOLE CAP 40MG 12/31/9999 20121 62037064030 OMEPRAZOLE CAP 40MG 12/31/9999 20121 62175013632 OMEPRAZOLE CAP 40MG 12/31/9999 20121 62175013637 OMEPRAZOLE CAP 40MG 12/31/9999 20121 62175013643 OMEPRAZOLE CAP 40MG 12/31/9999 20121 63739044510 OMEPRAZOLE CAP 40MG 12/31/9999 20121 68084046601 OMEPRAZOLE CAP 40MG 12/31/9999 20121 00113091530 OMEPRAZOLE TAB 20MG 12/31/9999 20121 00113091555 OMEPRAZOLE TAB 20MG 12/31/9999 20121 00113091574 OMEPRAZOLE TAB 20MG 12/31/9999 20121 00904583441 OMEPRAZOLE TAB 20MG 12/31/9999 20121 00904583442 OMEPRAZOLE TAB 20MG 12/31/9999 20121 00904583471 OMEPRAZOLE TAB 20MG 12/31/9999 20121 36800091530 OMEPRAZOLE TAB 20MG 12/31/9999 20121 36800091555 OMEPRAZOLE TAB 20MG 12/31/9999 20121 36800091574 OMEPRAZOLE TAB 20MG 12/31/9999 20121 37205083706 OMEPRAZOLE TAB 20MG 12/31/9999 20121 37205083715 OMEPRAZOLE TAB 20MG 12/31/9999 20121 37205083774 OMEPRAZOLE TAB 20MG 12/31/9999 20121 45802088830 OMEPRAZOLE TAB 20MG 12/31/9999 20121 45802088855 OMEPRAZOLE TAB 20MG 12/31/9999 20121 46122002903 OMEPRAZOLE TAB 20MG 12/31/9999 20121 46122002904 OMEPRAZOLE TAB 20MG 12/31/9999 20121 46122002974 OMEPRAZOLE TAB 20MG 12/31/9999 20121 49348084646 OMEPRAZOLE TAB 20MG 12/31/9999 20121 49348084661 OMEPRAZOLE TAB 20MG 12/31/9999 20121 49348084678 OMEPRAZOLE TAB 20MG 12/31/9999 20121 62011015701 OMEPRAZOLE TAB 20MG 12/31/9999 20121 62011015702 OMEPRAZOLE TAB 20MG 12/31/9999 20121 62011015703 OMEPRAZOLE TAB 20MG 12/31/9999 20121 63402070101 OMNARIS SPR 12/31/9999 20121 00407140152 OMNIPAQUE INJ 140MG/ML 12/31/9999 20121 00407141110 OMNIPAQUE INJ 180MG/ML 12/31/9999 20121 00407141120 OMNIPAQUE INJ 180MG/ML 12/31/9999 20121 00407141210 OMNIPAQUE INJ 240MG/ML 12/31/9999 20121 00407141220 OMNIPAQUE INJ 240MG/ML 12/31/9999 20121 00407141229 OMNIPAQUE INJ 240MG/ML 12/31/9999 20121 00407141230 OMNIPAQUE INJ 240MG/ML 12/31/9999 20121 00407141233 OMNIPAQUE INJ 240MG/ML 12/31/9999 20121 00407141234 OMNIPAQUE INJ 240MG/ML 12/31/9999 20121 00407141235 OMNIPAQUE INJ 240MG/ML 12/31/9999 20121 00407141238 OMNIPAQUE INJ 240MG/ML 12/31/9999 20121 00407141240 OMNIPAQUE INJ 240MG/ML 03/31/2013 20121 00407141249 OMNIPAQUE INJ 240MG/ML 04/01/2013 20121 00407141250 OMNIPAQUE INJ 240MG/ML 12/31/9999 20121 00407141260 OMNIPAQUE INJ 240MG/ML 12/31/9999 20121 00407141284 OMNIPAQUE INJ 240MG/ML 02/03/2013 20121 00407141310 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141330 OMNIPAQUE INJ 300MG/ML 10/01/2013 20121 00407141341 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141342 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141343 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141346 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141350 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141351 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141353 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141359 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141360 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141361 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141362 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141363 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141365 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141366 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141368 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121
NDC Product Description Termination Date Quarter Covered 00407141386 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141387 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141388 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141389 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141390 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141391 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141392 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141393 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141394 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141395 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141396 OMNIPAQUE INJ 300MG/ML 12/31/9999 20121 00407141403 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141404 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141421 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141422 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141423 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141424 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141425 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141441 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141442 OMNIPAQUE INJ 350MG/ML 04/01/2013 20121 00407141443 OMNIPAQUE INJ 350MG/ML 10/01/2012 20121 00407141444 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141445 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141450 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141451 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141452 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141453 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141460 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141476 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141482 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141484 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141485 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141486 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141487 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141488 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141489 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141490 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141491 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141493 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141494 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00407141498 OMNIPAQUE INJ 350MG/ML 12/31/9999 20121 00065063825 OMNIPRED SUS 1% OP 12/31/9999 20121 00065063827 OMNIPRED SUS 1% OP 12/31/9999 20121 00407069162 OMNISCAN INJ /NACL 12/31/9999 20121 00407069163 OMNISCAN INJ /NACL 12/31/9999 20121 00407069005 OMNISCAN INJ 287MG/ML 12/31/9999 20121 00407069010 OMNISCAN INJ 287MG/ML 12/31/9999 20121 00407069012 OMNISCAN INJ 287MG/ML 12/31/9999 20121 00407069015 OMNISCAN INJ 287MG/ML 12/31/9999 20121 00407069017 OMNISCAN INJ 287MG/ML 12/31/9999 20121 00407069020 OMNISCAN INJ 287MG/ML 12/31/9999 20121 00407069022 OMNISCAN INJ 287MG/ML 12/31/9999 20121 00407069030 OMNISCAN INJ 287MG/ML 12/31/9999 20121 00407069040 OMNISCAN INJ 287MG/ML 12/31/9999 20121 00407069042 OMNISCAN INJ 287MG/ML 12/31/9999 20121 00407069043 OMNISCAN INJ 287MG/ML 12/31/9999 20121 00407069050 OMNISCAN INJ 287MG/ML 12/31/9999 20121 00407069070 OMNISCAN INJ 287MG/ML 12/31/9999 20121 00781300407 OMNITROPE INJ 10/1.5ML 12/31/9999 20121 00781300426 OMNITROPE INJ 10/1.5ML 12/31/9999 20121 00781400436 OMNITROPE INJ 5.8MG 12/31/9999 20121 00781300107 OMNITROPE INJ 5/1.5ML 12/31/9999 20121 00781300126 OMNITROPE INJ 5/1.5ML 12/31/9999 20121 54482030101 ONCASPAR INJ 750/ML 12/31/9999 20121 62107003901 ONCE DAILY TAB 12/31/9999 20121 62107003910 ONCE DAILY TAB 12/31/9999 20121 62107004001 ONCE DAILY TAB IRON 12/31/9999 20121
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August 31, 2012 - Iowa Medicaid Enterprise

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