August 31, 2012 - Iowa Medicaid Enterprise

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NDC Product Description Termination Date Quarter Covered 52544096691 QUASENSE TAB 12/31/9999 20121 00409697010 QUELICIN INJ -1000 12/31/9999 20121 00409662902 QUELICIN INJ 20MG/ML 12/31/9999 20121 00603086054 QUENALIN SYP 12.5/5ML 12/31/9999 20121 51552099707 QUERCITIN POW 12/31/9999 20121 49884093665 QUESTRAN POW 4GM 12/31/9999 20121 49884093666 QUESTRAN POW 4GM 12/31/9999 20121 49884093765 QUESTRAN POW 4GM LITE 12/31/9999 20121 49884093767 QUESTRAN POW 4GM LITE 12/31/9999 20121 00054022125 QUETIAPINE TAB 100MG 12/31/9999 20121 00093816201 QUETIAPINE TAB 100MG 12/31/9999 20121 00093816210 QUETIAPINE TAB 100MG 12/31/9999 20121 16729014701 QUETIAPINE TAB 100MG 12/31/9999 20121 16729014717 QUETIAPINE TAB 100MG 12/31/9999 20121 47335090418 QUETIAPINE TAB 100MG 12/31/9999 20121 47335090488 QUETIAPINE TAB 100MG 12/31/9999 20121 55111018601 QUETIAPINE TAB 100MG 12/31/9999 20121 60505313301 QUETIAPINE TAB 100MG 12/31/9999 20121 60505313308 QUETIAPINE TAB 100MG 12/31/9999 20121 68180044701 QUETIAPINE TAB 100MG 12/31/9999 20121 68180044703 QUETIAPINE TAB 100MG 12/31/9999 20121 00054022225 QUETIAPINE TAB 200MG 12/31/9999 20121 00093816301 QUETIAPINE TAB 200MG 12/31/9999 20121 00093816310 QUETIAPINE TAB 200MG 12/31/9999 20121 16729014800 QUETIAPINE TAB 200MG 12/31/9999 20121 16729014817 QUETIAPINE TAB 200MG 12/31/9999 20121 47335090518 QUETIAPINE TAB 200MG 12/31/9999 20121 47335090588 QUETIAPINE TAB 200MG 12/31/9999 20121 55111018901 QUETIAPINE TAB 200MG 12/31/9999 20121 60505313501 QUETIAPINE TAB 200MG 12/31/9999 20121 60505313508 QUETIAPINE TAB 200MG 12/31/9999 20121 68180044801 QUETIAPINE TAB 200MG 12/31/9999 20121 68180044802 QUETIAPINE TAB 200MG 12/31/9999 20121 00054022025 QUETIAPINE TAB 25MG 12/31/9999 20121 00054022031 QUETIAPINE TAB 25MG 12/31/9999 20121 00093816101 QUETIAPINE TAB 25MG 12/31/9999 20121 00093816110 QUETIAPINE TAB 25MG 12/31/9999 20121 00378101101 QUETIAPINE TAB 25MG 12/31/9999 20121 00378101110 QUETIAPINE TAB 25MG 12/31/9999 20121 16729014501 QUETIAPINE TAB 25MG 12/31/9999 20121 16729014517 QUETIAPINE TAB 25MG 12/31/9999 20121 47335090218 QUETIAPINE TAB 25MG 12/31/9999 20121 47335090288 QUETIAPINE TAB 25MG 12/31/9999 20121 55111024901 QUETIAPINE TAB 25MG 12/31/9999 20121 55111024905 QUETIAPINE TAB 25MG 12/31/9999 20121 60505313001 QUETIAPINE TAB 25MG 12/31/9999 20121 60505313008 QUETIAPINE TAB 25MG 12/31/9999 20121 68180044501 QUETIAPINE TAB 25MG 12/31/9999 20121 68180044503 QUETIAPINE TAB 25MG 12/31/9999 20121 00054022321 QUETIAPINE TAB 300MG 12/31/9999 20121 00093816401 QUETIAPINE TAB 300MG 12/31/9999 20121 00093816410 QUETIAPINE TAB 300MG 12/31/9999 20121 16729014912 QUETIAPINE TAB 300MG 12/31/9999 20121 16729014917 QUETIAPINE TAB 300MG 12/31/9999 20121 47335090618 QUETIAPINE TAB 300MG 12/31/9999 20121 47335090688 QUETIAPINE TAB 300MG 12/31/9999 20121 55111019060 QUETIAPINE TAB 300MG 12/31/9999 20121 60505313706 QUETIAPINE TAB 300MG 12/31/9999 20121 68180044901 QUETIAPINE TAB 300MG 12/31/9999 20121 68180044902 QUETIAPINE TAB 300MG 12/31/9999 20121 68180044907 QUETIAPINE TAB 300MG 12/31/9999 20121 00054023025 QUETIAPINE TAB 400MG 12/31/9999 20121 00093816501 QUETIAPINE TAB 400MG 12/31/9999 20121 00093816510 QUETIAPINE TAB 400MG 12/31/9999 20121 16729015000 QUETIAPINE TAB 400MG 12/31/9999 20121 16729015016 QUETIAPINE TAB 400MG 12/31/9999 20121 47335090788 QUETIAPINE TAB 400MG 12/31/9999 20121
NDC Product Description Termination Date Quarter Covered 55111060601 QUETIAPINE TAB 400MG 12/31/9999 20121 60505313901 QUETIAPINE TAB 400MG 12/31/9999 20121 68180045001 QUETIAPINE TAB 400MG 12/31/9999 20121 68180045002 QUETIAPINE TAB 400MG 12/31/9999 20121 00054022925 QUETIAPINE TAB 50MG 12/31/9999 20121 00054022931 QUETIAPINE TAB 50MG 12/31/9999 20121 00093816601 QUETIAPINE TAB 50MG 12/31/9999 20121 00093816610 QUETIAPINE TAB 50MG 12/31/9999 20121 16729014601 QUETIAPINE TAB 50MG 12/31/9999 20121 16729014617 QUETIAPINE TAB 50MG 12/31/9999 20121 47335090318 QUETIAPINE TAB 50MG 12/31/9999 20121 47335090388 QUETIAPINE TAB 50MG 12/31/9999 20121 55111016901 QUETIAPINE TAB 50MG 12/31/9999 20121 55111016905 QUETIAPINE TAB 50MG 12/31/9999 20121 60505313201 QUETIAPINE TAB 50MG 12/31/9999 20121 60505313208 QUETIAPINE TAB 50MG 12/31/9999 20121 68180044601 QUETIAPINE TAB 50MG 12/31/9999 20121 68180044603 QUETIAPINE TAB 50MG 12/31/9999 20121 00093105105 QUINAPRIL TAB 10MG 05/31/2012 20121 00093105198 QUINAPRIL TAB 10MG 05/31/2012 20121 55111062290 QUINAPRIL TAB 10MG 12/31/9999 20121 59762502001 QUINAPRIL TAB 10MG 12/31/9999 20121 60505017300 QUINAPRIL TAB 10MG 12/31/9999 20121 60505017301 QUINAPRIL TAB 10MG 12/31/9999 20121 68180055709 QUINAPRIL TAB 10MG 12/31/9999 20121 00378025477 QUINAPRIL TAB 20MG 08/31/2012 20121 55111062390 QUINAPRIL TAB 20MG 12/31/9999 20121 59762502101 QUINAPRIL TAB 20MG 12/31/9999 20121 60505017400 QUINAPRIL TAB 20MG 12/31/9999 20121 60505017401 QUINAPRIL TAB 20MG 12/31/9999 20121 68180055809 QUINAPRIL TAB 20MG 12/31/9999 20121 00093105305 QUINAPRIL TAB 40MG 05/31/2012 20121 00093105398 QUINAPRIL TAB 40MG 06/30/2012 20121 00378027277 QUINAPRIL TAB 40MG 08/31/2012 20121 55111062490 QUINAPRIL TAB 40MG 12/31/9999 20121 59762502201 QUINAPRIL TAB 40MG 12/31/9999 20121 60505017500 QUINAPRIL TAB 40MG 12/31/9999 20121 60505017501 QUINAPRIL TAB 40MG 12/31/9999 20121 68180055909 QUINAPRIL TAB 40MG 12/31/9999 20121 00093105098 QUINAPRIL TAB 5MG 05/31/2012 20121 55111062190 QUINAPRIL TAB 5MG 12/31/9999 20121 59762501901 QUINAPRIL TAB 5MG 12/31/9999 20121 60505017200 QUINAPRIL TAB 5MG 12/31/9999 20121 60505017201 QUINAPRIL TAB 5MG 12/31/9999 20121 68180055609 QUINAPRIL TAB 5MG 12/31/9999 20121 52152023808 QUINARETIC TAB 10-12.5 12/31/9999 20121 52152023830 QUINARETIC TAB 10-12.5 12/31/9999 20121 52152023908 QUINARETIC TAB 20-12.5 12/31/9999 20121 52152023930 QUINARETIC TAB 20-12.5 12/31/9999 20121 52152024008 QUINARETIC TAB 20-25MG 12/31/9999 20121 52152024030 QUINARETIC TAB 20-25MG 12/31/9999 20121 00002140701 QUINIDINE GL INJ 80MG/ML 12/31/9999 20121 51079002701 QUINIDINE GL TAB 324MG CR 12/31/9999 20121 51079002720 QUINIDINE GL TAB 324MG CR 12/31/9999 20121 53489014101 QUINIDINE GL TAB 324MG CR 12/31/9999 20121 53489014103 QUINIDINE GL TAB 324MG CR 02/28/2013 20121 53489014105 QUINIDINE GL TAB 324MG CR 02/28/2013 20121 00185434601 QUINIDINE SU TAB 200MG 12/31/9999 20121 00185434610 QUINIDINE SU TAB 200MG 12/31/9999 20121 00228235610 QUINIDINE SU TAB 200MG 12/31/9999 20121 00591543801 QUINIDINE SU TAB 200MG 12/31/9999 20121 00185104701 QUINIDINE SU TAB 300MG 12/31/9999 20121 00185104710 QUINIDINE SU TAB 300MG 12/31/9999 20121 00591545401 QUINIDINE SU TAB 300MG 12/31/9999 20121 00093917501 QUINIDINE SU TAB 300MG ER 12/31/9999 20121 68669013505 QUIXIN SOL 0.5% 01/31/2013 20121 49685092801 QUTENZA KIT 8% 1-PCH 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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