August 31, 2012 - Iowa Medicaid Enterprise

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NDC Product Description Termination Date Quarter Covered 00603568628 RISPERIDONE TAB 2MG 12/31/9999 20121 00603568632 RISPERIDONE TAB 2MG 12/31/9999 20121 00904597661 RISPERIDONE TAB 2MG 12/31/9999 20121 13107012205 RISPERIDONE TAB 2MG 12/31/9999 20121 13107012260 RISPERIDONE TAB 2MG 12/31/9999 20121 13668003801 RISPERIDONE TAB 2MG 12/31/9999 20121 13668003805 RISPERIDONE TAB 2MG 12/31/9999 20121 13668003860 RISPERIDONE TAB 2MG 12/31/9999 20121 13668003874 RISPERIDONE TAB 2MG 12/31/9999 20121 16252056160 RISPERIDONE TAB 2MG 01/31/2013 20121 50458059310 RISPERIDONE TAB 2MG 12/31/9999 20121 50458059350 RISPERIDONE TAB 2MG 12/31/9999 20121 50458059360 RISPERIDONE TAB 2MG 12/31/9999 20121 51079046301 RISPERIDONE TAB 2MG 12/31/9999 20121 51079046320 RISPERIDONE TAB 2MG 12/31/9999 20121 51079046330 RISPERIDONE TAB 2MG 12/31/9999 20121 51079046356 RISPERIDONE TAB 2MG 12/31/9999 20121 52343000605 RISPERIDONE TAB 2MG 12/31/9999 20121 52343000660 RISPERIDONE TAB 2MG 12/31/9999 20121 60505258700 RISPERIDONE TAB 2MG 12/31/9999 20121 60505258705 RISPERIDONE TAB 2MG 12/31/9999 20121 60505258706 RISPERIDONE TAB 2MG 12/31/9999 20121 64679055702 RISPERIDONE TAB 2MG 12/31/9999 20121 64679055704 RISPERIDONE TAB 2MG 12/31/9999 20121 65862012205 RISPERIDONE TAB 2MG 12/31/9999 20121 65862012260 RISPERIDONE TAB 2MG 12/31/9999 20121 68084027301 RISPERIDONE TAB 2MG 12/31/9999 20121 68382011505 RISPERIDONE TAB 2MG 12/31/9999 20121 68382011514 RISPERIDONE TAB 2MG 12/31/9999 20121 00378604528 RISPERIDONE TAB 2MG ODT 12/31/9999 20121 00781531208 RISPERIDONE TAB 2MG ODT 12/31/9999 20121 49884040191 RISPERIDONE TAB 2MG ODT 12/31/9999 20121 50458060328 RISPERIDONE TAB 2MG ODT 12/31/9999 20121 51079034601 RISPERIDONE TAB 2MG ODT 12/31/9999 20121 51079034605 RISPERIDONE TAB 2MG ODT 12/31/9999 20121 55111020981 RISPERIDONE TAB 2MG ODT 12/31/9999 20121 68382015606 RISPERIDONE TAB 2MG ODT 12/31/9999 20121 00093724205 RISPERIDONE TAB 3MG 08/31/2012 20121 00093724206 RISPERIDONE TAB 3MG 12/31/9999 20121 00378351305 RISPERIDONE TAB 3MG 12/31/9999 20121 00378351391 RISPERIDONE TAB 3MG 12/31/9999 20121 00603568920 RISPERIDONE TAB 3MG 12/31/9999 20121 00603568928 RISPERIDONE TAB 3MG 12/31/9999 20121 00904597761 RISPERIDONE TAB 3MG 12/31/9999 20121 13107012305 RISPERIDONE TAB 3MG 12/31/9999 20121 13668003901 RISPERIDONE TAB 3MG 12/31/9999 20121 13668003905 RISPERIDONE TAB 3MG 12/31/9999 20121 13668003960 RISPERIDONE TAB 3MG 12/31/9999 20121 13668003974 RISPERIDONE TAB 3MG 12/31/9999 20121 16252056260 RISPERIDONE TAB 3MG 01/31/2013 20121 50458059410 RISPERIDONE TAB 3MG 12/31/9999 20121 50458059450 RISPERIDONE TAB 3MG 12/31/9999 20121 50458059460 RISPERIDONE TAB 3MG 12/31/9999 20121 51079046401 RISPERIDONE TAB 3MG 12/31/9999 20121 51079046420 RISPERIDONE TAB 3MG 12/31/9999 20121 51079046430 RISPERIDONE TAB 3MG 12/31/9999 20121 51079046456 RISPERIDONE TAB 3MG 12/31/9999 20121 52343000705 RISPERIDONE TAB 3MG 12/31/9999 20121 60505258800 RISPERIDONE TAB 3MG 12/31/9999 20121 60505258805 RISPERIDONE TAB 3MG 12/31/9999 20121 60505258806 RISPERIDONE TAB 3MG 12/31/9999 20121 64679057102 RISPERIDONE TAB 3MG 12/31/9999 20121 64679057104 RISPERIDONE TAB 3MG 12/31/9999 20121 65862012305 RISPERIDONE TAB 3MG 12/31/9999 20121 65862012360 RISPERIDONE TAB 3MG 12/31/9999 20121 68084027401 RISPERIDONE TAB 3MG 12/31/9999 20121 68382011605 RISPERIDONE TAB 3MG 12/31/9999 20121
NDC Product Description Termination Date Quarter Covered 68382011614 RISPERIDONE TAB 3MG 12/31/9999 20121 00378604628 RISPERIDONE TAB 3MG ODT 12/31/9999 20121 00781531308 RISPERIDONE TAB 3MG ODT 12/31/9999 20121 49884040291 RISPERIDONE TAB 3MG ODT 12/31/9999 20121 50458060428 RISPERIDONE TAB 3MG ODT 12/31/9999 20121 51079034701 RISPERIDONE TAB 3MG ODT 12/31/9999 20121 51079034705 RISPERIDONE TAB 3MG ODT 12/31/9999 20121 55111047081 RISPERIDONE TAB 3MG ODT 12/31/9999 20121 00093724306 RISPERIDONE TAB 4MG 12/31/9999 20121 00378351491 RISPERIDONE TAB 4MG 12/31/9999 20121 00603568820 RISPERIDONE TAB 4MG 12/31/9999 20121 00603568828 RISPERIDONE TAB 4MG 12/31/9999 20121 00904597861 RISPERIDONE TAB 4MG 12/31/9999 20121 13107012460 RISPERIDONE TAB 4MG 12/31/9999 20121 13668004001 RISPERIDONE TAB 4MG 12/31/9999 20121 13668004005 RISPERIDONE TAB 4MG 12/31/9999 20121 13668004060 RISPERIDONE TAB 4MG 12/31/9999 20121 13668004064 RISPERIDONE TAB 4MG 12/31/9999 20121 16252056360 RISPERIDONE TAB 4MG 12/31/9999 20121 50458059510 RISPERIDONE TAB 4MG 12/31/9999 20121 50458059560 RISPERIDONE TAB 4MG 12/31/9999 20121 51079046501 RISPERIDONE TAB 4MG 12/31/9999 20121 51079046520 RISPERIDONE TAB 4MG 12/31/9999 20121 51079046530 RISPERIDONE TAB 4MG 12/31/9999 20121 51079046556 RISPERIDONE TAB 4MG 12/31/9999 20121 52343000860 RISPERIDONE TAB 4MG 12/31/9999 20121 60505258900 RISPERIDONE TAB 4MG 12/31/9999 20121 60505258906 RISPERIDONE TAB 4MG 12/31/9999 20121 64679057204 RISPERIDONE TAB 4MG 12/31/9999 20121 65862012460 RISPERIDONE TAB 4MG 12/31/9999 20121 68084027701 RISPERIDONE TAB 4MG 12/31/9999 20121 68382011705 RISPERIDONE TAB 4MG 12/31/9999 20121 68382011714 RISPERIDONE TAB 4MG 12/31/9999 20121 00378604728 RISPERIDONE TAB 4MG ODT 12/31/9999 20121 00781531408 RISPERIDONE TAB 4MG ODT 12/31/9999 20121 49884040391 RISPERIDONE TAB 4MG ODT 12/31/9999 20121 50458060528 RISPERIDONE TAB 4MG ODT 12/31/9999 20121 55111047181 RISPERIDONE TAB 4MG ODT 12/31/9999 20121 00078044005 RITALIN TAB 10MG 12/31/9999 20121 00078044105 RITALIN TAB 20MG 12/31/9999 20121 00078043905 RITALIN TAB 5MG 12/31/9999 20121 00078042405 RITALIN LA CAP 10MG 12/31/9999 20121 00078037005 RITALIN LA CAP 20MG 12/31/9999 20121 00078037105 RITALIN LA CAP 30MG 12/31/9999 20121 00078037205 RITALIN LA CAP 40MG 12/31/9999 20121 00078044205 RITALIN SR TAB 20MG 12/31/9999 20121 50242005121 RITUXAN INJ 100MG 12/31/9999 20121 50242005306 RITUXAN INJ 500MG 12/31/9999 20121 00591320860 RIVASTIGMINE CAP 1.5MG 12/31/9999 20121 00781261413 RIVASTIGMINE CAP 1.5MG 12/31/9999 20121 00781261460 RIVASTIGMINE CAP 1.5MG 12/31/9999 20121 55111035205 RIVASTIGMINE CAP 1.5MG 12/31/9999 20121 55111035260 RIVASTIGMINE CAP 1.5MG 12/31/9999 20121 62756014513 RIVASTIGMINE CAP 1.5MG 12/31/9999 20121 62756014586 RIVASTIGMINE CAP 1.5MG 12/31/9999 20121 68084055001 RIVASTIGMINE CAP 1.5MG 12/31/9999 20121 00591320960 RIVASTIGMINE CAP 3MG 12/31/9999 20121 00781261513 RIVASTIGMINE CAP 3MG 12/31/9999 20121 00781261560 RIVASTIGMINE CAP 3MG 12/31/9999 20121 55111035305 RIVASTIGMINE CAP 3MG 12/31/9999 20121 55111035360 RIVASTIGMINE CAP 3MG 12/31/9999 20121 62756014613 RIVASTIGMINE CAP 3MG 12/31/9999 20121 62756014686 RIVASTIGMINE CAP 3MG 12/31/9999 20121 00591321060 RIVASTIGMINE CAP 4.5MG 12/31/9999 20121 00781261613 RIVASTIGMINE CAP 4.5MG 12/31/9999 20121 00781261660 RIVASTIGMINE CAP 4.5MG 12/31/9999 20121 55111035405 RIVASTIGMINE CAP 4.5MG 12/31/9999 20121
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Rebatable Drug List for Iowa Medica
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August 31, 2012 - Iowa Medicaid Enterprise

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