August 31, 2012 - Iowa Medicaid Enterprise

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NDC Product Description Termination Date Quarter Covered 16729000617 SIMVASTATIN TAB 40MG 12/31/9999 20121 24658021310 SIMVASTATIN TAB 40MG 12/31/9999 20121 24658021345 SIMVASTATIN TAB 40MG 12/31/9999 20121 24658021390 SIMVASTATIN TAB 40MG 12/31/9999 20121 24658030310 SIMVASTATIN TAB 40MG 12/31/9999 20121 24658030330 SIMVASTATIN TAB 40MG 12/31/9999 20121 24658030345 SIMVASTATIN TAB 40MG 12/31/9999 20121 24658030390 SIMVASTATIN TAB 40MG 12/31/9999 20121 50742013910 SIMVASTATIN TAB 40MG 12/31/9999 20121 51079039801 SIMVASTATIN TAB 40MG 12/31/9999 20121 51079039820 SIMVASTATIN TAB 40MG 12/31/9999 20121 51079045601 SIMVASTATIN TAB 40MG 11/30/2012 20121 51079045620 SIMVASTATIN TAB 40MG 11/30/2012 20121 54458093210 SIMVASTATIN TAB 40MG 12/31/9999 20121 55111020005 SIMVASTATIN TAB 40MG 12/31/9999 20121 55111020010 SIMVASTATIN TAB 40MG 12/31/9999 20121 55111020030 SIMVASTATIN TAB 40MG 12/31/9999 20121 55111020090 SIMVASTATIN TAB 40MG 12/31/9999 20121 63304079210 SIMVASTATIN TAB 40MG 12/31/9999 20121 63304079290 SIMVASTATIN TAB 40MG 12/31/9999 20121 63739043810 SIMVASTATIN TAB 40MG 12/31/9999 20121 65862005322 SIMVASTATIN TAB 40MG 12/31/9999 20121 65862005330 SIMVASTATIN TAB 40MG 12/31/9999 20121 65862005390 SIMVASTATIN TAB 40MG 12/31/9999 20121 65862005399 SIMVASTATIN TAB 40MG 12/31/9999 20121 68084016401 SIMVASTATIN TAB 40MG 12/31/9999 20121 68084051301 SIMVASTATIN TAB 40MG 12/31/9999 20121 68180048001 SIMVASTATIN TAB 40MG 12/31/9999 20121 68180048002 SIMVASTATIN TAB 40MG 12/31/9999 20121 68180048003 SIMVASTATIN TAB 40MG 12/31/9999 20121 68382006805 SIMVASTATIN TAB 40MG 12/31/9999 20121 68382006806 SIMVASTATIN TAB 40MG 12/31/9999 20121 68382006810 SIMVASTATIN TAB 40MG 12/31/9999 20121 68382006816 SIMVASTATIN TAB 40MG 12/31/9999 20121 68645026254 SIMVASTATIN TAB 40MG 12/31/9999 20121 00093715219 SIMVASTATIN TAB 5MG 12/31/9999 20121 00093715256 SIMVASTATIN TAB 5MG 12/31/9999 20121 00093715293 SIMVASTATIN TAB 5MG 12/31/9999 20121 00093715298 SIMVASTATIN TAB 5MG 12/31/9999 20121 16252050530 SIMVASTATIN TAB 5MG 04/30/2013 20121 16252050550 SIMVASTATIN TAB 5MG 04/30/2013 20121 16252050590 SIMVASTATIN TAB 5MG 12/31/9999 20121 16714068101 SIMVASTATIN TAB 5MG 12/31/2020 20121 16714068102 SIMVASTATIN TAB 5MG 12/31/2020 20121 24658021010 SIMVASTATIN TAB 5MG 12/31/9999 20121 24658021030 SIMVASTATIN TAB 5MG 12/31/9999 20121 24658021045 SIMVASTATIN TAB 5MG 12/31/9999 20121 24658021090 SIMVASTATIN TAB 5MG 12/31/9999 20121 24658030010 SIMVASTATIN TAB 5MG 12/31/9999 20121 24658030030 SIMVASTATIN TAB 5MG 12/31/9999 20121 24658030045 SIMVASTATIN TAB 5MG 12/31/9999 20121 24658030090 SIMVASTATIN TAB 5MG 12/31/9999 20121 55111019705 SIMVASTATIN TAB 5MG 12/31/9999 20121 55111019730 SIMVASTATIN TAB 5MG 12/31/9999 20121 55111019790 SIMVASTATIN TAB 5MG 12/31/9999 20121 63304078910 SIMVASTATIN TAB 5MG 12/31/9999 20121 63304078990 SIMVASTATIN TAB 5MG 12/31/9999 20121 63739043510 SIMVASTATIN TAB 5MG 12/31/9999 20121 65862005030 SIMVASTATIN TAB 5MG 12/31/9999 20121 65862005090 SIMVASTATIN TAB 5MG 12/31/9999 20121 68084016101 SIMVASTATIN TAB 5MG 12/31/9999 20121 68084051001 SIMVASTATIN TAB 5MG 12/31/9999 20121 68180048206 SIMVASTATIN TAB 5MG 12/31/9999 20121 68180048209 SIMVASTATIN TAB 5MG 12/31/9999 20121 68382006506 SIMVASTATIN TAB 5MG 12/31/9999 20121 68382006510 SIMVASTATIN TAB 5MG 12/31/9999 20121 68382006516 SIMVASTATIN TAB 5MG 12/31/9999 20121
NDC Product Description Termination Date Quarter Covered 00093715610 SIMVASTATIN TAB 80MG 12/31/9999 20121 00093715619 SIMVASTATIN TAB 80MG 12/31/9999 20121 00093715656 SIMVASTATIN TAB 80MG 12/31/9999 20121 00093715693 SIMVASTATIN TAB 80MG 12/31/9999 20121 00093715698 SIMVASTATIN TAB 80MG 12/31/9999 20121 16252050930 SIMVASTATIN TAB 80MG 01/31/2013 20121 16252050950 SIMVASTATIN TAB 80MG 01/31/2013 20121 16252050990 SIMVASTATIN TAB 80MG 01/31/2013 20121 16714068501 SIMVASTATIN TAB 80MG 12/31/2020 20121 16714068502 SIMVASTATIN TAB 80MG 12/31/2020 20121 16714068503 SIMVASTATIN TAB 80MG 12/31/2020 20121 16729000710 SIMVASTATIN TAB 80MG 12/31/9999 20121 16729000715 SIMVASTATIN TAB 80MG 12/31/9999 20121 16729000717 SIMVASTATIN TAB 80MG 12/31/9999 20121 24658021410 SIMVASTATIN TAB 80MG 12/31/9999 20121 24658021430 SIMVASTATIN TAB 80MG 12/31/9999 20121 24658021445 SIMVASTATIN TAB 80MG 12/31/9999 20121 24658021490 SIMVASTATIN TAB 80MG 12/31/9999 20121 24658030410 SIMVASTATIN TAB 80MG 12/31/9999 20121 24658030430 SIMVASTATIN TAB 80MG 12/31/9999 20121 24658030445 SIMVASTATIN TAB 80MG 12/31/9999 20121 24658030490 SIMVASTATIN TAB 80MG 12/31/9999 20121 50742014010 SIMVASTATIN TAB 80MG 12/31/9999 20121 55111026805 SIMVASTATIN TAB 80MG 12/31/9999 20121 55111026830 SIMVASTATIN TAB 80MG 12/31/9999 20121 55111026890 SIMVASTATIN TAB 80MG 12/31/9999 20121 63304079310 SIMVASTATIN TAB 80MG 12/31/9999 20121 63304079350 SIMVASTATIN TAB 80MG 12/31/9999 20121 63304079390 SIMVASTATIN TAB 80MG 12/31/9999 20121 65862005430 SIMVASTATIN TAB 80MG 12/31/9999 20121 65862005439 SIMVASTATIN TAB 80MG 12/31/9999 20121 65862005490 SIMVASTATIN TAB 80MG 12/31/9999 20121 65862005499 SIMVASTATIN TAB 80MG 12/31/9999 20121 68084016501 SIMVASTATIN TAB 80MG 12/31/9999 20121 68084051401 SIMVASTATIN TAB 80MG 12/31/9999 20121 68180048101 SIMVASTATIN TAB 80MG 12/31/9999 20121 68180048102 SIMVASTATIN TAB 80MG 12/31/9999 20121 68180048103 SIMVASTATIN TAB 80MG 12/31/9999 20121 68382006905 SIMVASTATIN TAB 80MG 12/31/9999 20121 68382006906 SIMVASTATIN TAB 80MG 12/31/9999 20121 68382006910 SIMVASTATIN TAB 80MG 12/31/9999 20121 68382006916 SIMVASTATIN TAB 80MG 12/31/9999 20121 68645026354 SIMVASTATIN TAB 80MG 12/31/9999 20121 00006391568 SINEMET TAB 10-100MG 12/31/9999 20121 00006391668 SINEMET TAB 25-100MG 12/31/9999 20121 00056065068 SINEMET TAB 25-100MG 09/30/2012 20121 00006391768 SINEMET TAB 25-250MG 12/31/9999 20121 00056065468 SINEMET TAB 25-250MG 05/17/2013 20121 00006391868 SINEMET CR TAB 25-100MG 12/31/9999 20121 00006391968 SINEMET CR TAB 50-200MG 12/31/9999 20121 00056052168 SINEMET CR TAB 50-200MG 06/22/2013 20121 00006071128 SINGULAIR CHW 4MG 12/31/9999 20121 00006071131 SINGULAIR CHW 4MG 12/31/9999 20121 00006071154 SINGULAIR CHW 4MG 12/31/9999 20121 00006027528 SINGULAIR CHW 5MG 12/31/9999 20121 00006027531 SINGULAIR CHW 5MG 12/31/9999 20121 00006027554 SINGULAIR CHW 5MG 12/31/9999 20121 00006027582 SINGULAIR CHW 5MG 12/31/9999 20121 00006384130 SINGULAIR GRA 4MG 12/31/9999 20121 00006011728 SINGULAIR TAB 10MG 12/31/9999 20121 00006011731 SINGULAIR TAB 10MG 12/31/9999 20121 00006011754 SINGULAIR TAB 10MG 12/31/9999 20121 00006011780 SINGULAIR TAB 10MG 12/31/9999 20121 63868007124 SINUS CONGST TAB /PAIN 12/31/9999 20121 00113027262 SINUS CONGST TAB /PAIN DT 12/31/9999 20121 36800027262 SINUS CONGST TAB /PAIN DT 12/31/9999 20121 00113081710 SINUS NASAL SPR 0.05% 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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