August 31, 2012 - Iowa Medicaid Enterprise

More documents

Recommendations

Info

NDC Product Description Termination Date Quarter Covered 53329005157 SOOTHE&COOL POW BODY 12/31/9999 20121 53329005367 SOOTHE&COOL POW BODY 12/31/9999 20121 24385013395 SOOTHNG BATH POW TREATMNT 12/31/9999 20121 51552021606 SORBITOL POW 12/31/9999 20121 00338029547 SORBITOL SOL 3% IRR 12/31/9999 20121 00264230150 SORBITOL SOL 3.3% IRR 12/31/9999 20121 00264230170 SORBITOL SOL 3.3% IRR 12/31/9999 20121 00603090058 SORBITOL SOL 70% 12/31/9999 20121 00409798108 SORBITOL-MAN SOL 12/31/9999 20121 00904177121 SORE THROAT AER CHERRY 12/31/9999 20121 00904177021 SORE THROAT AER MENTHOL 12/31/9999 20121 24385032830 SORE THROAT LIQ 1.4% 12/31/9999 20121 24385053230 SORE THROAT LIQ 1.4% 12/31/9999 20121 00904625549 SORE THROAT LOZ 15-3.6MG 12/31/9999 20121 00904502198 SORE THROAT LOZ CHERRY 12/31/9999 20121 37205032630 SORE THROAT SPR 12/31/9999 20121 37205032730 SORE THROAT SPR 12/31/9999 20121 45802028282 SORE THROAT SPR 12/31/9999 20121 00113032830 SORE THROAT SPR 1.4% 12/31/9999 20121 00121062806 SORE THROAT SPR 1.4% 12/31/9999 20121 36800032830 SORE THROAT SPR 1.4% 12/31/9999 20121 36800034330 SORE THROAT SPR 1.4% 12/31/9999 20121 62011008801 SORE THROAT SPR 1.4% 12/31/9999 20121 45802032782 SORE THROAT SPR CHERRY 12/31/9999 20121 63868081155 SORE THROAT SPR CHERRY 12/31/9999 20121 00113034330 SORE THROAT SPR MENTHOL 12/31/9999 20121 63868081255 SORE THROAT SPR MENTHOL 12/31/9999 20121 00145009025 SORIATANE CAP 10MG 12/31/9999 20121 00145381703 SORIATANE CAP 17.5MG 12/31/9999 20121 00145382103 SORIATANE CAP 22.5MG 04/30/2013 20121 00145009125 SORIATANE CAP 25MG 12/31/9999 20121 00245001301 SORINE TAB 120MG 12/31/9999 20121 00245001401 SORINE TAB 160MG 12/31/9999 20121 00245001501 SORINE TAB 240MG 12/31/9999 20121 00245001201 SORINE TAB 80MG 12/31/9999 20121 00378512401 SOTALOL AF TAB 120MG 12/31/9999 20121 60505022301 SOTALOL AF TAB 120MG 12/31/9999 20121 00378512501 SOTALOL AF TAB 160MG 12/31/9999 20121 60505022401 SOTALOL AF TAB 160MG 12/31/9999 20121 00378512301 SOTALOL AF TAB 80MG 12/31/9999 20121 60505022201 SOTALOL AF TAB 80MG 12/31/9999 20121 67457017610 SOTALOL HCL INJ 150/10ML 12/31/9999 20121 00093106001 SOTALOL HCL TAB 120MG 12/31/9999 20121 00185017001 SOTALOL HCL TAB 120MG 12/31/9999 20121 00185017009 SOTALOL HCL TAB 120MG 12/31/9999 20121 00378031001 SOTALOL HCL TAB 120MG 12/31/2012 20121 00603577021 SOTALOL HCL TAB 120MG 12/31/9999 20121 00603577025 SOTALOL HCL TAB 120MG 12/31/9999 20121 60505015900 SOTALOL HCL TAB 120MG 12/31/9999 20121 00093106201 SOTALOL HCL TAB 160MG 12/31/9999 20121 00185017701 SOTALOL HCL TAB 160MG 12/31/9999 20121 00185017709 SOTALOL HCL TAB 160MG 12/31/9999 20121 00378031401 SOTALOL HCL TAB 160MG 06/30/2012 20121 00603577121 SOTALOL HCL TAB 160MG 12/31/9999 20121 60505008100 SOTALOL HCL TAB 160MG 12/31/9999 20121 00093106301 SOTALOL HCL TAB 240MG 12/31/9999 20121 00185017401 SOTALOL HCL TAB 240MG 12/31/9999 20121 00185017409 SOTALOL HCL TAB 240MG 12/31/9999 20121 60505008200 SOTALOL HCL TAB 240MG 12/31/9999 20121 00093106101 SOTALOL HCL TAB 80MG 12/31/9999 20121 00185017101 SOTALOL HCL TAB 80MG 12/31/9999 20121 00185017105 SOTALOL HCL TAB 80MG 12/31/9999 20121 00185017109 SOTALOL HCL TAB 80MG 12/31/9999 20121 00378030501 SOTALOL HCL TAB 80MG 06/30/2012 20121 00603576921 SOTALOL HCL TAB 80MG 12/31/9999 20121 00603576928 SOTALOL HCL TAB 80MG 12/31/9999 20121 60505008000 SOTALOL HCL TAB 80MG 12/31/9999 20121
NDC Product Description Termination Date Quarter Covered 68084049701 SOTALOL HCL TAB 80MG 12/31/9999 20121 67457016202 SOTRADECOL INJ 1% 12/31/9999 20121 67457016302 SOTRADECOL INJ 3% 12/31/9999 20121 10631058431 SOTRET CAP 10MG 12/31/9999 20121 10631058477 SOTRET CAP 10MG 12/31/9999 20121 10631058531 SOTRET CAP 20MG 12/31/9999 20121 10631058577 SOTRET CAP 20MG 12/31/9999 20121 10631044731 SOTRET CAP 30MG 12/31/9999 20121 10631058631 SOTRET CAP 40MG 12/31/9999 20121 10631058677 SOTRET CAP 40MG 12/31/9999 20121 51552096207 SOY ISOFLAVO POW 40% 12/31/9999 20121 51552087306 SOYBEAN OIL REFINED 12/31/9999 20121 51552096406 SPAN 20 LIQ 12/31/9999 20121 51552032106 SPAN 80 LIQ 12/31/9999 20121 10122080120 SPECTRACEF TAB 200MG 03/31/2014 20121 10122080220 SPECTRACEF TAB 400MG 11/30/2013 20121 10122080228 SPECTRACEF TAB 400MG 11/30/2013 20121 51552047106 SPERMACETI MIS 12/31/9999 20121 00597007541 SPIRIVA CAP HANDIHLR 12/31/9999 20121 00597007547 SPIRIVA CAP HANDIHLR 12/31/9999 20121 00597007575 SPIRIVA CAP HANDIHLR 12/31/9999 20121 00378014101 SPIRONO/HCTZ TAB 25/25 12/31/9999 20121 00378014105 SPIRONO/HCTZ TAB 25/25 12/31/9999 20121 51079010401 SPIRONO/HCTZ TAB 25/25 12/31/9999 20121 51079010420 SPIRONO/HCTZ TAB 25/25 12/31/9999 20121 53489014401 SPIRONO/HCTZ TAB 25/25 12/31/9999 20121 53489014405 SPIRONO/HCTZ TAB 25/25 12/31/9999 20121 53489014410 SPIRONO/HCTZ TAB 25/25 12/31/9999 20121 59762501401 SPIRONO/HCTZ TAB 25/25 12/31/9999 20121 00228267311 SPIRONOLACT TAB 100MG 12/31/9999 20121 00228267350 SPIRONOLACT TAB 100MG 12/31/9999 20121 00378043701 SPIRONOLACT TAB 100MG 12/31/9999 20121 00603576516 SPIRONOLACT TAB 100MG 12/31/9999 20121 00603576521 SPIRONOLACT TAB 100MG 12/31/9999 20121 00603576528 SPIRONOLACT TAB 100MG 12/31/9999 20121 00904595306 SPIRONOLACT TAB 100MG 12/31/9999 20121 51079098001 SPIRONOLACT TAB 100MG 12/31/9999 20121 51079098020 SPIRONOLACT TAB 100MG 12/31/9999 20121 53489032901 SPIRONOLACT TAB 100MG 12/31/9999 20121 53489032905 SPIRONOLACT TAB 100MG 12/31/9999 20121 53489032906 SPIRONOLACT TAB 100MG 12/31/9999 20121 53489032907 SPIRONOLACT TAB 100MG 12/31/9999 20121 59762501301 SPIRONOLACT TAB 100MG 12/31/9999 20121 65162051510 SPIRONOLACT TAB 100MG 12/31/9999 20121 65162051550 SPIRONOLACT TAB 100MG 12/31/9999 20121 68084020801 SPIRONOLACT TAB 100MG 12/31/9999 20121 00228238810 SPIRONOLACT TAB 25MG 12/31/9999 20121 00228280311 SPIRONOLACT TAB 25MG 12/31/9999 20121 00228280350 SPIRONOLACT TAB 25MG 12/31/9999 20121 00378214601 SPIRONOLACT TAB 25MG 12/31/9999 20121 00378214605 SPIRONOLACT TAB 25MG 12/31/9999 20121 00603576321 SPIRONOLACT TAB 25MG 12/31/9999 20121 00603576328 SPIRONOLACT TAB 25MG 12/31/9999 20121 00603576330 SPIRONOLACT TAB 25MG 12/31/9999 20121 00603576332 SPIRONOLACT TAB 25MG 12/31/9999 20121 00615153505 SPIRONOLACT TAB 25MG 12/31/9999 20121 00781159901 SPIRONOLACT TAB 25MG 12/31/9999 20121 00781159905 SPIRONOLACT TAB 25MG 12/31/9999 20121 00781159910 SPIRONOLACT TAB 25MG 12/31/9999 20121 00904595161 SPIRONOLACT TAB 25MG 12/31/9999 20121 50268072615 SPIRONOLACT TAB 25MG 12/31/9999 20121 51079010301 SPIRONOLACT TAB 25MG 12/31/9999 20121 51079010317 SPIRONOLACT TAB 25MG 12/31/9999 20121 51079010319 SPIRONOLACT TAB 25MG 12/31/9999 20121 51079010320 SPIRONOLACT TAB 25MG 12/31/9999 20121 51079010363 SPIRONOLACT TAB 25MG 12/31/9999 20121 53489014301 SPIRONOLACT TAB 25MG 12/31/9999 20121
Page 1 and 2:
Rebatable Drug List for Iowa Medica
Page 3 and 4:
NDC Product Description Termination
Page 5 and 6:
Page 7 and 8:
Page 9 and 10:
Page 11 and 12:
Page 13 and 14:
Page 15 and 16:
Page 17 and 18:
Page 19 and 20:
Page 21 and 22:
Page 23 and 24:
Page 25 and 26:
Page 27 and 28:
Page 29 and 30:
Page 31 and 32:
Page 33 and 34:
Page 35 and 36:
Page 37 and 38:
Page 39 and 40:
Page 41 and 42:
Page 43 and 44:
Page 45 and 46:
Page 47 and 48:
Page 49 and 50:
Page 51 and 52:
Page 53 and 54:
Page 55 and 56:
Page 57 and 58:
Page 59 and 60:
Page 61 and 62:
Page 63 and 64:
Page 65 and 66:
Page 67 and 68:
Page 69 and 70:
Page 71 and 72:
Page 73 and 74:
Page 75 and 76:
Page 77 and 78:
Page 79 and 80:
Page 81 and 82:
Page 83 and 84:
Page 85 and 86:
Page 87 and 88:
Page 89 and 90:
Page 91 and 92:
Page 93 and 94:
Page 95 and 96:
Page 97 and 98:
Page 99 and 100:
Page 101 and 102:
Page 103 and 104:
Page 105 and 106:
Page 107 and 108:
Page 109 and 110:
Page 111 and 112:
Page 113 and 114:
Page 115 and 116:
Page 117 and 118:
Page 119 and 120:
Page 121 and 122:
Page 123 and 124:
Page 125 and 126:
Page 127 and 128:
Page 129 and 130:
Page 131 and 132:
Page 133 and 134:
Page 135 and 136:
Page 137 and 138:
Page 139 and 140:
Page 141 and 142:
Page 143 and 144:
Page 145 and 146:
Page 147 and 148:
Page 149 and 150:
Page 151 and 152:
Page 153 and 154:
Page 155 and 156:
Page 157 and 158:
Page 159 and 160:
Page 161 and 162:
Page 163 and 164:
Page 165 and 166:
Page 167 and 168:
Page 169 and 170:
Page 171 and 172:
Page 173 and 174:
Page 175 and 176:
Page 177 and 178:
Page 179 and 180:
Page 181 and 182:
Page 183 and 184:
Page 185 and 186:
Page 187 and 188:
Page 189 and 190:
Page 191 and 192:
Page 193 and 194:
Page 195 and 196:
Page 197 and 198:
Page 199 and 200:
Page 201 and 202:
Page 203 and 204:
Page 205 and 206:
Page 207 and 208:
Page 209 and 210:
Page 211 and 212:
Page 213 and 214:
Page 215 and 216:
Page 217 and 218:
Page 219 and 220:
Page 221 and 222:
Page 223 and 224:
Page 225 and 226:
Page 227 and 228:
Page 229 and 230:
Page 231 and 232:
Page 233 and 234:
Page 235 and 236:
Page 237 and 238:
Page 239 and 240:
Page 241 and 242:
Page 243 and 244:
Page 245 and 246:
Page 247 and 248:
Page 249 and 250:
Page 251 and 252:
Page 253 and 254:
Page 255 and 256:
Page 257 and 258:
Page 259 and 260:
Page 261 and 262:
Page 263 and 264:
Page 265 and 266:
Page 267 and 268:
Page 269 and 270:
Page 271 and 272:
Page 273 and 274:
Page 275 and 276:
Page 277 and 278:
Page 279 and 280:
Page 281 and 282:
Page 283 and 284:
Page 285 and 286:
Page 287 and 288:
Page 289 and 290:
Page 291 and 292:
Page 293 and 294:
Page 295 and 296:
Page 297 and 298:
Page 299 and 300:
Page 301 and 302:
Page 303 and 304:
Page 305 and 306:
Page 307 and 308:
Page 309 and 310:
Page 311 and 312:
Page 313 and 314:
Page 315 and 316:
Page 317 and 318:
Page 319 and 320:
Page 321 and 322:
Page 323 and 324:
Page 325 and 326:
Page 327 and 328:
Page 329 and 330:
Page 331 and 332:
Page 333 and 334:
Page 335 and 336:
Page 337 and 338:
Page 339 and 340:
Page 341 and 342:
Page 343 and 344:
Page 345 and 346:
Page 347 and 348:
Page 349 and 350:
Page 351 and 352:
Page 353 and 354:
Page 355 and 356: NDC Product Description Termination
Page 405: NDC Product Description Termination
Page 457 and 458:
Page 459 and 460:
Page 461 and 462:
Page 463 and 464:
Page 465 and 466:
Page 467 and 468:
Page 469:
show all

August 31, 2012 - Iowa Medicaid Enterprise

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?