August 31, 2012 - Iowa Medicaid Enterprise

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NDC Product Description Termination Date Quarter Covered 68405088026 THERAPROFEN PAK -60 12/31/9999 20121 68405808826 THERAPROFEN PAK -60 12/31/9999 20121 68405818836 THERAPROFEN PAK 800MG 12/31/9999 20121 68405808836 THERAPROFEN PAK -90 12/31/9999 20121 68405801806 THERAPROXEN PAK 12/31/9999 20121 68405811836 THERAPROXEN PAK 500MG 12/31/9999 20121 68405018006 THERAPROXEN PAK -60 12/31/9999 20121 68405801836 THERAPROXEN PAK -90 12/31/9999 20121 00904573226 THERAPY ICE GEL 2% 09/30/2012 20121 68405038026 THERATRAMADO PAK -60 12/31/9999 20121 68405803826 THERATRAMADO PAK -60 12/31/9999 20121 68405803836 THERATRAMADO PAK -90 12/31/9999 20121 00536466010 THEREMS TAB 12/31/9999 20121 00536466038 THEREMS TAB 12/31/9999 20121 00536466711 THEREMS H TAB 12/31/9999 20121 00536466110 THEREMS M TAB 12/31/9999 20121 00536466138 THEREMS M TAB 12/31/9999 20121 08880950502 THERMAZENE CRE 1% 12/31/9999 20121 08880950505 THERMAZENE CRE 1% 12/31/9999 20121 08880950510 THERMAZENE CRE 1% 12/31/9999 20121 08880950540 THERMAZENE CRE 1% 12/31/9999 20121 08880950550 THERMAZENE CRE 1% 12/31/9999 20121 08880950585 THERMAZENE CRE 1% 12/31/9999 20121 67877012405 THERMAZENE CRE 1% 12/31/9999 20121 67877012420 THERMAZENE CRE 1% 12/31/9999 20121 67877012440 THERMAZENE CRE 1% 12/31/9999 20121 67877012450 THERMAZENE CRE 1% 12/31/9999 20121 67877012485 THERMAZENE CRE 1% 12/31/9999 20121 00603597021 THEROBEC TAB PLUS 07/31/2013 20121 51552048105 THIABENDAZOL POW 12/31/9999 20121 63323001302 THIAMINE HCL INJ 100MG/ML 12/31/9999 20121 00536468001 THIAMINE HCL TAB 100MG 12/31/9999 20121 00536468010 THIAMINE HCL TAB 100MG 12/31/9999 20121 00178090001 THIOLA TAB 100MG 12/31/9999 20121 00378061801 THIORIDAZINE TAB 100MG 12/31/9999 20121 00378061810 THIORIDAZINE TAB 100MG 07/31/2013 20121 51079058001 THIORIDAZINE TAB 100MG 12/31/9999 20121 51079058020 THIORIDAZINE TAB 100MG 12/31/9999 20121 53489050001 THIORIDAZINE TAB 100MG 12/31/9999 20121 00378061201 THIORIDAZINE TAB 10MG 12/31/9999 20121 00378061210 THIORIDAZINE TAB 10MG 08/31/2012 20121 51079056501 THIORIDAZINE TAB 10MG 12/31/9999 20121 51079056520 THIORIDAZINE TAB 10MG 12/31/9999 20121 53489014801 THIORIDAZINE TAB 10MG 12/31/9999 20121 53489014810 THIORIDAZINE TAB 10MG 12/31/9999 20121 00378061401 THIORIDAZINE TAB 25MG 12/31/9999 20121 00378061410 THIORIDAZINE TAB 25MG 07/13/2013 20121 51079056601 THIORIDAZINE TAB 25MG 12/31/9999 20121 51079056620 THIORIDAZINE TAB 25MG 12/31/9999 20121 53489014901 THIORIDAZINE TAB 25MG 12/31/9999 20121 53489014910 THIORIDAZINE TAB 25MG 12/31/9999 20121 00378061601 THIORIDAZINE TAB 50MG 12/31/9999 20121 00378061610 THIORIDAZINE TAB 50MG 07/31/2013 20121 51079056701 THIORIDAZINE TAB 50MG 12/31/9999 20121 51079056720 THIORIDAZINE TAB 50MG 12/31/9999 20121 53489015001 THIORIDAZINE TAB 50MG 12/31/9999 20121 53489015010 THIORIDAZINE TAB 50MG 12/31/9999 20121 51552051206 THIOSULFATE CRY SODIUM 12/31/9999 20121 55390003010 THIOTEPA INJ 15MG 12/31/9999 20121 00378501001 THIOTHIXENE CAP 10MG 12/31/9999 20121 00378501010 THIOTHIXENE CAP 10MG 08/31/2012 20121 00781222901 THIOTHIXENE CAP 10MG 12/31/9999 20121 51079058901 THIOTHIXENE CAP 10MG 12/31/9999 20121 51079058920 THIOTHIXENE CAP 10MG 12/31/9999 20121 00378100101 THIOTHIXENE CAP 1MG 12/31/9999 20121 00781222601 THIOTHIXENE CAP 1MG 12/31/9999 20121 00378200201 THIOTHIXENE CAP 2MG 12/31/9999 20121
NDC Product Description Termination Date Quarter Covered 00378200210 THIOTHIXENE CAP 2MG 11/30/2012 20121 00781222701 THIOTHIXENE CAP 2MG 12/31/9999 20121 51079058701 THIOTHIXENE CAP 2MG 12/31/9999 20121 51079058720 THIOTHIXENE CAP 2MG 12/31/9999 20121 00378300501 THIOTHIXENE CAP 5MG 12/31/9999 20121 00378300510 THIOTHIXENE CAP 5MG 10/31/2012 20121 00781222801 THIOTHIXENE CAP 5MG 12/31/9999 20121 51079058801 THIOTHIXENE CAP 5MG 12/31/9999 20121 51079058820 THIOTHIXENE CAP 5MG 12/31/9999 20121 00472145791 THIOTHIXENE CON 5MG/ML 12/31/9999 20121 00472145794 THIOTHIXENE CON 5MG/ML 12/31/9999 20121 51552074605 THREONINE POW 12/31/9999 20121 00067560511 THRIVE GUM 2MG MINT 12/31/9999 20121 00067560595 THRIVE GUM 2MG MINT 12/31/9999 20121 00067560611 THRIVE GUM 4MG MINT 12/31/9999 20121 00067560695 THRIVE GUM 4MG MINT 12/31/9999 20121 00904600505 THROAT LOZ 12/31/9999 20121 13533060320 THROMBAT III INJ 500UNIT 12/31/9999 20121 60793020505 THROMBIN KIT 5000UNIT 12/31/9999 20121 60793021721 THROMBIN-JMI KIT 20000UNT 12/31/9999 20121 60793021722 THROMBIN-JMI KIT 20000UNT 12/31/9999 20121 60793070505 THROMBIN-JMI KIT 5000UNIT 12/31/9999 20121 60793021720 THROMBIN-JMI SOL 20000UNT 12/31/9999 20121 60793021505 THROMBIN-JMI SOL 5000UNIT 12/31/9999 20121 58468008001 THYMOGLOBULN INJ 25MG 12/31/9999 20121 58468184904 THYROGEN INJ 1.1MG 12/31/9999 20121 00456005001 THYROLAR-1 TAB 60MG 12/31/9999 20121 00456004501 THYROLAR-1/2 TAB 30MG 12/31/9999 20121 00456004001 THYROLAR-1/4 TAB 15MG 12/31/9999 20121 00456005501 THYROLAR-2 TAB 120MG 12/31/9999 20121 00456006001 THYROLAR-3 TAB 180MG 12/31/9999 20121 00456261200 TIAZAC CAP 120MG/24 12/31/9999 20121 00456261230 TIAZAC CAP 120MG/24 12/31/9999 20121 00456261290 TIAZAC CAP 120MG/24 12/31/9999 20121 00456261300 TIAZAC CAP 180MG/24 12/31/9999 20121 00456261330 TIAZAC CAP 180MG/24 12/31/9999 20121 00456261390 TIAZAC CAP 180MG/24 12/31/9999 20121 00456261400 TIAZAC CAP 240MG/24 12/31/9999 20121 00456261430 TIAZAC CAP 240MG/24 12/31/9999 20121 00456261463 TIAZAC CAP 240MG/24 09/30/2012 20121 00456261490 TIAZAC CAP 240MG/24 12/31/9999 20121 00456261500 TIAZAC CAP 300MG/24 12/31/9999 20121 00456261530 TIAZAC CAP 300MG/24 12/31/9999 20121 00456261590 TIAZAC CAP 300MG/24 12/31/9999 20121 00456261600 TIAZAC CAP 360MG/24 12/31/9999 20121 00456261630 TIAZAC CAP 360MG/24 12/31/9999 20121 00456261690 TIAZAC CAP 360MG/24 12/31/9999 20121 00456261700 TIAZAC CAP 420MG/24 12/31/9999 20121 00456261730 TIAZAC CAP 420MG/24 12/31/9999 20121 00456261790 TIAZAC CAP 420MG/24 12/31/9999 20121 00052060202 TICE BCG INJ 12/31/9999 20121 00093015401 TICLOPIDINE TAB 250MG 12/31/9999 20121 00093015405 TICLOPIDINE TAB 250MG 12/31/9999 20121 00228261303 TICLOPIDINE TAB 250MG 12/31/9999 20121 00228261306 TICLOPIDINE TAB 250MG 12/31/9999 20121 00228261311 TICLOPIDINE TAB 250MG 12/31/9999 20121 00904537840 TICLOPIDINE TAB 250MG 12/31/9999 20121 00904537846 TICLOPIDINE TAB 250MG 12/31/9999 20121 00904537852 TICLOPIDINE TAB 250MG 12/31/9999 20121 57664032706 TICLOPIDINE TAB 250MG 12/31/9999 20121 57664032713 TICLOPIDINE TAB 250MG 12/31/9999 20121 57664032783 TICLOPIDINE TAB 250MG 12/31/9999 20121 60505002702 TICLOPIDINE TAB 250MG 12/31/9999 20121 60505002704 TICLOPIDINE TAB 250MG 12/31/9999 20121 60505002707 TICLOPIDINE TAB 250MG 12/31/9999 20121 61570007901 TIGAN CAP 300MG 12/31/9999 20121 42023011801 TIGAN INJ 100MG/ML 12/31/9999 20121
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August 31, 2012 - Iowa Medicaid Enterprise

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