August 31, 2012 - Iowa Medicaid Enterprise

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NDC Product Description Termination Date Quarter Covered 65862017360 TOPIRAMATE TAB 100MG 12/31/9999 20121 68084034401 TOPIRAMATE TAB 100MG 12/31/9999 20121 68382014005 TOPIRAMATE TAB 100MG 12/31/9999 20121 68382014014 TOPIRAMATE TAB 100MG 12/31/9999 20121 68462010910 TOPIRAMATE TAB 100MG 12/31/9999 20121 68462010960 TOPIRAMATE TAB 100MG 12/31/9999 20121 00093722006 TOPIRAMATE TAB 200MG 12/31/9999 20121 00093722010 TOPIRAMATE TAB 200MG 12/31/9999 20121 00378610505 TOPIRAMATE TAB 200MG 12/31/9999 20121 00378610591 TOPIRAMATE TAB 200MG 12/31/9999 20121 13668003401 TOPIRAMATE TAB 200MG 12/31/9999 20121 13668003405 TOPIRAMATE TAB 200MG 12/31/9999 20121 13668003460 TOPIRAMATE TAB 200MG 12/31/9999 20121 13668003477 TOPIRAMATE TAB 200MG 12/31/9999 20121 31722028105 TOPIRAMATE TAB 200MG 12/31/9999 20121 31722028110 TOPIRAMATE TAB 200MG 12/31/9999 20121 31722028160 TOPIRAMATE TAB 200MG 12/31/9999 20121 59762103301 TOPIRAMATE TAB 200MG 09/30/2012 20121 60505276305 TOPIRAMATE TAB 200MG 12/31/9999 20121 60505276306 TOPIRAMATE TAB 200MG 12/31/9999 20121 62756071213 TOPIRAMATE TAB 200MG 12/31/9999 20121 62756071286 TOPIRAMATE TAB 200MG 12/31/9999 20121 65862017460 TOPIRAMATE TAB 200MG 12/31/9999 20121 68084034521 TOPIRAMATE TAB 200MG 12/31/9999 20121 68382014105 TOPIRAMATE TAB 200MG 12/31/9999 20121 68382014114 TOPIRAMATE TAB 200MG 12/31/9999 20121 68462011010 TOPIRAMATE TAB 200MG 12/31/9999 20121 68462011060 TOPIRAMATE TAB 200MG 12/31/9999 20121 00093015506 TOPIRAMATE TAB 25MG 12/31/9999 20121 00093015510 TOPIRAMATE TAB 25MG 12/31/9999 20121 00378610105 TOPIRAMATE TAB 25MG 12/31/9999 20121 00378610191 TOPIRAMATE TAB 25MG 12/31/9999 20121 13668003101 TOPIRAMATE TAB 25MG 12/31/9999 20121 13668003105 TOPIRAMATE TAB 25MG 12/31/9999 20121 13668003130 TOPIRAMATE TAB 25MG 12/31/9999 20121 13668003160 TOPIRAMATE TAB 25MG 12/31/9999 20121 13668003174 TOPIRAMATE TAB 25MG 12/31/9999 20121 31722027805 TOPIRAMATE TAB 25MG 12/31/9999 20121 31722027810 TOPIRAMATE TAB 25MG 12/31/9999 20121 31722027860 TOPIRAMATE TAB 25MG 12/31/9999 20121 51079072601 TOPIRAMATE TAB 25MG 12/31/9999 20121 51079072620 TOPIRAMATE TAB 25MG 12/31/9999 20121 59762103001 TOPIRAMATE TAB 25MG 09/30/2012 20121 60505276005 TOPIRAMATE TAB 25MG 12/31/9999 20121 60505276006 TOPIRAMATE TAB 25MG 12/31/9999 20121 62756070713 TOPIRAMATE TAB 25MG 12/31/9999 20121 62756070786 TOPIRAMATE TAB 25MG 12/31/9999 20121 65862017160 TOPIRAMATE TAB 25MG 12/31/9999 20121 68084034201 TOPIRAMATE TAB 25MG 12/31/9999 20121 68382013805 TOPIRAMATE TAB 25MG 12/31/9999 20121 68382013814 TOPIRAMATE TAB 25MG 12/31/9999 20121 68462010810 TOPIRAMATE TAB 25MG 12/31/9999 20121 68462010860 TOPIRAMATE TAB 25MG 12/31/9999 20121 00093754006 TOPIRAMATE TAB 50MG 12/31/9999 20121 00093754010 TOPIRAMATE TAB 50MG 12/31/9999 20121 00378610205 TOPIRAMATE TAB 50MG 12/31/9999 20121 00378610291 TOPIRAMATE TAB 50MG 12/31/9999 20121 13668003201 TOPIRAMATE TAB 50MG 12/31/9999 20121 13668003205 TOPIRAMATE TAB 50MG 12/31/9999 20121 13668003230 TOPIRAMATE TAB 50MG 12/31/9999 20121 13668003260 TOPIRAMATE TAB 50MG 12/31/9999 20121 13668003274 TOPIRAMATE TAB 50MG 12/31/9999 20121 31722027905 TOPIRAMATE TAB 50MG 12/31/9999 20121 31722027910 TOPIRAMATE TAB 50MG 12/31/9999 20121 31722027960 TOPIRAMATE TAB 50MG 12/31/9999 20121 51079072701 TOPIRAMATE TAB 50MG 12/31/9999 20121 51079072720 TOPIRAMATE TAB 50MG 12/31/9999 20121
NDC Product Description Termination Date Quarter Covered 59762103101 TOPIRAMATE TAB 50MG 09/30/2012 20121 60505276105 TOPIRAMATE TAB 50MG 12/31/9999 20121 60505276106 TOPIRAMATE TAB 50MG 12/31/9999 20121 62756071013 TOPIRAMATE TAB 50MG 12/31/9999 20121 62756071086 TOPIRAMATE TAB 50MG 12/31/9999 20121 65862017260 TOPIRAMATE TAB 50MG 12/31/9999 20121 68084034321 TOPIRAMATE TAB 50MG 12/31/9999 20121 68382013905 TOPIRAMATE TAB 50MG 12/31/9999 20121 68382013914 TOPIRAMATE TAB 50MG 12/31/9999 20121 68462015310 TOPIRAMATE TAB 50MG 12/31/9999 20121 68462015360 TOPIRAMATE TAB 50MG 12/31/9999 20121 00703565301 TOPOSAR INJ 100/5ML 12/31/9999 20121 00703565701 TOPOSAR INJ 1GM/50ML 12/31/9999 20121 00703565601 TOPOSAR INJ 500/25ML 12/31/9999 20121 25021020606 TOPOTECAN INJ 4MG 12/31/9999 20121 25021020661 TOPOTECAN INJ 4MG 12/31/9999 20121 25021082406 TOPOTECAN INJ 4MG 12/31/9999 20121 55390037010 TOPOTECAN INJ 4MG 12/31/9999 20121 63323076210 TOPOTECAN INJ 4MG 12/31/9999 20121 63323076217 TOPOTECAN INJ 4MG 12/31/9999 20121 66435041005 TOPOTECAN INJ 4MG 12/31/9999 20121 00409030201 TOPOTECAN INJ 4MG/4ML 12/31/9999 20121 00186109205 TOPROL XL TAB 100MG 12/31/9999 20121 00186109239 TOPROL XL TAB 100MG 12/31/9999 20121 00186109405 TOPROL XL TAB 200MG 12/31/9999 20121 00186108805 TOPROL XL TAB 25MG 12/31/9999 20121 00186108839 TOPROL XL TAB 25MG 12/31/9999 20121 00186109005 TOPROL XL TAB 50MG 12/31/9999 20121 00186109039 TOPROL XL TAB 50MG 12/31/9999 20121 00008117901 TORISEL SOL 25MG/ML 12/31/9999 20121 00517077010 TORSEMIDE INJ 20MG/2ML 12/31/9999 20121 00517077110 TORSEMIDE INJ 50MG/5ML 12/31/9999 20121 31722053201 TORSEMIDE TAB 100MG 12/31/9999 20121 49884010901 TORSEMIDE TAB 100MG 10/31/2012 20121 50111091801 TORSEMIDE TAB 100MG 12/31/9999 20121 59762170301 TORSEMIDE TAB 100MG 12/31/9999 20121 60505023501 TORSEMIDE TAB 100MG 12/31/9999 20121 62756076488 TORSEMIDE TAB 100MG 12/31/9999 20121 65862012801 TORSEMIDE TAB 100MG 12/31/9999 20121 00603613521 TORSEMIDE TAB 10MG 12/31/9999 20121 31722053001 TORSEMIDE TAB 10MG 12/31/9999 20121 49884010701 TORSEMIDE TAB 10MG 08/31/2012 20121 49884010705 TORSEMIDE TAB 10MG 08/31/2012 20121 50111091601 TORSEMIDE TAB 10MG 12/31/9999 20121 59762170101 TORSEMIDE TAB 10MG 12/31/9999 20121 60505023301 TORSEMIDE TAB 10MG 12/31/9999 20121 62756076288 TORSEMIDE TAB 10MG 12/31/9999 20121 65862012601 TORSEMIDE TAB 10MG 12/31/9999 20121 00054007725 TORSEMIDE TAB 20MG 12/31/9999 20121 00054007729 TORSEMIDE TAB 20MG 12/31/9999 20121 00603613621 TORSEMIDE TAB 20MG 12/31/9999 20121 00603613628 TORSEMIDE TAB 20MG 12/31/9999 20121 31722053101 TORSEMIDE TAB 20MG 12/31/9999 20121 49884010801 TORSEMIDE TAB 20MG 06/30/2012 20121 49884010805 TORSEMIDE TAB 20MG 06/30/2012 20121 50111091701 TORSEMIDE TAB 20MG 12/31/9999 20121 50111091703 TORSEMIDE TAB 20MG 12/31/9999 20121 59762170201 TORSEMIDE TAB 20MG 12/31/9999 20121 60505023401 TORSEMIDE TAB 20MG 12/31/9999 20121 62756076313 TORSEMIDE TAB 20MG 12/31/9999 20121 62756076388 TORSEMIDE TAB 20MG 12/31/9999 20121 65862012701 TORSEMIDE TAB 20MG 12/31/9999 20121 68084053901 TORSEMIDE TAB 20MG 12/31/9999 20121 00603613421 TORSEMIDE TAB 5MG 12/31/9999 20121 31722052901 TORSEMIDE TAB 5MG 12/31/9999 20121 49884010601 TORSEMIDE TAB 5MG 11/30/2012 20121 50111091501 TORSEMIDE TAB 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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