August 31, 2012 - Iowa Medicaid Enterprise

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NDC Product Description Termination Date Quarter Covered 68405800306 TRAZAMINE PAK 12/31/9999 20121 00182126000 TRAZODONE TAB 100MG 12/31/9999 20121 00182126089 TRAZODONE TAB 100MG 12/31/9999 20121 00228244110 TRAZODONE TAB 100MG 12/31/9999 20121 00378347201 TRAZODONE TAB 100MG 05/31/2013 20121 00378347210 TRAZODONE TAB 100MG 01/31/2013 20121 00603614832 TRAZODONE TAB 100MG 05/31/2012 20121 00603616102 TRAZODONE TAB 100MG 12/31/9999 20121 00603616104 TRAZODONE TAB 100MG 12/31/9999 20121 00603616116 TRAZODONE TAB 100MG 12/31/9999 20121 00603616120 TRAZODONE TAB 100MG 12/31/9999 20121 00603616121 TRAZODONE TAB 100MG 12/31/9999 20121 00603616128 TRAZODONE TAB 100MG 12/31/9999 20121 00603616132 TRAZODONE TAB 100MG 12/31/9999 20121 00904399161 TRAZODONE TAB 100MG 12/31/9999 20121 50111043401 TRAZODONE TAB 100MG 12/31/9999 20121 50111043402 TRAZODONE TAB 100MG 12/31/9999 20121 50111043403 TRAZODONE TAB 100MG 12/31/9999 20121 53489051101 TRAZODONE TAB 100MG 12/31/9999 20121 60505265400 TRAZODONE TAB 100MG 12/31/9999 20121 60505265401 TRAZODONE TAB 100MG 12/31/9999 20121 60505265405 TRAZODONE TAB 100MG 12/31/9999 20121 60505265407 TRAZODONE TAB 100MG 12/31/9999 20121 60505292107 TRAZODONE TAB 100MG 12/31/9999 20121 00378347301 TRAZODONE TAB 150MG 12/31/9999 20121 00378347310 TRAZODONE TAB 150MG 12/31/9999 20121 50111044101 TRAZODONE TAB 150MG 12/31/9999 20121 50111044102 TRAZODONE TAB 150MG 12/31/9999 20121 53489051701 TRAZODONE TAB 150MG 12/31/9999 20121 60505265501 TRAZODONE TAB 150MG 12/31/9999 20121 60505265505 TRAZODONE TAB 150MG 12/31/9999 20121 60505265507 TRAZODONE TAB 150MG 12/31/9999 20121 60505292207 TRAZODONE TAB 150MG 12/31/9999 20121 68645018054 TRAZODONE TAB 150MG 12/31/9999 20121 00378347401 TRAZODONE TAB 300MG 05/31/2013 20121 00555073302 TRAZODONE TAB 300MG 12/31/9999 20121 60505265901 TRAZODONE TAB 300MG 12/31/9999 20121 00182125900 TRAZODONE TAB 50MG 12/31/9999 20121 00182125989 TRAZODONE TAB 50MG 12/31/9999 20121 00378347101 TRAZODONE TAB 50MG 06/30/2013 20121 00378347110 TRAZODONE TAB 50MG 12/31/9999 20121 00603614732 TRAZODONE TAB 50MG 06/30/2012 20121 00603616002 TRAZODONE TAB 50MG 12/31/9999 20121 00603616013 TRAZODONE TAB 50MG 12/31/9999 20121 00603616016 TRAZODONE TAB 50MG 12/31/9999 20121 00603616020 TRAZODONE TAB 50MG 12/31/9999 20121 00603616021 TRAZODONE TAB 50MG 12/31/9999 20121 00603616028 TRAZODONE TAB 50MG 12/31/9999 20121 00603616032 TRAZODONE TAB 50MG 12/31/9999 20121 00904399061 TRAZODONE TAB 50MG 12/31/9999 20121 50111043301 TRAZODONE TAB 50MG 12/31/9999 20121 50111043302 TRAZODONE TAB 50MG 12/31/9999 20121 50111043303 TRAZODONE TAB 50MG 12/31/9999 20121 53489051001 TRAZODONE TAB 50MG 12/31/9999 20121 60505265301 TRAZODONE TAB 50MG 12/31/9999 20121 60505265305 TRAZODONE TAB 50MG 12/31/9999 20121 60505265307 TRAZODONE TAB 50MG 12/31/9999 20121 60505292007 TRAZODONE TAB 50MG 12/31/9999 20121 13811051215 TREAGAN OTIC DRO 12/31/9999 20121 63459039120 TREANDA INJ 100MG 12/31/9999 20121 63459039008 TREANDA INJ 25MG 12/31/9999 20121 00008411701 TRECATOR TAB 250MG 12/31/9999 20121 52544018976 TRELSTAR DEP INJ 3.75MG 12/31/9999 20121 52544018876 TRELSTAR LA INJ 11.25MG 12/31/9999 20121 52544009276 TRELSTAR MIX INJ 22.5MG 12/31/9999 20121 00039007810 TRENTAL TAB 400MG CR 12/31/9999 20121 68405101601 TREPADONE CAP 12/31/9999 20121
NDC Product Description Termination Date Quarter Covered 68405101603 TREPADONE CAP 12/31/9999 20121 68405801636 TREPOXEN PAK 250MG 12/31/9999 20121 68405803636 TREPOXICAM PAK 7.5MG 12/31/9999 20121 00555080802 TRETINOIN CAP 10MG 12/31/9999 20121 00472011720 TRETINOIN CRE 0.025% 12/31/9999 20121 00472011745 TRETINOIN CRE 0.025% 12/31/9999 20121 43478024320 TRETINOIN CRE 0.025% 12/31/9999 20121 43478024345 TRETINOIN CRE 0.025% 12/31/9999 20121 45802018202 TRETINOIN CRE 0.025% 12/31/9999 20121 45802018242 TRETINOIN CRE 0.025% 12/31/9999 20121 43478024220 TRETINOIN CRE 0.05% 12/31/9999 20121 43478024245 TRETINOIN CRE 0.05% 12/31/9999 20121 45802036102 TRETINOIN CRE 0.05% 12/31/9999 20121 45802036142 TRETINOIN CRE 0.05% 12/31/9999 20121 43478024120 TRETINOIN CRE 0.1% 12/31/9999 20121 43478024145 TRETINOIN CRE 0.1% 12/31/9999 20121 45802018302 TRETINOIN CRE 0.1% 12/31/9999 20121 45802018342 TRETINOIN CRE 0.1% 12/31/9999 20121 43478024515 TRETINOIN GEL 0.01% 12/31/9999 20121 43478024545 TRETINOIN GEL 0.01% 12/31/9999 20121 45802036235 TRETINOIN GEL 0.01% 12/31/9999 20121 45802036242 TRETINOIN GEL 0.01% 12/31/9999 20121 43478024415 TRETINOIN GEL 0.025% 12/31/9999 20121 43478024445 TRETINOIN GEL 0.025% 12/31/9999 20121 45802036335 TRETINOIN GEL 0.025% 12/31/9999 20121 45802036342 TRETINOIN GEL 0.025% 12/31/9999 20121 66530041140 TRETINOIN EM CRE 0.05% 12/31/9999 20121 66530041160 TRETINOIN EM CRE 0.05% 12/31/9999 20121 51285036801 TREXALL TAB 10MG 12/31/9999 20121 51285036901 TREXALL TAB 15MG 12/31/9999 20121 51285036601 TREXALL TAB 5MG 12/31/9999 20121 51285036701 TREXALL TAB 7.5MG 12/31/9999 20121 64543050004 TREXBROM LIQ 12/31/9999 20121 64543050016 TREXBROM LIQ 12/31/9999 20121 64543050104 TREXBROM LIQ 10-4-25 12/31/9999 20121 64543050116 TREXBROM LIQ 10-4-25 12/31/9999 20121 00173075000 TREXIMET TAB 85-500MG 12/31/9999 20121 66992034010 TREZIX CAP 04/03/2020 20121 67112040130 TRI PRENATAL CAP DHA ONE 12/31/9999 20121 67112040190 TRI PRENATAL CAP DHA ONE 12/31/9999 20121 13811052690 TRI RX TAB 12/31/9999 20121 00472163304 TRIACIN-C SYP 12/31/9999 20121 00472163316 TRIACIN-C SYP 12/31/9999 20121 24385098126 TRIACTING DT LIQ COLD/CGH 12/31/9999 20121 36800044426 TRIACTING DT LIQ COLD/CGH 12/31/9999 20121 00113091326 TRIACTING NT LIQ COLD/CGH 06/21/2012 20121 24385012126 TRIACTING NT LIQ COLD/CGH 12/31/9999 20121 36800091326 TRIACTING NT LIQ COLD/CGH 12/31/9999 20121 11701003132 TRIAD WOUND PST DRESSING 12/31/9999 20121 11701003133 TRIAD WOUND PST DRESSING 12/31/9999 20121 13811052990 TRIADVANCE TAB 12/31/9999 20121 00781324375 TRIAMCIN ACE INJ 10MG/ML 12/31/9999 20121 00781324572 TRIAMCIN ACE INJ 40MG/ML 12/31/9999 20121 51672126705 TRIAMCIN/ORA PST 0.1% 12/31/9999 20121 00168000315 TRIAMCINOLON CRE 0.025% 12/31/9999 20121 00168000380 TRIAMCINOLON CRE 0.025% 12/31/9999 20121 00603786174 TRIAMCINOLON CRE 0.025% 12/31/9999 20121 00603786190 TRIAMCINOLON CRE 0.025% 12/31/9999 20121 45802006305 TRIAMCINOLON CRE 0.025% 12/31/9999 20121 45802006335 TRIAMCINOLON CRE 0.025% 12/31/9999 20121 45802006336 TRIAMCINOLON CRE 0.025% 12/31/9999 20121 00168000415 TRIAMCINOLON CRE 0.1% 12/31/9999 20121 00168000416 TRIAMCINOLON CRE 0.1% 12/31/9999 20121 00168000480 TRIAMCINOLON CRE 0.1% 12/31/9999 20121 00472030105 TRIAMCINOLON CRE 0.1% 12/31/9999 20121 00472030115 TRIAMCINOLON CRE 0.1% 12/31/9999 20121 00472030116 TRIAMCINOLON CRE 0.1% 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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