August 31, 2012 - Iowa Medicaid Enterprise

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NDC Product Description Termination Date Quarter Covered 55390017910 ATRACURIUM INJ 10MG/ML 12/31/9999 20121 55390018005 ATRACURIUM INJ 10MG/ML 12/31/9999 20121 13548007045 ATRALIN GEL 0.05% 12/31/9999 20121 15584010101 ATRIPLA TAB 12/31/9999 20121 17478021410 ATROPIN-CARE SOL 1% OP 12/31/9999 20121 17478021412 ATROPIN-CARE SOL 1% OP 12/31/9999 20121 17478021420 ATROPIN-CARE SOL 1% OP 12/31/9999 20121 51552015602 ATROPINE POW SULFATE 12/31/9999 20121 51552015604 ATROPINE POW SULFATE 12/31/9999 20121 00409963005 ATROPINE SUL INJ 0.05MG/1 12/31/9999 20121 00409163010 ATROPINE SUL INJ 0.1MG/ML 12/31/9999 20121 00409491034 ATROPINE SUL INJ 0.1MG/ML 12/31/9999 20121 00409491134 ATROPINE SUL INJ 0.1MG/ML 12/31/9999 20121 00517080525 ATROPINE SUL INJ 0.4/0.5 12/31/9999 20121 00517040125 ATROPINE SUL INJ 0.4MG/ML 12/31/9999 20121 10019025012 ATROPINE SUL INJ 0.4MG/ML 12/31/9999 20121 10019025020 ATROPINE SUL INJ 0.4MG/ML 12/31/9999 20121 10019025037 ATROPINE SUL INJ 0.4MG/ML 12/31/9999 20121 10019025039 ATROPINE SUL INJ 0.4MG/ML 12/31/9999 20121 00517010125 ATROPINE SUL INJ 1MG/ML 12/31/9999 20121 00517101025 ATROPINE SUL INJ 1MG/ML 12/31/9999 20121 10019025112 ATROPINE SUL INJ 1MG/ML 12/31/9999 20121 10019025139 ATROPINE SUL INJ 1MG/ML 12/31/9999 20121 24208082555 ATROPINE SUL OIN 1% OP 12/31/9999 20121 00065070212 ATROPINE SUL SOL 1% OP 12/31/9999 20121 24208075006 ATROPINE SUL SOL 1% OP 12/31/9999 20121 24208075060 ATROPINE SUL SOL 1% OP 12/31/9999 20121 61314030301 ATROPINE SUL SOL 1% OP 12/31/9999 20121 61314030302 ATROPINE SUL SOL 1% OP 12/31/9999 20121 00597008717 ATROVENT HFA AER 17MCG 12/31/9999 20121 00597008130 ATROVENT NAS SOL 0.03% 12/31/9999 20121 00597008676 ATROVENT NAS SOL 0.06% 12/31/9999 20121 67386052151 ATRYN INJ 1750 12/31/9999 20121 59702080016 ATUSS DS SUS 12/31/9999 20121 00168026515 AUG BETAMET CRE 0.05% 12/31/9999 20121 00168026550 AUG BETAMET CRE 0.05% 12/31/9999 20121 00781707427 AUG BETAMET CRE 0.05% 12/31/9999 20121 00781707450 AUG BETAMET CRE 0.05% 12/31/9999 20121 45802037632 AUG BETAMET CRE 0.05% 12/31/9999 20121 45802037635 AUG BETAMET CRE 0.05% 12/31/9999 20121 51672131001 AUG BETAMET CRE 0.05% 12/31/9999 20121 51672131003 AUG BETAMET CRE 0.05% 12/31/9999 20121 68462029017 AUG BETAMET CRE 0.05% 12/31/9999 20121 68462029052 AUG BETAMET CRE 0.05% 12/31/9999 20121 51672130901 AUG BETAMET GEL 0.05% 12/31/9999 20121 51672130903 AUG BETAMET GEL 0.05% 12/31/9999 20121 00168026730 AUG BETAMET LOT 0.05% 12/31/9999 20121 00168026760 AUG BETAMET LOT 0.05% 12/31/9999 20121 51672134003 AUG BETAMET LOT 0.05% 12/31/9999 20121 51672134004 AUG BETAMET LOT 0.05% 12/31/9999 20121 00168026815 AUG BETAMET OIN 0.05% 12/31/9999 20121 00472038215 AUG BETAMET OIN 0.05% 12/31/9999 20121 00472038245 AUG BETAMET OIN 0.05% 12/31/9999 20121 00472038250 AUG BETAMET OIN 0.05% 12/31/9999 20121 51672131701 AUG BETAMET OIN 0.05% 12/31/9999 20121 51672131703 AUG BETAMET OIN 0.05% 12/31/9999 20121 00029608522 AUGMENTIN SUS 125/5ML 09/05/2012 20121 00029608523 AUGMENTIN SUS 125/5ML 09/05/2012 20121 00029608539 AUGMENTIN SUS 125/5ML 09/05/2012 20121 43598001251 AUGMENTIN SUS 125/5ML 12/31/9999 20121 43598001252 AUGMENTIN SUS 125/5ML 12/31/9999 20121 43598001253 AUGMENTIN SUS 125/5ML 12/31/9999 20121 00029609022 AUGMENTIN SUS 250/5ML 09/05/2012 20121 00029609023 AUGMENTIN SUS 250/5ML 09/05/2012 20121 00029609039 AUGMENTIN SUS 250/5ML 09/05/2012 20121 43598000451 AUGMENTIN SUS 250/5ML 12/31/9999 20121 43598000452 AUGMENTIN SUS 250/5ML 12/31/9999 20121
NDC Product Description Termination Date Quarter Covered 43598000453 AUGMENTIN SUS 250/5ML 12/31/9999 20121 43598000614 AUGMENTIN TAB 500MG 12/31/9999 20121 00029608612 AUGMENTIN TAB 875MG 09/12/2012 20121 43598002114 AUGMENTIN TAB 875MG 12/31/9999 20121 43598002028 AUGMENTIN XR TAB 12HR 12/31/9999 20121 43598002040 AUGMENTIN XR TAB 12HR 12/31/9999 20121 00904079310 AURODEX SOL OTIC 12/31/9999 20121 00472001699 AUROTO SOL OTIC 12/31/9999 20121 00023923630 AVAGE CRE 0.1% 12/31/9999 20121 00087277531 AVALIDE TAB 150-12.5 12/31/9999 20121 00087277532 AVALIDE TAB 150-12.5 12/31/9999 20121 00087287531 AVALIDE TAB 150-12.5 12/31/9999 20121 00087287532 AVALIDE TAB 150-12.5 12/31/9999 20121 00087277631 AVALIDE TAB 300-12.5 12/31/9999 20121 00087277632 AVALIDE TAB 300-12.5 12/31/9999 20121 00087287631 AVALIDE TAB 300-12.5 12/31/9999 20121 00087287632 AVALIDE TAB 300-12.5 12/31/9999 20121 00087278831 AVALIDE TAB 300-25MG 06/30/2012 20121 00087278832 AVALIDE TAB 300-25MG 06/30/2012 20121 00173083818 AVANDAMET TAB 2-1000MG 12/31/9999 20121 00173083718 AVANDAMET TAB 2-500MG 12/31/9999 20121 00173084018 AVANDAMET TAB 4-1000MG 12/31/9999 20121 00173083918 AVANDAMET TAB 4-500MG 12/31/9999 20121 00173084113 AVANDARYL TAB 4-1MG 12/31/9999 20121 00173084213 AVANDARYL TAB 4-2MG 12/31/9999 20121 00173084313 AVANDARYL TAB 4-4MG 12/31/9999 20121 00173084413 AVANDARYL TAB 8-2MG 12/31/9999 20121 00173084513 AVANDARYL TAB 8-4MG 12/31/9999 20121 00173083418 AVANDIA TAB 2MG 12/31/9999 20121 00173083513 AVANDIA TAB 4MG 12/31/9999 20121 00173083613 AVANDIA TAB 8MG 12/31/9999 20121 00087277215 AVAPRO TAB 150MG 12/31/9999 20121 00087277231 AVAPRO TAB 150MG 12/31/9999 20121 00087277232 AVAPRO TAB 150MG 12/31/9999 20121 00087277235 AVAPRO TAB 150MG 12/31/9999 20121 00087277315 AVAPRO TAB 300MG 12/31/9999 20121 00087277331 AVAPRO TAB 300MG 12/31/9999 20121 00087277332 AVAPRO TAB 300MG 12/31/9999 20121 00087277131 AVAPRO TAB 75MG 12/31/9999 20121 00087277132 AVAPRO TAB 75MG 12/31/9999 20121 50242006001 AVASTIN INJ 12/31/9999 20121 50242006101 AVASTIN INJ 12/31/9999 20121 66663010304 AVC CRE 15% 12/31/9999 20121 00085173701 AVELOX INJ 12/31/9999 20121 00085173301 AVELOX TAB 400MG 12/31/9999 20121 00085173302 AVELOX TAB 400MG 12/31/9999 20121 00085173303 AVELOX ABC TAB 400MG 12/31/9999 20121 00555904558 AVIANE TAB 12/31/9999 20121 60793060801 AVINZA CAP 120MG 12/31/9999 20121 60793060501 AVINZA CAP 30MG 12/31/9999 20121 60793060301 AVINZA CAP 45MG 12/31/9999 20121 60793060601 AVINZA CAP 60MG 12/31/9999 20121 60793060401 AVINZA CAP 75MG 12/31/9999 20121 60793060701 AVINZA CAP 90MG 12/31/9999 20121 00378614144 AVITA CRE 0.025% 12/31/9999 20121 00378614145 AVITA CRE 0.025% 12/31/9999 20121 00378614044 AVITA GEL 0.025% 12/31/9999 20121 00378614045 AVITA GEL 0.025% 12/31/9999 20121 00173071204 AVODART CAP 0.5MG 12/31/9999 20121 00173071215 AVODART CAP 0.5MG 12/31/9999 20121 00173071225 AVODART CAP 0.5MG 12/31/9999 20121 59627000103 AVONEX KIT 30MCG 12/31/9999 20121 59627000304 AVONEX PEN KIT 30MCG 12/31/9999 20121 59627000205 AVONEX PREFL KIT 30MCG 12/31/9999 20121 00062208512 AXERT TAB 12.5MG 12/31/9999 20121 00062208006 AXERT TAB 6.25MG 12/31/9999 20121 52268014762 AXID SOL 15MG/ML 12/31/9999 20121
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August 31, 2012 - Iowa Medicaid Enterprise

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