August 31, 2012 - Iowa Medicaid Enterprise

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NDC Product Description Termination Date Quarter Covered 68462012901 ZONISAMIDE CAP 50MG 12/31/9999 20121 68462012905 ZONISAMIDE CAP 50MG 12/31/9999 20121 44087338807 ZORBTIVE INJ 8.8MG 12/31/9999 20121 00078041720 ZORTRESS TAB 0.25MG 12/31/9999 20121 00078041761 ZORTRESS TAB 0.25MG 12/31/9999 20121 00078041420 ZORTRESS TAB 0.5MG 12/31/9999 20121 00078041461 ZORTRESS TAB 0.5MG 12/31/9999 20121 00078041520 ZORTRESS TAB 0.75MG 12/31/9999 20121 00078041561 ZORTRESS TAB 0.75MG 12/31/9999 20121 61787018802 ZOSTRIX CRE 0.075% 12/31/9999 20121 61787044202 ZOSTRIX ARTH CRE PAIN REL 12/31/9999 20121 00206240402 ZOSYN INJ 2-0.25GM 12/31/9999 20121 00206885208 ZOSYN INJ 2-0.25GM 12/31/9999 20121 00206885216 ZOSYN INJ 2-0.25GM 12/31/9999 20121 00206240502 ZOSYN INJ 3-0.375G 12/31/9999 20121 00206885408 ZOSYN INJ 3-0.375G 12/31/9999 20121 00206885416 ZOSYN INJ 3-0.375G 12/31/9999 20121 00206241601 ZOSYN INJ 36-4.5GM 12/31/9999 20121 00206885910 ZOSYN INJ 36-4.5GM 12/31/9999 20121 00206240802 ZOSYN INJ 4-0.5GM 12/31/9999 20121 00206885508 ZOSYN INJ 4-0.5GM 12/31/9999 20121 00206885516 ZOSYN INJ 4-0.5GM 12/31/9999 20121 00206240902 ZOSYN SOL 2-0.25GM 12/31/9999 20121 00206886001 ZOSYN SOL 2-0.25GM 12/31/9999 20121 00206886002 ZOSYN SOL 2-0.25GM 12/31/9999 20121 00206241102 ZOSYN SOL 3-0.375G 12/31/9999 20121 00206886101 ZOSYN SOL 3-0.375G 12/31/9999 20121 00206886102 ZOSYN SOL 3-0.375G 12/31/9999 20121 00206241302 ZOSYN SOL 4-0.50GM 12/31/9999 20121 00206886201 ZOSYN SOL 4-0.50GM 12/31/9999 20121 00206886202 ZOSYN SOL 4-0.50GM 12/31/9999 20121 68025003716 ZOTEX-C SYP 12/31/9999 20121 68025003616 ZOTEX-D SYP 12/31/9999 20121 68025003510 ZOTEX-EX TAB 12/31/9999 20121 68025003410 ZOTEX-PE TAB 6-30MG 12/31/9999 20121 52544038328 ZOVIA 1/35E TAB 12/31/9999 20121 52544038428 ZOVIA 1/50E TAB 12/31/9999 20121 00173099155 ZOVIRAX CAP 200MG 12/31/9999 20121 64455099442 ZOVIRAX CRE 5% 12/31/9999 20121 64455099445 ZOVIRAX CRE 5% 12/31/9999 20121 64455099394 ZOVIRAX OIN 5% 01/31/2016 20121 64455099395 ZOVIRAX OIN 5% 12/31/9999 20121 00173095396 ZOVIRAX SUS 200/5ML 12/31/9999 20121 00173094955 ZOVIRAX TAB 400MG 12/31/9999 20121 00173094555 ZOVIRAX TAB 800MG 12/31/9999 20121 44183036287 Z-PRAM KIT 2.35-1% 12/31/9999 20121 58407092016 Z-TUSS AC LIQ 2-9/5ML 12/31/9999 20121 58407023916 Z-TUSS E LIQ 12/31/9999 20121 49884032462 ZUPLENZ MIS 4MG 11/30/2012 20121 49884032562 ZUPLENZ MIS 8MG 07/31/2012 20121 63717087616 ZUTRIPRO LIQ 12/31/9999 20121 00173055601 ZYBAN TAB 150MG SR 12/31/9999 20121 00173055602 ZYBAN TAB 150MG SR 12/31/9999 20121 29336071028 ZYCLARA CRE 3.75% 09/30/2013 20121 99207027028 ZYCLARA CRE 3.75% 12/31/9999 20121 99207027175 ZYCLARA PUMP CRE 3.75% 12/31/9999 20121 63481069870 ZYDONE TAB 10-400MG 12/31/9999 20121 63481066870 ZYDONE TAB 5-400MG 12/31/9999 20121 63481066970 ZYDONE TAB 7.5-400 12/31/9999 20121 10122090112 ZYFLO TAB 600MG 12/31/9999 20121 10122090212 ZYFLO CR TAB 600MG 12/31/9999 20121 24208035805 ZYLET SUS 0.5-0.3% 12/31/9999 20121 24208035810 ZYLET SUS 0.5-0.3% 12/31/9999 20121 24208035825 ZYLET SUS 0.5-0.3% 07/18/2013 20121 65483099110 ZYLOPRIM TAB 100MG 12/31/9999 20121 65483099310 ZYLOPRIM TAB 300MG 12/31/9999 20121 65483099350 ZYLOPRIM TAB 300MG 12/31/9999 20121
NDC Product Description Termination Date Quarter Covered 00023921805 ZYMAR DRO 0.3% 01/17/2013 20121 00023361525 ZYMAXID SOL 0.5% 12/31/9999 20121 68025004030 ZYPRAM CRE 2.35-1% 12/31/9999 20121 00002759701 ZYPREXA INJ 10MG 12/31/9999 20121 00002411701 ZYPREXA TAB 10MG 01/31/2014 20121 00002411704 ZYPREXA TAB 10MG 12/31/9999 20121 00002411730 ZYPREXA TAB 10MG 12/31/9999 20121 00002411733 ZYPREXA TAB 10MG 01/31/2014 20121 00002441501 ZYPREXA TAB 15MG 12/31/9999 20121 00002441504 ZYPREXA TAB 15MG 12/31/9999 20121 00002441530 ZYPREXA TAB 15MG 12/31/9999 20121 00002441533 ZYPREXA TAB 15MG 12/31/9999 20121 00002411201 ZYPREXA TAB 2.5MG 12/31/9999 20121 00002411204 ZYPREXA TAB 2.5MG 12/31/9999 20121 00002411230 ZYPREXA TAB 2.5MG 12/31/9999 20121 00002411233 ZYPREXA TAB 2.5MG 12/31/9999 20121 00002442001 ZYPREXA TAB 20MG 12/31/9999 20121 00002442004 ZYPREXA TAB 20MG 12/31/9999 20121 00002442030 ZYPREXA TAB 20MG 12/31/9999 20121 00002442033 ZYPREXA TAB 20MG 12/31/9999 20121 00002411501 ZYPREXA TAB 5MG 12/31/9999 20121 00002411504 ZYPREXA TAB 5MG 12/31/9999 20121 00002411530 ZYPREXA TAB 5MG 12/31/9999 20121 00002411533 ZYPREXA TAB 5MG 12/31/9999 20121 00002411601 ZYPREXA TAB 7.5MG 12/31/9999 20121 00002411604 ZYPREXA TAB 7.5MG 12/31/9999 20121 00002411630 ZYPREXA TAB 7.5MG 12/31/9999 20121 00002411633 ZYPREXA TAB 7.5MG 12/31/9999 20121 00002763511 ZYPREXA RELP INJ 210MG 12/31/9999 20121 00002763611 ZYPREXA RELP INJ 300MG 12/31/9999 20121 00002763711 ZYPREXA RELP INJ 405MG 12/31/9999 20121 00002445401 ZYPREXA ZYDI TAB 10MG 12/31/9999 20121 00002445485 ZYPREXA ZYDI TAB 10MG 12/31/9999 20121 00002445501 ZYPREXA ZYDI TAB 15MG 12/31/9999 20121 00002445585 ZYPREXA ZYDI TAB 15MG 12/31/9999 20121 00002445601 ZYPREXA ZYDI TAB 20MG 12/31/9999 20121 00002445685 ZYPREXA ZYDI TAB 20MG 12/31/9999 20121 00002445301 ZYPREXA ZYDI TAB 5MG 12/31/9999 20121 00002445385 ZYPREXA ZYDI TAB 5MG 12/31/9999 20121 57894015012 ZYTIGA TAB 250MG 12/31/9999 20121 00009513701 ZYVOX SOL 2MG/ML 12/31/9999 20121 00009514001 ZYVOX SOL 2MG/ML 12/31/9999 20121 00009513601 ZYVOX SUS 100MG/5M 12/31/9999 20121 00009513502 ZYVOX TAB 600MG 12/31/9999 20121 00009513503 ZYVOX TAB 600MG 12/31/9999 20121
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Rebatable Drug List for Iowa Medica
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NDC Product Description Termination
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August 31, 2012 - Iowa Medicaid Enterprise

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