August 31, 2012 - Iowa Medicaid Enterprise

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NDC Product Description Termination Date Quarter Covered 64720014310 BENZTROPINE TAB 0.5MG 09/30/2012 20121 64720014311 BENZTROPINE TAB 0.5MG 09/30/2012 20121 68084038101 BENZTROPINE TAB 0.5MG 12/31/9999 20121 00603243421 BENZTROPINE TAB 1MG 12/31/9999 20121 00603243432 BENZTROPINE TAB 1MG 12/31/9999 20121 00832108100 BENZTROPINE TAB 1MG 12/31/9999 20121 00832108110 BENZTROPINE TAB 1MG 12/31/9999 20121 00904105661 BENZTROPINE TAB 1MG 12/31/9999 20121 00904105680 BENZTROPINE TAB 1MG 12/31/9999 20121 50111039401 BENZTROPINE TAB 1MG 12/31/9999 20121 50111039403 BENZTROPINE TAB 1MG 12/31/9999 20121 51079040601 BENZTROPINE TAB 1MG 09/30/2012 20121 51079040617 BENZTROPINE TAB 1MG 05/31/2012 20121 51079040619 BENZTROPINE TAB 1MG 05/31/2012 20121 51079040620 BENZTROPINE TAB 1MG 09/30/2012 20121 64720014410 BENZTROPINE TAB 1MG 08/31/2013 20121 64720014411 BENZTROPINE TAB 1MG 08/31/2013 20121 64980011201 BENZTROPINE TAB 1MG 12/31/9999 20121 64980011210 BENZTROPINE TAB 1MG 12/31/9999 20121 68084038801 BENZTROPINE TAB 1MG 12/31/9999 20121 00603243521 BENZTROPINE TAB 2MG 12/31/9999 20121 00603243532 BENZTROPINE TAB 2MG 12/31/9999 20121 00832108200 BENZTROPINE TAB 2MG 12/31/9999 20121 00832108210 BENZTROPINE TAB 2MG 12/31/9999 20121 00904105760 BENZTROPINE TAB 2MG 12/31/9999 20121 00904105761 BENZTROPINE TAB 2MG 12/31/9999 20121 00904105780 BENZTROPINE TAB 2MG 12/31/9999 20121 50111039501 BENZTROPINE TAB 2MG 12/31/9999 20121 50111039503 BENZTROPINE TAB 2MG 12/31/9999 20121 51079022201 BENZTROPINE TAB 2MG 12/31/9999 20121 51079022220 BENZTROPINE TAB 2MG 12/31/9999 20121 64720014510 BENZTROPINE TAB 2MG 03/31/2013 20121 64720014511 BENZTROPINE TAB 2MG 03/31/2013 20121 64980011301 BENZTROPINE TAB 2MG 12/31/9999 20121 64980011310 BENZTROPINE TAB 2MG 12/31/9999 20121 68084038901 BENZTROPINE TAB 2MG 12/31/9999 20121 51552024206 BENZYL ALC LIQ 12/31/9999 20121 51552024208 BENZYL ALC LIQ 12/31/9999 20121 38779103001 BENZYL BENZO LIQ 12/31/9999 20121 38779103008 BENZYL BENZO LIQ 12/31/9999 20121 67425000750 BEPREVE DRO 1.5% 12/31/9999 20121 67425000775 BEPREVE DRO 1.5% 12/31/9999 20121 63833082502 BERINERT INJ 500UNIT 12/31/9999 20121 24208044605 BESIVANCE SUS 0.6% 12/31/9999 20121 00536490201 BETA CAROTEN CAP 25000UNT 12/31/9999 20121 51552075802 BETA CAROTEN POW 12/31/9999 20121 51552075804 BETA CAROTEN POW 12/31/9999 20121 51552106001 BETA GLUCAN POW 12/31/9999 20121 67618014803 BETADINE AER 5% SPRAY 12/31/9999 20121 67618015201 BETADINE MIS SWAB AID 12/31/9999 20121 67618015301 BETADINE MIS SWABSTCK 12/31/9999 20121 67618015303 BETADINE MIS SWABSTCK 12/31/9999 20121 67618015001 BETADINE SOL 10% 12/31/9999 20121 67618015004 BETADINE SOL 10% 12/31/9999 20121 67618015005 BETADINE SOL 10% 12/31/9999 20121 67618015008 BETADINE SOL 10% 12/31/9999 20121 67618015009 BETADINE SOL 10% 12/31/9999 20121 67618015016 BETADINE SOL 10% 12/31/9999 20121 67618015017 BETADINE SOL 10% 12/31/9999 20121 67618015032 BETADINE SOL 10% 12/31/9999 20121 67618014904 BETADINE SKN SOL 7.5% CLR 12/31/9999 20121 67618015101 BETADINE SRG SOL 7.5% 12/31/9999 20121 67618015104 BETADINE SRG SOL 7.5% 12/31/9999 20121 67618015116 BETADINE SRG SOL 7.5% 12/31/9999 20121 67618015117 BETADINE SRG SOL 7.5% 12/31/9999 20121 67618015132 BETADINE SRG SOL 7.5% 12/31/9999 20121 00023438505 BETAGAN SOL 0.5% OP 12/31/9999 20121
NDC Product Description Termination Date Quarter Covered 00023438510 BETAGAN SOL 0.5% OP 12/31/9999 20121 00023438515 BETAGAN SOL 0.5% OP 12/31/9999 20121 38779104008 BETAINE POW ANHYDROU 12/31/9999 20121 51552062801 BETAMETH ACE POW 12/31/9999 20121 51552062802 BETAMETH ACE POW 12/31/9999 20121 51552062805 BETAMETH ACE POW 12/31/9999 20121 00168005515 BETAMETH DIP CRE 0.05% 12/31/9999 20121 00168005546 BETAMETH DIP CRE 0.05% 12/31/9999 20121 00472038015 BETAMETH DIP CRE 0.05% 12/31/9999 20121 00472038045 BETAMETH DIP CRE 0.05% 12/31/9999 20121 51672127401 BETAMETH DIP CRE 0.05% 12/31/9999 20121 51672127406 BETAMETH DIP CRE 0.05% 12/31/9999 20121 00168005760 BETAMETH DIP LOT 0.05% 12/31/9999 20121 00472138202 BETAMETH DIP LOT 0.05% 12/31/9999 20121 45802002146 BETAMETH DIP LOT 0.05% 12/31/9999 20121 00168005615 BETAMETH DIP OIN 0.05% 12/31/9999 20121 00168005646 BETAMETH DIP OIN 0.05% 12/31/9999 20121 00472038115 BETAMETH DIP OIN 0.05% 12/31/9999 20121 00472038145 BETAMETH DIP OIN 0.05% 12/31/9999 20121 00168004015 BETAMETH VAL CRE 0.1% 12/31/9999 20121 00168004046 BETAMETH VAL CRE 0.1% 12/31/9999 20121 00472037015 BETAMETH VAL CRE 0.1% 12/31/9999 20121 00472037045 BETAMETH VAL CRE 0.1% 12/31/9999 20121 51672126901 BETAMETH VAL CRE 0.1% 12/31/9999 20121 51672126906 BETAMETH VAL CRE 0.1% 12/31/9999 20121 00168004160 BETAMETH VAL LOT 0.1% 12/31/9999 20121 00472037202 BETAMETH VAL LOT 0.1% 12/31/9999 20121 00168003315 BETAMETH VAL OIN 0.1% 12/31/9999 20121 00168003346 BETAMETH VAL OIN 0.1% 12/31/9999 20121 00472037115 BETAMETH VAL OIN 0.1% 12/31/9999 20121 00472037145 BETAMETH VAL OIN 0.1% 12/31/9999 20121 50419010910 BETAPACE TAB 120MG 12/31/9999 20121 50419010610 BETAPACE TAB 160MG 12/31/9999 20121 50419010710 BETAPACE TAB 240MG 12/31/9999 20121 50419010510 BETAPACE TAB 80MG 12/31/9999 20121 50419011906 BETAPACE AF TAB 120MG 12/31/9999 20121 50419011606 BETAPACE AF TAB 160MG 12/31/9999 20121 50419011506 BETAPACE AF TAB 80MG 12/31/9999 20121 00517072001 BETA-PHOS/AC INJ 3-3MG/ML 12/31/9999 20121 67618020001 BETASEPT LIQ 4% 12/31/9999 20121 67618020004 BETASEPT LIQ 4% 12/31/9999 20121 67618020008 BETASEPT LIQ 4% 12/31/9999 20121 67618020016 BETASEPT LIQ 4% 12/31/9999 20121 67618020030 BETASEPT LIQ 4% 12/31/9999 20121 67618020032 BETASEPT LIQ 4% 12/31/9999 20121 50419052335 BETASERON INJ 0.3MG 12/31/9999 20121 00093067315 BETA-VAL CRE 0.1% 09/30/2013 20121 00093067395 BETA-VAL CRE 0.1% 09/30/2013 20121 00093067139 BETA-VAL LOT 0.1% 09/30/2013 20121 61314024501 BETAXOLOL SOL 0.5% OP 12/31/9999 20121 61314024502 BETAXOLOL SOL 0.5% OP 12/31/9999 20121 61314024503 BETAXOLOL SOL 0.5% OP 12/31/9999 20121 10702001301 BETAXOLOL TAB 10MG 12/31/9999 20121 42806003801 BETAXOLOL TAB 10MG 12/31/9999 20121 52152017902 BETAXOLOL TAB 10MG 12/31/9999 20121 10702001401 BETAXOLOL TAB 20MG 12/31/9999 20121 42806003901 BETAXOLOL TAB 20MG 12/31/9999 20121 52152018002 BETAXOLOL TAB 20MG 12/31/9999 20121 00115952201 BETHANECHOL TAB 10MG 12/31/9999 20121 00527134001 BETHANECHOL TAB 10MG 12/31/9999 20121 00615255739 BETHANECHOL TAB 10MG 12/31/9999 20121 00832051100 BETHANECHOL TAB 10MG 12/31/9999 20121 00832051101 BETHANECHOL TAB 10MG 12/31/9999 20121 00904617760 BETHANECHOL TAB 10MG 12/31/9999 20121 50111032401 BETHANECHOL TAB 10MG 12/31/9999 20121 50268011315 BETHANECHOL TAB 10MG 12/31/9999 20121 57664010488 BETHANECHOL TAB 10MG 12/31/9999 20121
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August 31, 2012 - Iowa Medicaid Enterprise

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