August 31, 2012 - Iowa Medicaid Enterprise

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NDC Product Description Termination Date Quarter Covered 64679096601 BETHANECHOL TAB 10MG 12/31/9999 20121 64980016101 BETHANECHOL TAB 10MG 12/31/9999 20121 65162057210 BETHANECHOL TAB 10MG 12/31/9999 20121 67877013801 BETHANECHOL TAB 10MG 12/31/9999 20121 68084016601 BETHANECHOL TAB 10MG 12/31/9999 20121 00115953301 BETHANECHOL TAB 25MG 12/31/9999 20121 00527135601 BETHANECHOL TAB 25MG 12/31/9999 20121 00615255839 BETHANECHOL TAB 25MG 12/31/9999 20121 00832051200 BETHANECHOL TAB 25MG 12/31/9999 20121 00832051201 BETHANECHOL TAB 25MG 12/31/9999 20121 00832051250 BETHANECHOL TAB 25MG 12/31/9999 20121 00904617860 BETHANECHOL TAB 25MG 12/31/9999 20121 50111032501 BETHANECHOL TAB 25MG 12/31/9999 20121 50268011415 BETHANECHOL TAB 25MG 12/31/9999 20121 57664013888 BETHANECHOL TAB 25MG 12/31/9999 20121 64679096701 BETHANECHOL TAB 25MG 12/31/9999 20121 64980016201 BETHANECHOL TAB 25MG 12/31/9999 20121 65162057310 BETHANECHOL TAB 25MG 12/31/9999 20121 67877013901 BETHANECHOL TAB 25MG 12/31/9999 20121 68084011001 BETHANECHOL TAB 25MG 12/31/9999 20121 00115954401 BETHANECHOL TAB 50MG 12/31/9999 20121 00832051300 BETHANECHOL TAB 50MG 12/31/9999 20121 00832051301 BETHANECHOL TAB 50MG 12/31/9999 20121 00904617960 BETHANECHOL TAB 50MG 12/31/9999 20121 50111032601 BETHANECHOL TAB 50MG 12/31/9999 20121 57664010688 BETHANECHOL TAB 50MG 12/31/9999 20121 64679096801 BETHANECHOL TAB 50MG 12/31/9999 20121 64980016301 BETHANECHOL TAB 50MG 12/31/9999 20121 65162057410 BETHANECHOL TAB 50MG 12/31/9999 20121 67877014001 BETHANECHOL TAB 50MG 12/31/9999 20121 00115951101 BETHANECHOL TAB 5MG 12/31/9999 20121 00527133201 BETHANECHOL TAB 5MG 12/31/9999 20121 00832051000 BETHANECHOL TAB 5MG 12/31/9999 20121 50111032301 BETHANECHOL TAB 5MG 12/31/9999 20121 57664013788 BETHANECHOL TAB 5MG 12/31/9999 20121 64679096501 BETHANECHOL TAB 5MG 12/31/9999 20121 64980016001 BETHANECHOL TAB 5MG 12/31/9999 20121 65162057110 BETHANECHOL TAB 5MG 12/31/9999 20121 67877013701 BETHANECHOL TAB 5MG 12/31/9999 20121 68669052205 BETIMOL SOL 0.25% 12/31/9999 20121 68669052505 BETIMOL SOL 0.5% 12/31/9999 20121 68669052510 BETIMOL SOL 0.5% 12/31/9999 20121 68669052515 BETIMOL SOL 0.5% 12/31/9999 20121 00065024610 BETOPTIC-S SUS 0.25% OP 12/31/9999 20121 00065024615 BETOPTIC-S SUS 0.25% OP 12/31/9999 20121 00007326031 BEXXAR CON 14MG/ML 12/31/9999 20121 00007326036 BEXXAR CON 14MG/ML 12/31/9999 20121 00007326101 BEXXAR 131 I INJ 0.61/ML 12/31/9999 20121 00007326201 BEXXAR 131 I INJ 5.6MCI/M 12/31/9999 20121 50419040703 BEYAZ TAB 12/31/9999 20121 38779006505 BHT POW 12/31/9999 20121 38779006508 BHT POW 12/31/9999 20121 00074318813 BIAXIN SUS 250/5ML 12/31/9999 20121 00074318850 BIAXIN SUS 250/5ML 12/31/9999 20121 00074336860 BIAXIN TAB 250MG 12/31/9999 20121 00074258611 BIAXIN TAB 500MG 12/31/9999 20121 00074258660 BIAXIN TAB 500MG 12/31/9999 20121 00074316511 BIAXIN XL TAB 500MG 12/31/9999 20121 00074316560 BIAXIN XL TAB 500MG 12/31/9999 20121 00074316514 BIAXIN XL TAB PAC 500 12/31/9999 20121 00074316541 BIAXIN XL TAB PAC 500 12/31/9999 20121 00093022001 BICALUTAMIDE TAB 50MG 12/31/9999 20121 00093022056 BICALUTAMIDE TAB 50MG 12/31/9999 20121 00378701705 BICALUTAMIDE TAB 50MG 12/31/9999 20121 00378701793 BICALUTAMIDE TAB 50MG 12/31/9999 20121 00781540901 BICALUTAMIDE TAB 50MG 12/31/9999 20121 00781540931 BICALUTAMIDE TAB 50MG 12/31/9999 20121
NDC Product Description Termination Date Quarter Covered 00781540964 BICALUTAMIDE TAB 50MG 12/31/9999 20121 00904601946 BICALUTAMIDE TAB 50MG 12/31/9999 20121 00904601960 BICALUTAMIDE TAB 50MG 12/31/9999 20121 16714057101 BICALUTAMIDE TAB 50MG 12/31/2020 20121 16714057102 BICALUTAMIDE TAB 50MG 12/31/2020 20121 16729002301 BICALUTAMIDE TAB 50MG 12/31/9999 20121 16729002310 BICALUTAMIDE TAB 50MG 12/31/9999 20121 41616048583 BICALUTAMIDE TAB 50MG 12/31/9999 20121 41616048588 BICALUTAMIDE TAB 50MG 12/31/9999 20121 51079069201 BICALUTAMIDE TAB 50MG 12/31/9999 20121 51079069203 BICALUTAMIDE TAB 50MG 12/31/9999 20121 51991056001 BICALUTAMIDE TAB 50MG 12/31/9999 20121 60505264201 BICALUTAMIDE TAB 50MG 12/31/9999 20121 60505264203 BICALUTAMIDE TAB 50MG 12/31/9999 20121 62175013232 BICALUTAMIDE TAB 50MG 12/31/9999 20121 68084037421 BICALUTAMIDE TAB 50MG 12/31/9999 20121 68382022401 BICALUTAMIDE TAB 50MG 12/31/9999 20121 68382022406 BICALUTAMIDE TAB 50MG 12/31/9999 20121 60793060002 BICILLIN C-R INJ 1200000 12/31/9999 20121 60793060010 BICILLIN C-R INJ 1200000 12/31/9999 20121 60793060110 BICILLIN C-R INJ 1200000 12/31/9999 20121 60793060210 BICILLIN C-R INJ 900/300 12/31/9999 20121 60793070110 BICILLIN L-A INJ 1200000 12/31/9999 20121 60793070210 BICILLIN L-A INJ 2400000 12/31/9999 20121 60793070010 BICILLIN L-A INJ 600000 12/31/9999 20121 00015301260 BICNU INJ 100MG 12/31/9999 20121 45985065401 BIDEX TAB 400MG 12/31/9999 20121 12948000112 BIDIL TAB 12/31/9999 20121 51552113307 BIFIDOBACTER POW BIFIDUM 12/31/9999 20121 00085174701 BILTRICIDE TAB 600MG 12/31/9999 20121 50419074701 BILTRICIDE TAB 600MG 12/31/9999 20121 51552089802 BIOFLAVINOID POW LEMON 12/31/9999 20121 00065041918 BION TEARS SOL OP 12/31/9999 20121 00065041928 BION TEARS SOL OP 12/31/9999 20121 00135048801 BIOTENE DRY GEL MOUTH 12/31/9999 20121 00135048701 BIOTENE DRY PST MOUTH 12/31/9999 20121 00135048702 BIOTENE DRY PST MOUTH 12/31/9999 20121 00135048901 BIOTENE DRY PST MTH/SENS 12/31/9999 20121 00135049001 BIOTENE PBF PST DRY MTH 12/31/9999 20121 00536665901 BIOTIN TAB 300MCG 12/31/9999 20121 00713010901 BISAC-EVAC SUP 10MG 12/31/9999 20121 00713010905 BISAC-EVAC SUP 10MG 12/31/9999 20121 00713010908 BISAC-EVAC SUP 10MG 12/31/9999 20121 00713010910 BISAC-EVAC SUP 10MG 12/31/9999 20121 00713010912 BISAC-EVAC SUP 10MG 12/31/9999 20121 00713010950 BISAC-EVAC SUP 10MG 12/31/9999 20121 00472510012 BISACODYL SUP 10MG 12/31/9999 20121 00536135501 BISACODYL SUP 10MG 12/31/9999 20121 00536135512 BISACODYL SUP 10MG 12/31/9999 20121 00574705012 BISACODYL SUP 10MG 12/31/9999 20121 00574705050 BISACODYL SUP 10MG 12/31/9999 20121 37205010253 BISACODYL SUP 10MG 12/31/9999 20121 45802071030 BISACODYL SUP 10MG 12/31/9999 20121 45802071032 BISACODYL SUP 10MG 12/31/9999 20121 45802071033 BISACODYL SUP 10MG 12/31/9999 20121 00536338101 BISACODYL TAB 5MG EC 12/31/9999 20121 00536338110 BISACODYL TAB 5MG EC 12/31/9999 20121 00603248321 BISACODYL TAB 5MG EC 12/31/9999 20121 00603248332 BISACODYL TAB 5MG EC 09/30/2013 20121 00904792717 BISACODYL TAB 5MG EC 12/31/9999 20121 00904792760 BISACODYL TAB 5MG EC 12/31/9999 20121 00904792761 BISACODYL TAB 5MG EC 12/31/9999 20121 00904792780 BISACODYL TAB 5MG EC 12/31/9999 20121 37205012863 BISACODYL TAB 5MG EC 12/31/9999 20121 49483000301 BISACODYL TAB 5MG EC 12/31/9999 20121 49483000310 BISACODYL TAB 5MG EC 12/31/9999 20121 00904505812 BISCOLAX SUP 10MG 12/31/9999 20121
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August 31, 2012 - Iowa Medicaid Enterprise

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