Prescribed Drugs Provider Manual - Iowa Department of Human ...
Prescribed Drugs Provider Manual - Iowa Department of Human ...
Prescribed Drugs Provider Manual - Iowa Department of Human ...
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<strong>Iowa</strong><strong>Department</strong><strong>of</strong> <strong>Human</strong>Services<strong>Provider</strong> and Chapter<strong>Prescribed</strong> <strong>Drugs</strong>Chapter III. <strong>Provider</strong>-Specific PoliciesPage64DateAugust 1, 2013Drug ProductAvalide 150-12.5 mg(irbesartan/HCTZ)Avalide 300-12.5 mg(irbesartan/HCTZ)Avalide 300-25 mg(irbesartan/HCTZ)Avandaryl 4 mg/1 mg(glimepiride/rosiglitazone)Avandaryl 4 mg/2 mg(glimepiride/rosiglitazone)Avandaryl 4 mg/4 mg(glimepiride/rosiglitazone)Days’Quantity Supply30 3030 3030 3060 3060 3060 30Avandia 8 mg (rosiglitazone) 30 30Avapro 75 mg (irbesartan) 30 30Avapro 150 mg (irbesartan) 30 30Avapro 300 mg (irbesartan) 30 30Avinza 30 mg (morphine ER) 30 30Avinza 45 mg (morphine ER) 30 30Avinza 60 mg (morphine ER) 30 30Avinza 75 mg (morphine ER) 30 30Avinza 90 mg (morphine ER) 30 30Avinza 120 mg (morphine ER) 150 30Bactroban nasal ointment 10 grams 30Bactroban ointment (mupirocin) 44 grams 30Beconase AQ (beclomethasonedipropionate)2 inhalers(50 gm)Benicar 5 mg (olmesartan) 30 30Benicar 20 mg (olmesartan) 30 30Benicar 40 mg (olmesartan) 30 30Benicar HCT 20-12.5 mg30 30(olmesartan/HCTZ)Benicar HCT 40-12.5 mg30 30(olmesartan/HCTZ)Benicar HCT 40-25 mg30 30(olmesartan/HCTZ)Boniva 2.5 mg (ibandronate) 30 30Boniva 150 mg (ibandronate) 1 tablet 30Boniva syr (ibandronate) 1 syringe 9030Comments
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