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 PoliciesPage68DateAugust 1, 2013Drug ProductQuantityDays’SupplyEnablex 7.5 mg (darifenacin) 30 30Enablex 15 mg (darifenacin) 30 30Epinephrine, racemic solution30 152.25% (racepinephrine)Epipen (epinephrine) 2 units 30Epipen, Jr (epinephrine) 2 units 30Estraderm (estradiol) 8 patches 30Exelon 1.5 mg (rivastigmine) 60 30Exelon 2 mg/ml oral solution180 ml 30(rivastigmine)Exelon 3 mg (rivastigmine) 60 30Exelon 4.5 mg (rivastigmine) 60 30Exelon 6 mg (rivastigmine) 60 30Fanapt 1 mg (iloperidone) 60 30Fanapt 2 mg (iloperidone) 60 30Fanapt 4 mg (iloperidone) 60 30Fanapt 6 mg (iloperidone) 60 30Fanapt 8 mg (iloperidone) 60 30Fanapt 10 mg (iloperidone) 60 30Fanapt 12 mg (iloperidone) 60 30Fioricet (butalbital-acetaminophencaffeine)360 30Fioricet/codeine (butalbitalacetaminophen-caffeine-codeine)180 30Flomax 0.4 mg (tamsulosin) 60 30Flonase (fluticasone propionate) 2 inhalers(32grams)30Flovent HFA 44 mcg (fluticasonepropionate)Flovent HFA 110 mcg (fluticasonepropionate)Flovent HFA 220 mcg (fluticasonepropionate)Focalin XR 5 mg(dexmethylphenidate)Focalin XR 10 mg(dexmethylphenidate)Focalin XR 15 mg(dexmethylphenidate)Focalin XR 20 mg(dexmethylphenidate)1 inhaler 30(10.6 gm)1 inhaler 30(12 gm)2 inhalers 30(24 gm)60 3060 3090 3060 30Comments
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