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 PoliciesPage69DateAugust 1, 2013Drug ProductFocalin XR 25 mg(dexmethylphenidate)Focalin XR 30 mg(dexmethylphenidate)Focalin XR 35 mg(dexmethylphenidate)Focalin XR 40 mg(dexmethylphenidate)Days’Quantity Supply60 3060 3030 3030 30Foradil aerolizer (formoterol) 60 30Fosamax 5 mg (alendronate) 30 30Fosamax 10 mg (alendronate) 30 30Fosamax 40 mg(alendronate) 30 30Fosamax 70 mg (alendronate) 4 30Geodon 20 mg (ziprasidone) 60 30Geodon 40 mg (ziprasidone) 60 30Geodon 60 mg (ziprasidone) 60 30Geodon 80 mg (ziprasidone) 60 30Glucagen emergency kit (glucagon) 5 30Glucagon emergency kit 5 30Haldol decanoate 50 mg/ml-1 ml 1 ml 30vial (haloperidol decanoate)Haldol decanoate 50 mg/ml-5 ml 10 ml 30vial (haloperidol decanoate)Haldol decanoate 100 mg/ml-1 ml 1 ml 30vial (haloperidol decanoate)Haldol decanoate 100 mg/ml-5 ml 5 ml 30vial (haloperidol decanoate)Hycet solution (hydrocodone/ 3600 ml 30acetaminophen)Hytrin 1 mg (terazosin) 30 30Hytrin 2 mg (terazosin) 60 30Hytrin 5 mg (terazosin) 30 30Hytrin 10 mg (terazosin) 60 30Hyzaar 50-12.5 mg (HCTZ/losartan) 30 30Hyzaar 100-12.5 mg30 30(HCTZ/losartan)Hyzaar 100-25 mg (HCTZ/losartan) 30 30Innopran XL 80 mg (propranolol 30 30ER)Intal inhaler (cromolyn sodium) 3 inhalers(42.6 gm)30Comments
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