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 PoliciesPage71DateAugust 1, 2013Drug ProductLortab elixir (hydrocodone/acetaminophen)Lortab 5/500 mg (hydrocodone/acetaminophen)Lortab 7.5/500 mg (hydrocodone/acetaminophen)Lortab 10/500 mg (hydrocodone/acetaminophen)Days’Quantity Supply2700 ml 30240 30180 30180 30Lunesta 1 mg (eszopiclone) 30 30Lunesta 2 mg (eszopiclone) 30 30Lunesta 3 mg (eszopiclone) 30 30Luvox 25 mg (fluvoxamine) 30 30Luvox 50 mg (fluvoxamine) 30 30Lyrica 25 mg (pregabalin) 90 30Lyrica 50 mg (pregabalin) 90 30Lyrica 75 mg (pregabalin) 90 30Lyrica 100 mg (pregabalin) 90 30Lyrica 150 mg (pregabalin) 90 30Lyrica 200 mg (pregabalin) 90 30Lyrica 225 mg (pregabalin) 60 30Lyrica 300 mg (pregabalin) 60 30Mavik 1 mg (trandolapril) 30 30Mavik 2 mg (trandolapril) 30 30Mavik 4 mg (trandolapril) 60 30Maxair autoinhaler 14 g (pirbuterolacetate)Maxidone (hydrocodone/acetaminophen)Metadate CD 10 mg(methylphenidate ER)Metadate CD 20 mg(methylphenidate ER)Metadate CD 30 mg(methylphenidate ER)Metadate CD 40 mg(methylphenidate ER)Metadate CD 50 mg(methylphenidate ER)Metadate CD 60 mg(methylphenidate ER)2 inhalers 30(28 gm)150 3060 3090 3060 3060 3060 3060 30Metadate ER 10 mg (methylin ER) 90 30Metadate ER 20 mg (methylin ER) 90 30Comments
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