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 PoliciesPage72DateAugust 1, 2013Drug ProductMetrogel vaginal (metronidazolevaginal gel 0.75%)Days’Quantity Supply70 gm 30Mevacor 10 mg (lovastatin) 30 30Mevacor 20 mg (lovastatin) 30 30Mevacor 40 mg (lovastatin) 60 30Miacalcin nasal 200 U/dose4 ml 30(calcitonin)Mobic 7.5 mg (meloxicam) 30 30Mobic 15 mg (meloxicam) 30 30Monopril 10 mg (fosinopril) 60 30Monopril 20 mg (fosinopril) 60 30Monopril 40 mg (fosinopril) 60 30Mscontin 15 mg (morphine sulfate 90 30SA)Mscontin 30 mg (morphine sulfate 90 30SA)Mscontin 60 mg (morphine sulfate 90 30SA)Mscontin 100 mg (morphine sulfateSA)300 30Namenda 2 mg/1 ml oral solution(memantine)Namenda 5 mg (memantine) 60 30Namenda 10 mg (memantine) 60 30Nasacort AQ (triamcinoloneacetonide)Nasarel (flunisolide)Nasonex 50 mcg nasal spray(mometasone furoate)Comments300 ml 30 Comes in 360 mlcontainers2 bottles(33 gm)3 bottles(75 ml)2 bottles(34 gm)Nexium 20 mg (esomeprazole) 30 30Nexium 40 mg (esomeprazole) 60 30Niaspan 500 mg (niacin) 30 30Niaspan 750 mg (niacin) 60 30Niaspan 1000 mg (niacin) 60 30Norco 5/325 mg (hydrocodone/ 360 30acetaminophen)Norco 7.5/325 mg (hydrocodone/ 240 30acetaminophen)Norco 10/325 mg (hydrocodone/acetaminophen)180 30303030
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