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 PoliciesPage73DateAugust 1, 2013Drug ProductQuantityDays’SupplyNorvasc 2.5 mg (amlodipine) 30 30Norvasc 5 mg (amlodipine) 30 30Nucynta 50 mg (tapentadol) 180 30Nucynta 75 mg (tapentadol) 180 30Nucynta 100 mg (tapentadol) 180 30Onfi 5 mg (clobazam) 60 30Onfi 10 mg (clobazam) 60 30Onfi 20 mg (clobazam) 60 30Opana ER 5 mg (oxymorphone) 60 30Opana ER 7.5 mg (oxymorphone) 60 30Opana ER 10 mg (oxymorphone) 60 30Opana ER 15 mg (oxymorphone) 60 30Opana ER 20 mg (oxymorphone) 60 30Opana ER 30 mg (oxymorphone) 60 30Panlor SS (acetaminophencaffeine-dihyrdocodeine)150 30Paxil 10 mg (paroxetine) 30 30Paxil 20 mg (paroxetine) 30 30Paxil 30 mg (paroxetine) 30 30Paxil 40 mg (paroxetine) 45 30Paxil CR 12.5 mg (paroxetine ER) 30 30Paxil CR 25 mg (paroxetine ER) 60 30Paxil CR 37.5 mg (paroxetine ER) 60 30Pegasys kit (peginterferon1 28alpha-2a)Pegasys syringe (peginterferon 4 ml 28alpha-2a)Percocet 5/325 mg (oxycodone/ 360 30acetaminophen)Percocet 7.5/325 mg (oxycodone/ 240 30acetaminophen)Percocet 7.5/500 mg (oxycodone/ 240 30acetaminophen)Percocet 10/325 mg (oxycodone/ 180 30acetaminophen)Percocet 10/650 mg (oxycodone/ 180 30acetaminophen)Pravachol 10 mg (pravastatin) 30 30Pravachol 20 mg (pravastatin) 30 30Pravachol 40 mg (pravastatin) 30 30Pravachol 80 mg (pravastatin) 30 30Comments
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