Rebatable Drug List for Iowa Medicaid Effective Date December 01 ...
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Rebatable Drug List for Iowa Medicaid Effective Date December 01 ...

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68645025254 CITALOPRAM TAB 40MG 12/31/9999 2<strong>01</strong>2368645028254 CITALOPRAM TAB 40MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>78079830 CITRANATAL CAP HARMONY 12/31/9999 2<strong>01</strong>230<strong>01</strong>78079930 CITRANATAL CAP HARMONY 02/28/2<strong>01</strong>3 2<strong>01</strong>230<strong>01</strong>78082930 CITRANATAL MIS 90 DHA 12/31/9999 2<strong>01</strong>230<strong>01</strong>78086630 CITRANATAL MIS B-CALM 12/31/9999 2<strong>01</strong>230<strong>01</strong>78089330 CITRANATAL PAK ASSURE 12/31/9999 2<strong>01</strong>230<strong>01</strong>78089830 CITRANATAL PAK DHA 12/31/9999 2<strong>01</strong>230<strong>01</strong>78085990 CITRANATAL TAB RX 12/31/9999 2<strong>01</strong>2351552<strong>01</strong>5706 CITRIC ACID POW ANHYDROU 12/31/9999 2<strong>01</strong>2351552<strong>01</strong>5709 CITRIC ACID POW ANHYDROU 12/31/9999 2<strong>01</strong>230<strong>01</strong>21059515 CITRIC ACID/ SOL SOD CITR 12/31/9999 2<strong>01</strong>230<strong>01</strong>21059516 CITRIC ACID/ SOL SOD CITR 12/31/9999 2<strong>01</strong>230<strong>01</strong>21059530 CITRIC ACID/ SOL SOD CITR 12/31/9999 2<strong>01</strong>2351552<strong>01</strong>9202 CITRONELLA OIL 12/31/9999 2<strong>01</strong>2351552<strong>01</strong>9205 CITRONELLA OIL 12/31/9999 2<strong>01</strong>2351552<strong>01</strong>9206 CITRONELLA OIL 12/31/9999 2<strong>01</strong>230<strong>01</strong>35<strong>01</strong>0557 CITRUCEL POW CLR-MIX 12/31/9999 2<strong>01</strong>230<strong>01</strong>350238<strong>01</strong> CITRUCEL POW FIBERSHK 12/31/9999 2<strong>01</strong>230<strong>01</strong>35023802 CITRUCEL POW FIBERSHK 12/31/9999 2<strong>01</strong>230<strong>01</strong>35008969 CITRUCEL POW ORANGE 12/31/9999 2<strong>01</strong>230<strong>01</strong>35008971 CITRUCEL POW ORANGE 12/31/9999 2<strong>01</strong>230<strong>01</strong>35008975 CITRUCEL POW ORANGE 12/31/9999 2<strong>01</strong>230<strong>01</strong>35009068 CITRUCEL POW SF ORANG 12/31/9999 2<strong>01</strong>230<strong>01</strong>35009070 CITRUCEL POW SF ORANG 12/31/9999 2<strong>01</strong>230<strong>01</strong>35009074 CITRUCEL POW SF ORANG 12/31/9999 2<strong>01</strong>230<strong>01</strong>35009075 CITRUCEL POW SF ORANG 12/31/9999 2<strong>01</strong>230<strong>01</strong>35<strong>01</strong>99<strong>01</strong> CITRUCEL TAB 500MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>35<strong>01</strong>9902 CITRUCEL TAB 500MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>35<strong>01</strong>9907 CITRUCEL TAB 500MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>35<strong>01</strong>9914 CITRUCEL TAB 500MG 12/31/9999 2<strong>01</strong>2351552083206 CITRUS SYP 12/31/9999 2<strong>01</strong>2300069008618 CLADRIBINE INJ 1MG/ML 12/31/9999 2<strong>01</strong>2355390<strong>01</strong>15<strong>01</strong> CLADRIBINE INJ 1MG/ML 12/31/9999 2<strong>01</strong>2355390<strong>01</strong>24<strong>01</strong> CLADRIBINE INJ 1MG/ML 12/31/9999 2<strong>01</strong>2363323<strong>01</strong>4<strong>01</strong>0 CLADRIBINE INJ 1MG/ML 12/31/9999 2<strong>01</strong>23000390020<strong>01</strong> CLAFORAN INJ 10GM 12/31/9999 2<strong>01</strong>23000390<strong>01</strong>810 CLAFORAN INJ 1GM 12/31/9999 2<strong>01</strong>2300039002325 CLAFORAN INJ 1GM 12/31/9999 2<strong>01</strong>23000390<strong>01</strong>910 CLAFORAN INJ 2GM 12/31/9999 2<strong>01</strong>2300039002425 CLAFORAN INJ 2GM 12/31/9999 2<strong>01</strong>23000390<strong>01</strong>710 CLAFORAN INJ 500MG 12/31/9999 2<strong>01</strong>2300039003705 CLAFORAN/D5W INJ 1GM 12/31/9999 2<strong>01</strong>2300039003805 CLAFORAN/D5W INJ 2GM 12/31/9999 2<strong>01</strong>2300555105456 CLARAVIS CAP 10MG 12/31/9999 2<strong>01</strong>2300555105486 CLARAVIS CAP 10MG 12/31/9999 2<strong>01</strong>2300555105556 CLARAVIS CAP 20MG 12/31/9999 2<strong>01</strong>2300555105586 CLARAVIS CAP 20MG 12/31/9999 2<strong>01</strong>2300555105686 CLARAVIS CAP 30MG 12/31/9999 2<strong>01</strong>2300555105756 CLARAVIS CAP 40MG 12/31/9999 2<strong>01</strong>2300555105786 CLARAVIS CAP 40MG 12/31/9999 2<strong>01</strong>2316781<strong>01</strong>5460 CLARIFOAM EF AER 10-5% 12/31/9999 2<strong>01</strong>2316781<strong>01</strong>5496 CLARIFOAM EF AER 10-5% 12/31/9999 2<strong>01</strong>23000851334<strong>01</strong> CLARINEX SYP 0.5MG/ML 12/31/9999 2<strong>01</strong>23000851264<strong>01</strong> CLARINEX TAB 5MG 12/31/9999 2<strong>01</strong>2300085126402 CLARINEX TAB 5MG 12/31/9999 2<strong>01</strong>2300085126403 CLARINEX TAB 5MG 12/31/9999 2<strong>01</strong>2300085126404 CLARINEX TAB 5MG 12/31/9999 2<strong>01</strong>23000851408<strong>01</strong> CLARINEX RDT TAB 2.5MG 12/31/9999 2<strong>01</strong>23000851384<strong>01</strong> CLARINEX RDT TAB 5MG 12/31/9999 2<strong>01</strong>23

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