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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516724043<strong>01</strong> CLORAZ DIPOT TAB 7.5MG 12/31/9999 2<strong>01</strong>2351672404302 CLORAZ DIPOT TAB 7.5MG 12/31/9999 2<strong>01</strong>23633040553<strong>01</strong> CLORAZ DIPOT TAB 7.5MG 12/31/9999 2<strong>01</strong>2363304055305 CLORAZ DIPOT TAB 7.5MG 12/31/9999 2<strong>01</strong>230037800<strong>01</strong><strong>01</strong> CLORPRES TAB 0.1-15MG 12/31/9999 2<strong>01</strong>23003780027<strong>01</strong> CLORPRES TAB 0.2-15MG 12/31/9999 2<strong>01</strong>23003780072<strong>01</strong> CLORPRES TAB 0.3-15MG 12/31/9999 2<strong>01</strong>2366993089815 CLOTRIM/BETA CRE 1-0.05% 12/31/9999 2<strong>01</strong>2366993089845 CLOTRIM/BETA CRE 1-0.05% 12/31/9999 2<strong>01</strong>230<strong>01</strong>68025815 CLOTRIM/BETA CRE DIPROP 12/31/9999 2<strong>01</strong>230<strong>01</strong>68025846 CLOTRIM/BETA CRE DIPROP 12/31/9999 2<strong>01</strong>2300472037915 CLOTRIM/BETA CRE DIPROP 12/31/9999 2<strong>01</strong>2300472037945 CLOTRIM/BETA CRE DIPROP 12/31/9999 2<strong>01</strong>23516724048<strong>01</strong> CLOTRIM/BETA CRE DIPROP 12/31/9999 2<strong>01</strong>2351672404806 CLOTRIM/BETA CRE DIPROP 12/31/9999 2<strong>01</strong>230<strong>01</strong>68037030 CLOTRIM/BETA LOT DIPROP 12/31/9999 2<strong>01</strong>2351672130803 CLOTRIM/BETA LOT DIPROP 12/31/9999 2<strong>01</strong>230<strong>01</strong>68<strong>01</strong>3315 CLOTRIMAZOLE CRE 1% 12/31/9999 2<strong>01</strong>230<strong>01</strong>68<strong>01</strong>3330 CLOTRIMAZOLE CRE 1% 12/31/9999 2<strong>01</strong>230<strong>01</strong>68<strong>01</strong>3346 CLOTRIMAZOLE CRE 1% 12/31/9999 2<strong>01</strong>2300472022041 CLOTRIMAZOLE CRE 1% 12/31/9999 2<strong>01</strong>2300472022063 CLOTRIMAZOLE CRE 1% 12/31/9999 2<strong>01</strong>2337205<strong>01</strong>6<strong>01</strong>0 CLOTRIMAZOLE CRE 1% 12/31/9999 2<strong>01</strong>23458020434<strong>01</strong> CLOTRIMAZOLE CRE 1% 12/31/9999 2<strong>01</strong>2345802043411 CLOTRIMAZOLE CRE 1% 12/31/9999 2<strong>01</strong>23516721275<strong>01</strong> CLOTRIMAZOLE CRE 1% 12/31/9999 2<strong>01</strong>2351672127502 CLOTRIMAZOLE CRE 1% 12/31/9999 2<strong>01</strong>2351672127506 CLOTRIMAZOLE CRE 1% 12/31/9999 2<strong>01</strong>2351672127507 CLOTRIMAZOLE CRE 1% 12/31/9999 2<strong>01</strong>23516722002<strong>01</strong> CLOTRIMAZOLE CRE 1% 12/31/9999 2<strong>01</strong>2351672200202 CLOTRIMAZOLE CRE 1% 12/31/9999 2<strong>01</strong>2363868200202 CLOTRIMAZOLE CRE 1% 12/31/9999 2<strong>01</strong>2368462<strong>01</strong>8117 CLOTRIMAZOLE CRE 1% 12/31/9999 2<strong>01</strong>2368462<strong>01</strong>8135 CLOTRIMAZOLE CRE 1% 12/31/9999 2<strong>01</strong>2368462<strong>01</strong>8147 CLOTRIMAZOLE CRE 1% 12/31/9999 2<strong>01</strong>2300904782231 CLOTRIMAZOLE CRE 1% A/F 12/31/9999 2<strong>01</strong>2300904782236 CLOTRIMAZOLE CRE 1% A/F 12/31/9999 2<strong>01</strong>2300472000741 CLOTRIMAZOLE CRE 1% VAG 12/31/9999 2<strong>01</strong>2349348079376 CLOTRIMAZOLE CRE 1% VAG 12/31/9999 2<strong>01</strong>2351672200306 CLOTRIMAZOLE CRE 1% VAG 12/31/9999 2<strong>01</strong>2324385<strong>01</strong>1009 CLOTRIMAZOLE CRE 3 DAY 12/31/9999 2<strong>01</strong>2351672670800 CLOTRIMAZOLE CRE 3 DAY 12/31/9999 2<strong>01</strong>2300574<strong>01</strong>0714 CLOTRIMAZOLE LOZ 10MG 12/31/9999 2<strong>01</strong>2300574<strong>01</strong>0770 CLOTRIMAZOLE LOZ 10MG 12/31/9999 2<strong>01</strong>2300574<strong>01</strong>0777 CLOTRIMAZOLE LOZ 10MG 12/31/9999 2<strong>01</strong>2351552131802 CLOTRIMAZOLE POW 12/31/9999 2<strong>01</strong>2351552131804 CLOTRIMAZOLE POW 12/31/9999 2<strong>01</strong>2351552131805 CLOTRIMAZOLE POW 12/31/9999 2<strong>01</strong>2300093024831 CLOTRIMAZOLE SOL 1% 12/31/9999 2<strong>01</strong>2300093024843 CLOTRIMAZOLE SOL 1% 12/31/9999 2<strong>01</strong>2351672126003 CLOTRIMAZOLE SOL 1% 12/31/9999 2<strong>01</strong>23516722037<strong>01</strong> CLOTRIMAZOLE SOL 1% 12/31/9999 2<strong>01</strong>2300054414622 CLOTRIMAZOLE TRO 10MG 12/31/9999 2<strong>01</strong>2300054414623 CLOTRIMAZOLE TRO 10MG 12/31/9999 2<strong>01</strong>2300054814622 CLOTRIMAZOLE TRO 10MG 12/31/9999 2<strong>01</strong>23000933<strong>01</strong>0<strong>01</strong> CLOZAPINE TAB 100/ODT 12/31/9999 2<strong>01</strong>23000933<strong>01</strong><strong>01</strong>9 CLOZAPINE TAB 100/ODT 12/31/9999 2<strong>01</strong>23000933<strong>01</strong>084 CLOZAPINE TAB 100/ODT 12/31/9999 2<strong>01</strong>23000937772<strong>01</strong> CLOZAPINE TAB 100MG 12/31/9999 2<strong>01</strong>2300093777205 CLOZAPINE TAB 100MG 12/31/9999 2<strong>01</strong>23

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