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

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

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00409230402 CORLOPAM INJ 10MG/ML 12/31/9999 2<strong>01</strong>23004093373<strong>01</strong> CORLOPAM INJ 10MG/ML 12/31/9999 2<strong>01</strong>2300409337302 CORLOPAM INJ 10MG/ML 12/31/9999 2<strong>01</strong>2352544004886 CORMAX OIN 0.05% 05/31/2<strong>01</strong>3 2<strong>01</strong>2352544004889 CORMAX OIN 0.05% 05/31/2<strong>01</strong>3 2<strong>01</strong>2352544004955 CORMAX SOL 0.05% 10/31/2<strong>01</strong>3 2<strong>01</strong>2352544004983 CORMAX SOL 0.05% 10/31/2<strong>01</strong>3 2<strong>01</strong>2300095004950 CORMAX SCALP SOL 0.05% 12/31/9999 2<strong>01</strong>2351552082506 CORN OIL 12/31/9999 2<strong>01</strong>2351552082508 CORN OIL 12/31/9999 2<strong>01</strong>2300603<strong>01</strong>2916 CORRECTIVE TAB 5MG EC 12/31/2<strong>01</strong>2 2<strong>01</strong>23000090031<strong>01</strong> CORTEF TAB 10MG 12/31/9999 2<strong>01</strong>23000090044<strong>01</strong> CORTEF TAB 20MG 12/31/9999 2<strong>01</strong>23000090<strong>01</strong>2<strong>01</strong> CORTEF TAB 5MG 12/31/9999 2<strong>01</strong>23625591110<strong>01</strong> CORTENEMA ENE 100MG 12/31/9999 2<strong>01</strong>2362559111007 CORTENEMA ENE 100MG 12/31/9999 2<strong>01</strong>2351879<strong>01</strong>1<strong>01</strong>5 CORTICOOL GEL 1% 12/31/9999 2<strong>01</strong>2368220<strong>01</strong>4<strong>01</strong>5 CORTIFOAM AER 90MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>431202<strong>01</strong> CORTISONE AC TAB 25MG 12/31/9999 2<strong>01</strong>2361570003275 CORTISPORIN CRE 0.5% 12/31/9999 2<strong>01</strong>2361570003150 CORTISPORIN OIN 1% 12/31/9999 2<strong>01</strong>2361570003410 CORTISPORIN SOL 1% OTIC 12/31/9999 2<strong>01</strong>2342023<strong>01</strong>09<strong>01</strong> CORTISPORIN SUS -TC OTIC 12/31/9999 2<strong>01</strong>2300548590000 CORTROSYN INJ 0.25MG 12/31/9999 2<strong>01</strong>23000093794<strong>01</strong> CORVERT INJ 1MG/10ML 12/31/9999 2<strong>01</strong>2300009379422 CORVERT INJ 1MG/10ML 12/31/9999 2<strong>01</strong>2313811002810 CORVITA TAB 12/31/9999 2<strong>01</strong>2313811006610 CORVITA 150 TAB 12/31/9999 2<strong>01</strong>23680250<strong>01</strong>110 CORVITE TAB 12/31/9999 2<strong>01</strong>2368025003110 CORVITE 150 TAB 12/31/9999 2<strong>01</strong>2368025004230 CORVITE FE TAB 12/31/9999 2<strong>01</strong>2368025003<strong>01</strong>0 CORVITE FREE TAB 12/31/9999 2<strong>01</strong>2363717055316 CORZALL PLUS LIQ 03/31/2<strong>01</strong>3 2<strong>01</strong>2363717055616 CORZALL-PE LIQ 02/28/2<strong>01</strong>3 2<strong>01</strong>23607930283<strong>01</strong> CORZIDE TAB 40-5MG 12/31/9999 2<strong>01</strong>23607930284<strong>01</strong> CORZIDE TAB 80-5MG 12/31/9999 2<strong>01</strong>2367386081155 COSMEGEN INJ 0.5MG 12/31/9999 2<strong>01</strong>2300006362836 COSOPT SOL 2-0.5%OP 12/31/9999 2<strong>01</strong>2300006362960 COSOPT PF SOL 12/31/9999 2<strong>01</strong>2300006362962 COSOPT PF SOL 12/31/9999 2<strong>01</strong>2300781305271 COSYNTROPIN INJ 0.25MG 12/31/9999 2<strong>01</strong>2300781305295 COSYNTROPIN INJ 0.25MG 12/31/9999 2<strong>01</strong>231<strong>01</strong>39090502 COSYNTROPIN INJ 0.25MG 12/31/9999 2<strong>01</strong>231<strong>01</strong>39090510 COSYNTROPIN INJ 0.25MG 12/31/9999 2<strong>01</strong>2367457022702 COSYNTROPIN INJ 0.25MG 12/31/9999 2<strong>01</strong>23586050436<strong>01</strong> COTAB A TAB 4-10MG 12/31/9999 2<strong>01</strong>23586050437<strong>01</strong> COTAB AX TAB 4-20MG 12/31/9999 2<strong>01</strong>23586050438<strong>01</strong> COTABFLU TAB 20-4-500 12/31/9999 2<strong>01</strong>2351552025806 COTTONSEED OIL 12/31/9999 2<strong>01</strong>2351552025808 COTTONSEED OIL 12/31/9999 2<strong>01</strong>2300536082585 COUGH SYP 100/5ML 12/31/9999 2<strong>01</strong>2300536082597 COUGH SYP 100/5ML 12/31/9999 2<strong>01</strong>2300904581744 COUGH & COLD TAB 12/31/9999 2<strong>01</strong>2336800066634 COUGH & SORE LIQ NGT TIME 12/31/9999 2<strong>01</strong>2336800069834 COUGH & SORE LIQ THRT DAY 12/31/9999 2<strong>01</strong>2315127094544 COUGH CONTRO SYP DM 12/31/9999 2<strong>01</strong>2315127094548 COUGH CONTRO SYP DM 12/31/9999 2<strong>01</strong>2300904631256 COUGH DM LIQ 30MG/5ML 12/31/9999 2<strong>01</strong>2337205069721 COUGH DM LIQ 30MG/5ML 12/31/9999 2<strong>01</strong>2349348064944 COUGH DROPS LOZ BLUE MNT 12/31/9999 2<strong>01</strong>23

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