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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000321212<strong>01</strong> CREON CAP 12000UNT 12/31/9999 2<strong>01</strong>2300032121207 CREON CAP 12000UNT 12/31/9999 2<strong>01</strong>23000321224<strong>01</strong> CREON CAP 24000UNT 12/31/9999 2<strong>01</strong>2300032122407 CREON CAP 24000UNT 12/31/9999 2<strong>01</strong>2300032120370 CREON CAP 3000UNIT 12/31/9999 2<strong>01</strong>23000321206<strong>01</strong> CREON CAP 6000UNIT 12/31/9999 2<strong>01</strong>2300032120607 CREON CAP 6000UNIT 12/31/9999 2<strong>01</strong>2300310075139 CRESTOR TAB 10MG 12/31/9999 2<strong>01</strong>2300310075190 CRESTOR TAB 10MG 12/31/9999 2<strong>01</strong>2300310075239 CRESTOR TAB 20MG 12/31/9999 2<strong>01</strong>2300310075290 CRESTOR TAB 20MG 12/31/9999 2<strong>01</strong>2300310075430 CRESTOR TAB 40MG 12/31/9999 2<strong>01</strong>2300310075590 CRESTOR TAB 5MG 12/31/9999 2<strong>01</strong>2352544028324 CRINONE GEL 4% VAG 12/31/9999 2<strong>01</strong>2352544028412 CRINONE GEL 8% VAG 12/31/9999 2<strong>01</strong>23117<strong>01</strong>006714 CRITIC-AID OIN 2% 12/31/9999 2<strong>01</strong>23117<strong>01</strong>006722 CRITIC-AID OIN 2% 12/31/9999 2<strong>01</strong>23117<strong>01</strong>006723 CRITIC-AID OIN 2% 12/31/9999 2<strong>01</strong>23117<strong>01</strong>006622 CRITIC-AID OIN CLEAR 12/31/9999 2<strong>01</strong>23117<strong>01</strong>006632 CRITIC-AID OIN CLEAR 12/31/9999 2<strong>01</strong>23117<strong>01</strong>006633 CRITIC-AID OIN CLEAR 12/31/9999 2<strong>01</strong>23117<strong>01</strong>004032 CRITIC-AID PST 12/31/9999 2<strong>01</strong>23117<strong>01</strong>004033 CRITIC-AID PST 12/31/9999 2<strong>01</strong>23117<strong>01</strong>0050<strong>01</strong> CRITIC-AID PST 12/31/9999 2<strong>01</strong>23117<strong>01</strong>005032 CRITIC-AID PST BARRIER 12/31/9999 2<strong>01</strong>23117<strong>01</strong>005033 CRITIC-AID PST BARRIER 12/31/9999 2<strong>01</strong>2300006057062 CRIXIVAN CAP 100MG 12/31/9999 2<strong>01</strong>2300006057143 CRIXIVAN CAP 200MG 12/31/9999 2<strong>01</strong>2300006057340 CRIXIVAN CAP 400MG 12/31/9999 2<strong>01</strong>2300006057354 CRIXIVAN CAP 400MG 12/31/9999 2<strong>01</strong>2300006057362 CRIXIVAN CAP 400MG 12/31/9999 2<strong>01</strong>2300281033<strong>01</strong>0 CROFAB INJ 06/30/2<strong>01</strong>3 2<strong>01</strong>2316571060096 CROMOLYN SOD CON 100/5ML 12/31/9999 2<strong>01</strong>2366993047096 CROMOLYN SOD CON 100/5ML 12/31/9999 2<strong>01</strong>230<strong>01</strong>72640649 CROMOLYN SOD NEB 20MG/2ML 12/31/9999 2<strong>01</strong>230<strong>01</strong>72640659 CROMOLYN SOD NEB 20MG/2ML 12/31/9999 2<strong>01</strong>2300472075060 CROMOLYN SOD NEB 20MG/2ML 12/31/9999 2<strong>01</strong>2300093138943 CROMOLYN SOD SOL 4% OP 12/31/9999 2<strong>01</strong>2317478029111 CROMOLYN SOD SOL 4% OP 12/31/9999 2<strong>01</strong>2361314023710 CROMOLYN SOD SOL 4% OP 12/31/9999 2<strong>01</strong>2300904553267 CROMOLYN SOD SPR 5.2/ACT 12/31/9999 2<strong>01</strong>2337205022361 CROMOLYN SOD SPR 5.2/ACT 12/31/9999 2<strong>01</strong>2357782039726 CROMOLYN SOD SPR 5.2/ACT 12/31/9999 2<strong>01</strong>2351552022403 CROTON OIL 12/31/9999 2<strong>01</strong>2351552022404 CROTON OIL 12/31/9999 2<strong>01</strong>23000679506<strong>01</strong> CRUEX CRE 1% 12/31/9999 2<strong>01</strong>2300555904958 CRYSELLE-28 TAB 28 TABS 12/31/9999 2<strong>01</strong>23679190<strong>01</strong>1<strong>01</strong> CUBICIN SOL 500MG 12/31/9999 2<strong>01</strong>23004094092<strong>01</strong> CUPRIC CHLOR INJ 0.4MG/ML 12/31/9999 2<strong>01</strong>2325<strong>01</strong>0070515 CUPRIMINE CAP 250MG 12/31/9999 2<strong>01</strong>2300462033230 CUTIVATE CRE 0.05% 12/31/9999 2<strong>01</strong>2300462033260 CUTIVATE CRE 0.05% 12/31/9999 2<strong>01</strong>2300462043404 CUTIVATE LOT 0.05% 12/31/9999 2<strong>01</strong>2359630020616 CUVPOSA SOL 1MG/5ML 12/31/9999 2<strong>01</strong>2300517003125 CYANOCOBALAM INJ 1000MCG 12/31/9999 2<strong>01</strong>2300517003225 CYANOCOBALAM INJ 1000MCG 12/31/9999 2<strong>01</strong>2300517<strong>01</strong>3005 CYANOCOBALAM INJ 1000MCG 12/31/9999 2<strong>01</strong>23633230044<strong>01</strong> CYANOCOBALAM INJ 1000MCG 12/31/9999 2<strong>01</strong>2300603752117 CYCLAFEM TAB 1/35 12/31/9999 2<strong>01</strong>2300603752149 CYCLAFEM TAB 1/35 12/31/9999 2<strong>01</strong>23

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