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

00591325601 CYCLOBENZAPR TAB 5MG 12/31/9999 2012300603307821 CYCLOBENZAPR TAB 5MG 12/31/9999 2012300603307828 CYCLOBENZAPR TAB 5MG 12/31/9999 2012300781503210 CYCLOBENZAPR TAB 5MG 12/31/9999 2012331722028201 CYCLOBENZAPR TAB 5MG 12/31/9999 2012351991046701 CYCLOBENZAPR TAB 5MG 12/31/9999 2012351991046710 CYCLOBENZAPR TAB 5MG 12/31/9999 2012352152030102 CYCLOBENZAPR TAB 5MG 12/31/9999 2012359746021106 CYCLOBENZAPR TAB 5MG 12/31/9999 2012359746021110 CYCLOBENZAPR TAB 5MG 12/31/9999 2012365862019001 CYCLOBENZAPR TAB 5MG 12/31/9999 2012368462055201 CYCLOBENZAPR TAB 5MG 12/31/9999 2012300065039515 CYCLOGYL SOL 0.5% OP 12/31/9999 2012300065039602 CYCLOGYL SOL 1% OP 12/31/9999 2012300065039605 CYCLOGYL SOL 1% OP 12/31/9999 2012300065039615 CYCLOGYL SOL 1% OP 12/31/9999 2012300065039702 CYCLOGYL SOL 2% OP 12/31/9999 2012300065039705 CYCLOGYL SOL 2% OP 12/31/9999 2012300065039715 CYCLOGYL SOL 2% OP 12/31/9999 2012300065035902 CYCLOMYDRIL SOL OP 12/31/9999 2012300065035905 CYCLOMYDRIL SOL OP 12/31/9999 2012317478010002 CYCLOPENTOL SOL 1% OP 12/31/9999 2012317478010012 CYCLOPENTOL SOL 1% OP 12/31/9999 2012324208073501 CYCLOPENTOL SOL 1% OP 12/31/9999 2012324208073506 CYCLOPENTOL SOL 1% OP 12/31/9999 2012361314039601 CYCLOPENTOL SOL 1% OP 12/31/9999 2012361314039603 CYCLOPENTOL SOL 1% OP 12/31/9999 2012310019095601 CYCLOPHOSPH INJ 1GM 12/31/9999 2012310019095616 CYCLOPHOSPH INJ 1GM 12/31/9999 2012310019095701 CYCLOPHOSPH INJ 2GM 12/31/9999 2012310019095711 CYCLOPHOSPH INJ 2GM 12/31/9999 2012310019095501 CYCLOPHOSPH INJ 500MG 12/31/9999 2012310019095550 CYCLOPHOSPH INJ 500MG 12/31/9999 2012300054412925 CYCLOPHOSPH TAB 25MG 12/31/9999 2012300054413025 CYCLOPHOSPH TAB 50MG 12/31/9999 2012360505013400 CYCLOSPORINE CAP 100MG 12/31/9999 2012300172731200 CYCLOSPORINE CAP 100MG MD 12/31/9999 2012300172731246 CYCLOSPORINE CAP 100MG MD 12/31/9999 2012300185093330 CYCLOSPORINE CAP 100MG MD 12/31/9999 2012300591222315 CYCLOSPORINE CAP 100MG MD 12/31/9999 2012360505013300 CYCLOSPORINE CAP 25MG 12/31/9999 2012300172731000 CYCLOSPORINE CAP 25MG MOD 12/31/9999 2012300172731046 CYCLOSPORINE CAP 25MG MOD 12/31/9999 2012300185093230 CYCLOSPORINE CAP 25MG MOD 12/31/9999 2012300591222215 CYCLOSPORINE CAP 25MG MOD 12/31/9999 2012300172731100 CYCLOSPORINE CAP 50MG MOD 12/31/9999 2012300172731146 CYCLOSPORINE CAP 50MG MOD 12/31/9999 2012300574086610 CYCLOSPORINE INJ 50MG/ML 12/31/9999 2012355390012210 CYCLOSPORINE INJ 50MG/ML 12/31/9999 2012300172731320 CYCLOSPORINE SOL MODIFIED 12/31/9999 2012300591222455 CYCLOSPORINE SOL MODIFIED 12/31/9999 2012360505035401 CYCLOSPORINE SOL MODIFIED 12/31/9999 2012300013111401 CYKLOKAPRON INJ 100MG/ML 12/31/9999 2012300013111410 CYKLOKAPRON INJ 100MG/ML 12/31/9999 2012300002323560 CYMBALTA CAP 20MG 12/31/9999 2012300002324001 CYMBALTA CAP 30MG 12/31/9999 2012300002324030 CYMBALTA CAP 30MG 12/31/9999 2012300002324033 CYMBALTA CAP 30MG 12/31/9999 2012300002324090 CYMBALTA CAP 30MG 12/31/9999 2012300002327001 CYMBALTA CAP 60MG 12/31/9999 20123