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

00069303020 DOXORUBICIN INJ 2MG/ML 12/31/9999 2012300069303120 DOXORUBICIN INJ 2MG/ML 12/31/9999 2012300069303220 DOXORUBICIN INJ 2MG/ML 12/31/9999 2012300069303320 DOXORUBICIN INJ 2MG/ML 12/31/9999 2012300069303420 DOXORUBICIN INJ 2MG/ML 12/31/9999 2012355390024610 DOXORUBICIN INJ 2MG/ML 12/31/9999 2012355390024701 DOXORUBICIN INJ 2MG/ML 12/31/9999 2012355390024801 DOXORUBICIN INJ 2MG/ML 11/30/2012 2012363323010161 DOXORUBICIN INJ 2MG/ML 12/31/9999 2012363323088305 DOXORUBICIN INJ 2MG/ML 12/31/9999 2012363323088310 DOXORUBICIN INJ 2MG/ML 12/31/9999 2012363323088330 DOXORUBICIN INJ 2MG/ML 12/31/9999 2012300069017101 DOXORUBICIN INJ 50MG 12/31/9999 2012300703504601 DOXORUBICIN INJ 50MG 12/31/9999 2012355390024301 DOXORUBICIN INJ 50MG 12/31/9999 2012300591041150 DOXYCYC MONO CAP 100MG 12/31/9999 2012349884072703 DOXYCYC MONO CAP 100MG 12/31/9999 2012349884072704 DOXYCYC MONO CAP 100MG 12/31/9999 2012300591041001 DOXYCYC MONO CAP 50MG 12/31/9999 2012349884072601 DOXYCYC MONO CAP 50MG 12/31/9999 2012300185021652 DOXYCYC MONO TAB 100MG 12/31/9999 2012300185021653 DOXYCYC MONO TAB 100MG 12/31/9999 2012300378602389 DOXYCYC MONO TAB 100MG 12/31/9999 2012300527133825 DOXYCYC MONO TAB 100MG 12/31/9999 2012300527133850 DOXYCYC MONO TAB 100MG 12/31/9999 2012323155013525 DOXYCYC MONO TAB 100MG 12/31/9999 2012349884009303 DOXYCYC MONO TAB 100MG 12/31/9999 2012349884009304 DOXYCYC MONO TAB 100MG 12/31/9999 2012363304013250 DOXYCYC MONO TAB 100MG 12/31/9999 2012300378612493 DOXYCYC MONO TAB 150MG 12/31/9999 2012300527153730 DOXYCYC MONO TAB 150MG 12/31/9999 2012323155013603 DOXYCYC MONO TAB 150MG 12/31/9999 2012349884023611 DOXYCYC MONO TAB 150MG 12/31/9999 2012363304017330 DOXYCYC MONO TAB 150MG 12/31/9999 2012300378602101 DOXYCYC MONO TAB 50MG 12/31/9999 2012300527133501 DOXYCYC MONO TAB 50MG 12/31/9999 2012323155013301 DOXYCYC MONO TAB 50MG 12/31/9999 2012349884009101 DOXYCYC MONO TAB 50MG 12/31/9999 2012300378602201 DOXYCYC MONO TAB 75MG 12/31/9999 2012300527153501 DOXYCYC MONO TAB 75MG 12/31/9999 2012323155013401 DOXYCYC MONO TAB 75MG 12/31/9999 2012349884009201 DOXYCYC MONO TAB 75MG 12/31/9999 2012363304013101 DOXYCYC MONO TAB 75MG 12/31/9999 2012300143314205 DOXYCYCL HYC CAP 100MG 12/31/9999 2012300143314250 DOXYCYCL HYC CAP 100MG 12/31/9999 2012300591544005 DOXYCYCL HYC CAP 100MG 12/31/9999 2012300591544050 DOXYCYCL HYC CAP 100MG 12/31/9999 2012300603348119 DOXYCYCL HYC CAP 100MG 02/28/2014 2012300603348128 DOXYCYCL HYC CAP 100MG 06/30/2014 2012300904042840 DOXYCYCL HYC CAP 100MG 12/31/9999 2012300904042851 DOXYCYCL HYC CAP 100MG 12/31/9999 2012300904042861 DOXYCYCL HYC CAP 100MG 12/31/9999 2012315338010014 DOXYCYCL HYC CAP 100MG 12/31/9999 2012353489011902 DOXYCYCL HYC CAP 100MG 12/31/9999 2012353489011905 DOXYCYCL HYC CAP 100MG 12/31/9999 2012361748011114 DOXYCYCL HYC CAP 100MG 12/31/9999 2012300143314150 DOXYCYCL HYC CAP 50MG 12/31/9999 2012300591553550 DOXYCYCL HYC CAP 50MG 12/31/9999 2012300904042751 DOXYCYCL HYC CAP 50MG 12/31/9999 2012353489011802 DOXYCYCL HYC CAP 50MG 12/31/9999 20123