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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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49348081812 ALLERGY RELF TAB 10MG 12/31/9999 2<strong>01</strong>2349348081813 ALLERGY RELF TAB 10MG 12/31/9999 2<strong>01</strong>2349348081844 ALLERGY RELF TAB 10MG 12/31/9999 2<strong>01</strong>2349348092904 ALLERGY RELF TAB 10MG 12/31/9999 2<strong>01</strong>23516600526<strong>01</strong> ALLERGY RELF TAB 10MG 12/31/9999 2<strong>01</strong>2351660052605 ALLERGY RELF TAB 10MG 12/31/9999 2<strong>01</strong>2351660052628 ALLERGY RELF TAB 10MG 12/31/9999 2<strong>01</strong>2351660052631 ALLERGY RELF TAB 10MG 12/31/9999 2<strong>01</strong>2351660052660 ALLERGY RELF TAB 10MG 12/31/9999 2<strong>01</strong>2351660052731 ALLERGY RELF TAB 10MG 12/31/9999 2<strong>01</strong>2362<strong>01</strong>10073<strong>01</strong> ALLERGY RELF TAB 10MG 12/31/9999 2<strong>01</strong>2362<strong>01</strong>10074<strong>01</strong> ALLERGY RELF TAB 10MG 12/31/9999 2<strong>01</strong>2362<strong>01</strong>1007402 ALLERGY RELF TAB 10MG 12/31/9999 2<strong>01</strong>2362<strong>01</strong>1007403 ALLERGY RELF TAB 10MG 12/31/9999 2<strong>01</strong>2363868<strong>01</strong>5710 ALLERGY RELF TAB 10MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>13047962 ALLERGY RELF TAB 25MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>13047978 ALLERGY RELF TAB 25MG 12/31/9999 2<strong>01</strong>2337205034852 ALLERGY RELF TAB D-24 12/31/9999 2<strong>01</strong>2337205034888 ALLERGY RELF TAB D-24 12/31/9999 2<strong>01</strong>2349614<strong>01</strong>7252 ALLERGY RELF TAB D-24 12/31/9999 2<strong>01</strong>2351660072411 ALLERGY RELF TAB DECONGES 12/31/9999 2<strong>01</strong>2351660072415 ALLERGY RELF TAB DECONGES 12/31/9999 2<strong>01</strong>2351660072469 ALLERGY RELF TAB DECONGES 12/31/9999 2<strong>01</strong>2324385035122 ALLERGY/CONG TAB 10-240MG 12/31/9999 2<strong>01</strong>2324385035152 ALLERGY/CONG TAB 10-240MG 12/31/9999 2<strong>01</strong>2362<strong>01</strong>1<strong>01</strong>20<strong>01</strong> ALLERGY/CONG TAB 5-120MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>13<strong>01</strong>6522 ALLERGY/CONG TAB RELIEF 12/31/9999 2<strong>01</strong>230<strong>01</strong>13<strong>01</strong>6552 ALLERGY/CONG TAB RELIEF 12/31/9999 2<strong>01</strong>230<strong>01</strong>13<strong>01</strong>7653 ALLERGY-D TAB 5-120MG 12/31/9999 2<strong>01</strong>2300904583112 ALLERGY-D TAB 5-120MG 12/31/9999 2<strong>01</strong>2324385<strong>01</strong>7553 ALLERGY-D TAB 5-120MG 12/31/9999 2<strong>01</strong>2324385<strong>01</strong>7562 ALLERGY-D TAB 5-120MG 12/31/9999 2<strong>01</strong>2349348085104 ALLERGY-D TAB 5-120MG 12/31/9999 2<strong>01</strong>2337205022873 ALLERHIST-1 TAB 1.34MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>13<strong>01</strong>7662 ALLER-TEC D TAB 5-120MG 12/31/9999 2<strong>01</strong>23586050400<strong>01</strong> ALLFEN TAB 400MG 12/31/9999 2<strong>01</strong>23586050404<strong>01</strong> ALLFEN CD TAB 400-10MG 12/31/9999 2<strong>01</strong>2358605020516 ALLFEN CDX LIQ 12/31/9999 2<strong>01</strong>23586050405<strong>01</strong> ALLFEN CDX TAB 400-20MG 12/31/9999 2<strong>01</strong>235860504<strong>01</strong><strong>01</strong> ALLFEN DM TAB 400-20MG 12/31/9999 2<strong>01</strong>2362<strong>01</strong>10055<strong>01</strong> ALLGY COMP-D TAB 5-120MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>350461<strong>01</strong> ALLI CAP 60MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>35046102 ALLI CAP 60MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>35046104 ALLI CAP 60MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>35046105 ALLI CAP 60MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>35046106 ALLI CAP 60MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>35046107 ALLI CAP 60MG 12/31/9999 2<strong>01</strong>2300904577621 ALL-NITE LIQ COLD/FLU 12/31/9999 2<strong>01</strong>2300904577721 ALL-NITE LIQ COLD/FLU 12/31/9999 2<strong>01</strong>2355390<strong>01</strong>06<strong>01</strong> ALLOPURINOL INJ 500MG 12/31/9999 2<strong>01</strong>2300378<strong>01</strong>37<strong>01</strong> ALLOPURINOL TAB 100MG 12/31/9999 2<strong>01</strong>2300378<strong>01</strong>3710 ALLOPURINOL TAB 100MG 12/31/9999 2<strong>01</strong>23005915543<strong>01</strong> ALLOPURINOL TAB 100MG 12/31/9999 2<strong>01</strong>2300591554310 ALLOPURINOL TAB 100MG 12/31/9999 2<strong>01</strong>2300603211502 ALLOPURINOL TAB 100MG 12/31/9999 2<strong>01</strong>2300603211504 ALLOPURINOL TAB 100MG 12/31/9999 2<strong>01</strong>2300603211521 ALLOPURINOL TAB 100MG 12/31/9999 2<strong>01</strong>2300603211532 ALLOPURINOL TAB 100MG 12/31/9999 2<strong>01</strong>2300603211593 ALLOPURINOL TAB 100MG 12/31/9999 2<strong>01</strong>2300615159239 ALLOPURINOL TAB 100MG 12/31/9999 2<strong>01</strong>23

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