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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0<strong>01</strong>85<strong>01</strong>40<strong>01</strong> ETODOLAC TAB 400MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>85<strong>01</strong>4005 ETODOLAC TAB 400MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>85<strong>01</strong>4<strong>01</strong>0 ETODOLAC TAB 400MG 12/31/9999 2<strong>01</strong>2300228259911 ETODOLAC TAB 400MG 11/30/2<strong>01</strong>3 2<strong>01</strong>2300228259950 ETODOLAC TAB 400MG 10/30/2<strong>01</strong>3 2<strong>01</strong>23516724<strong>01</strong>8<strong>01</strong> ETODOLAC TAB 400MG 12/31/9999 2<strong>01</strong>23605050041<strong>01</strong> ETODOLAC TAB 400MG 12/31/9999 2<strong>01</strong>23000931893<strong>01</strong> ETODOLAC TAB 500MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>85<strong>01</strong>39<strong>01</strong> ETODOLAC TAB 500MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>85<strong>01</strong>3905 ETODOLAC TAB 500MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>85<strong>01</strong>3910 ETODOLAC TAB 500MG 12/31/9999 2<strong>01</strong>2300228263211 ETODOLAC TAB 500MG 11/30/2<strong>01</strong>3 2<strong>01</strong>23516724036<strong>01</strong> ETODOLAC TAB 500MG 12/31/9999 2<strong>01</strong>2360505<strong>01</strong>02<strong>01</strong> ETODOLAC TAB 500MG 12/31/9999 2<strong>01</strong>23000931122<strong>01</strong> ETODOLAC ER TAB 400MG 12/31/9999 2<strong>01</strong>23516724051<strong>01</strong> ETODOLAC ER TAB 400MG 12/31/9999 2<strong>01</strong>2351672405104 ETODOLAC ER TAB 400MG 12/31/9999 2<strong>01</strong>23000937172<strong>01</strong> ETODOLAC ER TAB 500MG 12/31/9999 2<strong>01</strong>23516724052<strong>01</strong> ETODOLAC ER TAB 500MG 12/31/9999 2<strong>01</strong>2351672405204 ETODOLAC ER TAB 500MG 12/31/9999 2<strong>01</strong>23000931118<strong>01</strong> ETODOLAC ER TAB 600MG 12/31/9999 2<strong>01</strong>23516724053<strong>01</strong> ETODOLAC ER TAB 600MG 12/31/9999 2<strong>01</strong>2351672405304 ETODOLAC ER TAB 600MG 12/31/9999 2<strong>01</strong>23000690006<strong>01</strong> ETOMIDATE INJ 2MG/ML 12/31/9999 2<strong>01</strong>2300069000602 ETOMIDATE INJ 2MG/ML 12/31/9999 2<strong>01</strong>2300069000603 ETOMIDATE INJ 2MG/ML 12/31/9999 2<strong>01</strong>2300069000604 ETOMIDATE INJ 2MG/ML 12/31/9999 2<strong>01</strong>2300517078<strong>01</strong>0 ETOMIDATE INJ 2MG/ML 12/31/9999 2<strong>01</strong>2300517078110 ETOMIDATE INJ 2MG/ML 12/31/9999 2<strong>01</strong>2325021067410 ETOMIDATE INJ 2MG/ML 12/31/9999 2<strong>01</strong>2325021067420 ETOMIDATE INJ 2MG/ML 12/31/9999 2<strong>01</strong>2355390076210 ETOMIDATE INJ 2MG/ML 12/31/9999 2<strong>01</strong>2355390076320 ETOMIDATE INJ 2MG/ML 12/31/9999 2<strong>01</strong>2300<strong>01</strong>5340420 ETOPOPHOS INJ 100MG 12/31/9999 2<strong>01</strong>2300378326694 ETOPOSIDE CAP 50MG 12/31/9999 2<strong>01</strong>2316729<strong>01</strong>1431 ETOPOSIDE INJ 20MG/ML 12/31/9999 2<strong>01</strong>23553900291<strong>01</strong> ETOPOSIDE INJ 20MG/ML 12/31/9999 2<strong>01</strong>23553900292<strong>01</strong> ETOPOSIDE INJ 20MG/ML 12/31/9999 2<strong>01</strong>23553900293<strong>01</strong> ETOPOSIDE INJ 20MG/ML 12/31/9999 2<strong>01</strong>23553900491<strong>01</strong> ETOPOSIDE INJ 20MG/ML 12/31/9999 2<strong>01</strong>23553900492<strong>01</strong> ETOPOSIDE INJ 20MG/ML 12/31/9999 2<strong>01</strong>23553900493<strong>01</strong> ETOPOSIDE INJ 20MG/ML 12/31/9999 2<strong>01</strong>2363323<strong>01</strong>0405 ETOPOSIDE INJ 20MG/ML 12/31/9999 2<strong>01</strong>2363323<strong>01</strong>0425 ETOPOSIDE INJ 20MG/ML 12/31/9999 2<strong>01</strong>2363323<strong>01</strong>0450 ETOPOSIDE INJ 20MG/ML 12/31/9999 2<strong>01</strong>2351552077004 EUCALYPTOL LIQ 12/31/9999 2<strong>01</strong>2351552<strong>01</strong>8202 EUCALYPTUS OIL 12/31/9999 2<strong>01</strong>2351552<strong>01</strong>8203 EUCALYPTUS OIL 12/31/9999 2<strong>01</strong>2351552<strong>01</strong>8205 EUCALYPTUS OIL 12/31/9999 2<strong>01</strong>2351552<strong>01</strong>8206 EUCALYPTUS OIL 12/31/9999 2<strong>01</strong>2310631009160 EURAX CRE 10% 12/31/9999 2<strong>01</strong>2310631009216 EURAX LOT 10% 12/31/9999 2<strong>01</strong>2310631009260 EURAX LOT 10% 12/31/9999 2<strong>01</strong>2364<strong>01</strong>1021541 EVAMIST SPR 1.53MG 12/31/9999 2<strong>01</strong>2300002416502 EVISTA TAB 60MG 12/31/9999 2<strong>01</strong>2300002416507 EVISTA TAB 60MG 12/31/9999 2<strong>01</strong>2300002416530 EVISTA TAB 60MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>45006100 EVOCLIN AER 1% 12/31/9999 2<strong>01</strong>2363032006150 EVOCLIN AER 1% 12/31/9999 2<strong>01</strong>236339502<strong>01</strong>13 EVOXAC CAP 30MG 12/31/9999 2<strong>01</strong>23

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