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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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00904261360 ALLOPURINOL TAB 100MG 12/31/9999 2<strong>01</strong>2300904261361 ALLOPURINOL TAB 100MG 12/31/9999 2<strong>01</strong>2300904626661 ALLOPURINOL TAB 100MG 12/31/9999 2<strong>01</strong>23167140041<strong>01</strong> ALLOPURINOL TAB 100MG 12/31/2020 2<strong>01</strong>2316714004104 ALLOPURINOL TAB 100MG 12/31/2020 2<strong>01</strong>2316714004106 ALLOPURINOL TAB 100MG 12/31/2020 2<strong>01</strong>23510790205<strong>01</strong> ALLOPURINOL TAB 100MG 12/31/9999 2<strong>01</strong>2351079020517 ALLOPURINOL TAB 100MG 12/31/9999 2<strong>01</strong>2351079020519 ALLOPURINOL TAB 100MG 12/31/9999 2<strong>01</strong>2351079020520 ALLOPURINOL TAB 100MG 12/31/9999 2<strong>01</strong>2353489<strong>01</strong>56<strong>01</strong> ALLOPURINOL TAB 100MG 02/28/2<strong>01</strong>5 2<strong>01</strong>2353489<strong>01</strong>5605 ALLOPURINOL TAB 100MG 02/28/2<strong>01</strong>5 2<strong>01</strong>2353489<strong>01</strong>5610 ALLOPURINOL TAB 100MG 02/28/2<strong>01</strong>5 2<strong>01</strong>23551110729<strong>01</strong> ALLOPURINOL TAB 100MG 03/31/2<strong>01</strong>3 2<strong>01</strong>2355111072910 ALLOPURINOL TAB 100MG 08/31/2<strong>01</strong>3 2<strong>01</strong>2360505251602 ALLOPURINOL TAB 100MG 12/31/9999 2<strong>01</strong>2360505251603 ALLOPURINOL TAB 100MG 12/31/9999 2<strong>01</strong>23625840988<strong>01</strong> ALLOPURINOL TAB 100MG 12/31/9999 2<strong>01</strong>23633040539<strong>01</strong> ALLOPURINOL TAB 100MG 12/31/9999 2<strong>01</strong>2363304053910 ALLOPURINOL TAB 100MG 12/31/9999 2<strong>01</strong>2367877<strong>01</strong>22<strong>01</strong> ALLOPURINOL TAB 100MG 12/31/9999 2<strong>01</strong>2367877<strong>01</strong>2210 ALLOPURINOL TAB 100MG 12/31/9999 2<strong>01</strong>2300228210350 ALLOPURINOL TAB 300MG 12/31/9999 2<strong>01</strong>2300378<strong>01</strong>81<strong>01</strong> ALLOPURINOL TAB 300MG 12/31/9999 2<strong>01</strong>2300378<strong>01</strong>8105 ALLOPURINOL TAB 300MG 12/31/9999 2<strong>01</strong>23005915544<strong>01</strong> ALLOPURINOL TAB 300MG 12/31/9999 2<strong>01</strong>2300591554405 ALLOPURINOL TAB 300MG 12/31/9999 2<strong>01</strong>2300603211602 ALLOPURINOL TAB 300MG 12/31/9999 2<strong>01</strong>2300603211621 ALLOPURINOL TAB 300MG 12/31/9999 2<strong>01</strong>2300603211628 ALLOPURINOL TAB 300MG 12/31/9999 2<strong>01</strong>2300603211632 ALLOPURINOL TAB 300MG 12/31/9999 2<strong>01</strong>2300615159305 ALLOPURINOL TAB 300MG 12/31/9999 2<strong>01</strong>2300615159339 ALLOPURINOL TAB 300MG 12/31/9999 2<strong>01</strong>2300904261461 ALLOPURINOL TAB 300MG 12/31/9999 2<strong>01</strong>23167140042<strong>01</strong> ALLOPURINOL TAB 300MG 12/31/2020 2<strong>01</strong>2316714004204 ALLOPURINOL TAB 300MG 12/31/2020 2<strong>01</strong>2316714004205 ALLOPURINOL TAB 300MG 12/31/2020 2<strong>01</strong>23510790206<strong>01</strong> ALLOPURINOL TAB 300MG 12/31/9999 2<strong>01</strong>2351079020617 ALLOPURINOL TAB 300MG 12/31/9999 2<strong>01</strong>2351079020619 ALLOPURINOL TAB 300MG 12/31/9999 2<strong>01</strong>2351079020620 ALLOPURINOL TAB 300MG 12/31/9999 2<strong>01</strong>2353489<strong>01</strong>57<strong>01</strong> ALLOPURINOL TAB 300MG 02/28/2<strong>01</strong>5 2<strong>01</strong>2353489<strong>01</strong>5705 ALLOPURINOL TAB 300MG 02/28/2<strong>01</strong>5 2<strong>01</strong>2353489<strong>01</strong>5710 ALLOPURINOL TAB 300MG 02/28/2<strong>01</strong>5 2<strong>01</strong>23551110730<strong>01</strong> ALLOPURINOL TAB 300MG 04/18/2<strong>01</strong>3 2<strong>01</strong>2355111073005 ALLOPURINOL TAB 300MG 08/29/2<strong>01</strong>3 2<strong>01</strong>2360505251702 ALLOPURINOL TAB 300MG 12/31/9999 2<strong>01</strong>2360505251703 ALLOPURINOL TAB 300MG 12/31/9999 2<strong>01</strong>23625840713<strong>01</strong> ALLOPURINOL TAB 300MG 12/31/9999 2<strong>01</strong>23633040540<strong>01</strong> ALLOPURINOL TAB 300MG 12/31/9999 2<strong>01</strong>2363304054005 ALLOPURINOL TAB 300MG 12/31/9999 2<strong>01</strong>2367877<strong>01</strong>23<strong>01</strong> ALLOPURINOL TAB 300MG 12/31/9999 2<strong>01</strong>2367877<strong>01</strong>2305 ALLOPURINOL TAB 300MG 12/31/9999 2<strong>01</strong>2367877<strong>01</strong>2310 ALLOPURINOL TAB 300MG 12/31/9999 2<strong>01</strong>23005363504<strong>01</strong> ALMACONE CHW 12/31/9999 2<strong>01</strong>2300536002583 ALMACONE SUS 12/31/9999 2<strong>01</strong>23005360<strong>01</strong>583 ALMACONE-II SUS DS 12/31/9999 2<strong>01</strong>2351552<strong>01</strong>2804 ALMOND OIL SWEET 12/31/9999 2<strong>01</strong>2351552<strong>01</strong>2806 ALMOND OIL SWEET 12/31/9999 2<strong>01</strong>2351552<strong>01</strong>2807 ALMOND OIL SWEET 12/31/9999 2<strong>01</strong>23

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