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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16714052205 FINASTERIDE TAB 5MG 12/31/2020 2<strong>01</strong>2316714052210 FINASTERIDE TAB 5MG 12/31/2020 2<strong>01</strong>23167290090<strong>01</strong> FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>2316729009<strong>01</strong>0 FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>2316729009<strong>01</strong>5 FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>2316729009<strong>01</strong>6 FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>2331722052530 FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>2331722052590 FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>2345963050002 FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>2345963050008 FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>2345963050030 FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>2347335071513 FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>2347335071581 FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>2347335071583 FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>2350268032315 FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>2350742<strong>01</strong>2330 FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>2350742<strong>01</strong>2390 FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>23510790520<strong>01</strong> FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>2351079052020 FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>2351079052030 FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>2351079052056 FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>2355111<strong>01</strong>7230 FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>2355111<strong>01</strong>7290 FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>2359762085002 FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>2359762085003 FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>2359762085007 FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>2365862<strong>01</strong>49<strong>01</strong> FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>2365862<strong>01</strong>4930 FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>2365862<strong>01</strong>4990 FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>23680840247<strong>01</strong> FINASTERIDE TAB 5MG 12/31/9999 2<strong>01</strong>23525440957<strong>01</strong> FIORICET TAB 12/31/9999 2<strong>01</strong>2352544095705 FIORICET TAB 12/31/9999 2<strong>01</strong>23525440958<strong>01</strong> FIORICET/COD CAP 12/31/9999 2<strong>01</strong>23525440955<strong>01</strong> FIORINAL CAP 12/31/9999 2<strong>01</strong>23525440956<strong>01</strong> FIORINAL/COD CAP 30MG 12/31/9999 2<strong>01</strong>2354092070202 FIRAZYR INJ 30MG/3ML 12/31/9999 2<strong>01</strong>2354092070203 FIRAZYR INJ 30MG/3ML 12/31/9999 2<strong>01</strong>235556684<strong>01</strong><strong>01</strong> FIRMAGON INJ 120MG 12/31/9999 2<strong>01</strong>235556683<strong>01</strong><strong>01</strong> FIRMAGON INJ 80MG 12/31/9999 2<strong>01</strong>2351879021002 FIRST AID GEL 0.2-2.5% 12/31/9999 2<strong>01</strong>2300025194250 FLAGYL CAP 375MG 12/31/9999 2<strong>01</strong>2300025183131 FLAGYL TAB 250MG 12/31/9999 2<strong>01</strong>2300025183150 FLAGYL TAB 250MG 12/31/9999 2<strong>01</strong>2300025182131 FLAGYL TAB 500MG 12/31/9999 2<strong>01</strong>2300025182150 FLAGYL TAB 500MG 12/31/9999 2<strong>01</strong>2300025196130 FLAGYL ER TAB 750MG 12/31/9999 2<strong>01</strong>2300065009605 FLAREX SUS 0.1% OP 12/31/9999 2<strong>01</strong>230<strong>01</strong>151811<strong>01</strong> FLAVOXATE TAB 100MG 12/31/9999 2<strong>01</strong>2300574<strong>01</strong>15<strong>01</strong> FLAVOXATE TAB 100MG 12/31/9999 2<strong>01</strong>23428060058<strong>01</strong> FLAVOXATE TAB 100MG 12/31/9999 2<strong>01</strong>2351224<strong>01</strong>5450 FLAVOXATE TAB 100MG 12/31/9999 2<strong>01</strong>2324385093378 FLAXSEED OIL CAP 1000MG 12/31/9999 2<strong>01</strong>23619530005<strong>01</strong> FLEBOGAMMA INJ 10% 12/31/9999 2<strong>01</strong>2361953000502 FLEBOGAMMA INJ 10% 12/31/9999 2<strong>01</strong>2361953000503 FLEBOGAMMA INJ 10% 12/31/9999 2<strong>01</strong>23619530004<strong>01</strong> FLEBOGAMMA INJ DIF 5% 12/31/9999 2<strong>01</strong>2361953000402 FLEBOGAMMA INJ DIF 5% 12/31/9999 2<strong>01</strong>2361953000403 FLEBOGAMMA INJ DIF 5% 12/31/9999 2<strong>01</strong>2361953000404 FLEBOGAMMA INJ DIF 5% 12/31/9999 2<strong>01</strong>2361953000405 FLEBOGAMMA INJ DIF 5% 12/31/9999 2<strong>01</strong>23

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