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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58063<strong>01</strong>00<strong>01</strong> GLIADEL WAF 7.7MG 10/31/2<strong>01</strong>4 2<strong>01</strong>2362856<strong>01</strong>7708 GLIADEL WAF 7.7MG 12/31/9999 2<strong>01</strong>23000937254<strong>01</strong> GLIMEPIRIDE TAB 1MG 12/31/9999 2<strong>01</strong>23003784<strong>01</strong>1<strong>01</strong> GLIMEPIRIDE TAB 1MG 12/31/9999 2<strong>01</strong>2300603374421 GLIMEPIRIDE TAB 1MG 12/31/9999 2<strong>01</strong>2300603374428 GLIMEPIRIDE TAB 1MG 12/31/9999 2<strong>01</strong>231672900<strong>01</strong><strong>01</strong> GLIMEPIRIDE TAB 1MG 12/31/9999 2<strong>01</strong>2345802077078 GLIMEPIRIDE TAB 1MG 12/31/9999 2<strong>01</strong>2354458096810 GLIMEPIRIDE TAB 1MG 12/31/9999 2<strong>01</strong>23551110320<strong>01</strong> GLIMEPIRIDE TAB 1MG 12/31/9999 2<strong>01</strong>2355111032005 GLIMEPIRIDE TAB 1MG 12/31/9999 2<strong>01</strong>2361442<strong>01</strong>15<strong>01</strong> GLIMEPIRIDE TAB 1MG 12/31/9999 2<strong>01</strong>23633040425<strong>01</strong> GLIMEPIRIDE TAB 1MG 12/31/9999 2<strong>01</strong>23000937255<strong>01</strong> GLIMEPIRIDE TAB 2MG 12/31/9999 2<strong>01</strong>23003784<strong>01</strong>2<strong>01</strong> GLIMEPIRIDE TAB 2MG 12/31/9999 2<strong>01</strong>2300603374521 GLIMEPIRIDE TAB 2MG 12/31/9999 2<strong>01</strong>2300603374528 GLIMEPIRIDE TAB 2MG 12/31/9999 2<strong>01</strong>23167290002<strong>01</strong> GLIMEPIRIDE TAB 2MG 12/31/9999 2<strong>01</strong>2345802082278 GLIMEPIRIDE TAB 2MG 12/31/9999 2<strong>01</strong>23510790425<strong>01</strong> GLIMEPIRIDE TAB 2MG 12/31/9999 2<strong>01</strong>2351079042520 GLIMEPIRIDE TAB 2MG 12/31/9999 2<strong>01</strong>2354458096710 GLIMEPIRIDE TAB 2MG 12/31/9999 2<strong>01</strong>23551110321<strong>01</strong> GLIMEPIRIDE TAB 2MG 12/31/9999 2<strong>01</strong>2355111032105 GLIMEPIRIDE TAB 2MG 12/31/9999 2<strong>01</strong>2361442<strong>01</strong>16<strong>01</strong> GLIMEPIRIDE TAB 2MG 12/31/9999 2<strong>01</strong>23633040426<strong>01</strong> GLIMEPIRIDE TAB 2MG 12/31/9999 2<strong>01</strong>2366993<strong>01</strong>6302 GLIMEPIRIDE TAB 2MG 07/31/2<strong>01</strong>4 2<strong>01</strong>23680840326<strong>01</strong> GLIMEPIRIDE TAB 2MG 12/31/9999 2<strong>01</strong>23000937256<strong>01</strong> GLIMEPIRIDE TAB 4MG 12/31/9999 2<strong>01</strong>2300093725652 GLIMEPIRIDE TAB 4MG 12/31/9999 2<strong>01</strong>23003784<strong>01</strong>3<strong>01</strong> GLIMEPIRIDE TAB 4MG 12/31/9999 2<strong>01</strong>2300603374621 GLIMEPIRIDE TAB 4MG 12/31/9999 2<strong>01</strong>2300603374628 GLIMEPIRIDE TAB 4MG 12/31/9999 2<strong>01</strong>23167290003<strong>01</strong> GLIMEPIRIDE TAB 4MG 12/31/9999 2<strong>01</strong>2345802094778 GLIMEPIRIDE TAB 4MG 12/31/9999 2<strong>01</strong>23510790426<strong>01</strong> GLIMEPIRIDE TAB 4MG 12/31/9999 2<strong>01</strong>2351079042620 GLIMEPIRIDE TAB 4MG 12/31/9999 2<strong>01</strong>2354458096610 GLIMEPIRIDE TAB 4MG 12/31/9999 2<strong>01</strong>23551110322<strong>01</strong> GLIMEPIRIDE TAB 4MG 12/31/9999 2<strong>01</strong>2355111032205 GLIMEPIRIDE TAB 4MG 12/31/9999 2<strong>01</strong>2361442<strong>01</strong>17<strong>01</strong> GLIMEPIRIDE TAB 4MG 12/31/9999 2<strong>01</strong>23633040427<strong>01</strong> GLIMEPIRIDE TAB 4MG 12/31/9999 2<strong>01</strong>2366993<strong>01</strong>6402 GLIMEPIRIDE TAB 4MG 12/31/9999 2<strong>01</strong>23680840327<strong>01</strong> GLIMEPIRIDE TAB 4MG 12/31/9999 2<strong>01</strong>23000937455<strong>01</strong> GLIP/METFORM TAB 2.5-250M 12/31/9999 2<strong>01</strong>23003783131<strong>01</strong> GLIP/METFORM TAB 2.5-250M 12/31/9999 2<strong>01</strong>23005913971<strong>01</strong> GLIP/METFORM TAB 2.5-250M 12/31/9999 2<strong>01</strong>2323155<strong>01</strong>15<strong>01</strong> GLIP/METFORM TAB 2.5-250M 12/31/9999 2<strong>01</strong>23000937456<strong>01</strong> GLIP/METFORM TAB 2.5-500M 12/31/9999 2<strong>01</strong>23003783132<strong>01</strong> GLIP/METFORM TAB 2.5-500M 12/31/9999 2<strong>01</strong>23005913972<strong>01</strong> GLIP/METFORM TAB 2.5-500M 12/31/9999 2<strong>01</strong>2323155<strong>01</strong>16<strong>01</strong> GLIP/METFORM TAB 2.5-500M 12/31/9999 2<strong>01</strong>23000937457<strong>01</strong> GLIP/METFORM TAB 5-500MG 12/31/9999 2<strong>01</strong>23003783133<strong>01</strong> GLIP/METFORM TAB 5-500MG 12/31/9999 2<strong>01</strong>23005913973<strong>01</strong> GLIP/METFORM TAB 5-500MG 12/31/9999 2<strong>01</strong>2323155<strong>01</strong>17<strong>01</strong> GLIP/METFORM TAB 5-500MG 12/31/9999 2<strong>01</strong>2351552106402 GLIPIZIDE POW 12/31/9999 2<strong>01</strong>230<strong>01</strong>72365000 GLIPIZIDE TAB 10MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>72365<strong>01</strong>0 GLIPIZIDE TAB 10MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>72365060 GLIPIZIDE TAB 10MG 12/31/9999 2<strong>01</strong>23

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