Rebatable Drug List for Iowa Medicaid Effective Date December 01 ...

68084024901 HALOPERIDOL TAB 10MG 12/31/9999 2012368382008001 HALOPERIDOL TAB 10MG 12/31/9999 2012300378025701 HALOPERIDOL TAB 1MG 12/31/9999 2012300378025710 HALOPERIDOL TAB 1MG 12/31/9999 2012300615259539 HALOPERIDOL TAB 1MG 12/31/9999 2012300781139201 HALOPERIDOL TAB 1MG 12/31/9999 2012300781139213 HALOPERIDOL TAB 1MG 12/31/9999 2012300904592361 HALOPERIDOL TAB 1MG 12/31/9999 2012351079073401 HALOPERIDOL TAB 1MG 12/31/9999 2012351079073420 HALOPERIDOL TAB 1MG 12/31/9999 2012300378033501 HALOPERIDOL TAB 20MG 12/31/9999 2012300406208101 HALOPERIDOL TAB 20MG 12/31/9999 2012300781139801 HALOPERIDOL TAB 20MG 12/31/9999 2012368084025021 HALOPERIDOL TAB 20MG 12/31/9999 2012368382008101 HALOPERIDOL TAB 20MG 12/31/9999 2012300378021401 HALOPERIDOL TAB 2MG 12/31/9999 2012300378021410 HALOPERIDOL TAB 2MG 12/31/9999 2012300615259639 HALOPERIDOL TAB 2MG 12/31/9999 2012300781139301 HALOPERIDOL TAB 2MG 12/31/9999 2012300781139313 HALOPERIDOL TAB 2MG 12/31/9999 2012300904592461 HALOPERIDOL TAB 2MG 12/31/9999 2012351079073501 HALOPERIDOL TAB 2MG 12/31/9999 2012351079073520 HALOPERIDOL TAB 2MG 12/31/9999 2012300378032701 HALOPERIDOL TAB 5MG 12/31/9999 2012300378032710 HALOPERIDOL TAB 5MG 12/31/9999 2012300615259739 HALOPERIDOL TAB 5MG 12/31/9999 2012300781139601 HALOPERIDOL TAB 5MG 12/31/9999 2012300781139610 HALOPERIDOL TAB 5MG 12/31/9999 2012300781139613 HALOPERIDOL TAB 5MG 12/31/9999 2012300904592561 HALOPERIDOL TAB 5MG 12/31/9999 2012351079073601 HALOPERIDOL TAB 5MG 12/31/9999 2012351079073620 HALOPERIDOL TAB 5MG 12/31/9999 2012351079073656 HALOPERIDOL TAB 5MG 12/31/9999 2012351552113707 HAWTHORN BER POW 2% 12/31/9999 2012345802019003 HC AC/ALOE CRE 0.5% 11/22/2012 2012360258004843 HC AC/ALOE GEL 2% 12/31/9999 2012343478027015 HC BUTYRATE CRE 0.1% 12/31/9999 2012343478027045 HC BUTYRATE CRE 0.1% 12/31/9999 2012351672407401 HC BUTYRATE CRE 0.1% 12/31/9999 2012351672407406 HC BUTYRATE CRE 0.1% 12/31/9999 2012343478027115 HC BUTYRATE OIN 0.1% 12/31/9999 2012343478027145 HC BUTYRATE OIN 0.1% 12/31/9999 2012351672408301 HC BUTYRATE OIN 0.1% 12/31/9999 2012351672408306 HC BUTYRATE OIN 0.1% 12/31/9999 2012343478027361 HC BUTYRATE SOL 0.1% 12/31/9999 2012351672406102 HC BUTYRATE SOL 0.1% 12/31/9999 2012351672406104 HC BUTYRATE SOL 0.1% 12/31/9999 2012345802014464 HC PRAMOXINE CRE 1-1% 12/31/9999 2012345802012416 HC PRAMOXINE CRE 1-2.5% 12/31/9999 2012345802012464 HC PRAMOXINE CRE 1-2.5% 12/31/9999 2012342192010701 HC PRAMOXINE CRE 2.5-1% 12/31/9999 2012342192010804 HC PRAMOXINE CRE 2.5-1% 12/31/9999 2012345802047253 HC PRAMOXINE CRE 2.5-1% 12/31/9999 2012345802047264 HC PRAMOXINE CRE 2.5-1% 12/31/9999 2012345802047265 HC PRAMOXINE CRE 2.5-1% 12/31/9999 2012345802045535 HC VALERATE CRE 0.2% 12/31/9999 2012345802045537 HC VALERATE CRE 0.2% 12/31/9999 2012345802045542 HC VALERATE CRE 0.2% 12/31/9999 2012351672129001 HC VALERATE CRE 0.2% 12/31/9999 2012351672129003 HC VALERATE CRE 0.2% 12/31/9999 20123