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

37205057224 HEMORRHOIDAL CRE 12/31/9999 2012324385042106 HEMORRHOIDAL GEL COOLING 12/31/9999 2012300113040016 HEMORRHOIDAL OIN 06/22/2014 2012300603052052 HEMORRHOIDAL OIN 12/31/9999 2012324385038746 HEMORRHOIDAL OIN 12/31/9999 2012336800040016 HEMORRHOIDAL OIN 12/31/9999 2012349614038716 HEMORRHOIDAL OIN 12/31/9999 2012363868020102 HEMORRHOIDAL OIN 12/31/9999 2012300113039453 HEMORRHOIDAL SUP 05/25/2014 2012300113039462 HEMORRHOIDAL SUP 01/15/2014 2012300536138912 HEMORRHOIDAL SUP 12/31/9999 2012300603052411 HEMORRHOIDAL SUP 12/31/9999 2012324385031553 HEMORRHOIDAL SUP 12/31/9999 2012336800039453 HEMORRHOIDAL SUP 12/31/9999 2012336800039462 HEMORRHOIDAL SUP 12/31/9999 2012363868020812 HEMORRHOIDAL SUP 12/31/9999 2012300603812711 HEMORRHOIDAL SUP -HC 25MG 12/31/2012 2012300904512437 HEM-PREP CRE 12/31/9999 2012300904530424 HEM-PREP SUP 12/31/9999 2012300245011212 HEMRIL-30 SUP 30MG 12/31/9999 2012300245011224 HEMRIL-30 SUP 30MG 12/31/9999 2012300409779362 HEP SOD/D5W INJ 100/ML 12/31/9999 2012300264956710 HEP SOD/D5W INJ 20000UNT 12/31/9999 2012300409776003 HEP SOD/D5W INJ 20000UNT 12/31/9999 2012300264957710 HEP SOD/D5W INJ 25000UNT 12/31/9999 2012300264958720 HEP SOD/D5W INJ 25000UNT 12/31/9999 2012300409776103 HEP SOD/D5W INJ 25000UNT 12/31/9999 2012300409779462 HEP SOD/D5W INJ 50UNT/ML 12/31/9999 2012300264987210 HEP SOD/NACL INJ 1000UNIT 12/31/9999 2012300338043103 HEP SOD/NACL INJ 1000UNIT 12/31/9999 2012300409765162 HEP SOD/NACL INJ 12500UNT 12/31/9999 2012300338043304 HEP SOD/NACL INJ 2000UNIT 12/31/9999 2012300409765062 HEP SOD/NACL INJ 25000UNT 12/31/9999 2012300409765103 HEP SOD/NACL INJ 25000UNT 12/31/9999 2012300409762003 HEP SOD/NACL INJ 2UNIT/ML 12/31/9999 2012300409762059 HEP SOD/NACL INJ 2UNIT/ML 12/31/9999 2012353270005101 HEPAGAM B INJ 12/31/9999 2012353270005201 HEPAGAM B INJ 12/31/9999 2012353270005301 HEPAGAM B INJ 12/31/9999 2012353270005401 HEPAGAM B INJ 12/31/9999 2012300409115270 HEPARIN LOCK INJ 100/ML 12/31/9999 2012300409115278 HEPARIN LOCK INJ 100/ML 12/31/9999 2012300409128131 HEPARIN LOCK INJ 100/ML 12/31/9999 2012300409128132 HEPARIN LOCK INJ 100/ML 12/31/9999 2012300409128133 HEPARIN LOCK INJ 100/ML 12/31/9999 2012300409128135 HEPARIN LOCK INJ 100/ML 12/31/9999 2012300409115170 HEPARIN LOCK INJ 10UNT/ML 12/31/9999 2012300409128031 HEPARIN LOCK INJ 10UNT/ML 12/31/9999 2012300409128032 HEPARIN LOCK INJ 10UNT/ML 12/31/9999 2012300409128033 HEPARIN LOCK INJ 10UNT/ML 12/31/9999 2012300409128035 HEPARIN LOCK INJ 10UNT/ML 12/31/9999 2012300069004301 HEPARIN SOD INJ 1000/ML 12/31/9999 2012300069004302 HEPARIN SOD INJ 1000/ML 12/31/9999 2012300069005801 HEPARIN SOD INJ 1000/ML 12/31/9999 2012300069005802 HEPARIN SOD INJ 1000/ML 12/31/9999 2012300409272001 HEPARIN SOD INJ 1000/ML 12/31/9999 2012300409272002 HEPARIN SOD INJ 1000/ML 12/31/9999 2012300409272003 HEPARIN SOD INJ 1000/ML 12/31/9999 2012300641039112 HEPARIN SOD INJ 1000/ML 12/31/9999 2012300641245055 HEPARIN SOD INJ 1000/ML 12/31/9999 20123