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

25021040001 HEPARIN SOD INJ 1000/ML 12/31/9999 2012325021040010 HEPARIN SOD INJ 1000/ML 12/31/9999 2012325021040030 HEPARIN SOD INJ 1000/ML 12/31/9999 2012325021040102 HEPARIN SOD INJ 1000/ML 12/31/9999 2012363323027602 HEPARIN SOD INJ 1000/ML 12/31/9999 2012363323054001 HEPARIN SOD INJ 1000/ML 12/31/9999 2012363323054011 HEPARIN SOD INJ 1000/ML 12/31/9999 2012363323054031 HEPARIN SOD INJ 1000/ML 12/31/9999 2012363323054057 HEPARIN SOD INJ 1000/ML 12/31/9999 2012300069006201 HEPARIN SOD INJ 10000/ML 12/31/9999 2012300069006202 HEPARIN SOD INJ 10000/ML 12/31/9999 2012300409272101 HEPARIN SOD INJ 10000/ML 12/31/9999 2012300641041012 HEPARIN SOD INJ 10000/ML 12/31/9999 2012325021040301 HEPARIN SOD INJ 10000/ML 12/31/9999 2012325021040304 HEPARIN SOD INJ 10000/ML 12/31/9999 2012363323045909 HEPARIN SOD INJ 10000/ML 12/31/9999 2012363323054201 HEPARIN SOD INJ 10000/ML 12/31/9999 2012363323054207 HEPARIN SOD INJ 10000/ML 12/31/9999 2012363323054302 HEPARIN SOD INJ 10000/ML 12/31/9999 2012325021040401 HEPARIN SOD INJ 20000/ML 12/31/9999 2012363323091501 HEPARIN SOD INJ 20000/ML 12/31/9999 2012300409131625 HEPARIN SOD INJ 5000/0.5 12/31/9999 2012300409131632 HEPARIN SOD INJ 5000/0.5 12/31/9999 2012300069005901 HEPARIN SOD INJ 5000/ML 12/31/9999 2012300069005902 HEPARIN SOD INJ 5000/ML 12/31/9999 2012300069005903 HEPARIN SOD INJ 5000/ML 12/31/9999 2012300069005904 HEPARIN SOD INJ 5000/ML 12/31/9999 2012300409140212 HEPARIN SOD INJ 5000/ML 12/31/9999 2012300409272301 HEPARIN SOD INJ 5000/ML 12/31/9999 2012300409272302 HEPARIN SOD INJ 5000/ML 12/31/9999 2012300641040012 HEPARIN SOD INJ 5000/ML 12/31/9999 2012300641246055 HEPARIN SOD INJ 5000/ML 12/31/9999 2012325021040201 HEPARIN SOD INJ 5000/ML 12/31/9999 2012325021040210 HEPARIN SOD INJ 5000/ML 12/31/9999 2012363323004710 HEPARIN SOD INJ 5000/ML 12/31/9999 2012363323026201 HEPARIN SOD INJ 5000/ML 12/31/9999 2012363323026255 HEPARIN SOD INJ 5000/ML 12/31/9999 2012300264937155 HEPATAMINE SOL 8% 12/31/9999 2012300338050403 HEPATASOL INJ 8% 12/31/9999 2012361958050101 HEPSERA TAB 10MG 12/31/9999 2012350242005656 HERCEPTIN INJ 440MG 12/31/9999 2012350242013468 HERCEPTIN INJ 440MG 12/31/9999 2012300264196510 HESPAN INJ 6%/NACL 12/31/9999 2012300409724803 HETASTARCH INJ 6%/NACL 12/31/9999 2012300409724849 HETASTARCH INJ 6%/NACL 12/31/9999 2012300703507937 HETASTARCH INJ 6%/NACL 12/31/9999 2012362856000110 HEXALEN CAP 50MG 12/31/9999 2012300409155554 HEXTEND SOL 6% 12/31/9999 2012300068027761 HIPREX TAB 1GM 12/31/9999 2012324385038326 HISTAFED SYP 1.25-30 12/31/9999 2012351552058502 HISTAMINE CRY DIPHOSPH 12/31/9999 2012351552058504 HISTAMINE CRY DIPHOSPH 12/31/9999 2012360258020130 HIST-PSE DRO 12/31/9999 2012344206045101 HIZENTRA INJ 1GM/5ML 12/31/9999 2012344206045202 HIZENTRA INJ 2GM/10ML 12/31/9999 2012344206045404 HIZENTRA INJ 4GM/20ML 12/31/9999 2012362011005801 HM ALLERGY TAB 25MG 12/31/9999 2012362011005803 HM ALLERGY TAB 25MG 12/31/9999 2012362011005901 HM ALLERGY TAB 4MG 12/31/9999 2012362011014701 HM ANTACID SUS ANTI-GAS 12/31/9999 20123